Exploring Children’s Experiences Following Sport-Related Concussions
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Keywords

Mental health
sport-related concussions
challenges
protective factors
resiliency

How to Cite

MuellerM., Schmidt L., WrightS., Ali RazaI., PatroG., RanaM., & VolpeR. (2022). Exploring Children’s Experiences Following Sport-Related Concussions : Identifying and Overcoming Emotional Challenges and Adversity Following Traumatic Brain Injury (TBI). International Journal of Child and Adolescent Resilience, 9(1). https://doi.org/10.54488/ijcar.2022.301

Abstract

Objectives: To gain a better understanding of the emotional and mental experiences of child and adolescent athletes following a sport-related concussion, in order to better support these athletes throughout recovery.

Methods: Adolescents (n=21) ages 15-24 years who self-reported experiencing a sport-related concussion under the age of 18, participated in a retrospective, single group, qualitative analysis based on semi-structured interviews. Thematic Content Analysis was used to identify themes amongst participants’ responses.

Results: The results indicated three overarching domains with underlying themes and subthemes within: (1) Acute Challenges Post-Concussion (i.e., difficulty accepting unknowns, self-image and mattering, school, missing out and isolation, feelings of hopelessness), (2) Coping with Acute Challenges Post-Concussion (i.e., support, previous concussions, prioritizing mental health), and (3) Take-Aways Post-Concussion (i.e., learning about injury, self-growth, long lasting impacts on overall health).

Conclusion: Child and adolescent athletes face numerous emotional challenges post-concussion and following recovery; however, there are many ways in which children are resilient and cope with these challenges.

Implications: It is critical that the knowledge of child and adolescent athletes’ challenges post-concussion, as well as the successful coping mechanisms and protective factors utilized throughout recovery are used to develop better preventative and interventive strategies, in order to support the athletes’ well-being post-concussion.

https://doi.org/10.54488/ijcar.2022.301
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References

Alvord, M. K., & Grados, J. J. (2005). Enhancing resilience in children: A proactive approach. Professional Psychology: Research and Practice, 36(3), 238-245. https://doi.org/10.1037/0735-7028.36.3.238

Andrews, T. K., Rose, F. D., & Johnson, D. A. (1998). Social and behavioural effects of traumatic brain injury in children. Brain Injury, 12(2), 133-138. https://doi.org/10.1080/026990598122755

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Brewer, B. W., Van Raalte, J. L., & Linder, D. E. (1993). Athletic identity: Hercules’ muscles or Achilles heel? International Journal of Sport Psychology, 24(2), 237-254.

Brooks, J. E. (2006). Strengthening resilience in children and youths: Maximizing opportunities in the schools. Children and Schools, 28(2), 69-76. https://doi.org/10.1093/cs/28.2.69

Bunt, S. C., Meredith-Duliba, T., Didehhani, N., Hynan, L. S., LoBue, C., Stokes, M., Miller, S. M., Bell, K., Batjer, H., & Cullum, C. M. (2021). Resilience and recovery from sports related concussion in adolescents and young adults. Journal of Clinical and Experimental Neuropsychology, 43(7), 677-688. https://doi.org/10.1080/13803395.2021.1990214

Caplan, B., Bogner, J., Brenner, L., Beadle, E. J., Ownsworth, T., Fleming, J., & Shum, D. (2016). The impact of traumatic brain injury on self-identity: A systematic review of the evidence for self-concept changes. Journal of Head Trauma Rehabilitation, 31(2), 12-25. https://doi.org/10.1097/HTR.0000000000000158

Chenail, R. J. (2010). Getting specific about qualitative research generalizability. Journal of Ethnographic & Qualitative Research, 5(1), 1-11.

Committee on Sports-Related Concussions in Youth, Board on Children, Youth, and Families, Institute of Medicine, National Research Council, Graham, R., Rivara, F. P., Ford, M. A., & Spicer, C. M. (2014). Sports-related concussions in youth: Improving the science, changing the culture. National Academies Press. https://www.ncbi.nlm.nih.gov/sites/books/NBK169016/pdf/Bookshelf_NBK169016.pdf

Costello, D. M., Kaye, A. H., O'Brien, T. J., & Shultz, S. R. (2018). Sport related concussion – Potential for biomarkers to improve acute management. Journal of Clinical Neuroscience, 56, 1-6. https://doi.org/10.1016/j.jocn.2018.07.002

Covassin, T., Crutcher, B., Bleecker, A., Heiden, E. O., Dailey, A., & Yang, J. (2014). Postinjury anxiety and social support among collegiate athletes: A comparison between orthopaedic injuries and concussions. Journal of Athletic Training, 49(4), 462-468. https://doi.org/10.4085/1062-6059-49.2.03

Cover, R., Roiger, T., & Zwart, M. B. (2018). The lived experiences of retired collegiate athletes with a history of 1 or more concussions. Journal of Athletic Training, 53(7), 646-656. https://doi.org/10.4085/1062-6050-338-17

Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. SAGE Publishing.

