Objective To investigate how some coping skills such as Freedom from Worry and depression symptoms interact to moderate the severity of post-concussion symptoms in rugby union players.

Design Cross-sectional study.

Setting Athletes underwent testing at a sports concussion facility.

Participants Participants included 151 rugby union players 17 to 40 years old, the majority of whom were from amateur rugby league clubs (87%).

Interventions (or Assessment of Risk Factors) Significantly correlated measures were entered into linear regression analyses, adding tests of interaction between the independent variables to predict post-concussion symptom severity score.

Outcome Measures Freedom from Worry subscale from the Athletic Coping Skills Inventory (ACSI), Beck Depression Inventory-Second Edition (BDI-II) and Post-Concussion Symptom Scale (PCSS).

Main Results Players with higher depressive symptoms and greater strengths on the Freedom from Worry subscale reported greater severity of post-concussion symptoms. A significant regression equation was found (F (3, 56) = 16.068, p < .000), with an R2 of .463. Importantly, there was a statistically significant interaction between freedom from worry skill and depressive symptoms, which show evidence that a synergy effect exists between these 2 variables. R-squared increased from 37% to 46%, which means that the model with interaction helped explaining 9% more of the outcome variability.

Conclusions This research proves that an increase in some aspects of coping skills may lead to a decrease in the post-concussion symptom severity in athletes who suffer a concussion while participating in sport.