Timothy B Meier1, Bradley J Brummel2, Rashmi Singh3, Christopher J Nerio4, David W Polanski4, Patrick S F Bellgowan5. 1. Laureate Institute for Brain Research, Tulsa, OK, USA. Electronic address: tmeier@laureateinstitute.org. 2. Department of Psychology, The University of Tulsa, Tulsa, OK, USA. 3. Laureate Institute for Brain Research, Tulsa, OK, USA. 4. Department of Athletics, The University of Tulsa, Tulsa, OK, USA. 5. Laureate Institute for Brain Research, Tulsa, OK, USA; Faculty of Community Medicine, The University of Tulsa, Tulsa, OK, USA.
Abstract
OBJECTIVES: This cohort study was conducted to examine patterns of symptom reporting in concussed athletes in two different testing environments. DESIGN: A prospective cohort study was conducted with repeated measures. METHODS: Self-reported symptoms collected by team athletic trainers using the ImPACT Post-Concussion Scale (PCS) were compared to symptoms collected in a confidential setting using structured interviews for depression and anxiety. Ratings were scaled to match scoring of the PCS and categorized into symptom-domains. Scores collected 2 days post-concussion were compared across different rating scales. Confidential self-report scores approximately 9 days post-concussion in cleared athletes were compared to PCS scores collected during return-to-play decisions. Finally, confidential self-report scores collected 9 days post-concussion were compared between cleared and not cleared athletes. RESULTS: Athletes self-reported significantly fewer symptoms to team athletic trainers using the ImPACT test compared to self-reported symptoms collected in a confidential setting during the acute phase of concussion using standard psychiatric interviews. Athletes cleared to play continued to underreport symptoms 9 days post-concussion, particularly psychiatric symptoms. Finally, cleared athletes self-reported similar magnitude of symptoms than non-cleared athletes 9 days post-concussion in confidential research setting. CONCLUSIONS: The systematic underreporting of post-concussion symptoms may represent motivated behavior or differences in self-reporting data acquisition. By underreporting symptoms, many cleared athletes are still symptomatic over 1-week post-concussion. This study highlights the need for objective measures for somatic and psychiatric symptoms.
OBJECTIVES: This cohort study was conducted to examine patterns of symptom reporting in concussed athletes in two different testing environments. DESIGN: A prospective cohort study was conducted with repeated measures. METHODS: Self-reported symptoms collected by team athletic trainers using the ImPACT Post-Concussion Scale (PCS) were compared to symptoms collected in a confidential setting using structured interviews for depression and anxiety. Ratings were scaled to match scoring of the PCS and categorized into symptom-domains. Scores collected 2 days post-concussion were compared across different rating scales. Confidential self-report scores approximately 9 days post-concussion in cleared athletes were compared to PCS scores collected during return-to-play decisions. Finally, confidential self-report scores collected 9 days post-concussion were compared between cleared and not cleared athletes. RESULTS: Athletes self-reported significantly fewer symptoms to team athletic trainers using the ImPACT test compared to self-reported symptoms collected in a confidential setting during the acute phase of concussion using standard psychiatric interviews. Athletes cleared to play continued to underreport symptoms 9 days post-concussion, particularly psychiatric symptoms. Finally, cleared athletes self-reported similar magnitude of symptoms than non-cleared athletes 9 days post-concussion in confidential research setting. CONCLUSIONS: The systematic underreporting of post-concussion symptoms may represent motivated behavior or differences in self-reporting data acquisition. By underreporting symptoms, many cleared athletes are still symptomatic over 1-week post-concussion. This study highlights the need for objective measures for somatic and psychiatric symptoms.
Authors: Jaclyn A Stephens; Patricia L Davies; William J Gavin; Stewart H Mostofsky; Beth S Slomine; Stacy J Suskauer Journal: J Mot Behav Date: 2019-02-07 Impact factor: 1.328
Authors: Volker Krutsch; Markus Gesslein; Oliver Loose; Johannes Weber; Michael Nerlich; Axel Gaensslen; Viktor Bonkowsky; Werner Krutsch Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-02-08 Impact factor: 4.342
Authors: Brad G Kurowski; Wendy J Pomerantz; Courtney Schaiper; Mona Ho; Michael A Gittelman Journal: J Trauma Acute Care Surg Date: 2015-09 Impact factor: 3.313
Authors: S P Broglio; A Rettmann; J Greer; S Brimacombe; B Moore; N Narisetty; X He; J Eckner Journal: Int J Sports Med Date: 2016-06-10 Impact factor: 3.118