The Associations Among Sport-Related Concussion, Head Impact Biomechanics, and Emotion Dysregulation in High School Athletes Public Deposited

Downloadable Content

Download PDF
Last Modified
  • March 20, 2019
  • Fraser, Melissa
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Curriculum in Human Movement Science
  • Background: Current recommendations advise athletic trainers to develop and implement plans for athletes’ with psychological concerns.[1] Associations between head impact severity (impact frequency, location, and magnitude) and sport-related concussion (SRC) have been identified in football players. However, it is unknown if the inclusion of emotion dysregulation measures may improve clinicians’ ability to identify at-risk players at baseline with respect to head impact biomechanics and incident SRC. Objectives: This prospective longitudinal study included four objectives: 1) To assess the associations between concussion history and preseason emotion dysregulation measures in high school student-athletes, 2) to assess the associations among preseason baseline emotion dysregulation scores, competition Impact Severity Profiles (ISP), and in-season incident concussion in high school football players, 3) To determine the associations among in-season incident SRC, full season ISPs and emotion dysregulation change-scores in high school football players, and 4) To determine the association of in-season incident SRC and full season emotion dysregulation change-scores (postseason-preseason) in high school student-athletes over one season. Methods: 1,053 student-athletes (age = 15.59 ± 1.21) from three high schools completed preseason and postseason concussion history and emotion dysregulation questionnaires during the 2013/14–2015/16 academic years. Of these individuals, 182 football players were chosen to have their helmets instrumented with Head Impact Telemetry System (HITS) accelerometers. Data from these sensors were used to formulate Impact Severity Profiles (ISP) (normal, moderate, poor). Our emotion dysregulation measures included depression (PHQ-9), anxiety (GAD-7), impulsivity (BIS-11), and aggression (BPAQ), and perceived stress (PSS4, covariate only). Linear regressions were utilized for all analyses. Results: Our data only supported our first hypothesis. Concussion history was associated with significantly higher depression (p=0.004) and impulsivity (p=0.014, p=0.002). Preseason scores were associated with age, sex, concussion history and sport. Conclusions: The emotion dysregulation scores were not significantly associated with the competition or full season ISPs, or in-season incident concussion. Our emotion dysregulation data supported preseason sex-related findings as well as novel associations that had not previously been reported. These findings indicate that the current protocol still requires further investigation before it could be utilized as an effective prediction method for at-risk athletes.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Hackney, Anthony
  • Guskiewicz, Kevin M.
  • Register-Mihalik, Johna
  • Marshall, Stephen
  • Fredrickson, Barbara
  • Mihalik, Jason
  • DeFreese, J.D.
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016

This work has no parents.