The Relationship Between the Post-Concussion Symptom Scale and State-Trait Anxiety Inventory in Concussed Athletes

Abstract

Abstract Purpose To document the relationship between concussion symptoms and state anxiety in concussed adolescent athletes. Methods One hundred fifty-three concussed athletes (mean age=16.06, SD=1.62 yrs.) completed the Post-Concussion Symptom Scale (PCSS) and the State-Trait Anxiety Inventory (STAI) at their initial clinical visit within 30 days of injury (M=8.29, SD=6.46 days). Due to violations of normality (Shapiro-Wilk=.95), Spearman’s Rank Order correlations were conducted between STAI state scores and PCSS affective, somatic, cognitive-migraine-fatigue, and sleep clusters and total symptoms. Correlations were also conducted within sub-samples of patients seen within one week (M=3.80, SD=1.72days) and 8 – 30 days post-injury (M=13.91, SD=5.76 days). Statistical significance was set at (p<.05). Results In the total sample (n=153), STAI state scores were significantly associated with total symptoms (r=.54), and the affective (r=.53), sleep (r=.44), cognitive-migraine-fatigue (r=.47), and somatic (r=.33) symptom clusters. All significant relationships among STAI state scores and PCSS total symptoms and symptom clusters were retained for patients seen within 1 week as well as patients completing their first clinical visit 8-30 days post-concussion (p<.05). Conclusion Post-concussion endorsement of concussion symptoms increases as a function of state anxiety. Although the PCSS affective symptom cluster is not a validated measure to diagnose anxiety; these findings support the utility of the PCSS to evaluate for potentially elevated anxiety in concussed adolescent athletes.