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Effects of Concussion in Adolescent Students: Perceptions and Performance

Published online by Cambridge University Press:  28 May 2019

Brian Rieger ,
Lawrence Lewandowski ,
Heather Potts  and
Nicole Shea
Brian Rieger*
Affiliation:
Department of Physical Medicine & Rehabilitation, SUNY Upstate Medical University, Syracuse, New York, USA
Lawrence Lewandowski
Affiliation:
Department of Psychology, Syracuse University, Syracuse, New York, USA
Heather Potts
Affiliation:
Department of Psychology, Syracuse University, Syracuse, New York, USA
Nicole Shea
Affiliation:
Department of Psychology, Syracuse University, Syracuse, New York, USA
*
*Correspondence and reprint requests to: Brian Rieger, Upstate Medical University, Concussion Center, 505 Irving Ave. Suite 1249, Syracuse, NY 13210. E-mail: riegerb@upstate.edu
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Abstract

Objective: The purpose of this study was to compare adolescent students with and without concussion on a battery of academic, neurocognitive, and socioemotional measures and assess the aftereffects of concussion across domains of functioning. Methods: Twenty-four adolescents (ages 13–17) reporting postconcussion symptoms were compared to 24 controls matched for age and gender across a battery of tests and surveys. Results: After correcting for multiple comparisons, there were no significant differences on any neuropsychological measures. Similarly, there were no significant group differences on academic measures of vocabulary, word recognition, or reading comprehension. Self-reported concussion symptoms were much greater for students with concussion, as were self-reports of anxiety, depression, and somatization symptoms. Parents also rated those with concussion as having greater depression and somatization symptoms, but not to a degree that survived Bonferroni correction. Lastly, those with concussion reported a significantly greater number of school problems and academic concerns. Conclusions: Results indicated that adolescents who reported postconcussion symptoms do not perform differently from peers on most neurocognitive and academic tasks, yet they showed considerably more worry, somatization, academic concerns, and feelings of inadequacy than matched controls. The findings suggest that interventions to address psychological and academic stress may be indicated for adolescents symptomatic from concussion.

Keywords

ConcussionPediatricPsychologicalNeuropsychologicalAcademicSelf-awareness
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 8 , September 2019 , pp. 777 - 786
Copyright
Copyright © INS. Published by Cambridge University Press, 2019. 

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References

REFERENCES

Alsalaheen, B., Stockdale, K., Pechumer, D., & Broglio, S.P. (2016). Validity of the immediate post concussion assessment and cognitive testing (ImPACT). Sports Medicine, 46(10), 1487–1501. doi: 10.1007/s40279-016-0532-yCrossRefGoogle Scholar
American Congress of Rehabilitation Medicine. (1993). Brain Injury Interdisciplinary Special Interest Group, Mild Traumatic Brain Injury Task Force Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 86–87.Google Scholar
Babikian, T., Satz, P., Zaucha, K., Light, R., Lewis, R.S., & Asarnow, R.F. (2011). The UCLA longitudinal study of neurocognitive outcomes following mild pediatric traumatic brain injury. Journal of the International Neuropsychological Society, 17(5), 886–895. doi: 10.1017/S1355617711000907CrossRefGoogle ScholarPubMed
Baker, R.H. (2016). Collegiate student-athlete perceptions of the impact of concussion on academic performance (Dissertation/Thesis), ProQuest Dissertations Publishing.Google Scholar
