The Sport Concussion Assessment Tool: A multidimensional symptom model for detecting elevated post-concussion symptoms

Eric O. Ingram, Justin E. Karr

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Investigate whether a four-factor model of post-concussion symptoms (i.e. cognitive, physical, affective, and sleep-arousal) aids in identifying student-athletes with persistent concerns not reflected by a total symptom score. Method: Collegiate student-athletes (N = 32,066) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool, 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e. beginning RTP and 6-month). Confirmatory factor analysis was used to compare a one- and four-factor model of post-concussion symptoms. Normative reference data were compared across stratifications (e.g. sex, prior concussions, and number of pre-existing conditions) using Mann-Whitney U tests, and elevation rates (i.e. (Formula presented.) 84th percentile) for subscales and the total score were recorded. Results: The four-factor model fit well before and after injury (CFIs >.95). Greater symptom severity on the subscale and total scores was associated with female sex (ps<.001, r range:.07 to.14) and more pre-existing conditions (ps<.001, (Formula presented.) 2 range:.01 to.04), while having more prior concussions was only related to total symptom scores (ps<.001, (Formula presented.) 2<.01). After a concussion, a sizeable portion of student-athletes (i.e., RTP = 11.8%; 6-month = 8.3%) had subscale elevations despite no total score elevation. Physical subscale elevations at RTP were the most common (i.e., 11.9%), driven by head and neck pain. Conclusion: After a sport-related concussion, a four-factor symptom model can be used to assess persistent symptoms in collegiate student-athletes. Identifying athletes with domain-specific elevations may help clinicians identify areas for further assessment and, in some cases, personalized rehabilitation plans.

Original languageEnglish
Pages (from-to)1683-1706
Number of pages24
JournalClinical Neuropsychologist
Volume38
Issue number7
DOIs
StatePublished - 2024

Bibliographical note

Publisher Copyright:
© 2024 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Sports medicine
  • brain concussion
  • clinical assessment/grading scales
  • factor analysis, statistical
  • post-concussion syndrome

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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