A-30 The Association between Pre-injury Symptoms and Self-Efficacy in Youth with Concussion

Abstract

Abstract Purpose Youth’s self-efficacy for managing their recovery is associated with post-concussion symptom severity. The association between pre-injury symptoms and self-efficacy is not known. Methods Participants were 947 youth ages 9-18 (mean age=14.28, 52% female) with concussion (mean days since injury=19.11) and their caregivers. Participants and caregivers reported on pre-injury symptom domains (physical, cognitive, fatigue, and emotional) using the age-specific Post Concussion Symptom Inventory-2 (PCSI-2; 8-12 years, 13-18 years, caregiver versions). Self-efficacy for managing concussion recovery was measured using the Progressive Activities of Controlled Exertion-Self-Efficacy (PACE-SE) scale Total score. In these three groups, bivariate correlations examined associations among pre-injury symptoms and self-efficacy. Results PACE-SE Total score did not differ based on age or sex. In 9-12-year-olds (n=205), PCSI-2 self-ratings of pre-injury symptoms in the cognitive (r=-.15, p=.03) and emotional (r=-.27, p<.001) domains were negatively associated with the PACE-SE Total score. In 13-18-year-olds (n=742), PCSI-2 self-ratings of pre-injury symptoms in the physical (r=-.20), cognitive (r=-.23), fatigue (r=-.25), and emotional (r=-.34) domains were negatively associated with the PACE-SE Total score (all p<.001). PCSI-2 caregiver-ratings of pre-injury symptoms were not associated with PACE-SE Total score for either age group. Conclusions Pre-injury functioning appears to influence confidence in post-injury recovery. Management of concussion recovery should account for pre-injury functioning. Youth who report more difficulties at baseline may benefit from efforts to boost self-efficacy following injury. Future research might further investigate the relationship of the caregiver report of pre-injury functioning with self-efficacy.