Exploring Psychological Resilience, Plasma Cortisol, and Sport-Related Concussion Outcomes Among Canadian Adolescent Sport Participants
Date
2024-06-26
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Abstract
Sport-related concussion (SRC) is a common injury among Canadian adolescent sport participants (ASP). Numerous factors potentially impact recovery from SRC, including psychological resilience and cortisol. Researchers have found low psychological resilience and low cortisol may be independently linked to increased post-SRC symptom burden and a longer duration of recovery. However, the relationship between resilience and cortisol has not yet been investigated following adolescent SRC, which was the overarching goal of this thesis.
The first aim of this study was to explore the trajectory of resilience, as measured by the Connor-Davidson Resilience Scale 10 (CDRISC-10), before and after SRC, controlling for age and sex. Following, we described the relationships between resilience and SRC outcomes, including symptom burden and length of recovery based on physician clearance to return to play. We also aimed to examine group differences in plasma cortisol (stratified by morning [before 11:00am] and basal [11:00am–6:00pm] collection times) between uninjured and post-SRC ASP, controlling for age and sex/menstrual cycle phase (male, female follicular, female luteal), and time of blood draw. We then compared post-SRC cortisol to SRC outcomes controlling for age, and sex/menstrual cycle phase. Finally, we aimed to investigate the associations between resilience and plasma cortisol before and after adolescent SRC. The analyses were stratified by time of cortisol collection as outlined above. Uninjured analyses controlled for age and sex, while post-SRC analyses controlled for age, sex, and symptom severity. We found sex-specific trajectories of resilience following SRC, and that acute post-SRC measures of resilience may better predict SRC outcomes compared to pre-injury measures. Morning and basal cortisol were significantly lower post-SRC for males and females regardless of menstrual cycle phase. Post-SRC morning and basal cortisol demonstrated non-linear relationships with symptom burden, potentially reflecting impairment of the HPA axis and HPA axis activation in response to stress. Finally, morning cortisol decreased with increased resilience in our uninjured participants, but not in our post-SRC participants, suggesting HPA axis impairment following SRC. Overall, the results of this thesis revealed novel aspects of SRC pathophysiology and provide groundwork for future investigations into the complex relationship between resilience, cortisol, and SRC outcomes.
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Keywords
Sport-related concussion, concussion, mTBI, psychological resilience, plasma cortisol, menstrual cycle, adolescents, sport participation, hypothalamic-pituitary-adrenal axis
Citation
Josafatow, N. (2024). Exploring psychological resilience, plasma cortisol, and sport-related concussion outcomes among Canadian adolescent sport participants (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.