Changes in Coping Skills Throughout Concussion Recovery in College-Aged Individuals

Context Psychosocial factors are important to consider throughout concussion recovery. Coping skills may play a role post-injury by influencing the stress response and health-promoting behaviors (e.g., rehabilitation adherence). However, limited evidence exists examining coping skills throughout concussion recovery in college-aged individuals. Objective To compare (1) changes in coping skills between acute and full medical clearance (FMC) visits in college-aged individuals diagnosed with concussion and healthy controls, and (2) determine the association between coping skills and recovery outcomes following concussion. Design Prospective cohort study Setting University laboratory Patients or Other Participants 96 college-aged individuals (concussion group: N=64, age=21.33±2.37 years; control group: N=32, age=21.54±2.54 years) were enrolled. Main Outcome Measures The Athletic Coping Skills Inventory (ACSI-28) was completed at acute (within 5 days of concussion) and FMC (within 3 days of clearance) visits. A 2 × 2 mixed ANOVA determined differences in total and subscale scores between groups (concussion vs. control) from acute to FMC visit. Multiple linear regressions determined the association between acute ACSI-28 scores and recovery for the concussion group, with statistical significance set a priori at p<0.05 for both tests. Results The concentration subscale was significantly lower for the concussion group at the initial visit (F(1,94)=7.28, p=0.01). The main effect of time showed both groups’ ACSI-28 total score significantly increased from acute to FMC visit (F(1,94)=22.08, p<0.001). There were no significant differences in total scores between groups at either visit (p>0.05). Additionally, no associations were found between ACSI-28 scores and concussion recovery outcomes when controlling for sex, race, history of depression/anxiety, and acute visit symptom severity (symptom resolution: B=0.06, p=0.62; FMC: B=0.09, p=0.46). Conclusions Only coping-related concentration skills from the ACSI-28 are impaired during the acute stage of concussion recovery but improve by the FMC visit. Other coping skills associated with the ACSI-28 remain unaffected throughout concussion recovery in college-aged individuals.