Psychological Resilience and Adolescent Sport-Related Concussion

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Objectives: Our primary objective was to investigate the trajectory of resilience from preinjury to acutely after sport-related concussion (SRC; within 10 days of injury) and to time of return to play (RTP) in adolescents. We further sought to determine whether this trajectory differed between sexes. Secondarily, we investigated the associations between resilience and post-SRC symptom burden and length of recovery. Setting: A substudy of the multicenter pan-Canadian SHRed Concussions (Surveillance in High Schools and Community Sport to Reduce the Risk of Concussions and their Consequences) prospective cohort study. Participants: Adolescent sport participants (ages 10–18 years) who sustained a SRC. Main Outcomes and Measures: Assessments included the Connor-Davidson Resilience Scale-10 (CDRISC-10) and Sport Concussion Assessment Tool-5 (SCAT-5; symptom number & symptom severity) completed before injury, acutely post-SRC, and at RTP. Linear mixed effect models evaluated the difference in CDRISC-10 scores between timepoints controlling for age and sex. Linear regressions and time to event analyses evaluated the associations between CDRISC-10 scores and symptom burden and time to RTP. Results: In total, 425 adolescents (45.65% female, ages 15.82 ± 1.33) participated. Longitudinally, the sex by timepoint interaction was significant, such that CDRISC-10 scores decreased acutely post-SRC in male participants, however, not in female participants ( β = −0.901, 95% CI: −1.707 to −0.094, P = .029), and scores increased at RTP in female participants, not in male participants ( β = 2.794, 95% CI: 1.495–4.093, P < .001). Lower acute CDRISC-10 scores were associated with higher symptom number ( β = −0.265, 95% CI: −0.428 to −0.102, P = .001), symptom severity ( β = −0.916, 95% CI: −1.471 to −0.361, P = .001), and longer time to RTP (HR = 1.044, 95% CI: 1.016–1.071, P = .002) after controlling for age and sex. Conclusions and Relevance: Male resilience was lower acutely post-SRC, and female resilience increased at RTP. Higher resilience acutely was associated with lower symptom burden and shorter recovery for both sexes. Our study provides evidence for resilience as a modifiable target to improve recovery after SRC in adolescents.