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Differential Emotional Responses of Varsity Athletes to Concussion and Musculoskeletal Injuries

Hutchison, Michael MSc; Mainwaring, Lynda M PhD, CPsych; Comper, Paul PhD, CPsych; Richards, Doug W MD, DipSportMed; Bisschop, Sean M MA

Clinical Journal of Sport Medicine: January 2009 - Volume 19 - Issue 1 - p 13-19
doi: 10.1097/JSM.0b013e318190ba06
Original Research

Objective: To determine if athletes with concussion and those with minor musculoskeletal injuries experienced differential emotional response to injury.

Design: A prospective longitudinal cohort study.

Setting: University of Toronto, Ontario, Canada.

Participants: Thirty-four injured athletes from Canadian Interuniversity Sport (CIS) and 19 healthy, physically active undergraduate students participated in the study.

Intervention: All participants completed the Profile of Mood States (POMS; short version) on 3 nonconsecutive days during a 2-week period after a baseline test.

Main Outcome Measures: Emotional responses were assessed using the POMS. The 7 main outcome measures assessed by POMS were tension, depression, anger, vigor, fatigue, confusion, and total mood disturbance.

Results: After injury, concussion produced an emotional profile characterized by significantly elevated fatigue and decreased vigor. In contrast, athletes with musculoskeletal injuries displayed a significant increase in anger that resolved to a pre-injury level within 2 weeks.

Conclusions: The results revealed that both injured groups experienced emotional disturbance after injury. More importantly, the findings strongly suggest that the emotional reaction after concussion is different from that of musculoskeletal injury. Therefore, we concluded that assessing emotional reactions to concussion is particularly important and recommend that sports medicine professionals assess and monitor emotional functioning as well as somatic complaints and neurocognitive changes during recovery.

From the *Faculty of Physical Education and Health, University of Toronto, Toronto, Ontario; and †Toronto Rehabilitation Institute, Toronto, Ontario.

Submitted for publication January 28, 2008; accepted October 2, 2008.

Michael Hutchison completed this study in partial fulfillment of his MSc degree. Support by Social Sciences and Humanities Research Council (SSHRC) and Ontario Neurotrauma Foundation (ONF).

The authors state that they have no financial interest in the products mentioned within this article.

Reprints: Michael Hutchison, MSc, Faculty of Physical Education and Health, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada (e-mail:

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