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

Context: Researchers have indicated that individuals may experience anxiety symptoms after concussion. A potential mechanism for these presentations is shifts in anxiety throughout recovery. Objective: To examine the levels of state and trait anxiety in individuals after concussion throughout recovery compared with the levels in individuals serving as uninjured matched control participants. Design: Prospective cohort study. Setting: University laboratory. Patients or Other Participants: Seventy-eight high schooland college-aged individuals (concussion group = 39, age = 18.4 6 2.3 years; matched control group = 39, age = 18.4 6 2.3 years) were enrolled. Main Outcome Measure(s): The State-Trait Anxiety Inventory was administered within 72 hours of injury (day 0: first test session), 5 days (61 day) after the first test session (day 5), and at the time of full medical clearance (thorn2 days). Separate 2 3 3 repeated-measures analyses of variance were used to investigate differences in state and trait anxiety for each group throughout recovery. Results: State and trait anxiety were higher in the concussion group than in the control group at day 0, day 5, and full medical clearance. For state anxiety, we observed a group 3 time interaction (F-2,F-150 = 10.45, P,.001,. eta p(2) = 0.12). For trait anxiety, we did not note an interaction (F-1.74,F-150 = 1.5, P =.22,. eta p(2) 1/4 0.02) but did find main effects for time (F-1.74,F-150 = 25.7, P,.001,. eta p(2) =0.3) and group (F-1,F-75 = 7.23, P =.01,. eta p(2) = 0.09). Conclusions: Participants with concussion experienced higher levels of state anxiety throughout recovery than matched control individuals. Although trait anxiety was higher in the concussion group and decreased over time, no interaction was seen, demonstrating that concussion may not affect this aspect of personality. Postinjury anxiety may result from increased state anxiety, and clinicians should screen for and manage these symptoms throughout recovery.