Trait Mindfulness Is Associated with Lower Post-Injury Psychological Symptoms Following a Mild Head Injury
Abstract
Up to 25% of individuals that experience a mild head injury (MHI) suffer from long-term psychological and cognitive symptoms. Currently, there is a lack of evidence regarding potential modifiable protective factors that could decrease the risk and severity of long-term MHI sequelae. Therefore, we investigated whether trait mindfulness was associated with fewer clinically relevant psychological and neurocognitive symptoms in individuals following a mild head injury. A quasi-experimental study design with university students (n = 63) was conducted to examine associations between self-reported facets of mindfulness and psychological, post-concussive, and neurocognitive symptoms in a MHI and a no-MHI cohort. In both MHI and no-MHI cohorts, greater mindfulness tendencies were associated with significantly fewer psychological and post-concussive symptoms. Further, the odds of reporting clinically relevant depression scores were significantly lower as a function of greater mindfulness skills. However, neurocognitive outcomes were not associated with any mindfulness facets. These results indicate that mindfulness traits could promote skill sets necessary to circumvent psychological and post-concussive symptoms following a MHI. Due to the increased risk of a myriad of potential adverse outcomes following MHI, more research should be directed towards interventions designed to increase mindfulness in those suffering from persistent symptoms and those at an increased risk of sustaining a MHI.
Keywords
Mild head injury Concussion Mindfulness Five facet mindfulness questionnaire DepressionNotes
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Funding
Funding for this study were provided by Brock University Faculty Funds.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All study procedures were approved by the Brock University Research Ethics Board (REB no. 13-310).
Informed Consent
Informed consent was obtained from all individual participants included in the study.
References
- Azulay, J., Smart, C. M., Mott, T., & Cicerone, K. D. (2013). A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. The Journal of Head Trauma Rehabilitation, 28(4), 323–331.CrossRefPubMedGoogle Scholar
- Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.CrossRefPubMedGoogle Scholar
- Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342.CrossRefPubMedGoogle Scholar
- Baker, J., & Good, D. (2008). Everyday Living Questionnnaire. St. Catharines: ON Neuropsychology Cognitive Research Lab, Brock University.Google Scholar
- Baker, J. M., & Good, D. E. (2013). Physiological emotional under-arousal in individuals with mild head injury. Brain Injury : [BI], 28(1), 51–65.CrossRefGoogle Scholar
- Beck, A. T. (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 3(67), 588–597.CrossRefGoogle Scholar
- Bédard, M., Felteau, M., Marshall, S., Dubois, S., Gibbons, C., Klein, R., & Weaver, B. (2012). Mindfulness-based cognitive therapy: benefits in reducing depression following a traumatic brain injury. Advances in Mind-Body Medicine, 26(1), 14–20.PubMedGoogle Scholar
- Belanger, H. G., Spiegel, E., & Vanderploeg, R. D. (2010). Neuropsychological performance following a history of multiple self-reported concussions : A meta-analysis. Journal of the International Neuropsychological Society, 16, 262–267.Google Scholar
- Brown, K. W., Goodman, R. J., & Inzlicht, M. (2012). Dispositional mindfulness and the attenuation of neural responses to emotional stimuli. Social Cognitive and Affective Neuroscience, 8(1), 93–99.Google Scholar
- Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23–33.Google Scholar
- Cassidy, J. D., Carroll, L., Peloso, P., Borg, J., von Holst, H., Holm, L., et al. (2004). Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury. Journal of Rehabilitation Medicine, 36, 28–60.CrossRefGoogle Scholar
- Chiesa, A. (2012). The difficulty of defining mindfulness: current thought and critical issues. Mindfulness, 4(3), 255–268.CrossRefGoogle Scholar
- Chiesa, A., Calati, R., & Serretti, A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review, 31(3), 449–464.CrossRefPubMedGoogle Scholar
- Clarke, L. A., Genat, R. C., & Anderson, J. F. I. (2012). Long-term cognitive complaint and post-concussive symptoms following mild traumatic brain injury: the role of cognitive and affective factors. Brain Injury, 26(3), 298–307.CrossRefPubMedGoogle Scholar
- Damasio, A. R. (1998). Emotion in the perspective of an integrated nervous system. Brain research reviews, 26(2), 83–86.Google Scholar
- Delis, D. C., Kaplan, E., & Kramer, J. H. (2002). Delis-Kaplan Executive Function System. San Antonio: Harcourt Assessment.Google Scholar
- Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mindfulness and emotion regulation in depression and anxiety: common and distinct mechanisms of action. Depression and Anxiety, 30, 654–661.CrossRefPubMedPubMedCentralGoogle Scholar
- Desrosiers, A., Vine, V., Curtiss, J., & Klemanski, D. H. (2014). Observing nonreactively: a conditional process model linking mindfulness facets, cognitive emotion regulation strategies, and depression and anxiety symptoms. Journal of Affective Disorders, 165, 31–37.CrossRefPubMedGoogle Scholar
