Predicting Symptom Recovery Post-Concussion: An Application of the Integrated Model of Response to Sport Injury

Abstract

Concussions are becoming a more prominent topic of discussion in sport. Following a concussion, most athletes experience only transitory symptoms that completely resolve within 10-14 days. However, approximately 10% of athletes experience prolonged symptoms that extend beyond this time period. There are few predictors of more severe or enduring self-reported concussion symptomatology, and those predictors that have been identified lack a theoretical underpinning. Using the Integrated Model of Response to Sport Injury (Wiese-Bjornstal, Smith, Shaffer, & Morrey, 1998) theoretically-grounded personal and situational psychosocial factors with the potential to influence changes in self-reported concussion symptoms over time are examined. Theoretically relevant personal factors include athletic identity, motivation for sport and performance anxiety. Theoretically relevant situational factors include goal-orientation, motivational climate and social support. Study participants were 70 youth athletes (Mage = 14.60 years) who presented at a local hospital within two weeks following a concussion. Athletes self-reported concussion symptomatology at this hospital visit (Time 1), and one (Time 2) and two (Time 3) weeks following their initial visit. At Time 2, youth athletes completed self-report measures that assessed each personal and situational factor. Regression analyses revealed that higher athletic identity, amotivation, and performance anxiety predicted more self-reported symptoms, especially at Time 2 and Time 3. Regression analyses also demonstrated that higher athletic identity, amotivation and performance anxiety predicted significantly fewer reductions in symptoms from Time 1 to Time 2 and from Time 1 to Time 3, even when accounting for symptom presentation at Time 1, age, gender, concussion history, and time since their last concussion. When combined, personal factors accounted for significant variance in symptom changes, while situational factors did not. Personal factors accounted for 25% of the variance in symptom change from Time 1 to Time 2, and 19% of the variance in symptom change from Time 1 to Time 3, after accounting for symptom presentation at Time 1, age, gender, concussion history, and time since their last concussion. Implications of these findings are discussed. Results suggest that further examination of psychosocial predictors of post-concussion recovery in youth athletes is warranted.