Barlow, K.M., Crawford, S., Brooks, B.L., Turley, B., & Mikrogianakis, A. (2015). The incidence of postconcussion syndrome remains stable following mild traumatic brain injury in children. Pediatric Neurology, 53(6), 491–497. doi: 10.1016/j.pediatrneurol.2015.04.011CrossRefGoogle ScholarPubMed
Barr, W.B. (2001). Methodologic issues in neuropsychological testing. Journal of Athletic Training, 36(3), 297–302.Google ScholarPubMed
Blanchet, S., Paradis-Giroux, A.A., Pépin, M., & McKerral, M. (2009). Impact of divided attention during verbal learning in young adults following mild traumatic brain injury. Brain Injury, 23(2), 111–122. doi: 10.1080/02699050802649688CrossRefGoogle ScholarPubMed
Brent, D.A. & Max, J. (2017). Psychiatric sequelae of concussions. Current Psychiatry Reports, 19(12), 108. doi: 10.1007/s11920-017-0862-yCrossRefGoogle ScholarPubMed
Broglio, S.P., Ferrara, M.S., Macciocchi, S.N., Baumgartner, T.A., & Elliott, R. (2007). Test-retest reliability of computerized concussion assessment programs. Journal of Athletic Training, 42(4), 509–514.Google ScholarPubMed
Broshek, D.K., De Marco, A.P., & Freeman, J.R. (2015). A review of post-concussion syndrome and psychological factors associated with concussion. Brain Injury, 29(2), 228–237. doi: 10.3109/02699052.2014.974674CrossRefGoogle ScholarPubMed
Collins, M.W., Grindel, S.H., Lovell, M.R., Dede, D.E., Moser, D.J., Moser, D.J., Phalin, B.R., Nogle, S., Wasik, M., Cordry, D., Daugherty, K.M., Sears, S.F., Nicolette, G., Indelicato, P., McKeag, D.B., & Sears, S.F. (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of the American Medical Association, 282(10), 964–970.CrossRefGoogle ScholarPubMed
Corwin, D.J., Zonfrillo, M.R., Master, C.L., Arbogast, K.B., Grady, M.F., Robinson, R.L., & Wiebe, D.J. (2014). Characteristics of prolonged concussion recovery in a pediatric subspecialty referral population. Journal of Pediatrics, 165(6), 1207–1215. doi: 10.1016/j.jpeds.2014.08.034CrossRefGoogle Scholar
Covassin, T., Elbin, R.J., Crutcher, B., Burkhart, S., & Kontos, A. (2013). The relationship between coping, neurocognitive performance, and concussion symptoms in high school and collegiate athletes. The Sport Psychologist, 27(4), 372–379. doi: 10.1123/tsp.27.4.372CrossRefGoogle Scholar
Eisenberg, M.A., Meehan, W.P., & Mannix, R. (2014). Duration and course of post-concussive symptoms. Pediatrics, 133(6), 999–1006. doi: 10.1542/peds.2014-0158CrossRefGoogle ScholarPubMed
Ewing-Cobbs, L., Fletcher, J.M., Levin, H.S., Iovino, I., &Miner, M.E. (1998). Academic achievement and academic placement following traumatic brain injury in children and adolescents: A two-year longitudinal study. Journal of Clinical and Experimental Neuropsychology, 20(6), 769–781.CrossRefGoogle ScholarPubMed
Field, M., Collins, M.W., Lovell, M.R., & Maroon, J. (2003). Does age play a role in recovery from sports-related concussion? A comparison of high school and collegiate athletes. Journal of Pediatrics, 142(5), 546–553. doi: 10.1067/mpd.2003.190CrossRefGoogle ScholarPubMed
Fineblit, S., Selci, E., Loewen, H., Ellis, M., & Russell, K. (2016). Health-related quality of life after pediatric mild traumatic brain injury/concussion: A systematic review. Journal of Neurotrauma, 33(17), 1561–1568.CrossRefGoogle ScholarPubMed
Gagnon, I., Galli, C., Friedman, D., Grilli, L., & Iverson, G.L. (2009). Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Injury, 23(12), 956–964. doi: 10.3109/02699050903373477CrossRefGoogle ScholarPubMed
Gioia, G.A. (2015). Multimodal evaluation and management of children with concussion: Using our heads and available evidence. Brain Injury, 29(2), 195–206. doi: 10.3109/02699052.2014.965210CrossRefGoogle ScholarPubMed
