Chapter 1. Chapter 13: PSYCHOLOGICAL DISORDERS

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Scientific American: Psychology
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STRIKING EVIDENCE LINKING FOOTBALL TO BRAIN DISEASE SPARKS CALLS FOR MORE RESEARCH

The biggest study of its kind offers the best evidence to date linking the sport to mood and cognitive impairments..

The controversy began about 10 years ago, when it emerged that the National Football League had first tried to cover up evidence linking repetitive head injuries in players to chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disorder, and then to discredit the scientists doing the work. Since then, evidence supporting this link has grown as an increasing number of players have come forward to report that they are suffering from depression, and some have committed suicide. And yet exactly how repetitive head injuries are linked to CTE development and the psychiatric symptoms associated with it is still a matter of debate.

The largest ever study of its kind has now given the most compelling evidence yet linking repetitive head impacts in football players to CTE. The study, published recently in JAMA, has notable limitations, however. It has also sparked calls for more research to measure the impact of head blows on players over the course of a lifetime.

In this latest study, the researchers examined the brains of 202 deceased football players, all of which had been donated to a brain bank created to investigate the long-term effects of repetitive head injuries in athletes, military personnel and victims of domestic abuse. They obtained detailed medical histories for all the subjects, measured the volume of their brain and then dissected the organ to look for CTE-related neuropathology.

Of the 202 participants examined in the study, 177 were diagnosed with CTE, based on the previously described pathological characteristics. They had an average of 15 years of experience with the game, at the high school, college or professional level. Their median age of death was 67 years, with the most common causes being neurodegenerative disease (39 percent), cardiovascular disease (19 percent) and suicide (10 percent). The severity of CTE pathologies was associated with the intensity of play, with all the former high school players exhibiting mild CTE pathology and more than half of the former college, semiprofessional and professional players exhibiting severe pathologies.

Behavioral and mood symptoms were common in all the former NFL players diagnosed with CTE, having occurred in almost all the 26 individuals with mild pathology and 75 of the 84 individuals with severe pathology. Other common symptoms included anxiety, depression and impulsivity. Verbal aggression, physical violence, suicidal thoughts and substance abuse had also occurred in the majority of those with mild CTE pathology, but post-traumatic stress disorder was uncommon, occurring in only three cases with mild pathology and nine cases of former players who were more severely affected.

Despite the high proportion of study participants exhibiting CTE pathology, the authors urged caution in interpreting their results. One important limitation of the study is the biased sample—brains that were donated for the specific purpose of examining links between head trauma and CTE. It does not necessarily follow that the frequency of CTE in the wider population of people exposed to repetitive head injuries is as high as that found in the study. Nor is the sample representative of the overall population of football players, most of whom play only on youth or high school teams. …

Mo Costandi. Reproduced with permission. Copyright © 2017 Scientific American, a division of Nature America, Inc. All rights reserved.

Quiz

Quiz

Question 1.1

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Question 1.2

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Question 1.3

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Question 1.4

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Question 1.5

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