Self-reported Symptomatology Research Articles

Psychopathology and the Validity of Gastrointestinal Symptom Reporting as Revealed Through Cluster Analyses of MMPI-2-RF Results.

Psychological state, self-reported gut symptoms, and somatic complaints are recognized relationships that can impact health assessment and subsequent treatment. To investigate the impact of psychological state and personality on symptom self-reporting and somatization. Sixty-two (62) participants from the Hunter region of NSW (Australia) undertook a survey of health and lifestyle along with an MMPI-2-RF assessment of personality, psychopathology, and test-taking attitude. Participants also completed the Rome Criteria to assess functional gastrointestinal disorders (FGIDs). To assist the interpretation of MMPI-2-RF results, clustering was applied to identify similar responses and sub-cohort profiles of reporting. Cluster analysis revealed four sub-cohorts, stratified by psychopathology, gut-related symptoms, and the validity of self-reported somatic complaints. Sample clustering identified one sub-cohort defined by high rates of negative affectivity and suicidal ideation. Apart from these differences, clusters were uniform for age, sex, smoking, mental health diagnoses, as well as for gut-related conditions. Results provide further evidence of the interaction of the gut-brain axis and its relationship to serious mental health conditions. It also points to the need to assess the veracity of self-reported symptomatology that may be both pathognomonic for psychopathology but might also be a consequence of gut dysbiosis. Clustering assisted these investigations by defining distinct sub-cohorts based on participant MMPI-2-RF responses.

What patients tell us: Assessing feedback and perspectives of patients with post-treatment Lyme disease symptoms.

While most patients with Lyme disease fully recover within 6 months, a minority of patients develop significant and persistent symptoms after appropriate antibiotic treatment. With no clear pathophysiology or treatment, post-treatment Lyme disease (PTLDS) (also sometimes referred to as chronic Lyme) is a highly contested condition within the medical community. After conducting a phone survey of 25 patients who had visited an outpatient, academic center for Lyme and other tick-borne diseases, we collected and summarized patients’ perspectives and feedback of the care they received for ongoing Lyme-related symptoms. Findings from this phone survey demonstrated an extremely varied history with regards to experiences with diagnosis, treatment, and management of long-term symptoms. Key themes include a wide-ranging but life-altering self-reported symptomatology, pervasive doubts/frustrations in the medical system regarding treatment of PTLDS symptoms, and how often patients tried unconventional and nontraditional treatment methods. Importantly, patients were unified in their appreciation for an approachable and validating healthcare team even if they did not find complete resolution in their symptoms.

Inpatient hospital course and self-reported symptomatology in underweight adults with ARFID compared to age- and sex-matched controls with anorexia nervosa

ObjectiveAvoidant restrictive food intake disorder (ARFID) has similar prevalence to anorexia nervosa (AN) in adults, but research in this population is lacking. Although inpatient or residential treatment involving nutritional rehabilitation is increasingly recommended for malnourished individuals with ARFID, best practices remain poorly defined. Existing studies on self-reported symptomatology and treatment course and outcome are primarily in child and adolescent cohorts and demonstrate inconsistent findings. This study aimed to compare hospital course and self-reported symptomatology of underweight adult inpatients with ARFID and sex- and age-matched patients with AN.MethodUnderweight adult patients with ARFID or AN admitted to a specialized, hospital-based behavioral treatment program completed measures of body dissatisfaction, drive for thinness, bulimic symptoms, anxiety, depression, and personality traits. Demographic and treatment course data were abstracted from electronic medical records. Patients with ARFID (n = 69) were matched to those with AN (n = 69) based on sex and age.ResultsAdults with ARFID were closer to target weight at admission, but gained weight at a slower rate, were discharged at lower BMI, and were less likely to reach target weight by discharge than adults with AN. Patients with ARFID reported less weight and shape-related eating disorder, state anxiety, and depression symptoms and lower neuroticism.DiscussionAdults with ARFID progress through treatment more slowly and achieve less favorable weight outcomes by hospital discharge than patients with AN, but long-term outcomes are unclear. Describing clinical presentations and course of illness of adult ARFID may help inform treatment protocols.