Gioia, G.A. (2016). Medical-school partnership in guiding return to school following mild traumatic brain injury in youth. Journal of Child Neurology, 31(1), 93–108. doi: 10.1177/0883073814555604CrossRefGoogle ScholarPubMed
Glang, A., Todis, B., Thomas, C.W., Hood, D., Bedell, G., & Cockrell, J. (2008). Return to school following childhood TBI: Who gets services? NeuroRehabilitation, 23(6), 477–486.Google ScholarPubMed
Green, P. (2004). Green’s Medical Symptom Validity Test (MSVT): Users Manual. Edmonton, Canada: Green’s Publishing.Google Scholar
Halstead, M.E., McAvoy, K., Devore, C.D., Carl, R., Lee, M., & Logan, K., (2013). Returning to learning following a concussion. Pediatrics, 132(5), 948–957. doi: 10.1542/peds.2013-2867CrossRefGoogle ScholarPubMed
Henry, L.C. & Sandel, N. (2015). Adolescent subtest norms for the ImPACT neurocognitive battery. Applied Neuropsychology: Child, 4(4), 266–276.CrossRefGoogle ScholarPubMed
Howell, D., Osternig, L., Van Donkelaar, P., Mayr, U., & Chou, L.S. (2013). Effects of concussion on attention and executive function in adolescents. Medicine & Science in Sports & Medicine, 45(6), 1030–1037. doi: 10.1249/MSS.0b013e3182814595Google ScholarPubMed
Iverson, G.L., Gardner, A.J., Terry, D.P., Ponsford, J.L., Sills, A.K., Broshek, D.K., & Solomon, G.S. (2017). Predictors of clinical recovery from concussion: A systematic review. British Journal of Sports Medicine, 51(12), 941–948. doi: 10.1136/bjsports-2017-097729CrossRefGoogle ScholarPubMed
Iverson, G.L., Lovell, M.R., & Collins, M.W. (2003). Interpreting change on ImPACT following sport concussion. The Clinical Neuropsychologist, 17(4), 460–467. doi: 10.1076/clin.17.4.460.27934CrossRefGoogle ScholarPubMed
Kirkwood, M.W., & Kirk, J.W. (2010). The base rate of suboptimal effort in a pediatric mild TBI sample: Performance on the medical symptom validity test. The Clinical Neuropsychologist, 24(5), 860–872. doi: 10.1080/13854040903527287CrossRefGoogle Scholar
Kirkwood, M.W., Yeates, K.O., Taylor, H.G., Randolph, C., McCrea, M., & Anderson, V.A. (2008). Management of pediatric mild traumatic brain injury: A neuropsychological review from injury through recovery. The Clinical Neuropsychologist, 22(5), 769–800. doi: 10.1080/13854040701543700CrossRefGoogle ScholarPubMed
Kontos, A.P., Covassin, T., Elbin, R.J., & Parker, T. (2012). Depression and neurocognitive performance after concussion among male and female high school and collegiate athletes. Archives of Physical and Medical Rehabilitation, 93(10), 1751–1756. doi: 10.1016/j.apmr.2012.03.032CrossRefGoogle ScholarPubMed
Kontos, A.P., Elbin, R.J., Newcomer Appaneal, R., Covassin, T., & Collins, M.W. (2013). A comparison of coping responses among high school and college athletes with concussion, orthopedic injuries, and healthy controls. Research and Sports Medicine, 21(4), 367–379. doi: 10.1080/15438627.2013.825801CrossRefGoogle ScholarPubMed
Lavigne, G., Khoury, S., Chauny, J.M., & Desautels, A. (2015). Pain and sleep in post-concussion/mild traumatic brain injury. Pain, 156, S75–S85.CrossRefGoogle ScholarPubMed
Lax, I.D., Paniccia, M., Agnihotri, S., Reed, N., Garmaise, E., Azadbakhsh, M., & Keightley, M. (2015). Developmental and gender influences on executive function following concussion in youth hockey players. Brain Injury, 29(12), 1409–1419. doi: 10.3109/02699052.2015.1043344CrossRefGoogle ScholarPubMed
Lewandowski, L., Gathje, R.A., Lovett, B.J., & Gordon, M. (2013). Test-taking skills in college students with and without ADHD. Journal of Psychoeducational Assessment, 31(1), 41–52. doi: 10.1177/0734282912446304CrossRefGoogle Scholar
