Network structure of physical, cognitive, and emotional symptoms at preseason baseline in student athletes with attention-deficit/hyperactivity disorder

Grant L. Iverson, Payton J. Jones, Justin E. Karr, Bruce Maxwell, Ross Zafonte, Paul D. Berkner, Richard J. McNally

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objective: Preexisting attention-deficit/hyperactivity disorder (ADHD) may be a risk factor for worse outcome following sport-related concussion. We used a statistical and psychometric approach known as network analysis to examine the architecture of physical, cognitive, and emotional symptoms at preseason baseline among student athletes with ADHD. Method: A cohort of 44,527 adolescent student athletes completed baseline preseason testing with ImPACT® between 2009 and 2015. A subsample of athletes reporting a diagnosis of ADHD and at least one symptom were included in this study (N = 3,074; 14–18 years old, 32.7% girls). All participants completed the 22-item Post-Concussion Symptom Scale at preseason baseline. Results: Student athletes reported high frequencies of difficulty concentrating (boys/girls = 50.7%/59.4%), emotional symptoms (nervousness: boys/girls = 30.2%/51.0%; irritability: boys/girls = 23.6%/34.8%; sadness: boys/girls = 21.4%/39.7%), sleep/arousal-related symptoms (trouble falling asleep: boys/girls = 39.5%/49.4%; sleeping less than usual: boys/girls = 36.2%/43.4%; and fatigue: boys/girls = 29.8%/36.4%), and headaches (boys/girls = 27.6%/39.0%) during preseason baseline testing. The most central symptoms included dizziness, which was related to multiple somatic symptoms, and increased emotionality, which was related to a cluster of emotional symptoms. Girls reported symptoms at a greater frequency than boys, and there was evidence for variance in the global strength of the symptom network across gender, but not specific intersymptom relationships. Conclusion: In the absence of injury, symptoms that commonly occur after concussion interact and potentially reinforce each other among student athletes with ADHD at preseason. Symptoms common in ADHD (i.e., difficulty concentrating) are not necessarily the most central within the symptom network. These findings may inform more precise interventions for athletes with ADHD and prolonged recovery following concussion.

Original languageEnglish
Pages (from-to)1109-1122
Number of pages14
JournalArchives of Clinical Neuropsychology
Volume35
Issue number7
DOIs
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© The Author(s) 2020. Published by Oxford University Press. All rights reserved.

Keywords

  • ADHD
  • Adolescent
  • Brain concussion
  • Child
  • Rehabilitation
  • Sports
  • Statistical methods

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

Fingerprint

Dive into the research topics of 'Network structure of physical, cognitive, and emotional symptoms at preseason baseline in student athletes with attention-deficit/hyperactivity disorder'. Together they form a unique fingerprint.

Cite this