Predictors of Post-concussion Symptoms in Collegiate Athletes
Open Access
- Author:
- Merritt, Victoria C
- Graduate Program:
- Psychology
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- June 14, 2013
- Committee Members:
- Peter Andrew Arnett, Thesis Advisor/Co-Advisor
- Keywords:
- sports-related concussion
post-concussion symptoms
collegiate athletes - Abstract:
- In recent years, the sports community has been faced with the challenge of determining when it is safe to return concussed athletes to play. Given that return to play decisions revolve around athletes’ self-reported symptoms, it follows that having the ability to accurately predict the nature of post-concussion symptom reporting would greatly benefit the decision-making process. The purpose of the present study was to better characterize the symptoms athletes endorse, as well as to determine what impact pre-morbid and injury-specific characteristics have on the development and severity of post-concussion symptoms in the acute injury period following concussion. Participants were comprised of two groups of athletes including baseline participants (N=702) and post-concussion participants (N=55). Athletes were administered a comprehensive battery of neuropsychological tests, consisting of both neurocognitive and neurobehavioral measures. The main outcome measure was the Post-Concussion Symptoms Scale (PCSS). A factor analysis was conducted on the participants’ baseline PCSS data to determine the factor structure of the PCSS. Four distinct symptom clusters emerged including cognitive, physical, affective, and sleep. Additionally, the Symptom Checklist 90-Revised symptom characterization framework (e.g., the “global indices of distress” variables) was applied to the PCSS, and descriptive statistics were reported. Finally, logistic regression analyses were conducted that examined the PCSS symptom clusters and global indices of distress variables, demographic/social variables, affective variables, neurocognitive variables, and injury-specific variables as predictors of dichotomized post-concussion PCSS total scores (e.g., low versus high symptom reporting). Results indicated that the physical and affective symptom clusters reliably predicted athletes’ post-concussion symptom group. Interestingly, physical symptoms were negatively associated with a high post-concussion symptom score while affective symptoms were positively associated with a high post-concussion symptom score. Additionally, the neurocognitive composite score significantly predicted athletes’ post-concussion symptom group in that those with higher cognitive scores at baseline were less likely to endorse high symptoms post-concussion. When all three significant predictors were analyzed together, the physical symptom cluster and neurocognitive composite score were most significantly associated with post-concussion symptom reporting. These findings suggest that future studies examining predictors of post-concussion symptoms are warranted.