Personalized relapse prediction in patients with major depressive disorder using digital biomarkers

Major depressive disorder (MDD) is a chronic illness wherein relapses contribute to significant patient morbidity and mortality. Near-term prediction of relapses in MDD patients has the potential to improve outcomes by helping implement a ‘predict and preempt’ paradigm in clinical care. In this study, we developed a novel personalized (N-of-1) encoder-decoder anomaly detection-based framework of combining anomalies in multivariate actigraphy features (passive) as triggers to utilize an active concurrent self-reported symptomatology questionnaire (core symptoms of depression and anxiety) to predict near-term relapse in MDD. The framework was evaluated on two independent longitudinal observational trials, characterized by regular bimonthly (every other month) in-person clinical assessments, weekly self-reported symptom assessments, and continuous activity monitoring data with two different wearable sensors for ≥ 1 year or until the first relapse episode. This combined passive-active relapse prediction framework achieved a balanced accuracy of ≥ 71%, false alarm rate of ≤ 2.3 alarm/patient/year with a median relapse detection time of 2–3 weeks in advance of clinical onset in both studies. The study results suggest that the proposed personalized N-of-1 prediction framework is generalizable and can help predict a majority of MDD relapses in an actionable time frame with relatively low patient and provider burden.

Body weight distortions in an auditory-driven body illusion in subclinical and clinical eating disorders

Previous studies suggest a stronger influence of visual signals on body image in individuals with eating disorders (EDs) than healthy controls; however, the influence of other exteroceptive sensory signals remains unclear. Here we used an illusion relying on auditory (exteroceptive) signals to manipulate body size/weight perceptions and investigated whether the mechanisms integrating sensory signals into body image are altered in subclinical and clinical EDs. Participants’ footstep sounds were altered to seem produced by lighter or heavier bodies. Across two experiments, we tested healthy women assigned to three groups based on self-reported Symptomatology of EDs (SED), and women with Anorexia Nervosa (AN), and used self-report, body-visualization, and behavioural (gait) measures. As with visual bodily illusions, we predicted stronger influence of auditory signals, leading to an enhanced body-weight illusion, in people with High-SED and AN. Unexpectedly, High-SED and AN participants displayed a gait typical of heavier bodies and a widest/heaviest visualized body in the ‘light’ footsteps condition. In contrast, Low-SED participants showed these patterns in the ‘heavy’ footsteps condition. Self-reports did not show group differences. The results of this pilot study suggest disturbances in the sensory integration mechanisms, rather than purely visually-driven body distortions, in subclinical/clinical EDs, opening opportunities for the development of novel diagnostic/therapeutic tools.

A-15 Gender Differences in Self-Reported Symptomatology at Baseline Testing

Abstract Purpose: To examine whether there are gender differences in symptomatology reported at baseline testing in individuals who did not report a prior concussion history or a diagnosis of ADHD, dyslexia, autism, headaches, psychiatric conditions, substance abuse, and epilepsy at baseline using ImPACT. Methods: Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (n = 1898) consisted of high school athletes who were primarily male (60.8%) adolescents in South Florida with an overall mean age of 15.35 years (SD = 1.09). A series of independent samples t-test was conducted to determine the relationship between gender and composite score performance at baseline. All analyses were conducted at p < 0.05. Results: The independent samples t-test found significant differences between gender and self-reported symptomatology concerning headaches [t(1,895) = 5.17, p < 0.001], irritability [t(1,895) = 5.23, p < 0.001], nervousness [t(1895) = 6.06, p < 0.001], sadness [t(1,895) = 3.86, p < 0.001], and feeling more emotional [t(1,895) = 7.83, p < 0.001]. No differences were seen in sleep, vestibular somatic, or cognitive symptoms. Conclusions: Results indicate high school age females are more likely to endorse symptoms related to disturbances in emotions and headaches when compared to their male counterparts at baseline testing. Differences were not seen between groups in regard to sleep, cognitive, and vestibular somatic symptoms. These results suggest that may be a specific gender profile of symptoms that can expected upon completion of baseline testing in high school athletes. Furthermore, these results signify certain symptoms that may need to be of more concern post-concussion in females when determining return to play and education.

Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic

Objective The long-term consequences of the COVID-19 pandemic on college students’ mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. Participants Undergraduate college students (N = 524) who volunteered for course credit. Methods Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. Results Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. Conclusions Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.

The impact of the COVID-19 pandemic and associated public health response on people with eating disorder symptomatology: an Australian study

ObjectivePeople with lived experience of eating disorders (ED) may be particularly vulnerable to the COVID-19 pandemic and associated public health response due to exasperating situations such as social isolation, presence of other mental and physical health conditions, disruptions to treatment, etc. This study investigates the association of the pandemic with ED symptomatology to consider impact and identify risk factors for clinical consideration.MethodsParticipants with self-reported ED diagnosis and/or symptomatology over 16 years were invited to complete an online survey during the first months of the pandemic in Australia. Questions included history of ED, occurrence of co-occurring mental health conditions, change in ED symptoms since the start of the pandemic, and validated measures of ED illness, state mental health and loneliness.ResultsOf 1723 participants (mode age 24.9 years, 91.6% identifying as female, EDE-Q Global Score x = 4.08, SD = 1.18, 79.0% reporting co-occurring mental health condition, predominantly obsessive–compulsive disorder and/or anxiety), 88.0% reported an increase in body image concerns, 74.1% in food restriction, 66.2% binge eating and 46.8% driven exercise during the pandemic. Increased ED symptomatology was associated with poorer state mental health (i.e., depression, anxiety, and stress) and loneliness across the ED symptom profile. Most participants were negatively impacted by various aspects of the public health response, more so for those with more acute ED illness as measured by the Eating Disorder Examination Questionnaire (EDE-Q).ConclusionsAssociated with the COVID-19 pandemic is a mental health crisis, particularly for those with a lived experience of an eating disorder. With 40.5% of participants not having sought formal diagnostic assessment and less than half in treatment, this study provides evidence for the detrimental impact of the pandemic on people with a lived experience of an eating disorder, especially for those not yet supported by the health care system.

Psychometrics of the <i>Brief Symptom Inventory</i> in University-Enrolled Emerging Adults: Factor Structure and Clinical Caseness Cutoff

Background: Distress screeners are an important form of psychological assessment instrument for their ability to efficiently detect self-reported symptomatology. One popular example is the Brief Symptom Inventory (BSI). Although the BSI has been studied extensively and there are established norms for groups such as adult in-patients and adolescents, its psychometric characteristics are murkier for emerging adults. There is growing evidence that this demographic, particularly in the context of higher education, tends to have unique mental health features such as higher stress levels than most other groups. Thus, we conducted this study to clarify the BSI’s factor structure and clinical caseness cutoffs in emerging adults in college/university settings. Method: Our sample consisted of three archival datasets of emerging adults at Midwestern universities, pooled together for a total size of n = 976. Participants responded to the BSI and a brief demographics form including age, gender identity, racial/ethnic identity, and psychotherapy/counseling status (i.e., currently, previously, or never in treatment). Analyses included an exploratory factor analysis (EFA) with a Monte Carlo parallel analysis of 1000 permutations, as well as calculation of the sensitivity and specificity of clinical cutoffs identifying current therapy clients. Results: The EFA suggested a single-factor solution, as opposed to the originally proposed structure of nine symptom dimensions. Of the evidence-based clinical caseness cutoffs calculated, a score of 1.2 on the BSI’s Global Severity Index performed best, yielding a sensitivity of 70.0% and a specificity of 77.8% in identifying current therapy clients. Discussion: We advocate for use of the BSI as a broadband distress screener, featuring one total distress score and a clinical significance cutoff of 1.2, in order to most reliably and validly assess emerging adults in higher education contexts.

Effectiveness of self-help plus (SH+) in reducing anxiety and post-traumatic symptomatology among care home workers during the COVID-19 pandemic: a randomized controlled trial.