Davies, S. C., Bernstein, E. R., & Daprano, C. M. (2020). A qualitative inquiry of social and emotional support for students with persistent concussion symptoms. Journal of Educational and Psychological Consultation, 30(2), 156-182. https://doi.org/10.1080/10474412.2019.1649598

DePadilla, L., Miller, G. F., Jones, S. E., Peterson, A. B., & Breiding, M. J. (2018). Self-reported concussions from playing a sport or being physically active among high school students – United States, 2017. Morbidity and Mortality Weekly Report, 67(24), 682-685. https://doi.org/10.15585/mmwr.mm6724a3

Duffy, A. (2012, September 27). Concussions ruin quality of life for young athletes. Calgary Herald. https://www.pressreader.com/canada/calgary-herald/20120927/281715496827902

Durish, C. L., Yeates, K. O., & Brooks, B. L. (2019). Psychological resilience as a predictor of symptom severity in adolescents with poor recovery following concussion. Journal of the International Neuropsychological Society, 25(4), 346-354. https://doi.org/10.1017/S1355617718001169

Engel, S. (1995). The stories children tell: Making sense of the narratives of childhood. W. H. Freeman and Company.

Engström, Å., Jumisko, E., Shahim, P., Lehto, N., Blennow, K., Zetterberg, H., & Tegner, Y. (2020). Losing the identity of a hockey player: The long-term effects of concussions. Concussion, 5(2). https://doi.org/10.2217/cnc-2019-0014

Faux, S. A., Walsh, M., & Deatrick, J. A. (1988). Intensive interviewing with children and adolescents. Western Journal of Nursing Research, 10(2), 180-194. https://doi.org/10.1177/019394598801000206

Harmon, K. G., Drezner, J., Gammons, M., Guskiewicz, K., Halstead, M., Herring, S., Kutcher, J., Pana, A., Putukian, M., & Roberts, W. (2013). American medical society for sports medicine position statement: Concussion in sport. Clinical Journal of Sport Medicine, 23(1), 1-18. https://doi.org/10.1097/JSM.0b013e31827f5f93

Hawley, C. A. (2003). Reported problems and their resolution following mild, moderate and severe traumatic brain injury amongst children and adolescents in the UK. Brain Injury, 17(2), 105-129. https://doi.org/10.1080/0269905021000010131

Hendry, K., Ownsworth, T., Waters, A. M., Jackson, M., & Lloyd, O. (2020). Investigation of children and adolescents’ mood and self-concept after acquired brain injury. Child Neuropsychology, 26(8), 1005-1025. https://doi.org/10.1080/09297049.2020.1750577

Hutchison, M., Mainwaring, L. M., Comper, P., Richards, D. W., & Bisschop, S. M. (2009). Differential emotional responses of varsity athletes to concussion and musculoskeletal injuries. Clinical Journal of Sport Medicine, 19(1), 13-19. https://doi.org/10.1097/JSM.0b013e318190ba06

Iadevaia, C., Roiger, T., & Zwart, M. B. (2015). Qualitative examination of adolescent health-related quality of life at 1 year postconcussion. Journal of Athletic Training, 50(11), 1182-1189. https://doi.org/10.4085/1062-6050-50.11.02

Kirkwood, M. W., Yeates, K. O., Taylor, H. G., Randolph, C., McCrea, M., & Anderson, V. A. (2008). Management of pediatric mild traumatic brain injury: A neuropsychological review from injury through recovery. The Clinical Neuropsychologist, 22(5), 769-800. https://doi.org/10.1080/13854040701543700

Kontos, A. P., Deitrick, J. M. A., & Reynolds, E. (2016). Mental health implications and consequences following sport-related concussion. British Journal of Sports Medicine, 50(3), 139-140. https://doi.org/10.1136/bjsports-2015-095564

Kroshus, E., Babkes Stellino, M., Chrisman, S. P., & Rivara, F. P. (2018). Threat, pressure, and communication about concussion safety: Implications for parent concussion education. Health Education & Behavior, 45(2), 254-261. https://doi.org/10.1177/1090198117715669

