Shannon B Juengst1,2, Lauren Terhorst3,4, Chung Lin Kew1,2, Amy K Wagner5,6,7. 1. a Department Physical Medicine and Rehabilitation , University of Texas Southwestern Medical Center , Dallas , TX , USA. 2. b Department Rehabilitation Counseling , University of Texas Southwestern Medical Center , Dallas , TX , USA. 3. c Department of Occupational Therapy , University of Pittsburgh , Pittsburgh , PA , USA. 4. d Clinical and Translational Science Institute, University of Pittsburgh , Pittsburgh , PA , USA. 5. e Department of Physical Medicine and Rehabilitation , University of Pittsburgh , Pittsburgh , PA , USA. 6. f Center for Neuroscience, University of Pittsburgh , Pittsburgh , PA , USA. 7. g Safar Center for Resuscitation, University of Pittsburgh , Pittsburgh , PA , USA.
Abstract
OBJECTIVE: To investigate within-person variability in daily self-reported emotional and fatigue symptoms and factors associated with high within-person variability among individuals with chronic traumatic brain injury (TBI). DESIGN: This was a prospective descriptive pilot study of n = 18 adults with chronic TBI (2-27 years post-injury) who owned and could independently use an Apple or Android device. METHODS: Participants completed daily assessments for 8 weeks via smartphone. Outcome measures included the Positive and Negative Affect Schedule, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a 7-point fatigue rating. We examined within-person variability over time using individual Multilevel Linear Models. We categorized within-person variability as High or Low based on individual standard deviations in relationship to sample standard deviation. RESULTS: Significant temporal within-person variability occurred for all measures. High variability was associated with more symptom reporting versus Low variability, and variability was associated with sex (High variability: 88% women; Low variability 90% men). CONCLUSIONS: Symptom measurement at a single time point among adults with chronic TBI may not capture day-to-day symptom fluctuation and may misidentify individuals in need of intervention. Assessing symptom profiles over time to capture temporal and individual variability may provide a more ecologically valid measure for managing long-term symptoms after TBI.
OBJECTIVE: To investigate within-person variability in daily self-reported emotional and fatigue symptoms and factors associated with high within-person variability among individuals with chronic traumatic brain injury (TBI). DESIGN: This was a prospective descriptive pilot study of n = 18 adults with chronic TBI (2-27 years post-injury) who owned and could independently use an Apple or Android device. METHODS:Participants completed daily assessments for 8 weeks via smartphone. Outcome measures included the Positive and Negative Affect Schedule, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a 7-point fatigue rating. We examined within-person variability over time using individual Multilevel Linear Models. We categorized within-person variability as High or Low based on individual standard deviations in relationship to sample standard deviation. RESULTS: Significant temporal within-person variability occurred for all measures. High variability was associated with more symptom reporting versus Low variability, and variability was associated with sex (High variability: 88% women; Low variability 90% men). CONCLUSIONS: Symptom measurement at a single time point among adults with chronic TBI may not capture day-to-day symptom fluctuation and may misidentify individuals in need of intervention. Assessing symptom profiles over time to capture temporal and individual variability may provide a more ecologically valid measure for managing long-term symptoms after TBI.
Authors: Katie M White; Charlotte Williamson; Nicol Bergou; Carolin Oetzmann; Valeria de Angel; Faith Matcham; Claire Henderson; Matthew Hotopf Journal: NPJ Digit Med Date: 2022-06-29
Authors: Shannon B Juengst; Lauren Terhorst; Andrew Nabasny; Tracey Wallace; Jennifer A Weaver; Candice L Osborne; Suzanne Perea Burns; Brittany Wright; Pey-Shan Wen; Chung-Lin Novelle Kew; John Morris Journal: Int J Environ Res Public Health Date: 2021-02-23 Impact factor: 3.390
Authors: Brandon G Smith; Stasa Tumpa; Orla Mantle; Charlotte J Whiffin; Harry Mee; Davi J Fontoura Solla; Wellingson S Paiva; Virginia F J Newcombe; Angelos G Kolias; Peter J Hutchinson Journal: J Neurotrauma Date: 2022-10 Impact factor: 4.869