Lewandowski, L., Hendricks, K., & Gordon, M. (2015). Test-taking performance of high school students with ADHD. Journal of Attention Disorders, 19(1), 27–34. doi: 10.1177/1087054712449183CrossRefGoogle ScholarPubMed
Lewandowski, L.J., Berger, C., Lovett, B.J., & Gordon, M. (2016). Test-taking skills of high school students with and without learning disabilities. Journal of Psychoeducational Assessment, 34(6), 566–576. doi: 10.1177/0734282915622854CrossRefGoogle Scholar
Light, R., Asarnow, R., Satz, P., Zaucha, K., McCleary, C., & Lewis, R. (1998). Mild closed-head injury in children and adolescents: Behavior problems and academic outcomes. Journal of Consulting and Clinical Psychology, 66(6), 1023–1029.CrossRefGoogle ScholarPubMed
Lovell, M. (2002). Immediate Post-Concussion and Cognitive Testing. Retrieved from http://www.impacttest.com/tf.htm2005Google Scholar
Lovell, M.R., Iverson, G.L., Collins, M.W., Podell, K., Johnston, K.M., Pardini, D., Pardini, J., Norwig, J. & Maroon, J.C. (2006). Measurement of symptoms following sports-related concussion: Reliability and normative data for the post-concussion scale. Applied Neuropsychology, 13(3), 166–174. doi: 10.1207/s15324826an1303_4CrossRefGoogle ScholarPubMed
Lumba-Brown, A., Yeates, K.O., Sarmiento, K., Breiding, M.J., Haegerich, T.M., Gioia, G.A., Turner, M., Benzel, E.C., Suskauer, S.J., Giza, C.C., Joseph, M., Broomand, C., Weissman, B., Gordon, W., Wright, D.W., Moser, R.S., McAvoy, K., Ewing-Cobbs, L., Duhaime, A.C., Putukian, M., Holshouser, B., Paulk, D., Wade, S.L., Herring, S.A., Halstead, M., Keenan, H.T., Choe, M., Christian, C.W., Guskiewicz, K., Raksin, P.B., Gregory, A., Mucha, A., Taylor, H.G., Callahan, J.M., DeWitt, J., Collins, M.W., Kirkwood, M.W., Ragheb, J., Ellenbogen, R.G., Spinks, T.J., Ganiats, T.G., Sabelhaus, L.J., Altenhofen, K., Hoffman, R., Getchius, T., Gronseth, G., Donnell, Z., O’Connor, R.E., & Timmons, S.D. (2018). Centers for Disease Control and Prevention: Guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatrics, 172(11), e182853–e182853. doi: 10.1001/jamapediatrics.2018.2853CrossRefGoogle ScholarPubMed
Makki, A.Y., Leddy, J., Hinds, A., Baker, J., Paluch, R., Shucard, J., & Willer, B. (2016). School attendance and symptoms in adolescents after sport-related concussion. Global Pediatric Health, 3, 1–3. doi: 10.1177/2333794X16630493CrossRefGoogle ScholarPubMed
McCrea, M., Iverson, G.L., McAllister, T.W., Hammeke, T.A., Powell, M.R., Barr, W.B., & Kelly, J.P. (2009). An integrated review of recovery after mild traumatic brain injury (MTBI): Implications for clinical management. The Clinical Neuropsychologist, 23(8), 1368–1390. doi: 10.1080/13854040903074652CrossRefGoogle ScholarPubMed
McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M., Bailes, J., Broglio, S., & Vos, P.E. (2017). Consensus statement on concussion in sport – The 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838–847. doi: 10.1136/bjsports-2017-097699Google Scholar
Mrazik, M., Brooks, B.L., Jubinville, A., Meeuwisse, W.H., & Emery, C.A. (2016). Psychosocial outcomes of sport concussions in youth hockey players. Archives of Clinical Neuropsychology, 31(4), 297–304. doi: 10.1093/arclin/acw013CrossRefGoogle ScholarPubMed
Nelson, L.D., Guskiewicz, K.M., Barr, W.B., Hammeke, T.A., Randolph, C., Ahn, K.W., & McCrea, M.A. (2016). Age differences in recovery after sport-related concussion: A comparison of high school and collegiate athletes. Journal of Athletic Training, 51(2), 142–152. doi: 10.4085/1062-6050-51.4.04CrossRefGoogle ScholarPubMed
Newlin, E. & Hooper, S.R. (2015). Return-to-school protocols following a concussion. North Carolina Medical Journal, 76(2), 107–108.CrossRefGoogle ScholarPubMed
