Table 1.
Characteristics of included studies.
| Study | Study characteristic |
Sample characteristic |
Study outcome |
||||||
|---|---|---|---|---|---|---|---|---|---|
| Study design | Country | Population | Age (range or/and mean ± SD (year)) | Stated psychological concept(s) | Outcome measure or assessment | Time of assessment | Definition of concussion | OCEBM level of evidence | |
| Quantitative | |||||||||
| Anderson et al. (2019)28 | Prospective cohort with repeated measures | USA | 41 high school athletes (male: n = 26) | 14–18 (14.8 ± 1.1) | Fear of recurrent injury | Tampa Scale of Kinesiophobia | At first clinical visit and within 30 days after medical clearance | CISG 2012/2016 | 3 |
| Guo et al. (2020)29 | Prospective cohort with repeated measures | USA | 71 Division I NCAA athletes (male: n = 53) | ≥18 | Psychological responses over time during the course of recovery | Fear of recurrent injury (1-item Likert scale 0–10); fear of return to play (1-item Likert scale 0–10) |
1 week and at RTS | CISG 2008 | 3 |
| Hammer et al. (2020)32 | Prospective cohort with repeat measures | USA | 125 high school athletes (male: n = 80) | Male: 16.2 ± 1.2; Female: 16.3 ± 1.2 | Depression | Patient Health Questionnaire-9 | Baseline and at RTS | Not defined | 3 |
| Hutchison et al. (2017)33 | Case-control with repeated measures | Canada | 52 varsity university athletes (male: n = 32) | 18–28 (21.0 ± 2.5) | Emotional disturbance | Profile of Mood States-Short Form; Perceived Stress Scale | Asymptomatic phase and 1 week post RTS | CISG 2012 | 3 |
| McGuine et al. (2020)36 | Prospective cohort with repeated measures | USA | 1176 high school football players (concussed: n = 92; male: n = 1172) | Concussed: 16.2 ± 1.3; Control: 16.0 ± 1.2 | Depression | Patient Health Questionnaire-9 | Baseline and at RTS | Wisconsin Act | 3 |
| Meier et al. (2020)35 | Prospective matched cohort with repeated measures | USA | 174 NCAA Intercollegiate athletes (concussed: n = 92; male: n = 78. control: n = 82; male: n = 67) | Concussed: 19.2 ± 0.9; Control: 19.2 ± 1.2 | Psychological symptoms | Brief Symptom Inventory-18 Global Severity Index | Baseline, asymptomatic phase, and 1 week post RTS | A change in brain function following a force to the head, which may be accompanied by temporary LOC, but is identified in awake individuals with measures of neurologic and cognitive dysfunction. | 3 |
| Reinking et al. (2022)41a | Prospective cohort with repeated measures | USA | 49 adolescents from a pediatric sport medicine clinic (concussed: n = 32; male: n = 16; control: n = 17; male: n = 9) | Concussed: 15.2 ± 1.7; Control: 16.5 ± 1.3 | Fear of movement | Tampa Scale of Kinesiophobia; Post-Concussion Symptom Inventory; Clinical Reaction Time |
Within 14 days of injury and at RTS clearance | CISG 2016 | 3 |
| Turner et al. (2017)34 | Prospective matched cohort with repeated measures | USA | 30 NCAA Division I intercollegiate athletes (concussed: n = 15; male: n = 8; ortho: n = 15; male: n = 9) | Concussed: 19.4 ± 1.5; Ortho: 20.0 ± 1.2 | Psychological responses | Profile of Mood States; State Trait Anxiety Inventory | Acute phase and at RTS | CISG 2012 | 3 |
| Weber et al. (2019)37 | Prospective cohort with repeated measures | USA | 244 NCAA Intercollegiate athletes (male: n = 132) | 19.4 ± 1.4 | Mental health, depression, anxiety | 12-Item Short Form Survey (mental component subscore); Hospital Anxiety and Depression Scale (anxiety and depression subscores) | Baseline and at RTS | NCAA guidelines | 3 |
| Williams et al. (2020)40 | Prospective cohort descriptive | USA | 70 high school athletes (male: n = 51; unreported: n = 12) | 14–17 (15.7 ± 0.9) | Depression, anxiety, peer relationships | PROMIS Pediatric-25 subscales | RTS | Not defined | 3 |
| Qualitative | |||||||||
| Caron et al. (2021)38 | Interpretivist paradigm | Canada | 3 athlete-teammate-coach triads (male athlete: n = 1) | “High status” university athletesb | Social dynamics | Semi-structured interview | Within 1 year of sustaining a concussion | Not defined | n/a |
| McGuckin et al. (2016)30 | Phenomenology | Canada | 5 competitive hockey players (male: n = 0) | 9–16 (12.2 ± 1.2) | Compassion, support, protection, pressure | Semi-structured interview | Within 1 year of RTS | Physician diagnosed | n/a |
| Tjong et al. (2017)31 | Narrative approach | USA | 40 varsity collegiate football players (male: n = 40) | 18–25 (22.2 ± 0.6) | Psychological factors (e.g., fear of replacement, letting team down), culture of football (e.g., stigma, expectations), player awareness | Semi-structured interview | Variable | Not defined | n/a |
| Valovich McLeod et al. (2017)39 | HRQOL as a theoretical framework | USA | 12 high school athletes (male: n = 8) | 15.7 ± 1.7 | Psychosocial aspects of HRQOL | Semi-structured interview | Between 15 and 30 days post-injury | Not defined | n/a |
a
Included as a peer reviewer-nominated study.
b
Age range and mean age are not available, this was a qualitative study of 3 athlete-teammate-coach triads.
Abbreviations: CISG = Concussion in Sport Group; HRQOL = health-related quality of life; LOC = loss of consciousness; n/a = not applicable; NCAA = National Collegiate Athletic Association; OCEBM = Centre of Evidence-Based Medicine; Ortho = orthopedic; PROMIS = Patient-Reported Outcomes Measurement Information System; RTS = return to sport.