Changes in Coping Skills Throughout Concussion Recovery in College-Aged Individuals.

Abstract

Context: Psychosocial factors are important to consider throughout concussion recovery. Coping skills may play a role post-injury by influencing the stress response and health-promoting behaviors (e.g., rehabilitation adherence). However, limited evidence exists examining coping skills throughout concussion recovery in college-aged individuals.

Objective: To compare (1) changes in coping skills between acute and full medical clearance (FMC) visits in college-aged individuals diagnosed with concussion and healthy controls, and (2) determine the association between coping skills and recovery outcomes following concussion.

Design: Prospective cohort study.

Setting: University laboratory.

Patients or other participants: 96 college-aged individuals (concussion group: N=64, age=21.33±2.37 years; control group: N=32, age=21.54±2.54 years) were enrolled.

Main outcome measures: The Athletic Coping Skills Inventory (ACSI-28) was completed at acute (within 5 days of concussion) and FMC (within 3 days of clearance) visits. A 2 × 2 mixed ANOVA determined differences in total and subscale scores between groups (concussion vs. control) from acute to FMC visit. Multiple linear regressions determined the association between acute ACSI-28 scores and recovery for the concussion group, with statistical significance set a priori at p<0.05 for both tests.

Results: The concentration subscale was significantly lower for the concussion group at the initial visit (F(1,94)=7.28, p=0.01). The main effect of time showed both groups' ACSI-28 total score significantly increased from acute to FMC visit (F(1,94)=22.08, p<0.001). There were no significant differences in total scores between groups at either visit (p>0.05). Additionally, no associations were found between ACSI-28 scores and concussion recovery outcomes when controlling for sex, race, history of depression/anxiety, and acute visit symptom severity (symptom resolution: B=0.06, p=0.62; FMC: B=0.09, p=0.46).

Conclusions: Only coping-related concentration skills from the ACSI-28 are impaired during the acute stage of concussion recovery but improve by the FMC visit. Other coping skills associated with the ACSI-28 remain unaffected throughout concussion recovery in college-aged individuals.