A-41 Establishing Empirically-Based Normative Cut-Offs For Identifying Anxiety Following Sports-Related Concussion

Abstract

Abstract Purpose: The State–Trait Anxiety Inventory (form Y-1; STAI) is widely used for identifying anxiety in non-clinical and clinical samples. Cutoff scores ≥40 are widely used to identify clinically significant anxiety. However, these scores correspond with the 50th–60th percentile in STAI normative tables. Given that anxiety is recognized as a common post-concussion symptom, and as a post-injury clinical profile, establishing statistically appropriate cutoffs for clinical anxiety is warranted. Methods: We compared rates of individuals falling above static (≥40) versus empirically-derived (>1, >1.5, >2 standard deviations) cutoffs, using a sample of 137 acutely concussed high school and college athletes (59% male, mean age 16.11 ± 1.56 years) who completed the STAI within 7 days of injury (mean 3.79 ± 1.4 days). Results: Approximately 47% of concussed athletes fell above the static cutoff of ≥40, whereas use of empirically-derived cutoffs identified 18% (1SD), 8% (1.5SD) and 3% (2SD). These empirically-derived cutoffs reflect the normal curve, and distribution of scores expected to fall outside 1, 1.5, and 2SD. Conclusions: Use of a static cutoff of ≥40 on the STAI identifies approximately 50% of high school and college athletes as anxious. As such, use of empirically-derived cutoffs are recommended over static cutoffs for clinical anxiety when using the STAI.