Does Anxiety Affect Neuropsychological Assessment in College Athletes?

Abstract

Clinical Scenario: Anxiety is a mental disorder that affects a large portion of the population and may be problematic when evaluating brain injuries such as concussion. The reliance of cognitive testing in concussion protocols call for the examination of potential cognitive alterations commonly seen in athletes with anxiety. Focused Clinical Question: Does anxiety affect neuropsychological assessments in healthy college athletes? Summary of Key Findings: Three studies were included: 1 cross-sectional study and 2 prospective cohort studies. One study examined the effect of a range of psychological issues on concussion baseline testing in college athletes. Another study examined the effect of anxiety on reaction time both before and after sport competition in college-aged athletes. The final study examined the effects of psychosocial issues on reaction time during demanding tasks in college athletes. The first study reported slower simple and complex reaction times in athletes with anxiety. The second study found that athletes with high trait anxiety have slower reaction times both before and after competition. The third study reported that demanding tasks led to increased state anxiety which slowed reaction time. Overall, all 3 studies support the adverse effect anxiety can have on cognitive testing in athletes. Clinical Bottom Line: College athletes who present with anxiety at baseline may be susceptible to decreased performance on neuropsychological assessments. Strength of Recommendation: There is level B evidence that anxiety in healthy college athletes can impact neuropsychological assessments, and level C evidence that anxiety at baseline concussion assessment impacts neuropsychological testing in college athletes.

Electrophysiological evidence of lexical processing impacted by foreign language reading anxiety

“…For example, a recent study found that individuals with high social anxiety had a significantly faster speed of information processing than individuals with low social anxiety [ 68 ]. On the contrary, other studies reported longer reaction times in individuals with high anxiety [ [69] , [70] ][ 71 ]. In the case of foreign language anxiety, Liu [ 16 ] found no significant group differences in response time during the FL verb-noun naming task.…”

“…The inconsistency between studies could be attributed to the differences in experimental design. The tasks varied across studies, including emotion recognition [ [68] , [72] ], muscular activities in response to auditory stimuli [ 69 ], verbal naming [ 16 ], as well as pre- and post-match performance comparisons in sports studies [ 70 ]. In contrast to these studies, our study employed a classic lexical decision task.…”

Acute Effects of Concussion in Adolescent Athletes With High Preseason Anxiety

“…To our knowledge, this study is the first to examine the association between pre-injury anxiety and the acute effects of concussion in adolescent athletes. Some researchers have reported that people with anxiety perform more poorly on cognitive testing, 18–21,31 although other studies have not found this association. 22,23 In the present study, we did not observe any differences in cognitive performance associated with anxiety.…”

“…15 State anxiety and anxiety disorders can drain mental resources and impair concentration and working memory, 16,17 thus negatively affecting performance on neuropsychological measures. 18–20 A recent analysis of evidence from 3 studies indicated that college athletes who present with anxiety at baseline testing have worse performance on objective cognitive testing compared with their less anxious peers 21 ; however, these findings have not been consistently replicated. 22,23…”

“…15 State anxiety and anxiety disorders can drain mental resources and impair concentration and working memory, 16,17 thus negatively affecting performance on neuropsychological measures. [18][19][20] A recent analysis of evidence from 3 studies indicated that college athletes who present with anxiety at baseline testing have worse performance on objective cognitive testing compared with their less anxious peers 21 ; however, these findings have not been consistently replicated. 22,23 The current study examines associations between anxiety symptoms at baseline and postconcussion symptoms and cognitive functioning in the acute phase of injury (ie, within 3 days of a suspected concussion) in a group of adolescent student athletes.…”