This article describes a randomized controlled trial to evaluate the effectiveness of a supervised online delivery of self-help plus (SH+), during the second wave of COVID-19 contagions in Northern Italy. The SH+ is a psychological intervention developed by the World Health Organization to increase a person's ability to deal with stress. In this trial, it was tested primarily as a tool to reduce anxiety and post-traumatic symptomatology in workers of residential nursing and care homes. In order to partial out non-specific effects of the intervention, the SH+ was compared to an equally supervised and structured alternative activity. Secondarily, in view of future emergencies, the potential of SH+ as a tool to reduce perceived stress, increase subjective well-being and foster individual resilience was explored. At post-intervention, the preregistered analysis revealed no difference in self-reported anxiety and/or post-traumatic symptomatology between the group receiving the SH+ and the group engaged in an alternative activity. Some specific and positive effects of the SH+ intervention were only found on self-reported intervention effectiveness and engagement in exploratory analyses. These findings raise the question whether the previously documented effectiveness of the SH+ on self-reported symptomatology and on the prevention of psychiatric conditions could be attributed mostly to non-specific rather than specific factors connected with participant enrolment in a psychological intervention. Indeed, the effects of the SH+ had been previously compared only to the effects of not being engaged in any alternative activity (often described in the literature as ‘treatment as usual’—or ‘enhanced treatment as usual’, when some relevant information is given to the control group as a one-off). Given the negative findings of this study, before the SH+ is implemented in clinical practice, further studies should be conducted to examine its short- and long-term beneficial effects, by means of randomized studies that employ alternative but similarly structured interventions as control conditions, aiming to minimize the confounding effect of non-specific factors.

Discrimination and Internalizing Symptoms in Rural Latinx Adolescents: The Protective Role of Family Resilience

ABSTRACT Objective: There is a well-documented relationship between discrimination and increases in internalizing symptoms among rural Latinx youth. Among numerous assets in these adolescents’ lives, family resilience emerges as a culturally relevant and robust protective factor. However, it is still unclear whether family resilience is equally protective across different internalizing symptom clusters and whether this buffering effect is independent of other interconnected resilience sources. Method: Latinx adolescents from an underserved rural community (n = 444; Mage = 15.74, SDage = 1.22; 51% male) reported on their internalizing symptoms, experiences of discrimination, and sources of resilience. We examined whether perceived family resilience moderated the association between perceived discrimination and self-reported depressive, somatic, and anxiety symptoms over and above adolescents’ sex, self-reported level of acculturation, as well as perceived individual and contextual resilience. Results: Analyses showed that perceived discrimination experiences were robustly associated with higher levels of self-reported internalizing symptoms, while perceived family resilience was related to lower self-reported symptomatology. Closer examination revealed that perceived family resilience buffered the negative effects of perceived discrimination on self-reported depression and somatic symptoms, but not anxiety symptoms. Conclusions: This study addresses a gap in the literature by identifying differential protective effects of family resilience that might be explained by cultural values and practices in rural Latinx families. Findings suggest that interventions that incorporate family members and promote supportive family environments may benefit rural Latinx youth with a broad range of internalizing symptoms.

The effect of medication and question wording on self-reported symptoms and their accuracy in young adults with attention-deficit/hyperactivity disorder.

This study examined the effect of whether participants were on or off their medications and the effect of questionnaire wording on self-reported symptoms in young adults with ADHD. Additionally, this research evaluated the relationships between these self-reported symptoms and objective performance on measures of working memory. This experimental study utilized a mixed factorial design with one between-subjects factor (whether participants were unmedicated or medicated at the time they completed their assessment) and one within-subjects factor (whether participants reported their on-medication or off-medication symptoms when describing their ADHD subjective symptomatology). Forty-five young adults with ADHD (ages 18-23) completed a brief neuropsychological evaluation and several self-report questionnaires. Although being medicated or unmedicated while completing the questionnaires did not directly affect self-reported symptoms or their accuracy, questionnaire wording exerted a statistically significant effect on subjective symptomatology; participants described themselves as substantially more symptomatic at times when they are off than at times when they are on their medications. More importantly, their general self-perceptions (symptoms when medication state was not specified) of their Inattention/Memory Problems and their Hyperactivity/Restlessness aligned with their descriptions of their off-medication symptoms, whereas their general self-perceptions of their Impulsivity/Emotional Lability and Problems with Self-Concept related to both their self-reported off-medication and on-medication symptoms. These results highlight the necessity of specifying medication state when asking patients to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications as they may describe the extent of their unmedicated, rather than medicated, symptomatology. Being medicated or unmedicated while completing questionnaires about subjective symptomatology did not directly affect self-reported symptoms of young adults with ADHD or the accuracy of these self-reports. When medication state was not specified on a questionnaire, young adults with ADHD reported symptoms similar to those they experience when they are not medicated. These results highlight the importance of specifying medication state when asking young adults with ADHD to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications. These findings open the door for further research with larger and more diverse and representative samples of adults with ADHD to evaluate the accuracy of their subjective symptomatology relative to their objective abilities. Future studies should also examine whether gender affects subjective symptoms, their accuracy, or the influence of question wording and medications on self-reported symptomatology of adults with ADHD, as the current study was unable to address this important issue.

