Sex differences in reporting of concussion symptoms in adults

Bunt, Stephen; Didehbani, Nyaz; LoBue, Christian; Stokes, Mathew; Heinzelmann, Morgan; Rossetti, Heidi; Miller, Shane M.; Nakonezny, Paul A.; Bell, Kathleen R.; Batjer, H. Hunt; Cullum, C. Munro

doi:10.1080/13854046.2020.1842500

Cited by 8 publications

(9 citation statements)

References 59 publications

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“…Results on the relationship between sex and sensory sensitivity were inconsistent. Some studies found that females with a mTBI reported light or auditory hypersensitivity more frequently or with a higher severity as compared to males with a mTBI (Brickell et al, 2017; Bunt et al, 2020, 2021; Frommer et al, 2011; Shepherd et al, 2019). However, no evidence for this sex difference was found by other studies (Elliott et al, 2018; Knoll, Herman, et al, 2020a; Lumba‐Brown et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

“…Less than half of the studies (36%) used a validated questionnaire such as the Post‐Concussion Symptom Scale of the Sport Concussion Assessment Tool (e.g. Bunt et al, 2020; Lumba‐Brown et al, 2020), the Rivermead Post‐Concussion Symptom Questionnaire (e.g. King & Kirwilliam, 2013; Lewis et al, 2020) and the Neurobehavioural Symptom Inventory (Brickell et al, 2017; Callahan & Storzbach, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…The results discussed below are based on research about sensory hyper sensitivity. Firstly, we observed inconsistent results regarding the relationship between sensory sensitivity and age or sex (Brickell et al, 2017; Bunt et al, 2020, 2021; Frommer et al, 2011; Helmich et al, 2019; Hu et al, 2017; Lumba‐Brown et al, 2020; Shepherd et al, 2019). These inconsistencies between studies could be due to differences in sample characteristics (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Sensory sensitivity after acquired brain injury: A systematic review

Thielen

Tuts

Welkenhuyzen

et al. 2022

Journal of Neuropsychology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sensory sensitivity after acquired brain injury: A systematic review

Thielen

Tuts

Welkenhuyzen

et al. 2022

Journal of Neuropsychology

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“…This validation can occur through the assessment of measurement invariance, which, if established, suggests that symptom subscales measure the same constructs across groups. Researchers have previously demonstrated that the 4-factor model evidenced full or partial strong measurement invariance at preseason baseline across age (among adolescents [13][14][15][16][17][18], sport contact level, concussion history, and several key preexisting conditions (eg, mental health conditions, attention-deficit/hyperactivity disorder, and learning disabilities). 10 However, measurement invariance of the 4-factor model has not been evaluated following concussion across gender, competitive level, or racial groups.…”

mentioning

confidence: 99%

“…Studies that have investigated gender/sex differences have demonstrated that adolescent girls and adult women report higher total symptoms scores, as well as greater physical symptoms compared with boys and men. [11][12][13] Research on age differences in symptomology has been inconsistent. Some studies suggested younger athletes report greater symptoms whereas other studies showed no differences between age groups.…”

mentioning

confidence: 99%

Group Differences in Postconcussion Cognitive, Physical, Sleep-Arousal, and Affective Symptom Subscales in High School and Collegiate Athletes by Race, Gender, and Competitive Level

Wallace¹,

Karr²,

Yengo‐Kahn³

et al. 2022

Journal of Head Trauma Rehabilitation

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Objective: Prior psychometric research has identified symptom subscales for the Post-Concussion Symptom Scale (PCSS) based on confirmatory factor analysis (CFA), including cognitive, physical, sleep-arousal, and affective symptom factors. Study objectives included: (1) replicate the 4-factor PCSS model in a diverse sample of athletes with concussion, (2) test the model for invariance across race, gender, and competitive level, and (3) compare symptom subscale and total symptom scores across concussed groups with established invariance. Setting: Three regional concussion care centers. Participants: A total of 400 athletes who completed the PCSS within 21 days of concussion (64% boys/men, 35% Black, and 69.5% collegiate athletes). Design: Cross-sectional. Main Measures: A CFA tested the 4-factor model and measurement invariance testing was performed across racial, competitive level, and gender groups. Symptom subscales and total symptom severity scores were compared based on demographic groupings with established invariance. Results: The 4-factor model fit well and strong invariance was established across all demographic categories, indicating symptom subscales could be meaningfully compared across groups. Black and White athletes differed on total symptoms (U = 15 714.5, P = .021, r = 0.12), sleep-arousal symptoms (U = 15 953.5, P = .026, r = 0.11), and physical symptoms (U = 16 140, P = .051, r = 0.10), with Black athletes reporting slightly more symptoms. Collegiate athletes reported greater total symptom severity (U = 10 748.5, P < .001, r = 0.30), with greater symptom reporting on the cognitive (U = 12 985, P < .001, r = 0.21), sleep-arousal (U = 12 594, P < .001, r = 0.22), physical (U = 10 959, P < .001, r = 0.29), and emotional (U = 14 727.5, P = .005, r = 0.14) symptom subscales. There were no significant differences by gender in the total symptom score or subscale scores. After controlling for time since injury, no racial differences persisted, but a significant difference by competitive level in physical symptom reporting (F = 7.39, P = .00, η2 = 0.02) and total symptom reporting (F = 9.16, P = .003, η2 = 0.02) remained. Conclusion: These results provide external validation for the PCSS 4-factor model and demonstrate that symptom subscale measurements are comparable across race, genders, and competitive levels. These findings support the continued use of the PCSS and 4-factor model for assessing a diverse population of concussed athletes.

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