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 language | English (US) |
|---|---|
| Pages (from-to) | 1742-1751 |
| Number of pages | 10 |
| Journal | American Journal of Sports Medicine |
| Volume | 46 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jun 1 2018 |
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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 journal › Article
}
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
UR - http://www.scopus.com/inward/record.url?scp=85047384506&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047384506&partnerID=8YFLogxK
U2 - 10.1177/0363546518765145
DO - 10.1177/0363546518765145
M3 - Article
AN - SCOPUS:85047384506
VL - 46
SP - 1742
EP - 1751
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
SN - 0363-5465
IS - 7
ER -