Impact of dynamic greenspace exposure on symptomatology in individuals with schizophrenia.

There are currently many tools available for capturing and defining the context of one’s environment. Digital phenotyping, the use of technology and sensors to capture moment-to-moment behavior, has shown potential in quantifying the lived experience of mental illness and in the identification of individualized targets related to recovery. Environmental data suggests that greenspace may have a restorative capacity on mental health. In this paper, we explore the relationship of greenspace derived from geolocation with self-reported symptomatology from individuals with schizophrenia as well as healthy controls. Individuals with schizophrenia had less exposure to greenspace than controls, but their exposure demonstrated a dosage effect: high greenspace environments were associated with lower symptoms for anxiety (Cohen’s d = -0.70), depression (d = -0.97), and psychosis (d = -0.94), whereas effect sizes for healthy controls were all negligible or small (d < 0.38). The notion that greenspace may have a more pronounced effect on individuals with mental illness presents both potential areas for recovery as well as implications for health care policy, especially in cities with a broad range of greenspace environments.

Audiovestibular symptoms in patients with multiple sclerosis: A correlation between self-reported symptomatology and MRI findings to monitor disease progression

BackgroundsThe interest about audiovestibular symptoms in patients with multiple sclerosis (MS) is recently growing. However, these symptoms can be often underestimated by patients. We aim to evaluate the presence of audiovestibular symptoms in patients with MS as reported by themselves and correlate these symptoms with the different phases of MS. Audiovestibular symptoms, if correlated with relapsing phase could be an indicator of disease progression. MethodsIn this prospective study 80 patients with MS were screened for the presence of audiovestibular symptoms, during their first neurological consultation, using a self-administered questionnaire developed by our research team. Magnetic Resonance Imaging (MRI) scans were performed within a week from the consultation and were compared with scan performed 12-month before, looking for the presence of new active lesions or enlargement of the ones already present. Data on the year of diagnosis, symptom onset, treatment history and expanded disability status scale (EDSS) were collected. Statistical analysis was performed to identify a correlation between audiovestibular symptoms and active lesions in MRI scan. Odds ratio were calculated. Results75% of patients reported audiovestibular symptoms and 37.5% of them had an active or enlarged (compared with previous MRI) lesion/s in their brain MRI scan when they referred to the symptoms’ presence. Active lesion/s in MRI were positively correlated with the presence of audiovestibular symptoms (p = 0.0009). Based on our analysis, patients with active lesions had an increased risk of developing audiovestibular symptoms compared to patients with enlarged but non-active lesions (odds ratio: 4.7). Lesions in the cortex rather than in the medulla (odds ratio: 0.6) or optic nerve (odds ratio:1.6), were more common in patients that developed audiovestibular symptoms. Patients with supratentorial active lesions were more at risk to present audiological symptoms than subjects with the infratentorial lesions (odds ratio: 1.3). ConclusionsAudio-vestibular symptoms can arise in the relapsing phases of MS and their presence may be correlated with an active lesion in the brain. The self-administered questionnaire can be useful both for patients and physicians, to early identify the presence of audiovestibular symptoms that might be related to the progression of the disease.

