The postconcussion symptom scale: Utility of a three-factor structure

Aisha S. Joyce*, Cynthia R. Labella, Rebecca L. Carl, Jin Shei Lai, Frank A. Zelko

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Purpose This study aimed to determine the factor structure of a 19-item Postconcussion Symptom Scale and to examine associations between factor scores and sex, previous history of concussion, and length of time since injury. Methods This is a retrospective medical record review of pediatric patients with concussion seen in a sports medicine clinic from April 2008 to September 2012. We performed an exploratory factor analysis (EFA) followed by a confirmatory factor analysis (CFA). ANOVA and regression analysis were used to examine associations between factor scores and sex, previous history of concussion, mood disorder, anxiety disorder or attention-deficit disorder, and length of time since injury. Results EFA supported a three-factor solution for postconcussive symptoms employing 18 of the original 19 scale items. Factor 1 consisted of eight cognition-related items, factor 2 consisted of six somatic-related items, and factor 3 consisted of four emotional-related items. CFA results confirmed the unidimensionality of factors 1 (neurocognitive), 2 (somatic) and 3 (emotional), with factor 3 being considered borderline. Females and patients with anxiety disorders had significantly worse (higher) scores on all three factors. Patients seen >14 d after the concussive injury had worse (higher) factor 3 (emotional) scores than those seen <14 d after the injury. There was no significant difference in postconcussive symptom factor structures between those with and without a previous history of concussion. Conclusions Our investigation demonstrates a consistent symptom 3-factor structure of the Postconcussion Symptom Scale in pediatric patients with concussions. Females and patients with anxiety disorders had higher scores than males for all three factors. Patients seen >14 d after concussive injury had higher scores for emotional symptoms, suggesting that prolonged concussion symptoms may affect emotional health.

Original languageEnglish (US)
Pages (from-to)1119-1123
Number of pages5
JournalMedicine and science in sports and exercise
Volume47
Issue number6
DOIs
StatePublished - Jun 4 2015

Keywords

  • ATHLETE
  • CONCUSSION
  • MILD TRAUMATIC BRAIN INJURY
  • PEDIATRIC
  • SPORTS

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

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