{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:42:03Z","timestamp":1761266523506,"version":"build-2065373602"},"reference-count":31,"publisher":"National Athletic Trainers' Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Context<\/jats:title>\n Psychosocial factors are important to consider throughout concussion recovery. Coping skills may play a role postinjury by influencing the stress response and health-promoting behaviors (eg, rehabilitation adherence). However, limited evidence exists examining coping skills throughout concussion recovery in college-aged individuals.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare (1) changes in coping skills between acute and full medical clearance (FMC) visits in college-aged individuals diagnosed with concussion and healthy controls and (2) determine the association between coping skills and recovery outcomes after concussion.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Prospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n University laboratory.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n Ninety-six college-aged individuals (concussion group: n = 64, age = 21.33 \u00b1 2.37 years; control group: n = 32, age = 21.54 \u00b1 2.54 years) were enrolled.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n \n The Athletic Coping Skills Inventory-28 (ACSI-28) was completed at acute (within 5 days of concussion) and FMC (within 3 days of clearance) visits. A 2 \u00d7 2 mixed analysis of variance determined differences in total and subscale scores between groups (concussion vs control) from an acute to FMC visit. Multiple linear regressions determined the association between acute ACSI-28 scores and recovery for the concussion group, with statistical significance set a priori at\n P<\/jats:italic>\n < .05 for both tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Concentration subscale was significantly lower for the concussion group at the initial visit (\n F<\/jats:italic>\n 1,94<\/jats:sub>\n = 7.28,\n P<\/jats:italic>\n = .01). The main effect of time showed both groups\u2019 ACSI-28 total scores significantly increased from the acute to FMC visit (\n F<\/jats:italic>\n 1,94<\/jats:sub>\n = 22.08,\n P<\/jats:italic>\n < .001). There were no significant differences in total scores between groups at either visit (\n P<\/jats:italic>\n > .05). Additionally, no associations were found between ACSI-28 scores and concussion recovery outcomes when controlling for sex, race, history of depression\/anxiety, and acute visit symptom severity (symptom resolution:\n B<\/jats:italic>\n = 0.06,\n P<\/jats:italic>\n = .62; FMC:\n B<\/jats:italic>\n = 0.09,\n P<\/jats:italic>\n = .46).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Only coping-related concentration skills from the ACSI-28 are impaired during the acute stage of concussion recovery, and these improve by the FMC visit. Other coping skills associated with the ACSI-28 remain unaffected throughout concussion recovery in college-aged individuals.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0467.24","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T04:11:14Z","timestamp":1747109474000},"page":"713-720","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Coping Skills Throughout Concussion Recovery in College-Aged Individuals"],"prefix":"10.4085","volume":"60","author":[{"given":"Lilian A.","family":"Klein","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Zynda","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery\/UPMC Sports Medicine Concussion Program, University of Pittsburgh Medical Center, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan C.","family":"Loftin","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa M.","family":"Pollard-McGrandy","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allie J.","family":"Tracey","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"Covassin","sequence":"additional","affiliation":[{"name":"Graduate Athletic Training Program, Michigan State University, East Lansing"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"12","key":"i1938-162X-60-10-713-b01","series-title":"JAMA Netw Open","first-page":"e1917626","article-title":"Characteristics and incidence of concussion among a US collegiate undergraduate population","volume":"2","author":"Breck","year":"2019","unstructured":"Breck J,\nBohr A,\nPoddar S,\nMcQueen MB,\nCasault T. Characteristics and incidence of concussion among a US collegiate undergraduate population. JAMA Netw Open. 2019;2(12):e1917626. doi:10.1001\/jamanetworkopen.2019.17626"},{"issue":"11","key":"i1938-162X-60-10-713-b02","series-title":"Br J Sports Med","first-page":"695","article-title":"Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport\u2014Amsterdam, October 2022","volume":"57","author":"Patricios","year":"2023","unstructured":"Patricios JS,\nSchneider