5. Baseline Symptoms in High School Athletes with ADHD and Comorbid Psychiatric Treatment History

Abstract

Athletes with attention-deficit/hyperactivity disorder (ADHD) and psychiatric treatment history (PsychHx) are at increased risk for differential outcomes after concussion. They may also exhibit differences on the Post Concussion Symptom Scale (PCSS) at baseline. Better understanding of baseline symptoms in these populations may improve concussion assessment and management. A sample of 1,642 high-school athletes were selected from an archival database (M age=15.11; 43.8% female). ADHD, PsychHx, and symptoms were self-reported on the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline. Differences in baseline PCSS symptom endorsement were compared using one-way ANCOVA among four diagnostic groups: Control, ADHD-only, PsychHx, and ADHD+PsychHx (covariates: age, sex). There were significant differences in PCSS Total Scores between the groups (p’s <.001). Those with PsychHx (M=13.47) and ADHD+PsychHx (M=14.11) did not differ; however, both groups had twice the Total Score compared to ADHD-only (M=7.49), which had nearly twice the score of Controls (M=4.83). Regarding symptom clusters (Cognitive, Physical, Affective, and Sleep), the PsychHx and ADHD+PsychHx groups had twice the symptom scores as the ADHD-only and Control groups for each of the symptom clusters (p’s<.001). We identified significantly higher baseline symptom endorsement among high-school athletes with PsychHx and ADHD+PsychHx when compared to athletes with ADHD-only and Controls. These findings are consistent with prior literature of athletes with ADHD or PsychHx; however, our findings show that athletes with both ADHD and PsychHx endorse significantly higher symptoms at baseline than those with ADHD-only.