Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance

Care Consortium Investigators

Research output: Contribution to journalArticle

4 Citations (Scopus)

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: rs = 0.43, P <.001; depression: rs = 0.42, P <.001; somatization: rs = 0.45, P <.001), as well as total symptom severity (anxiety: rs = 0.43, P <.001; depression: rs = 0.41, P <.001; somatization: rs = 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.

Original languageEnglish (US)
Pages (from-to)1742-1751
Number of pages10
JournalAmerican Journal of Sports Medicine
Volume46
Issue number7
DOIs
StatePublished - Jun 1 2018

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Anxiety
History
Depression
Psychology
Athletes
Students
Symptom Assessment

Keywords

  • anxiety
  • baseline assessments
  • concussion history
  • concussions
  • depression

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance. / Care Consortium Investigators.

In: American Journal of Sports Medicine, Vol. 46, No. 7, 01.06.2018, p. 1742-1751.

Research output: Contribution to journalArticle

@article{64103ae9fb824c058cf1cbb6b989a28c,
title = "Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance",
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: rs = 0.43, P <.001; depression: rs = 0.42, P <.001; somatization: rs = 0.45, P <.001), as well as total symptom severity (anxiety: rs = 0.43, P <.001; depression: rs = 0.41, P <.001; somatization: rs = 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.",
keywords = "anxiety, baseline assessments, concussion history, concussions, depression",
author = "{Care Consortium Investigators} and Weber, {Michelle L.} and Dean, {John Henry L.} and Hoffman, {Nicole L.} and Broglio, {Steven P.} and Michael McCrea and McAllister, {Thomas W.} and Schmidt, {Julianne D.} and Hoy, {April Reed} and Hazzard, {Joseph B.} and Kelly, {Louise A.} and Ortega, {Justus D.} and Nicholas Port and Margot Putukian and Langford, {T. Dianne} and Ryan Tierney and Campbell, {Darren E.} and Gerald McGinty and Patrick O’Donnell and Svoboda, {Steven J.} and DiFiori, {John P.} and Giza, {Christopher C.} and Benjamin, {Holly J.} and Thomas Buckley and Kaminski, {Thomas W.} and Clugston, {James R.} and Luis Feigenbaum and Eckner, {James T.} and Kevin Guskiewicz and Mihalik, {Jason P.} and Miles, {Jessica Dysart} and Scott Anderson and Master, {Christina L.} and Micky Collins and Kontos, {Anthony P.} and Bazarian, {Jeffrey J.} and Chrisman, {Sara P.D.} and Allison Brooks and Stefan Duma and Bullers, {Christopher Todd} and Miles, {Christopher M.} and Dykhuizen, {Brian H.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1177/0363546518765145",
language = "English (US)",
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pages = "1742--1751",
journal = "American Journal of Sports Medicine",
issn = "0363-5465",
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TY - JOUR

T1 - Influences of Mental Illness, Current Psychological State, and Concussion History on Baseline Concussion Assessment Performance

AU - Care Consortium Investigators

AU - Weber, Michelle L.

AU - Dean, John Henry L.

AU - Hoffman, Nicole L.

AU - Broglio, Steven P.

AU - McCrea, Michael

AU - McAllister, Thomas W.

AU - Schmidt, Julianne D.

AU - Hoy, April Reed

AU - Hazzard, Joseph B.

AU - Kelly, Louise A.

AU - Ortega, Justus D.

AU - Port, Nicholas

AU - Putukian, Margot

AU - Langford, T. Dianne

AU - Tierney, Ryan

AU - Campbell, Darren E.

AU - McGinty, Gerald

AU - O’Donnell, Patrick

AU - Svoboda, Steven J.

AU - DiFiori, John P.

AU - Giza, Christopher C.

AU - Benjamin, Holly J.

AU - Buckley, Thomas

AU - Kaminski, Thomas W.

AU - Clugston, James R.

AU - Feigenbaum, Luis

AU - Eckner, James T.

AU - Guskiewicz, Kevin

AU - Mihalik, Jason P.

AU - Miles, Jessica Dysart

AU - Anderson, Scott

AU - Master, Christina L.

AU - Collins, Micky

AU - Kontos, Anthony P.

AU - Bazarian, Jeffrey J.

AU - Chrisman, Sara P.D.

AU - Brooks, Allison

AU - Duma, Stefan

AU - Bullers, Christopher Todd

AU - Miles, Christopher M.

AU - Dykhuizen, Brian H.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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: rs = 0.43, P <.001; depression: rs = 0.42, P <.001; somatization: rs = 0.45, P <.001), as well as total symptom severity (anxiety: rs = 0.43, P <.001; depression: rs = 0.41, P <.001; somatization: rs = 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.

AB - 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: rs = 0.43, P <.001; depression: rs = 0.42, P <.001; somatization: rs = 0.45, P <.001), as well as total symptom severity (anxiety: rs = 0.43, P <.001; depression: rs = 0.41, P <.001; somatization: rs = 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.

KW - anxiety

KW - baseline assessments

KW - concussion history

KW - concussions

KW - depression

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