Abstract

Objective: This study examined factor models for the Post-Concussion Symptom Scale (PCSS) at baseline and after suspected sport-related concussion, and measurement invariance from pre-injury to post-injury assessments and across age, gender, and health history groups (e.g., attention-deficit/hyperactivity disorder, psychiatric history). Methods: Adolescent student athletes (ages 13-18) completed a baseline PCSS (n = 39,015; 54.3% boys) and a subsample within 21 days of a suspected concussion (n = 1,554; 56.7% boys) completed a post-injury PCSS. Five models were evaluated for fit and invariance. Results: Confirmatory factor analyses showed good baseline and post-injury model fit for a previously supported four-factor model (i.e., cognitive-sensory, sleep-arousal, vestibular-somatic, and affective), an alternative four-factor model (i.e., cognitive, sleep-arousal, physical, and affective), and an incomplete bifactor model with vestibular-somatic and affective specific factors, along with partial invariance from pre-injury to post-injury assessments. Partial-to-full invariance was established for each model at baseline across demographic and health history groups. Conclusions: Results showed empirical and conceptual support for both PCSS subscales (i.e., cognitive, sleep-arousal, physical, and affective) and a total score for use in pre-injury to post-injury assessments and across demographic and health history groups at baseline. Future normative data, stratified by demographics and health history, could provide more precise symptom assessments for concussion management.

摘要

目的：本研究检查了基线和可疑运动相关性脑震荡后脑震荡后症状量表（PCSS）的因子模型，以及从受伤前到受伤后评估以及年龄，性别和健康史各组的测量不变性（例如，注意力缺陷/多动症，精神病史）。方法：青少年运动员（13-18岁）完成了基线 PCSS （n = 39,015；男生54.3％），在怀疑脑震荡后21天内的子样本（n  = 1,554；男孩56.7％）完成了伤后PCSS。对五个模型进行了拟合和不变性评估。结果：验证性因素分析显示，基线和伤害后模型与先前支持的四因素模型（即认知-感觉，睡眠-唤醒，前庭体细胞和情感），替代性四因素模型（即认知，睡眠-唤醒，身体和情感），以及具有前庭躯体和情感特定因子的不完整双因子模型，以及从损伤前到损伤后评估的部分不变性。在人口统计和健康史组的基线，为每个模型建立了部分至全部不变性。结论：结果显示，在PCSS分量表（即认知，睡眠-觉醒，身体和情感）和实物总分中，从经验和概念上都支持损伤前评估，损伤后评估以及基线的人口统计和健康史组。未来的规范性数据（按人口统计学和健康史分类）可以为脑震荡管理提供更精确的症状评估。