Understanding how concussion history and contact sport participation influence perceived psychological distress may improve management and provide opportunities for early intervention.
PURPOSE: To examine how prior concussion history and contact sport participation influence college and high school athletes’ change in perceived psychological distress following concussion compared to preseason baseline.
METHODS: Student-athletes (n = 2629) from 6 Canadian and US colleges and 8 US high schools completed a concussion baseline assessment including the Brief Symptom Inventory-18 item scale (BSI-18). The same battery was completed by 165 participants that suffered a concussion. The BSI-18 items were summed to create a total score (higher=greater psychological distress). BSI-18 change score (post-injury minus pre-injury) was the primary outcome. Primary predictors were concussion history and contact sport participation. Covariates included age, sex, and participation level (college vs. high school). The association between concussion history, contact sport participation, and BSI-18 change score was examined using linear regression models clustered on study site using generalized estimating equations (a priori α≤0.05).
RESULTS: Analysis included 145 participants with complete predictor, outcome, and covariate data [45 females (30.8%); median age = 18 years (IQR: 18-20); 66 (45.5%) with 1+ prior concussions; 121 (83.4%) played a contact sport]. Concussion history, when adjusting for all covariates was not statistically associated with BSI-18 change score (p>0.05). Participants in non-contact sports (6.0±8.0) compared to contact sport participants (2.1±7.4 reported a greater BSI-18 change score (Adjusted Mean Difference=3.1, 95%CI: 0.9, 5.4; p=.006).
CONCLUSIONS: These data suggest individuals participating in non-contact sports may have greater increases in reported post-concussion psychological distress. These findings highlight psychological distress measures as an important consideration in concussion management. Participants in contact sports may respond to concussion differently than those in non-contact sports. Future research should investigate how this relates to overall quality of life post-concussion.
Supported by a grant from the National Football League