Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

The Risk for Traumatic Brain Injury and Persisting Symptomatology in Elementary, Secondary, and University-Level Students

An International Perspective With the Greek Version of the Brain Injury Screening Questionnaire

Makri, Andrea; Koulenti, Aphroditi; Argyrou, Kyriaki; Gordon, Wayne; Constantinidou, Fofi

doi: 10.1097/TLD.0000000000000188
Original Articles

Purpose: This study is part of the first systematic program in the Republic of Cyprus examining the prevalence of traumatic brain injury (TBI) in children, teenagers, and university students. The study incorporated the Greek Version of the Brain Injury Screening Questionnaire (BISQ-G) as the primary tool to identify students with TBI.

Methods: The BISQ-G was sent out to 2,800 families of children (aged 6–18 years) attending rural and urban elementary and secondary schools from varied socioeconomic backgrounds. Nine hundred forty-four questionnaires (33.8%) were returned. In addition to school-aged children, 322 university students (aged 17–25 years) were recruited from 3 universities and completed the BISQ-G.

Results: Analyses indicated that 5.8% elementary, 9.7% secondary, and 22.7% university students had symptoms consistent with TBI. Several participants reported more than 1 TBI. Etiology of TBI was similar in all 3 groups and included sports, biking, and falls. Factor analyses yielded a 7-factor structure for the BISQ-G.

Discussion/Conclusions: The BISQ-G is a valid tool for the identification of individuals with a prior history of TBI. Causes and symptoms of TBI were similar to those reported in the international literature. The article concludes with suggestions for TBI management in the schools.

Department of Psychology, University of Cyprus, Nicosia, Cyprus (Mss Makri and Koulenti); Educational Psychology Service, Ministry of Education and Culture, Republic of Cyprus (Dr Argyrou); Icahn School of Medicine, Mount Sinai, New York (Dr Gordon); and Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus (Dr Constantinidou).

Corresponding Author: Fofi Constantinidou, PhD, CCC-SLP, Department of Psychology, University of Cyprus, Kallipoleos 75, Nicosia 1678, Cyprus (

The authors express their gratitude to the study participants and their families, the schools that participated in the project, the teachers and school administrators who facilitated the data collection process, and the Cyprus Ministry of Education and Culture. In addition, the authors thank Militsa Demetriou, Militsa Ivanova, and Maria Makrygiorgi for their contribution in the data collection.

F.C. is senior author who conceptualized and designed the study, interpreted the data analyses, and revised the manuscript; A.M. is first author who conducted and interpreted the statistical analyses and drafted the initial manuscript; A.K. collected the secondary school data and assisted in initial manuscript preparation; K.A. translated the BISQ and collected the elementary school data; and W.G. is the creator of the BISQ, offered consultation, and revised the manuscript.

The authors have indicated that they have no financial and no nonfinancial relationships to disclose.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.