Plourde, V., Yeates, K.O., & Brooks, B.L. (2018). Predictors of long-term psychosocial functioning and health-related quality of life in children and adolescents with prior concussions. Journal of the International Neuropsychological Society: JINS, 24(6), 540–548. doi: 10.1017/S1355617718000061CrossRefGoogle ScholarPubMed
Ponsford, J., Cameron, P., Fitzgerald, M., Grant, M., & Mikocka-Walus, A. (2011). Long-term outcomes after uncomplicated mild traumatic brain injury: A comparison with trauma controls. Journal of Neurotrauma, 28(6), 937–946. doi: 10.1089/neu.2010.1516CrossRefGoogle ScholarPubMed
Prasad, M.R., Swank, P.R., & Ewing-Cobbs, L. (2017). Long-term school outcomes of children and adolescents with traumatic brain injury. The Journal of Head Trauma Rehabilitation, 32(1), E24.CrossRefGoogle ScholarPubMed
Ransom, D.M., Vaughan, C.G., Pratson, L., Sady, M.D., McGill, C.A., & Gioia, G.A. (2015). Academic effects of concussion in children and adolescents. Pediatrics, 135(6), 1043–1050. doi: 10.1542/peds.2014-3434CrossRefGoogle ScholarPubMed
Reed, N., Taha, T., Monette, G., & Keightley, M. (2016). A preliminary exploration of concussion and strength performance in youth ice hockey players. International Journal of Sports Medicine, 37(9), 708–713. doi: 10.1055/s-0042-104199Google ScholarPubMed
Reitan, R.M. & Wolfson, D. (1985). The Halstead–Reitan Neuropsychological Test Battery: Therapy and Clinical Interpretation. Tucson, AZ: Neuropsychological Press.Google Scholar
Reynolds, C.R. & Kamphaus, R.W. (2004). BASC 2: Behavior Assessment System for Children, Second Edition Manual. Circle Pines, MN: American Guidance Service.Google Scholar
Rieger, B.P., Lewandowski, L.J., Callahan, J.M., Spenceley, L., Truckenmiller, A., Gathje, R., & Miller, L.A. (2013). A prospective study of symptoms and neurocognitive outcomes in youth with concussion vs orthopaedic injuries. Brain Injury, 27(2), 169–178. doi: 10.3109/02699052.2012.729290CrossRefGoogle ScholarPubMed
Rose, S.C., Fischer, A.N., & Heyer, G.L. (2015). How long is too long? The lack of consensus regarding the post-concussion syndrome diagnosis. Brain Injury, 29(7–8), 798–803. doi: 10.3109/02699052.2015.1004756CrossRefGoogle Scholar
Russell, K., Hutchison, M.G., Selci, E., Leiter, J., Chateau, D., & Ellis, M.J. (2016). Academic outcomes in high-school students after a concussion: A retrospective population-based analysis. PLoS One, 11(10), e0165116. doi: 10.1371/journal.pone.0165116CrossRefGoogle ScholarPubMed
Sandel, N., Henry, L.C., French, J., & Lovell, M.R. (2015). Parent perceptions of their adolescent athlete’s concussion: A preliminary retrospective study. Applied Neuropsychology: Child, 4(3), 211–216. doi: 10.1080/21622965.2013.850692CrossRefGoogle ScholarPubMed
Schatz, P. & Putz, B.O. (2006). Cross-validation of measures used for computer-based assessment of concussion. Applied Neuropsychology, 13(3), 151–159. doi: 10.1207/s15324826an1303_2CrossRefGoogle ScholarPubMed
Smith, A. (1973). Symbol Digit Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Strauss, E., Sherman, E.M.S., & Spreen, O. (2006). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary (3rd ed.). Oxford, NY: Oxford University Press.Google Scholar
Treble-Barna, A., Schultz, H., Minich, N., Taylor, H.G., Yeates, K.O., Stancin, T., & Wade, S.L. (2017). Long-term classroom functioning and its association with neuropsychological and academic performance following traumatic brain injury during early childhood. Neuropsychology, 31(5), 486.CrossRefGoogle ScholarPubMed
Wasserman, E.B., Bazarian, J.J., Mapstone, M., Block, R., & van Wijngaarden, E. (2016). Academic dysfunction after a concussion among US high school and college students. American Journal of Public Health, 106(7), 1247–1253. doi: 10.2105/AJPH.2016.303154CrossRefGoogle ScholarPubMed