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 A.
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.
N1 - Funding Information:
*Address correspondence to Michelle L. Weber, MS, ATC, Concussion Research Laboratory, Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA (email: mlw76648@uga.edu). yConcussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, Georgia, USA. zSchool of Medicine, University of Virginia, Charlottesville, Virginia, USA. §NeuroTrauma Research Laboratory, University of Michigan Injury Center, University of Michigan, Ann Arbor, Michigan, USA. ||Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. {Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA. #Contributing investigators are listed in the Acknowledgment. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense (DHP funds). One or more of the authors has declared the following potential conflict of interest or source of funding: This project was supported, in part, by the Grand Alliance Concussion Assessment, Research, and Education (CARE) Consortium and was funded, in part, by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Ford Detrick, MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH-14-2-0151.
Publisher Copyright:
© 2018, © 2018 The Author(s).
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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U2 - 10.1177/0363546518765145
DO - 10.1177/0363546518765145
M3 - Article
C2 - 29672135
AN - SCOPUS:85047384506
VL - 46
SP - 1742
EP - 1751
JO - The Journal of sports medicine
JF - The Journal of sports medicine
SN - 0363-5465
IS - 7
ER -