Anxiety Sensitivity and Adolescent Sports Related Concussion

The yearly prevalence of sports-related concussion (SRC) amongst adolescents is quite high. While most adolescents recover within 4 weeks, there is a significant minority whose symptoms linger. One challenge facing clinicians is there is no single pathophysiological biomarker of concussion, so current diagnostic and treatment models are dependent on self-reporting of symptoms. Previous research has focused on factors that might be related to symptom reporting and duration symptoms, including anxiety and depression. However, few studies have focused on the psychological mechanisms that drive anxiety and depression and the unique contributions of these mechanisms to symptom reporting after concussion. One specifically promising psychological mechanism is anxiety sensitivity, the catastrophic misinterpretation of internal sensations. It is a mechanism that is well studied, related to a range of pathologies and adverse responses to biological sensations, and amenable to treatment. The present study examined the relationship that anxiety sensitivity has with the initial reporting of symptoms after adolescent SRC and rate of change in symptoms over time (6 weeks). Participants were 40 adolescents who presented for treatment following a sports injury at a specialty children’s sports medicine clinic with 20 sustaining a SRC and 20 sustaining a musculoskeletal injury. All participants filled out an online survey to their symptom severity and anxiety sensitivity across three time points during a six-week period. Anxiety sensitivity showed a moderating effect on symptoms reported for the concussed group, with those in the concussed group reporting more initial symptoms as their anxiety sensitivity scores increased. However, anxiety sensitivity was not related to rate of change (reduction) in symptoms reported overtime. Although further study is needed, the finding that anxiety sensitivity has a moderating effect on initial symptom reporting may suggest a target for early intervention. Overall, the present study serves as an early step in establishing the relationship of anxiety sensitivity with symptom reporting following adolescent SRC