How Do You Feel? Understanding “Postconcussion-Like Symptom” Changes Over the Course of a Baseline Neuropsychological Evaluation

To examine the relationship between neuropsychological test performance and mood symptoms and increases in postconcussion-like symptom reporting following cognitive exertion via a hybrid neuropsychological assessment. Collegiate athletes (N = 233; male = 171, female = 62) were assessed at baseline. A 21-item postconcussion scale (PCS) was administered at the beginning (pre-PCS) and the end (post-PCS) of baseline. A difference score was calculated by subtracting post-PCS from pre-PCS. Athletes were categorized as being in a stable symptoms group (N = 164; experiencing no change or a decrease in symptoms) or increased symptoms group (N = 69). Self-reported significant depression symptomatology on the Beck Depression Inventory–Fast Screen (Beck et al., 2000) score ($4) and significant anxiety symptomatology on the NEO-Five Factor Inventory (McCrae & Costa, 2004) Anxiety Subscale score ($10) were measured. Two neurocognitive composites were created (memory and attention/processing-speed) from indices on the hybrid neuropsychological test battery. There were no significant differences between the two groups on memory or attention/processing-speed composite performance (p?>.05) or proportion of athletes reporting significant anxiety symptomatology (p?>.05). However, a significantly greater proportion of athletes in the increased symptoms group reported significant depression symptomatology (11.59%) compared to the stable symptoms group (3.05%), X²(1, N = 233) = 6.72, p =.009, φ =.17. Self-reported depression symptomatology, but not self-reported anxiety symptomatology, is associated with an increase in postconcussion-like symptoms during the cognitive exertion associated with a typical baseline concussion assessment. Subjectively increased postconcussion-like symptoms are not associated with objective cognitive performance at baseline.