KJ,\nDvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport\u2014Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695\u2013711. doi:10.1136\/bjsports-2023-106898"},{"issue":"2","key":"i1938-162X-60-10-713-b03","series-title":"Br J Sports Med","first-page":"91","article-title":"Risk factors for sports concussion: an evidence-based systematic review","volume":"48","author":"Abrahams","year":"2014","unstructured":"Abrahams S,\nFie SM,\nPatricios J,\nPosthumus M,\nSeptember AV. Risk factors for sports concussion: an evidence-based systematic review. Br J Sports Med. 2014;48(2):91\u201397. doi:10.1136\/bjsports-2013-092734"},{"issue":"6","key":"i1938-162X-60-10-713-b04","series-title":"Sports Health","first-page":"537","article-title":"Risk modifiers for concussion and prolonged recovery","volume":"5","author":"Scopaz","year":"2013","unstructured":"Scopaz KA,\nHatzenbuehler JR. Risk modifiers for concussion and prolonged recovery. Sports Health. 2013;5(6):537\u2013541. doi:10.1177\/1941738112473059"},{"issue":"2","key":"i1938-162X-60-10-713-b05","series-title":"J Int Neuropsychol Soc","first-page":"109","article-title":"Learning and attention deficit\/hyperactivity disorders as risk factors for prolonged concussion recovery in children and adolescents","volume":"28","author":"Martin","year":"2022","unstructured":"Martin AK,\nPetersen AJ,\nSesma HW, et al. Learning and attention deficit\/hyperactivity disorders as risk factors for prolonged concussion recovery in children and adolescents. J Int Neuropsychol Soc. 2022;28(2):109\u2013122. doi:10.1017\/S1355617721000229"},{"issue":"6","key":"i1938-162X-60-10-713-b06","series-title":"Am J Sports Med","first-page":"1695","article-title":"Factors associated with a prolonged time to return to play after a concussion","volume":"50","author":"Wang","year":"2022","unstructured":"Wang EX,\nHwang CE,\nNguyen JN,\nSegovia NA,\nAbrams GD,\nKussman A. Factors associated with a prolonged time to return to play after a concussion. Am J Sports Med. 2022;50(6):1695\u20131701. doi:10.1177\/03635465221083646"},{"issue":"2","key":"i1938-162X-60-10-713-b07","series-title":"Int J Environ Res Public Health","first-page":"1211","article-title":"An examination of depression, anxiety, and self-esteem in collegiate student-athletes","volume":"20","author":"Weber","year":"2023","unstructured":"Weber SR,\nWinkelmann ZK,\nMonsma EV,\nArent SM,\nTorres-McGehee TM. An examination of depression, anxiety, and self-esteem in collegiate student-athletes. Int J Environ Res Public Health. 2023;20(2):1211. doi:10.3390\/ijerph20021211"},{"issue":"1","key":"i1938-162X-60-10-713-b08","series-title":"J Appl Sport Psychol","first-page":"103","article-title":"Psychological interventions in sport injury prevention and rehabilitation","volume":"10","author":"Cupal","year":"1998","unstructured":"Cupal DD. Psychological interventions in sport injury prevention and rehabilitation. J Appl Sport Psychol. 1998;10(1):103\u2013123. doi:10.1080\/10413209808406380"},{"issue":"1","key":"i1938-162X-60-10-713-b09","series-title":"Sport Psychol","first-page":"1","article-title":"Effects of selected mental practice on performance, self-efficacy, and competition confidence of figure skaters","volume":"12","author":"Garza","year":"1998","unstructured":"Garza DL,\nFeltz DL. Effects of selected mental practice on performance, self-efficacy, and competition confidence of figure skaters. Sport Psychol. 1998;12(1):1\u201315. doi:10.1123\/tsp.12.1.1"},{"issue":"suppl 2","key":"i1938-162X-60-10-713-b10","series-title":"Scand J Med Sci Sports","first-page":"78","article-title":"Psychological skills training as a way to enhance an athlete\u2019s performance in high-intensity sports","volume":"20","author":"Birrer","year":"2010","unstructured":"Birrer D,\nMorgan G. Psychological skills training as a way to enhance an athlete\u2019s performance in high-intensity sports. Scand J Med Sci Sports. 2010;20(suppl 2):78\u201387. doi:10.1111\/j.1600-0838.2010.01188.x"},{"issue":"13","key":"i1938-162X-60-10-713-b11","series-title":"Int J Environ Res Public Health","first-page":"6802","article-title":"Relationship between mindfulness, psychological skills, and mental toughness in college athletes","volume":"18","author":"Wu","year":"2021","unstructured":"Wu CH,\nNien JT,\nLin CY, et al. Relationship between mindfulness, psychological skills, and mental toughness in college athletes. Int J Environ Res Public Health. 2021;18(13):6802. doi:10.3390\/ijerph18136802"},{"issue":"9","key":"i1938-162X-60-10-713-b12","series-title":"Sports (Basel)","first-page":"162","article-title":"The impact of a psychological skills training and mindfulness-based intervention on the mental toughness, competitive anxiety, and coping skills of futsal players\u2014a longitudinal convergent mixed-methods design","volume":"11","author":"Vella-Fondacaro","year":"2023","unstructured":"Vella-Fondacaro D,\nRomano-Smith S. The impact of a psychological skills training and mindfulness-based intervention on the mental toughness, competitive anxiety, and coping skills of futsal players\u2014a longitudinal convergent mixed-methods design. Sports (Basel). 