Faculty Collaboration Database

Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance. Am J Sports Med 2018 Jun;46(7):1742-1751

Date

04/20/2018

Pubmed ID

29672135

DOI

10.1177/0363546518765145

Scopus ID

2-s2.0-85047384506 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND: A student-athlete's mental state, including history of trait anxiety and depression, or current psychological state may affect baseline concussion assessment performance.

PURPOSE: (1) To determine if mental illness (anxiety, depression, anxiety with depression) influences baseline scores, (2) to determine if psychological state correlates with baseline performance, and (3) to determine if history of concussion affects Brief Symptom Inventory-18 (BSI-18) subscores of state anxiety, depression, and somatization.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: A sample of 8652 collegiate student-athletes (54.5% males, 45.5% females) participated in the Concussion Assessment, Research and Education (CARE) Consortium. Baseline assessments included a demographic form, a symptom evaluation, Standardized Assessment of Concussion, Balance Error Scoring System, a psychological state assessment (BSI-18), and Immediate Post-concussion Assessment and Cognitive Test. Baseline scores were compared between individuals with a history of anxiety (n = 59), depression (n = 283), and anxiety with depression (n = 68) and individuals without a history of those conditions (n = 8242). Spearman's rho correlations were conducted to assess the relationship between baseline and psychological state subscores (anxiety, depression, somatization) (α = .05). Psychological state subscores were compared between individuals with a self-reported history of concussions (0, 1, 2, 3, 4+) using Kruskal-Wallis tests (α = .05).

RESULTS: Student-athletes with anxiety, depression, and anxiety with depression demonstrated higher scores in number of symptoms reported (anxiety, 4.3 ± 4.2; depression, 5.2 ± 4.8; anxiety with depression, 5.4 ± 3.9; no anxiety/depression, 2.5 ± 3.4), symptom severity (anxiety, 8.1 ± 9.8; depression, 10.4 ± 12.4; anxiety with depression, 12.4 ± 10.7; no anxiety/depression, 4.1 ± 6.9), and psychological distress in state anxiety (anxiety, 3.7 ± 4.7; depression, 2.5 ± 3.6; anxiety with depression, 3.8 ± 4.2; no anxiety/depression, 0.8 ± 1.8), depression (anxiety, 2.4 ± 4.0; depression, 3.2 ± 4.5; anxiety with depression, 3.8 ± 4.8; no anxiety/depression, 0.8 ± 1.8), and somatization (anxiety, 2.3 ± 2.9; depression, 1.8 ± 2.8; anxiety with depression, 2.2 ± 2.4; no anxiety/depression, 0.9 ± 1.7). A moderate positive relationship existed between all BSI-18 subscores and total symptom number (n = 8377; anxiety: r_s = 0.43, P < .001; depression: r_s = 0.42, P < .001; somatization: r_s = 0.45, P < .001), as well as total symptom severity (anxiety: r_s = 0.43, P < .001; depression: r_s = 0.41, P < .001; somatization: r_s = 0.45, P < .001). Anxiety, depression, and somatization subscores were greater among student-athletes that self-reported more concussions.

CONCLUSION: Clinicians should be cognizant that student-athletes with a history of trait anxiety, depression, and anxiety with depression may report higher symptom score and severity at baseline. Individuals with extensive concussion history may experience greater state anxiety, depression, and somatization.

Author List

Weber ML, Dean JL, Hoffman NL, Broglio SP, McCrea M, McAllister TW, Schmidt JD, CARE Consortium Investigators, Hoy AR, Hazzard JB, Kelly LA, Ortega JD, Port N, Putukian M, Langford TD, Tierney R, Campbell DE, McGinty G, O'Donnell P, Svoboda SJ, DiFiori JP, Giza CC, Benjamin HJ, Buckley T, Kaminski TW, Clugston JR, Feigenbaum LA, Eckner JT, Guskiewicz K, Mihalik JP, Miles JD, Anderson S, Master CL, Collins M, Kontos AP, Bazarian JJ, Chrisman SPD, Brooks A, Duma S, Bullers CT, Miles CM, Dykhuizen BH

Author

Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Anxiety
Athletes
Athletic Injuries
Brain Concussion
Cross-Sectional Studies
Depression
Female
Humans
Male
Neuropsychological Tests
Self Report
Students
Symptom Assessment
Young Adult