Meier Timothy B, Brummel Bradley J, Singh Rashmi, Nerio Christopher J, Polanski David W, Bellgowan Patrick S F
Laureate Institute for Brain Research, Tulsa, OK, USA.
Department of Psychology, The University of Tulsa, Tulsa, OK, USA.
J Sci Med Sport. 2015 Sep;18(5):507-11. doi: 10.1016/j.jsams.2014.07.008. Epub 2014 Jul 24.
This cohort study was conducted to examine patterns of symptom reporting in concussed athletes in two different testing environments.
A prospective cohort study was conducted with repeated measures.
Self-reported symptoms collected by team athletic trainers using the ImPACT Post-Concussion Scale (PCS) were compared to symptoms collected in a confidential setting using structured interviews for depression and anxiety. Ratings were scaled to match scoring of the PCS and categorized into symptom-domains. Scores collected 2 days post-concussion were compared across different rating scales. Confidential self-report scores approximately 9 days post-concussion in cleared athletes were compared to PCS scores collected during return-to-play decisions. Finally, confidential self-report scores collected 9 days post-concussion were compared between cleared and not cleared athletes.
Athletes self-reported significantly fewer symptoms to team athletic trainers using the ImPACT test compared to self-reported symptoms collected in a confidential setting during the acute phase of concussion using standard psychiatric interviews. Athletes cleared to play continued to underreport symptoms 9 days post-concussion, particularly psychiatric symptoms. Finally, cleared athletes self-reported similar magnitude of symptoms than non-cleared athletes 9 days post-concussion in confidential research setting.
The systematic underreporting of post-concussion symptoms may represent motivated behavior or differences in self-reporting data acquisition. By underreporting symptoms, many cleared athletes are still symptomatic over 1-week post-concussion. This study highlights the need for objective measures for somatic and psychiatric symptoms.
本队列研究旨在考察在两种不同测试环境下脑震荡运动员症状报告的模式。
进行一项采用重复测量的前瞻性队列研究。
将团队运动训练师使用脑震荡后症状评估量表（ImPACT PCS）收集的自我报告症状，与在保密环境中通过针对抑郁和焦虑的结构化访谈收集的症状进行比较。评分进行了调整以匹配ImPACT PCS的计分，并归类为症状领域。比较脑震荡后2天收集的不同评分量表的分数。将已恢复比赛的运动员在脑震荡后约9天的保密自我报告分数与在决定恢复比赛期间收集的ImPACT PCS分数进行比较。最后，比较已恢复比赛和未恢复比赛的运动员在脑震荡后9天收集的保密自我报告分数。
与在脑震荡急性期使用标准精神科访谈在保密环境中收集的自我报告症状相比，运动员使用ImPACT测试向团队运动训练师自我报告的症状明显更少。已恢复比赛的运动员在脑震荡后9天仍继续少报症状，尤其是精神症状。最后，在保密研究环境中，已恢复比赛的运动员在脑震荡后9天自我报告的症状程度与未恢复比赛的运动员相似。
脑震荡后症状的系统性少报可能代表了动机性行为或自我报告数据采集方面的差异。由于少报症状，许多已恢复比赛的运动员在脑震荡后1周以上仍有症状。本研究强调了对躯体和精神症状进行客观测量的必要性。
