How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review

Plourde, Vickie; Kung, Janice Y.; Gates, Allison; Jun, Shelly; Brooks, Brian L.; Sebastianski, Meghan

doi:10.1007/s11065-020-09430-y

Cited by 5 publications

(3 citation statements)

References 66 publications

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“…Biases are part of human nature and can readily influence clinical judgment. 61 When working with children and families after concussion, clinicians should be aware of potential biases that can occur and minimize these biases in their interactions. Below are some common biases and logical misconceptions that can influence how clinicians gather information and make decisions about concussion management, which can increase the risk for nocebo effects.…”

Section: Stay Abreast Of the Most Recent Research And Evidence-based Recommendationsmentioning

confidence: 99%

The Nocebo Effect and Pediatric Concussion

Kirkwood¹,

Howell²,

Brooks³

et al. 2021

Journal of Sport Rehabilitation

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While placebo effects are well recognized within clinical medicine, “nocebo effects” have received much less attention. Nocebo effects are problems caused by negative expectations derived from information or treatment provided during a clinical interaction. In this review, we examine how nocebo effects may arise following pediatric concussion and how they may worsen symptoms or prolong recovery. We offer several suggestions to prevent, lessen, or eliminate such effects. We provide recommendations for clinicians in the following areas: terminology selection, explicit and implicit messaging to patients, evidence-based recommendations, and awareness of potential biases during clinical interactions. Clinicians should consider the empirically grounded suggestions when approaching the care of pediatric patients with concussion.

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Section: Stay Abreast Of the Most Recent Research And Evidence-based Recommendationsmentioning

confidence: 99%

The Nocebo Effect and Pediatric Concussion

Kirkwood¹,

Howell²,

Brooks³

et al. 2021

Journal of Sport Rehabilitation

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“…[21][22][23][24] In adults, perceptions of acute distress and expectations of recovery seem to play an important role in the development of PCS. [25][26][27][28] However, these factors have rarely been investigated in relationship to pediatric concussion, 29,30 although negative perceptions of injury have been associated with more persistent PCS and emotional distress in adolescents. 30 Few studies have investigated whether psychosocial factors are associated with delayed recovery after pediatric concussion over and above well-established predictors such as sex and days to initial physician visit.…”

Section: Introductionmentioning

confidence: 99%

“…In adults, perceptions of acute distress and expectations of recovery seem to play an important role in the development of PCS. 25–28 However, these factors have rarely been investigated in relationship to pediatric concussion, 29,30 although negative perceptions of injury have been associated with more persistent PCS and emotional distress in adolescents. 30…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players

Luszawski,

Plourde,

Sick

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To investigate the association between psychosocial factors and physician clearance to return to play (RTP) in youth ice hockey players after sport-related concussion. Design: Prospective cohort study, Safe to Play (2013-2018). Setting: Youth hockey leagues in Alberta and British Columbia, Canada. Participants: Three hundred fifty-three ice hockey players (aged 11-18 years) who sustained a total of 397 physician-diagnosed concussions. Independent Variables: Psychosocial variables. Main Outcome Measures: Players and parents completed psychosocial questionnaires preinjury. Players with a suspected concussion were referred for a study physician visit, during which they completed the Sport Concussion Assessment Tool (SCAT3/SCAT5) and single question ratings of distress and expectations of recovery. Time to recovery (TTR) was measured as days between concussion and physician clearance to RTP. Accelerated failure time models estimated the association of psychosocial factors with TTR, summarized with time ratios (TRs). Covariates included age, sex, body checking policy, days from concussion to the initial physician visit, and symptom severity at the initial physician visit. Results: Self-report of increased peer-related problems on the Strengths and Difficulties Questionnaire (TR, 1.10 [95% CI, 1.02-1.19]), higher ratings of distress about concussion outcomes by participants (TR, 1.06 [95% CI, 1.01-1.11]) and parents (TR, 1.05 [95% CI, 1.01-1.09]), and higher parent ratings of distress about their child's well-being at the time of injury (TR, 1.06 [95% CI, 1.02-1.09]) were associated with longer recovery. Conclusions: Greater pre-existing peer-related problems and acute distress about concussion outcomes and youth well-being predicted longer TTR. Treatment targeting these psychosocial factors after concussion may promote recovery.

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