- Faul, M., Xu, L., Wald, M. M., & Coronado, V. G. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths 2002–2006. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.Google Scholar
- Giza, C. C., & Hovda, D. A. (2001). The neurometabolic cascade of concussion. Journal of Athletic Training, 36(3), 228–235.PubMedPubMedCentralGoogle Scholar
- Gordon, W. A., Haddad, L., Brown, M., Mary, H. R., & Martin, S. (2000). The sensitivity and specificity of selfreported symptoms in individuals with traumatic brain injury. Brain Injury, 14(1), 21–33.Google Scholar
- Gouvier, W. D., Cubic, B., Jones, G., Brantley, P., & Cutlip, Q. (1992). Postconcussion symptoms and daily stress in normal and head-injured college populations. Archives of Clinical Neuropsychology, 7(3), 193–211.CrossRefPubMedGoogle Scholar
- Hanley, A. W., & Garland, E. L. (2014). Dispositional mindfulness co-varies with self-reported positive reappraisal. Personality and Individual Differences, 66, 146–152.CrossRefPubMedPubMedCentralGoogle Scholar
- Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology, 78(2), 169–183.Google Scholar
- Iverson, G. L., & Lange, R. T. (2009). Moderate and severe traumatic brain injury. In: Schoenberg MR, Scott JG, editors. The black book of neuropsychology: a syndrome based approach. New York: Springer.Google Scholar
- Karr, J. E., Garcia-barrera, M. A., & Areshenkoff, C. N. (2014). Executive functions and intraindividual variability following concussion. Journal of Clinical and Experimental Neuropsychology, 36(1), 15–31.Google Scholar
- Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: a review of empirical studies. Clinical Psychology Review, 31(6), 1041–1056.CrossRefPubMedPubMedCentralGoogle Scholar
- Langlois, J. A., & Sattin, R. W. (2005). Traumatic brain injury in the United States: research and programs of the Centers for Disease Control and Prevention (CDC). Journal of Head Trauma Rehabilation, 20, 187–188.Google Scholar
- Laroche, A. A., Nelson, L. D., Connelly, P. K., Walter, K. D., & Mccrea, M. A. (2016). Sport-related concussion reporting and state legislative effects. Clinical Journal of Sport Medicine, 0(0), 1–7.Google Scholar
- Lezak, M. D., Howieson, D. B., Bigler, E. D., & Tranel, D. (2012). Neuropsychological assessment (5th ed.). New York: Oxford University Press.Google Scholar
- Link, J. S., Barker, T., Serpa, S., Pinjala, M., Oswald, T. M., & Lashley, L. K. (2016). Mild traumatic brain injury and mindfulness-based stress reduction: a review. Archives of Assessment Psychology, 6(1), 7–32.Google Scholar
- Lukken, D. T., & Venables, P. H. (1971). Direct measurement of skin conductnace: a proposal for standardization. Psychophysiology, 8(5).Google Scholar
- Maestas, K. L., Sander, A. M., Clark, A. N., van Veldhoven, L. M., Struchen, M. A., Sherer, M., & Hannay, H. J. (2013). Preinjury coping, emotional functioning, and quality of life following uncomplicated and complicated mild traumatic brain injury. The Journal of Head Trauma Rehabilitation, 29(5), 12–17.Google Scholar
- Pessoa, L. (2009). How do emotion and motivation direct executive control? Trends in Cognitive Sciences, 13(4), 160–166.Google Scholar
- Rubia, K. (2009). The neurobiology of Meditation and its clinical effectiveness in psychiatric disorders. Biological Psychology, 82(1), 1–11.Google Scholar
- Ruff, R. M. (2011). Mild traumatic brain injury and neural recovery: rethinking the debate. NeuroRehabilitation, 28(3), 167–180.PubMedGoogle Scholar
- Sawchyn, J. M., Mateer, C. a., & Suffield, J. B. (2005). Awareness, emotional adjustment, and injury severity in postacute brain injury. Journal of Head Trauma Rehabilitation, 20(4), 301–314.CrossRefPubMedGoogle Scholar
- Schoenberg, M. R., & Scott, J. G. (2011). The little black book of neuropsychology: a syndrome-based approach. Springer Science & Business Media.Google Scholar
- Schutte, N. S., & Malouff, J. M. (2011). Emotional intelligence mediates the relationship between mindfulness and subjective well-being. Personality and Individual Differences, 50(7), 1116–1119.CrossRefGoogle Scholar
- Smith, A. (1982). Symbol Digits Modalities Test. Los Angeles: Western Psychological Services.Google Scholar
- Suhr, J. A., & Gunstad, J. (2002). “Diagnosis threat”: the effect of negative expectations on cognitive performance in head injury. Journal of Clinical and Experimental Neuropsychology, 24(4), 448–457.CrossRefPubMedGoogle Scholar
- Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotional regulation and dysregulation. Journal of Affective Disorders, 61(3), 201–216.Google Scholar
- van Noordt, S., & Good, D. (2011). Mild head injury and sympathetic arousal: Investigating relationships with decision-making and neuropsychological performance in university students. Brain Injury, 25(7-8), 707–716.Google Scholar
- van Noordt, S., Chiappetta, K., & Good, D. (2016). Moral decision-making in university students with self-reported mild head injury. Social Neuroscience, 1–10.Google Scholar
- Van Vleet, T. M., Chen, A., Vernon, A., Novakovic-Agopian, T., & D’Esposito, M. T. (2015). Tonic and phasic alertness training: a novel treatment for executive control dysfunction following mild traumatic brain injury. Neurocase, 21(4), 489–498.CrossRefPubMedGoogle Scholar
- Wechsler, D. (2008). Wechsler adult intelligence scale-IV. New York: Psychological Corporation.Google Scholar