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Irritability and aggression in persistent youth concussions
  1. Y Han Dong (Dan)1,
  2. Hannah L Combs2,
  3. Lisa Koehl3,
  4. Fernanda C Camargo4,
  5. Carl G Mattacola3
  1. 1University of Kentucky, Kentucky Neuroscience Institute, Sports Medicine Research Institute, Spinal Cord and Brain, Injury Research Center, Saddle Up Safely Executive Committee, Lexington, Kentucky
  2. 2University of Kentucky, Kentucky Neuroscience Institute, Lexington, Kentucky
  3. 3Neuropsychology Fellow, University of Kentucky, Kentucky Neuroscience Institute, Lexington, Kentucky
  4. 4Equine Extension Specialist, University of Kentucky, Saddle Up Safely Executive Committee, Lexington, Kentucky


Objective To assess whether irritability and aggression are viable indicators of persistent post-concussive symptoms in adolescents.

Design Group differences between those diagnosed with concussions were analysed using ANOVAs (p < 0.05).

Setting Outpatient clinic.

Participants 46 concussed adolescents age 12–17 with persisting concussion symptoms were assessed. Athletes were split into two groups: those endorsing irritability/aggression (AGG, n=24) and a control group of those denying irritability/aggression (CON, n=22). Those with baseline psychiatric history and/or special education were excluded.

Assessment of risk factors Post-concussive symptom variable relationships were assessed.

Outcome measures group differences were analysed using ANOVAs.

Results Adolescents endorsing irritability/aggression reported more fatigue (p=0.002), disordered sleep (p=0.001), anxiety (p=0.028), depression (p=0.003), and mood lability (p<0.001) during clinical assessment. Adolescents reporting more irritability also had elevated scores on related psychometric scales, including the Beck Youth Inventory-II Anxiety [t(41)=−2.916, p = 0.006], Depression [t(41)=−3.551, p = 0.001], and Anger Scales [t(41)=−2.958, p=0.005].

Conclusions Results indicate that adolescents with self-reported irritability and aggression post-concussion were more likely to display more affective symptoms than those who did not endorse irritability and aggression following concussions. They were also more likely to complain of fatigue and disordered sleep. These findings suggest that change in level of irritability/aggression could potentially serve as an identifiable indicator for parents and coaches to recognise when an adolescent is not recovering well post-concussion.

Competing interests None.

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