The Relationship Between Psychological Distress and Baseline Sports-Related Concussion Testing

Bailey, Christopher M.; Samples, Hillary; Broshek, Donna K.; Freeman, Jason; Barth, Jeffrey T.

doi:10.1097/jsm.0b013e3181e8f8d8

Cited by 84 publications

(57 citation statements)

References 34 publications

(29 reference statements)

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“…Similarly, pre-injury resilience and depression were predictive of 1-month post-injury anxiety and post-concussive symptoms [54]. Along with prolonging recovery from a concussion, psychological distress has been shown to adversely influence performance on computerized neurocognitive tests which are commonly used to establish a pre-season baseline [55], thus further complicating how emotional distress can influence recovery or detection of clinical recovery.…”

Section: Predictors Of Pcsmentioning

confidence: 97%

A review of post-concussion syndrome and psychological factors associated with concussion

2014

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Section: Predictors Of Pcsmentioning

confidence: 97%

A review of post-concussion syndrome and psychological factors associated with concussion

2014

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“…Multiple situational factors have been shown to influence baseline test performance. 4,[13][14][15][16] However, the role of supervision in the testing environment has not yet been empirically evaluated, as far as we know. Therefore, the goal of our pilot study was to determine if general self-reported supervision, or lack thereof, affected neurocognitive baseline test performance systematically in high school athletes.…”

Section: Discussionmentioning

confidence: 99%

“…However, these factors rarely fluctuate in the short term and are therefore controlled between baseline and postconcussion tests. 12 In contrast, situational factors, such as psychological distress, 13 group (versus individual) test administration, 4 and motivation (including ''sandbagging''), [14][15][16] are more likely to vary between tests because these factors are harder to control. Unfortunately, many of these situational factors influence baseline test performance as well.…”

mentioning

confidence: 99%

Supervision and Computerized Neurocognitive Baseline Test Performance in High School Athletes: An Initial Investigation

Kuhn

Solomon

2014

Journal of Athletic Training

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Context: Computerized neuropsychological testing batteries have provided a time-efficient and cost-efficient way to assess and manage the neurocognitive aspects of patients with sport-related concussion. These tests are straightforward and mostly self-guided, reducing the degree of clinician involvement required by traditional clinical neuropsychological paper-andpencil tests.Objective: To determine if self-reported supervision status affected computerized neurocognitive baseline test performance in high school athletes.Design: Retrospective cohort study. . They reported taking the test either supervised by a sports medicine professional or unsupervised. These athletes (n ¼ 2140) were subjected to inclusion and exclusion criteria and then matched based on age, sex, and number of prior concussions. Main Outcome Measure(s):We extracted demographic and performance-based data from each de-identified baseline testing record. Paired t tests were performed between the selfreported supervised and unsupervised groups, comparing the following ImPACT baseline composite scores: verbal memory, visual memory, visual motor (processing) speed, reaction time, impulse control, and total symptom score. For differences that reached P , .05, the Cohen d was calculated to measure the effect size. Lastly, a v 2 analysis was conducted to compare the rate of invalid baseline testing between the groups. All statistical tests were performed at the 95% confidence interval level.Results Conclusions: Speed-based tasks were most affected by self-reported supervision status, although the effect sizes were relatively small. These data lend credence to the hypothesis that supervision status may be a factor in the evaluation of ImPACT baseline test scores.

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“…If repeat testing indicates invalid or sandbagging profiles, careful discussion with the athlete may reveal factors, such as illness, sleeping problems, attention or learning problems, or psychological distress, that may have contributed to his or her performance. 12,27 For example, student-athletes with histories of special education were more likely to be identified as demonstrating suboptimal effort on testing in our study. Therefore, invalid profiles actually may be valid results, which are lower than the norm because of the legitimately weak cognitive skills of the athlete.…”

Section: Discussionmentioning

confidence: 63%

Invalid Performance and the ImPACT in National Collegiate Athletic Association Division I Football Players

Szabo

Alosco

Fedor

et al. 2013

Journal of Athletic Training

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Intervention(s): An informational intervention regarding the importance of concussion testing to promote safety was administered before testing for the most recent season.Main Outcome Measure(s): We examined preseason ImPACT testing data across a 3-year period (total assessments ¼ 269). Based on invalid and sandbagging indices denoted by the ImPACT manual, protocols were examined to indicate how many invalid indices each athlete had.Results: A total of 27.9% (n ¼ 75) of assessments were suggestive of invalid scores, with 4.1% (n ¼ 11) suggesting invalid responding only, 17.5% (n ¼ 47) indicating ''sandbagging'' only, and 6.3% (n ¼ 17) showing both invalid and sandbagging responding. The informational intervention did not reduce the prevalence of invalid responding.Conclusions: These findings highlight the need for further information about the ImPACT validity indices and whether they truly reflect poor effort. Future work is needed to identify practices to reliably target and reduce invalid responding.Key Words: concussions, neuropsychological tests, malingering Key PointsMore than 25% (n ¼ 75) of the participants' baseline cognitive testing suggested suboptimal effort. Providing information about concussion risks and the importance of cognitive testing did not reduce the prevalence of poor effort; however, instructing athletes to repeat testing did reduce it. More research is needed to determine effective and efficient strategies to reduce the prevalence of invalid performance on Immediate Post-Concussion Assessment and Cognitive Testing.

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The Relationship Between Psychological Distress and Baseline Sports-Related Concussion Testing

Cited by 84 publications

References 34 publications

A review of post-concussion syndrome and psychological factors associated with concussion

A review of post-concussion syndrome and psychological factors associated with concussion

Supervision and Computerized Neurocognitive Baseline Test Performance in High School Athletes: An Initial Investigation

Invalid Performance and the ImPACT in National Collegiate Athletic Association Division I Football Players

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