Abstract

The purpose of the current study was to examine predictors (e.g., pre-injury anxiety and sub-types, concussion symptom severity, neurocognitive performance, and vestibular/ocular-motor impairment) of post-injury anxiety scores following concussion among youth aged 10–18 years. This observational cohort study enrolled patients (n = 129) within 30 days of a diagnosed concussion. Patients completed Screening for Child Anxiety Related Disorders-Child Reports (SCARED-C), Generalized Anxiety Disorder-7 (GAD-7), Post-concussion Symptom Scale, neurocognitive testing, and Vestibular-Ocular Motor Screening. Logistic regression analyses were conducted to evaluate the role of risk factors and clinical outcomes as predictors of mild (GAD-7 > 5) and moderate levels (GAD-7 > 10) of post-injury anxiety. Twenty-two percent (n = 28) of patients reported clinical levels of pre-injury anxiety, and 13% (n = 17) reported clinical levels of post-injury anxiety. The logistic regression model predicting mild or greater anxiety was significant (R² = 31.7%; p < 0.001) and supported pre-injury panic symptoms (OR = 1.38) and total symptom severity (OR = 1.04) as the most robust predictors. The logistic regression model predicting clinical anxiety was significant (R² = 47.2%; p < 0.001) and supported non-SRC injury type (OR = 9.48), vestibular dysfunction (OR = 1.74) and pre-injury panic symptoms (OR = 1.57) as the most robust predictors. Results suggest that clinicians should employ measures of pre-injury and post-injury emotional functioning when evaluating and treating concussion among adolescents. Moreover, these results highlight the importance of assessing different types of pre-injury and post-injury anxiety in the context of concussion management.

摘要

本研究的目的是检查 10-10 岁青少年脑震荡后损伤后焦虑评分的预测因子（例如，损伤前焦虑和亚型、脑震荡症状严重程度、神经认知表现和前庭/眼运动障碍）。 18年。 这项观察性队列研究在确诊脑震荡后 30 天内招募了患者 ( n = 129)。患者完成了儿童焦虑相关疾病筛查 - 儿童报告 (SCARED-C)、广泛性焦虑障碍 - 7 (GAD-7)、脑震荡后症状量表、神经认知测试和前庭眼运动筛查。进行逻辑回归分析以评估风险因素和临床结果作为轻度（GAD-7 > 5）和中度（GAD-7 > 10）损伤后焦虑的预测因子的作用。百分之二十二（n  = 28) 的患者报告了受伤前焦虑的临床水平，13% ( n  = 17) 的患者报告了受伤后焦虑的临床水平。预测轻度或更大焦虑的逻辑回归模型具有显着性（R ² = 31.7%；p  < 0.001），并支持受伤前恐慌症状（OR = 1.38）和总症状严重程度（OR = 1.04）作为最可靠的预测因子。预测临床焦虑的逻辑回归模型显着（R ² = 47.2%；p < 0.001) 并支持非 SRC 损伤类型 (OR = 9.48)、前庭功能障碍 (OR = 1.74) 和受伤前恐慌症状 (OR = 1.57) 作为最可靠的预测因子。结果表明，临床医生在评估和治疗青少年脑震荡时应采用伤前和伤后情绪功能测量。此外，这些结果强调了在脑震荡管理的背景下评估不同类型的伤前和伤后焦虑的重要性。