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Behavioral Regulation is Associated with De Creased Post-Concussion State Anxiety and Depression

K. J. Durfee, S. Amalfe,M. N. Womble,C. M. Dollar,P. Schatz, A. P. Kontos,M. W. Collins,R. J. Elbin

ARCHIVES OF CLINICAL NEUROPSYCHOLOGY(2023)

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Abstract
Purpose To examine the effects of self-reported behavioral regulation on post-concussion anxiety and depression in individuals with sport-related concussion (SRC) Methods A retrospective chart review of patients (ages 15–25yrs) seeking care for a SRC within 1-7 days following injury were included in this study. Participants completed a self-report, 4-point Likert scale (0-Never, 3-Most of the Time) questionnaire that assessed the previous week’s frequency of Sleep, Physical Activity (PA), Diet, Hydration, and Stress Management behavioral regulation domains. Scores were divided into HIGH (Most of the Time) and LOW (Some of the Time – Never) regulation groups for each domain. A series of independent samples t-tests and analyses of covariance (ANCOVA) were used to compare these groups on state anxiety (STAI) and depression (PHQ-9) scores. Results One hundred thirty-two participants (M=16.42, SD=1.95 yrs, 45% female) completed the study measures at 3.85 days post injury (SD=1.40). Participants in the HIGH behavioral regulation groups for Sleep (F(1,129)=4.67, p=.03), PA (F(1,128)=8.88, p=.003), and Stress (t(130)=1.89, p=.03) demonstrated significantly lower state anxiety scores than the LOW groups. Depression scores were significantly lower for the HIGH behavioral regulation in Sleep (F(1,129)=8.70, p=.004), Diet (F(1,125)=10.22, p=.002), and PA (F(1,128)=5.09, p=.03) domains than the LOW groups. Conclusions Behavioral regulation affects post-concussion state anxiety and depression. This low cost, non-pharmacological strategy should be the first step for the management of SRC.
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