Lower post-injury psychological resilience is associated with increased recovery time and symptom burden following sport-related concussion

Appl Neuropsychol Child. 2022 Oct-Dec;11(4):781-788. doi: 10.1080/21622965.2021.1964966. Epub 2021 Aug 19.


The purpose of this study was to compare athletes with high and low resilience scores on concussion outcomes, and identify significant predictors associated with protracted recovery (>30 days). Forty-five adolescent and young adult athletes (28 males; aged 15.13 ± 2.74; range of 11-22) were diagnosed with an SRC within 14 days of injury (M = 4.9 days) and grouped as high or low resilience based on score on the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Primary dependent measures included days to full clearance, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Depression Anxiety and Stress Scale-21 (DASS-21), and Vestibular/Ocular Motor Screening (VOMS). The low resilience group (n = 22) had a longer recovery (36.0 ± 27.6 vs 17.8 ± 11.2 days), endorsed more mood symptoms (PCSS Affective cluster; 3.8 ± 0.8 vs 0.9 ± 0.7), and were more likely to have VOMS scores above cut off (p = 0.01-0.02), compared to those with high psychological resilience (n = 23). Logistic regression found low resilience scores was the only significant predictor for protracted recovery among injury characteristics and risk factors. Psychological resilience is a critical factor associated with recovery time following sport-related concussions. Low resilience was also associated with other poor clinical outcomes, greater subjective symptom report, more severe vestibular dysfunction, and elevated levels of mood symptoms following injury.

Keywords: Athlete; concussion; recovery; resiliency.

MeSH terms

  • Adolescent
  • Athletes
  • Athletic Injuries* / diagnosis
  • Brain Concussion* / diagnosis
  • Humans
  • Male
  • Neuropsychological Tests
  • Post-Concussion Syndrome* / complications
  • Post-Concussion Syndrome* / diagnosis
  • Resilience, Psychological*
  • Sports*
  • Young Adult