Pediatric Concussion, Socioemotional Functioning, and Self-Efficacy

Ramsey, Kesley (Author); The Catholic University of America (Degree granting institution); Wagner, Barry (Thesis advisor); Rich, Brendan (Committee member); Vaughan, Christopher (Committee member); Greene, James (Committee member); Tran, Binh (Committee member)

Degree Awarded: Ph.D. Psychology. The Catholic University of America

143

Clinical psychology; anxiety, depression, pediatric concussion, self-efficacy; Psychology

http://hdl.handle.net/1961/cuislandora:213798

http://hdl.handle.net/1961/cuislandora:213798

anxiety; depression; pediatric concussion; self-efficacy

2019-01-01T00:00:00Z

2019-01-01T00:00:00Z

Concussion is a common injury that can create significant impairment (Centers for Disease Control and Prevention [CDCP], 2015a; Langlois et al., 2006). To date, the majority of concussion literature has focused on adult populations. Research is needed to identify pediatric concussion outcomes, including aspects of premorbid socioemotional functioning that may influence adjustment post-concussion. The present study examines whether youth with greater socioemotional difficulties pre-concussion differ in presentation compared to youth without premorbid socioemotional difficulties. Furthermore, this study examines whether youth’s self-efficacy beliefs regarding their ability to manage their concussion symptoms significantly predicts concussion symptom severity.This study uses data from 105 concussion patients and their caregivers. Participants were seen for an outpatient evaluation at a large regional hospital within 30 days of injury. Only persons with a confirmed concussion diagnosis based on CDCP criteria (2019) were included. Premorbid socioemotional functioning (depression, anxiety) was captured by retrospective parent- and child-report questionnaires. Patients completed a novel self-efficacy questionnaire. Outcomes (general concussion symptoms, executive functioning, academic functioning) were assessed with child- and parent-report questionnaires.Regression analyses were used to explore the relationship between participants’ premorbid socioemotional difficulties and concussion presentation. Results partially supported initial hypotheses. In separate regression analyses, child and parent reports of greater premorbid socioemotional concerns were associated with poorer post-concussive adjustment on a range of outcome measures. Analyses were also conducted to determine whether self-efficacy mediated the associations of premorbid function with concussion symptoms; the most consistent results were obtained for parents’ reports of premorbid depression as a predictor of poorer outcomes. Results revealed indirect effects for several aspects of self-efficacy on parent-reported (but not child-reported) premorbid socioemotional concerns and concussion outcomes.This project is unique in its exploration of self-efficacy within pediatric concussion. Results from this study align with previous research, highlighting the significance of parent-reported premorbid ratings of pediatric concussion patients’ depression as a predictor of concussion maladjustment (Yeates et al., 2012b). Mediation results suggest that self-efficacy plays an important role in the process by which depression influences concussion adjustment. Clinical implications for future directions in pediatric concussion, as well as limitations for the current study, are discussed.

Dissertation

Ramsey_cua_0043A_11084.pdf

The Catholic University of America

2019