Symptoms of titanium and nickel allergic sensitization in orthodontic treatment

AimThe study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic appliances.MethodsThe study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used.ResultsPrevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%; p = 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6; p = 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1; p = 0.022). None of the symptoms were significant predictors of titanium sensitization.ConclusionAllergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.

Prevalência da Sintomatologia Músculo-Esquelética nos Estudantes de Licenciatura em Enfermagem: uma Revisão Sistemática da Literatura

Background Musculoskeletal symptoms affect many individuals regardless of gender, age and socioeconomic context. Early in their clinical training, nursing students experience working conditions similar to nurses, and are also exposed to the same situations and risks that can trigger musculoskeletal symptomatology. Objective To identify the prevalence and risk factors of musculoskeletal symptomatology in undergraduate nursing students. Materials and Methods A systematic literature review was performed in the following platforms: EBSCOHost®, CINAHL, MEDLINE and BVS, from January to March 2019. The descriptors used were: Students, Nursing AND Musculoskeletal diseases OR Musculoskeletal disorders AND Prevalence). Results and Discussion Nine articles that met the established criteria were selected. The most frequently self-reported symptomatology was in the cervical and neck region followed by the lumbar and dorsal region, wrist, shoulders and hands. All articles underlined the fact that students report musculoskeletal symptoms in at least one of the body regions. Factors that contributed more often to this were repetitive efforts, manual handling tasks, gender, older age, anxiety and academic stress accumulated since the 1st year. Most studies suggested that nursing students are exposed to the same risks identified by nursing professionals. Conclusions This study shows that the prevalence and risk factors of musculoskeletal symptomatology identified in nursing students must be minimized and prevented from the 1st year of the course. We need to provide students with the knowledge and strategies to tackle this problem and the repercussion it may have on their professional life and well-being. We only be able to cope with this situation by having the contribution of several public health agents. Therefore, it is suggested to use occupational health strategies such as promoting physical exercise, health screening, managing anxiety and stress and improving classroom conditions, in order to contribute to both mental and physical well-being of nursing students and, in the future, professional nurses.

A-22 Gender Effects and Self-Reported Symptomatology at Baseline

ABSTRACT Objective To examine potential effects of gender on self-reported symptomatology in athletes who did not report a prior concussion history at baseline using ImPACT. Method Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (N = 28,616) consisted of primarily male (58.2%) student athletes in South Florida with a mean age of 15.36 years (SD = 1.332). An exploratory factor analysis performed by Kontos and colleagues (2012) was utilized to categorize ImPACT self-reported symptomatology into four symptom groups: Affective, Sleep, Cognitive, and Vestibular Somatic. An independent samples t-test was conducted to determine the relationship between gender and self-reported symptoms at baseline. Statistical significance was set at p &amp;lt; 0.01. Results The independent samples t-test determined significant differences (p &amp;lt; .001) between gender and self-reported symptomatology regarding cognitive (d = 0.14), affective (d = 0.30), sleep (d = 0.13), and vestibular somatic symptoms (d = 0.17). Descriptive statistics revealed females on average reported more symptoms than males at baseline. Conclusions Findings indicate females are more likely to endorse sleep, emotion, and somatic symptoms in comparison to males at baseline. The results suggest that gender may be a mediating factor in regards to self-reported symptomatology, and should be accounted for when comparing baseline assessments to post-injury. Additionally, these results suggest self-reported symptomatology may be an accurate representation of athlete’s baseline functioning and are not solely related to post injury complications. Going forward, one’s self-reported symptomatology at baseline should be highly considered when clearing athletes for both return to learn and play.

A-12 Differential Effects of Symptom Clusters at Baseline on Cognitive Performance

