Architecture of Physical, Cognitive, and Emotional Symptoms at Preseason Baseline in Adolescent Student Athletes With a History of Mental Health Problems

Abstract

Objective: Pre-injury mental health problems are associated with greater symptom reporting following sport-related concussion. We applied a statistical and psychometric approach known as network analysis to examine the interrelationships among symptoms at baseline in adolescent student athletes with a history of mental health problems.Design: Cross-sectional study.Setting: High schools in Maine, USA.Participants: A cohort of 44,527 adolescent student athletes completed baseline preseason testing with ImPACT ® between 2009 and 2015, and those with a history of mental health problems reporting at least one symptom were included (N = 2,412; 14-18 years-old, 60.1% girls).Independent Variables: Self-reported history of treatment for a psychiatric condition.Main Outcome Measures: Physical, cognitive, and emotional symptoms from the Post-Concussion Symptom Scale. Results:Student athletes reported high frequencies of emotional symptoms (nervousness: boys = 46.6%, girls = 58.3%; irritability: boys = 37.9%, girls = 46.9%; sadness: boys = 38.7%, girls = 53.2%), sleep/arousal-related symptoms (trouble falling asleep: boys = 50.4%, girls = 55.1%; sleeping less than usual: boys = 43.8%, girls = 45.2%; and fatigue: boys = 40.3%, girls = 45.2%), headaches (boys = 27.5%, girls = 41.8%), and inattention (boys = 47.8%, girls = 46.9%) before the start of the season. Although uncommonly endorsed, dizziness was the most central symptom (i.e., the symptom with the highest aggregate connectedness with different symptoms in the network), followed by feeling more emotional and feeling Iverson et al. Baseline Symptom Architecture in Athletes slowed down. Dizziness was related to physical and somatic symptoms (e.g., balance, headache, nausea, numbness/tingling) whereas increased emotionality was related to sadness, nervousness, and irritability. Feeling slowed down was connected to cognitive (e.g., fogginess, forgetfulness), and sensory symptoms (e.g., numbness/tingling, light sensitivity). There were no gender differences in the symptom network structure. Conclusions:We examined the interconnections between symptoms reported by student athletes with mental health problems at preseason baseline, identifying how physical, cognitive, and emotional symptoms interact and potentially reinforce each other in the absence of injury. These findings are a step toward informing more precise interventions for this subgroup of athletes if they are slow to recover following concussion.

Post-Traumatic Headache is Associated with Worse Anxiety and Mood Symptoms in Adolescent Mild Traumatic Brain Injury

“…Post-concussion symptoms are highly interrelated and interactive at baseline among student-athletes with mental health problems or attention-deficit/hyperactivity disorder [ 38 , 39 ]. The potential unidirectional (e.g., frequent headaches → helplessness → depression and anger) or bidirectional (e.g.…”

Cervical Spine and CranioVertebral region function in Elite Short Track Speed Skating Athletes

“…Concussions can lead to various symptoms that are usually short lasting and are not necessarily specific to concussions (Iverson et al, 2020). For instance, concussion-related symptoms can also be present with cervical or vestibular dysfunctions (Cheever et al, 2016;Leddy et al, 2015;Leslie & Craton, 2013;Wong et al, 2021).…”

Network analysis and relationship of symptom factors to functional outcomes and quality of life following mild traumatic brain injury: a TRACK-TBI study

“…In this framework, each node of the network corresponds to a specific symptom, while “edges” refer to the connections between nodes (i.e., symptoms) ( 6 ). NA theory suggests that a given pathology can be characterized as a dynamic relationship among active symptoms and produces a network map of the relationships between these symptoms, with the overall goal to identify individual symptoms or symptom clusters with particularly high influence on the overall network ( 7 , 8 ). The centrality hypothesis of network theory posits that certain symptoms in an individual’s network are more relevant or have above average influence over the rest of the network ( 9 ).…”