No abstract

Objective Exercise dependence has been linked to capability for suicide and suicidal behavior; however, less understood are which facets of exercise dependence confer risk for suicidal behavior and the potential mechanisms of this association. This study examined relationships between exercise dependence, capability for suicide, and past suicidal behavior. Methods A sample of 540 individuals recruited via MTurk completed online measures of their exercise dependence, capability for suicide, and history of suicidal behavior. Results Suicide attempters reported higher levels of continuance in exercise despite physical or psychological consequences, lack of control over exercise, and reductions in other activities due to exercise than nonattempters. Capability for suicide accounted for the relationship between continuance in exercise despite adverse consequences and lifetime number of suicide attempts. Conclusions When exercise becomes pathological in the form of exercise dependence, steps should be taken to reduce such engagement due to its observed association with suicidal behavior.

Purpose Research on sex differences in the presentation of concussion has produced mixed findings and have primarily studied adolescents and adults. The purpose of this study was to explore sex differences in post-concussion symptom reporting and recovery time in elementary school-aged children. Methods Retrospective data were abstracted from the medical records of patients aged 5-10 who presented to a specialty concussion clinic between 2020-2023 (N=109, 67% male). Groups were divided based on sex (female=36, Mage=8.9; male=73, Mage=8.8). A MANCOVA was conducted to determine the relationship between sex and Post-Concussion Symptom Scale total scores at initial visit (PCSS-1), PCSS total scores at follow-up visit (PCSS-2), and recovery time. Covariates included were age and days since injury (DSI). Results Mean DSI at initial visit was 8.5±23.9 for females and 5.7±6.4 for males. There was a significant difference between males and females on the combined dependent variables (Wilks’ Λ=.87, F(3,103)=5.36, p=.002, partial η2=.14) after controlling for age and DSI. Females reported significantly more symptoms than males on PCSS-1 (Mfem=31.8±21.3, Mmale=22.4±19.3; p=.02) and PCSS-2 (Mfem=17.1±18.5, Mmale=6.0±10.2; p<.001). Recovery days were not significantly different between sexes (Mfem=38.7±43.6, Mmale=31.0±43.9; p=.06). Conclusions Commensurate with studies that have evaluated sex differences in concussion in older cohorts, females reported greater symptom burden than their male peers. While not significantly different, females took one week longer to recover than males, suggesting that higher symptom reporting during initial and subsequent concussion visits is not necessarily indicative of longer recovery time. To provide tailored care, future research should examine sex differences in specific symptoms reported post-concussion across age cohorts.

Purpose Previous research determined that sports-related concussions (SRC) occurred at higher rates in cheerleading club practices compared to school practice. The purpose of the current study was to determine if mechanism of injury and skill during which injury occurred impacted symptom reporting and overall recovery days in school and All Star cheerleaders. Methods This study was a retrospective comparison of 101 female cheerleaders (aged 8-18 years) evaluated in a specialty concussion clinic and diagnosed with SRC from 2020-2023. Cheerleaders were stratified based on type of cheer, mechanism of injury, and skill during which they were injured. Post-Concussion Symptom Scale (PCSS) total score and recovery time in days were compared for each group. Chi square and factorial analyses were used. Results Most concussions occurred during stunting incidents (76.2%) with higher rates for school cheerleaders (43.6%) compared to All Star (32.7%). Tumbling incidents accounted for 11.9%, with higher rates for All Star (7.9%) compared to school cheerleaders (4.0%). Head to ground contact (49.5%) and head to body contact (42.6%) were the most reported mechanism of injury, with school cheerleaders having slightly higher rates (28.7%; 21.8%) compared to All Star cheerleaders (20.8%; 20.8%) respectively. School cheerleaders who suffered a SRC through head-to-head contact had significantly higher PCSS scores (P= 0.39) compared to other mechanisms across groups. Conclusions A majority of the SRCs in cheer athletes resulted from head to ground and head to body contacts. The results suggest that cheerleaders suffer higher rates of SRC when participating in stunting activities compared to other cheerleading skills. Future research examining the trajectory of recovery following SRC suffered in cheerleading, will identify the need for skill-specific protocols.

Objective To examine the relationship between athletes with and without Autism diagnosis and self-reported symptoms as measured by ImPACT. Method Participants were selected from an archival de-identified sports medicine ImPACT database. The sample (N = 232) was primarily male (72.4%) student athletes with a mean age of 15.41 years (SD = 1.292). Participants were divided into two groups: Autism diagnosis (n = 130); No diagnosis (n = 102). An independent samples t-test was conducted to analyze the variation of self-reported symptoms between athletes with and without an Autism diagnosis. Results The independent samples t-test revealed significant differences between diagnostic groups and self-reported cognitive (t = 5.832, p < .001, d = .72); sleep (t = 4.040, p < .001, d = .51); vestibular somatic (t = 4.154, p < .001, d = .53); and affective symptomatology (t = 3.988, p < .001, d = .51). Athletes with a diagnosis of Autism reported more symptoms overall in comparison to athletes without a diagnosis. Conclusions These findings suggest that prior psychological diagnoses play a significant role in symptom scores; however, the degree to which these symptoms can be attributed to the diagnosis itself or the concussion is unknown. It should be noted that individuals who have been diagnosed with Autism may already be at an increased risk of sleep difficulties, emotional regulation, and sensory stimulation within the environment. Therefore, differentiating the symptom scores from preexisting symptoms of Autism from a concussion can be beneficial when helping athletes return to play.