Abstract Objective The purpose of this study was to observe the effects of self-reported affective, sleep, and vestibular-somatic symptomatology on cognitive performance at baseline as measured by ImPACT. Method Participants were selected from a de-identified archival database of high school athletes aged 13–18. Symptom clusters included affective (N = 435, 61.7% female, Mage = 15.46), sleep (N = 435, 53.8% female, Mage = 15.49), and vestibular-somatic (N = 435, 52.2% male, Mage = 15.31). Three One-Way ANOVAs compared baseline composite scores between athletes who reported varying levels of symptomatology within each symptom cluster. Athletes were divided into groups based on their reported symptoms: None (n = 145), Mild (n = 145), and Moderate/Severe (n = 145). Significance was found at p = 0.01. Results No significant relationship between self-reported affective or sleep symptomatology and cognitive performance was observed. A significant relationship was shown between self-reported vestibular-somatic symptomatology regarding the Visual-Motor composite [F (2,432) = 5.925, p = .003]. Bonferroni pairwise comparisons revealed athletes with no reported vestibular-somatic symptoms performed significantly better on Visual-Motor tasks than those with Mild and Moderate/Severe symptoms. Conclusions These results may assist in the understanding of the influence of symptoms reported by athletes’ post-concussion. While those with varying levels of vestibular-somatic symptomatology were found to have significantly different performance on Visual-Motor tasks, this cluster of symptoms was not found to impact other domains of cognitive functioning. The influence of symptoms on cognitive performance likely varies between individual athletes, which can have implications on return-to-play decisions. This highlights the critical need for an individualized approach to be utilized when evaluating athletes post-concussion considering the current literature to date.

A-05 Self-Reported Symptomatology in Athletes with Autism Diagnosis

Abstract Objective To examine the relationship between athletes with and without Autism diagnosis and self-reported symptoms as measured by ImPACT. Method Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (N = 232) was primarily male (72.4%) student athletes with a mean age of 15.41 years (SD = 1.292). Participants were divided into two groups: Autism diagnosis (n = 130); No diagnosis (n = 102). An independent samples t-test was conducted to analyze the variation of self-reported symptoms between athletes with and without an Autism diagnosis. Results The independent samples t-test revealed significant differences between diagnostic groups and self-reported cognitive (t = 5.832, p &amp;lt; .001, d = .72); sleep (t = 4.040, p &amp;lt; .001, d = .51); vestibular somatic (t = 4.154, p &amp;lt; .001, d = .53); and affective symptomatology (t = 3.988, p &amp;lt; .001, d = .51). Athletes with a diagnosis of Autism reported more symptoms overall in comparison to athletes without a diagnosis. Conclusions These findings suggest that prior psychological diagnoses play a significant role in symptom scores; however, the degree to which these symptoms can be attributed to the diagnosis itself or the concussion is unknown. It should be noted that individuals who have been diagnosed with Autism may already be at an increased risk of sleep difficulties, emotional regulation, and sensory stimulation within the environment. Therefore, differentiating the symptom scores from preexisting symptoms of Autism from a concussion can be beneficial when helping athletes return to play.

Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer.

A recently published randomized controlled trial compared single-dose psilocybin with single-dose niacin in conjunction with psychotherapy in participants with cancer-related psychiatric distress. Results suggested that psilocybin-assisted psychotherapy facilitated improvements in psychiatric and existential distress, quality of life, and spiritual well-being up to seven weeks prior to the crossover. At the 6.5-month follow-up, after the crossover, 60-80% of participants continued to meet criteria for clinically significant antidepressant or anxiolytic responses. The present study is a long-term within-subjects follow-up analysis of self-reported symptomatology involving a subset of participants that completed the parent trial. All 16 participants who were still alive were contacted, and 15 participants agreed to participate at an average of 3.2 and 4.5 years following psilocybin administration. Reductions in anxiety, depression, hopelessness, demoralization, and death anxiety were sustained at the first and second follow-ups. Within-group effect sizes were large. At the second (4.5 year) follow-up approximately 60-80% of participants met criteria for clinically significant antidepressant or anxiolytic responses. Participants overwhelmingly (71-100%) attributed positive life changes to the psilocybin-assisted therapy experience and rated it among the most personally meaningful and spiritually significant experiences of their lives. These findings suggest that psilocybin-assisted psychotherapy holds promise in promoting long-term relief from cancer-related psychiatric distress. Limited conclusions, however, can be drawn regarding the efficacy of this therapy due to the crossover design of the parent study. Nonetheless, the present study adds to the emerging literature base suggesting that psilocybin-facilitated therapy may enhance the psychological, emotional, and spiritual well-being of patients with life-threatening cancer.