39 Measuring Psychological Resilience as a Predictor of mTBI Recovery: Is There Value Added to the Clinical Exam?

• Published in: Journal of the International Neuropsychological Society 2023-11, Vol.29 (s1), p.146-147
• Main Authors: Nahman, Julia C., Harper, Lauren Irwin, Ahumada, Luis, Irani, Sarah, Mularoni, P. Patrick, Ransom, Danielle M.
• Format: Article
• Language: English
• Subjects: Adolescents; Concussion; Concussion/Mild TBI (Child); Emotions; Orthopedics; Pediatrics; Poster Session 02: Acute & Acquired Brain Injury; Sex; Statistical analysis; Teenagers; Value added
• ISSN: 1355-6177; 1469-7661
• DOI: 10.1017/S1355617723002436

Objective:Recent studies have begun to explore the role of psychological resilience in pediatric mTBI recovery, with findings associating higher levels of resilience with shorter recovery and lower levels of resilience mediated by pre-injury anxiety and depression associated with persistent symptoms. The purpose of this study is to extend the current literature by further exploring the relationship between resilience, post-injury emotional changes, and length of recovery from pediatric mTBI. Based upon previous literature, we predicted that resilience would explain a unique portion of the variance in length of recovery above and beyond acute post-injury emotional symptoms in adolescents recovering from mTBI compared with orthopedic injured (OI) controls.Participants and Methods:The current study pulled data from a larger project utilizing a prospective cohort design in two cohorts of high school student-athletes aged 14-18 (N = 32). Participants with mTBI (n = 17) or OI (n = 15) sustained during sport were recruited within 10 days of injury from a quaternary care setting. Participants completed a neuropsychological screening evaluation within one week of enrollment, including self-report rating scales of resilience (Connor-Davidson Resilience Scale-10; CD-RISC) and self- and parent-reported post-concussion symptoms (Post-Concussion Symptom Inventory, Second Edition; PCSI-2). Hierarchical regression analysis was performed with days from injury to recovery as the dependent variable. Predictors were entered in three steps: (1) group (mTBI/OI) and sex, (2) PCSI self- and parent-reported post-injury change in emotional symptoms, and (3) CD-RISC raw score. Bonferroni correction was utilized to control for multiple comparisons.Results:Group and sex did not provide significant prediction when entered into the first block of the model (p= .61). Introducing PCSI emotional ratings in the second block showed statistically significant improvement, F (2,26) = 5.12, p< .01), accounting for 31% of the variance in recovery length. Addition of the CD-RISC in the third block was not statistically significant (p=.59). Post hoc testing indicated parent ratings on the PCSI were significantly associated with recovery length t(32) = 3.16, p < .01, while self-reported ratings were not (p=.54).Conclusions:Findings indicated that psychological resilience did not explain a unique portion of the variance in length of recovery above and beyond acute parent report of postinjury emotiona