Langlois, J. A., Rutland-Brown, W., & Wald, M. M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. The Journal of Head Trauma Rehabilitation, 21(5), 375-378. https://doi.org/10.1097/00001199-200609000-00001

Macdonald, I., & Hauber, R. (2016). Educating parents on sports-related concussions. The Journal of Neuroscience Nursing, 48(6), 297-302. https://doi.org/10.1097/JNN.0000000000000212

Masten, A. S. (2007). Resilience in developing systems: Progress and promise as the fourth wave rises. Development and Psychopathology, 19(3), 921-930. https://doi.org/10.1017/S0954579407000442

Masten, A. S. (2011). Resilience in children threatened by extreme adversity: Framework for research, practice, and translational synergy. Development and Psychopathology, 23(2), 493-506. https://doi.org/10.1017/S0954579411000198

Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2(4), 425-444. https://doi.org/10.1017/S0954579400005812

Masten, A. S., & Coatsworth, J. D. (1998). The development of competence in favorable and unfavorable environments: Lessons from research on successful children. American Psychologist, 53(2), 205-220. https://doi.org/10.1037/0003-066X.53.2.205

Max, J. E., Keatley, E., Wilde, E. A., Bigler, E. D., Levin, H. S., Schachar, R. J., Saunders, A., Ewing-Cobbs, L., Chapman, S. B., Dennis, M., & Yang, T. T. (2011). Anxiety disorders in children and adolescents in the first six months after traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 23(1), 29-39. https://doi.org/10.1176/appi.neuropsych.23.1.29

Max, J. E., Pardo, D., Hanten, G., Schachar, R. J., Saunders, A. E., Ewing-Cobbs, L., Chapman, S. B., Dennis, M., Wilde, E. A., Bigler, E. D., Thompson, W. K., Yang, T. T., & Levin, H. S. (2013). Psychiatric disorders in children and adolescents six-to-twelve months after mild traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 25(4), 272-282. https://doi.org/10.1176/appi.neuropsych.12040078

McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, R. C., Dvořák, J., Echemendia, R. J., Engebretsen, L., Johnston, K., Kutcher, J. S., Raftery, M., Sills, A., Benson, B. W., Davis, G. A., Ellenbogen, R., Guskiewicz, K. M., Herring, S. A., Iverson, G. L., Jordan, B. D., Kissick, J., … Turner, M. (2013). Consensus statement on concussion in sport: The 4th international conference on concussion in sport, Zurich, November 2012. Journal of Athletic Training, 48(4), 554-575. https://doi.org/10.4085/1062-6050-48.4.05

McCrory, P., Meeuwisse, W., Dvořák, J., Aubry, M., Bailes, J., Broglio, S., Cantu, R. C., Cassidy, D., Echemendia, R. J., Castellani, R. J., Davis, G. A., Ellenbogen, R., Emery, C., Engebretsen, L., Feddermann-Demont, N., Giza, C. C., Guskiewicz, K. M., Herring, S., Iverson, G. L., … Vos, P. E. (2017). Consensus statement on concussion in sport – The 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838-847. https://doi.org/10.1136/bjsports-2017-097699

Mrazik, M., Brooks, B. L., Jubinville, A., Meeuwisse, W. H., & Emery, C. A. (2016). Psychosocial outcomes of sport concussions in youth hockey players. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 31(4), 297-304. https://doi.org/10.1093/arclin/acw013

Plourde, V., Yeates, K. O., & Brooks, B. L. (2018). Predictors of long-term psychosocial functioning and health-related quality of life in children and adolescents with prior concussions. Journal of the International Neuropsychological Society, 24(6), 540-548. https://doi.org/10.1017/S1355617718000061

Polit, D. F., & Beck, C. T. (2010). Generalization in quantitative and qualitative research: myths and strategies. International Journal of Nursing Studies, 47(11), 1451-1458. https://doi.org/10.1016/j.ijnurstu.2010.06.004

Poucher, Z. A., Tamminen, K. A., Caron, J. G., & Sweet, S. N. (2020). Thinking through and designing qualitative research studies: A focused mapping review of 30 years of qualitative research in sport psychology. International Review of Sport and Exercise Psychology, 13(1), 163-186. https://doi.org/10.1080/1750984X.2019.1656276

Rak, C. F., & Patterson, L. E. (1996). Promoting resilience in at-risk children. Journal of Counseling and Development, 74(4), 368-373. https://doi.org/10.1002/j.1556-6676.1996.tb01881.x

