How Anxiety in Adolescent Athletes May Affect Baseline Neuropsychological Test Scores

Background: Anxiety is highly prevalent in the adolescent population and can affect performance on cognitive tasks. As part of a concussion protocol, measuring cognitive ability through the use of baseline neuropsychological testing is recommended in the high school setting. Because of the cognitive nature of baseline testing, there is potential for anxiety to influence scores. Purpose: To examine the effects of varying levels of state and trait anxiety on a baseline computerized neurocognitive assessment in the adolescent population. Methods: 75 adolescent athletes (age:15.91±1.33, height (cm): 168.72±9.07, weight (kg): 62.97±12.04) participated in the study. Cognitive ability was measured utilizing the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), while the anxiety screen utilized was the State Trait Anxiety Inventory. Data collection took place during preseason, and measures were administered within five minutes of each other. Participants were split into high and low groups based upon their level of state and trait anxiety. Statistical Analyses: Descriptive statistics were run on all demographic variables and outcome measures. Two one-way ANOVAs were conducted to compare ImPACT composite scores across high and low anxiety groups. Results: Significant differences were found between the high and low state anxiety groups for reaction time (LS 0.60±0.10, HS 0.69±0.09, F(1, 73) = 6.28, p =.01, r = -0.43, Cohen’s d = -0.95). No significant differences were found between the state and trait anxiety groups for any other composite score (p \u3e 0.05). Summary: Adolescent athletes consistently perceive situations as stressful, and those in the high state anxiety group have slower reaction times during baseline concussion assessment. Concussion is highly covered in media leading to a change in public perception and awareness. This heightened awareness potentially creates an environment where adolescent athletes do not assess baseline testing as stressful, thereby reducing the overall effect of anxiety on performance. The current concussion paradigm places substantial weight on neuropsychological testing, however post-injury testing may be more stress provoking. Therefore, future research should examine how anxiety affects the post-injury examination