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Changes in State and Trait Anxiety Throughout Concussion Recovery in High School and College-Aged Individuals.

CONTEXT: Research indicates that individuals may experience anxiety symptoms following concussion. A potential mechanism for these presentations are shifts in anxiety throughout recovery.

OBJECTIVE: To examine state and trait anxiety in individuals following concussion throughout recovery compared to healthy matched controls.

DESIGN: Prospective cohort study.

SETTING: University laboratory setting.

PATIENTS OR OTHER PARTICIPANTS: 78 high school and college-aged individuals (concussion: n=39, age=18.4 ± 2.3 years; healthy matched controls: n=39, age=18.4 ± 2.3 years) were enrolled.

MAIN OUTCOME MEASURES: The State Trait Anxiety Inventory (STAI) was administered within 72 hours of injury (day 0: first test session), 5 days (±1day) from first test session (Day 5), and at the time of full medical clearance (FMC) (+2 days). Separate 2 × 3 repeated measures analyses of variance (ANOVA) were used to investigate differences in state and trait anxiety for each group throughout recovery.

RESULTS: State and trait anxiety were significantly higher in the concussion group compared to healthy matched controls at day 0, day 5, and FMC. For state anxiety, there was a significant group × time interaction (F(2, 150) = 10.45, p < 0.001, ηp2 = 0.12). For trait anxiety, there was no significant interaction (F(1.74, 150) = 1.5, p = 0.22, ηp2 = 0.02), but significant main effects for time (F(1.74, 150) = 25.7, p < 0.001, ηp2 = 0.3) and group (F(1, 75) = 7.23, p = 0.01, ηp2 = 0.09).

CONCLUSIONS: Participants with concussion experienced significantly higher levels of state anxiety throughout recovery compared to healthy matched controls. While trait anxiety was higher in concussions and decreased over time, an interaction was not found. This demonstrates that concussion may not impact this aspect of personality. Post-injury anxiety may be a result of increased state anxiety, and clinicians should screen for and manage these symptoms throughout recovery.

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