Reed, N., Zemek, R., Dawson, J., Ledoux, A-A., Provvidenza, C., Paniccia, M., Tataryn, Z., Sampson, M., Eady, K., Bourke, T., Dean, S. Seguin, R., Babul, S., Bauman, S., Bayley, M., Beauchamp, M., Carson, J., DePompei, R., Edwards, C., … Yeates, K. (2019). Living guideline for diagnosing and managing pediatric concussion. Ontario Neurotrauma Foundation. https://doi.org/10.17605/OSF.IO/3VWN9

Rieger, B., Lewandowski, L., Potts, H., & Shea, N. (2019). Effects of concussion in adolescent students: Perceptions and performance. Journal of the International Neuropsychological Society, 25(8), 777-786. https://doi.org/10.1017/S1355617719000468

Ritchie, J., Lewis, J., Ormston, R., & Morrell, G. (2003). Generalising from qualitative research. In K. Metzier (Ed.), Qualitative research practice: A guide for social science students and researchers (2nd ed., pp. 347-362). SAGE Publishing. https://doi.org/10.12759/hsr.29.2004.4.171-177

Schachar, R. J., Park, L. S., & Dennis, M. (2015). Mental health implications of traumatic brain injury (TBI) in children and youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry / Journal de l'Academie Canadienne de Psychiatrie de l'Enfant et de l'Adolescent, 24(2), 100-108. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558980/

Simons, H. (2014). Case study research: In-depth understanding in context. In P. Leavy (Ed.), The Oxford handbook of qualitative research (pp. 455-470). Oxford University Press.

Smith, B. (2018). Generalizability in qualitative research: misunderstandings, opportunities and recommendations for the sport and exercise sciences. Qualitative Research in Sport, Exercise and Health, 10(1), 137-149. https://doi.org/10.1080/2159676X.2017.1393221

Snyder, A. (2019). The experiences of late adolescent and young adult females with sports-related concussions [Doctoral dissertation, Georgia State University], ScholarWorks @ Georgia State University. https://doi.org/10.57709/14891342

Stake, R. E. (1978). The case study method in social inquiry. Educational Researcher, 7(2), 5-8. https://doi.org/10.3102/0013189X007002005

Stake, R. E. (1995). The art of case study research. SAGE Publishing.

Stazyk, K., DeMatteo, C., Moll, S., & Missiuna, C. (2017). Depression in youth recovering from concussion: Correlates and predictors. Brain Injury, 31(5), 631-638. https://doi.org/10.1080/02699052.2017.1283533

Thomas, D. G., Apps, J. N., Hoffmann, R. G., McCrea, M., & Hammeke, T. (2015). Benefits of strict rest after acute concussion: A randomized controlled trial. Pediatrics, 135(2), 213-223. https://doi.org/10.1542/peds.2014-0966

Todd, R., Bhalerao, S., Vu, M. T., Soklaridis, S., & Cusimano, M. D. (2018). Understanding the psychiatric effects of concussion on constructed identity in hockey players: Implications for health professionals. PLOS One, 13(2), Article e0192125. https://doi.org/10.1371/journal.pone.0192125

Tracy, S. J. (2010). Qualitative quality: Eight “big-tent” criteria for excellent qualitative research. Qualitative Inquiry, 16(10), 837-851. https://doi.org/10.1177/1077800410383121

Valovich McLeod, T. C., Wagner, A. J., & Bacon, C. E. W. (2017). Lived experiences of adolescent athletes following sport-related concussion. The Orthopaedic Journal of Sports Medicine, 5(12). https://doi.org/10.1177/2325967117745033

Weber Rawlins, M. L., Welch Bacon, C. E., Tomporowski, P., Gay, J. L., Bierema, L., & Schmidt, J. D. (2021). A qualitative analysis of concussion-reporting behavior in collegiate student-athletes with a history of sport-related concussion. Journal of Athletic Training, 56(1), 92-100. https://doi.org/10.4085/1062-6050-0392-19

Weinberg, R. S., & Gould, D. S. (2014). Foundations of sport and exercise psychology (7th ed.). Human Kinetics.

Werner, E. E. (1986). The concept of risk from a developmental perspective. Advances in Special Education, 5, 1-23. https://psycnet.apa.org/record/1986-27253-001

Willer, B., & Leddy, J. J. (2006). Management of concussion and post-concussion syndrome. Current Treatment Options in Neurology, 8(5), 415-426. https://doi.org/10.1007/s11940-006-0031-9

Xie, Q-W., Dai, X., Lyu, R., & Lu, S. (2021). Effects of mindfulness-based parallel-group interventions on family functioning and child and parent mental health: A systematic review and meta-analysis. Mindfulness, 12(12), 2843-2864. https://doi.org/10.1007/s12671-021-01728-z