2023;11(9):162. doi:10.3390\/sports11090162"},{"issue":"3","key":"i1938-162X-60-10-713-b13","series-title":"J Athl Train","first-page":"258","article-title":"Athletic trainers\u2019 and physical therapists\u2019 perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs","volume":"43","author":"Hamson-Utley","year":"2008","unstructured":"Hamson-Utley JJ,\nMartin S,\nWalters J. Athletic trainers\u2019 and physical therapists\u2019 perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs. J Athl Train. 2008;43(3):258\u2013264. doi:10.4085\/1062-6050-43.3.258"},{"issue":"6","key":"i1938-162X-60-10-713-b14","series-title":"Sports Med","first-page":"352","article-title":"The psychological effects of sports injuries: coping","volume":"9","author":"Smith","year":"1990","unstructured":"Smith AM,\nScott SG,\nWiese DM. The psychological effects of sports injuries: coping. Sports Med. 1990;9(6):352\u2013369. doi:10.2165\/00007256-199009060-00004"},{"issue":"2","key":"i1938-162X-60-10-713-b15","series-title":"Pain","first-page":"171","article-title":"Coping with the coping concept: a brief comment","volume":"34","author":"Tunks","year":"1988","unstructured":"Tunks E,\nBellissimo A. Coping with the coping concept: a brief comment. Pain. 1988;34(2):171\u2013174. doi:10.1016\/0304-3959(88)90162-5"},{"issue":"4","key":"i1938-162X-60-10-713-b16","series-title":"Sport Psychol","first-page":"372","article-title":"The relationship between coping, neurocognitive performance, and concussion symptoms in high school and collegiate athletes","volume":"27","author":"Covassin","year":"2013","unstructured":"Covassin T,\nCrutcher B,\nElbin RJ,\nBurkhart S,\nKontos A. The relationship between coping, neurocognitive performance, and concussion symptoms in high school and collegiate athletes. Sport Psychol. 2013;27(4):372\u2013379. doi:10.1123\/tsp.27.4.372"},{"issue":"4","key":"i1938-162X-60-10-713-b17","series-title":"Res Sports Med","first-page":"367","article-title":"A comparison of coping responses among high school and college athletes with concussion, orthopedic injuries, and healthy controls","volume":"21","author":"Kontos","year":"2013","unstructured":"Kontos AP,\nElbin RJ,\nAppaneal RN,\nCovassin T,\nCollins MW. A comparison of coping responses among high school and college athletes with concussion, orthopedic injuries, and healthy controls. Res Sports Med. 2013;21(4):367\u2013379. doi:10.1080\/15438627.2013.825801"},{"issue":"2\u20133","key":"i1938-162X-60-10-713-b18","series-title":"Leis Sci","first-page":"115","article-title":"Leisure, stress, and coping: the sport participation of collegiate student-athletes","volume":"25","author":"Kimball","year":"2003","unstructured":"Kimball A,\nFreysinger VJ. Leisure, stress, and coping: the sport participation of collegiate student-athletes. Leis Sci. 2003;25(2\u20133):115\u2013141. doi:10.1080\/01490400306569"},{"issue":"2","key":"i1938-162X-60-10-713-b19","series-title":"J Int Neuropsychol Soc","first-page":"317","article-title":"Coping strategies as a predictor of post-concussive symptoms in children with mild traumatic brain injury versus mild orthopedic injury","volume":"17","author":"Woodrome","year":"2011","unstructured":"Woodrome SE,\nYeates KO,\nTaylor HG, et al. Coping strategies as a predictor of post-concussive symptoms in children with mild traumatic brain injury versus mild orthopedic injury. J Int Neuropsychol Soc. 2011;17(2):317\u2013326. doi:10.1017\/S1355617710001700"},{"key":"i1938-162X-60-10-713-b20","series-title":"Front Pediatr","first-page":"57","article-title":"Return to learn: academic effects of concussion in high school and college student-athletes","volume":"8","author":"Holmes","year":"2020","unstructured":"Holmes A,\nChen Z,\nYahng L,\nFletcher D,\nKawata K. Return to learn: academic effects of concussion in high school and college student-athletes. Front Pediatr. 2020;8:57. doi:10.3389\/fped.2020.00057"},{"issue":"9","key":"i1938-162X-60-10-713-b21","series-title":"J Pediatr Orthop","first-page":"e844","article-title":"The use of psychological patient reported outcome measures to identify adolescent athletes at risk for prolonged recovery following an ACL reconstruction","volume":"40","author":"Ellis","year":"2020","unstructured":"Ellis HB,\nSabatino M,\nNwelue E,\nWagner KJ III,\nForce E,\nWilson P. The use of psychological patient reported outcome measures to identify adolescent athletes at risk for prolonged recovery following an ACL reconstruction. J Pediatr Orthop. 2020;40(9):e844\u2013e852. doi:10.1097\/BPO.0000000000001624"},{"issue":"4","key":"i1938-162X-60-10-713-b22","series-title":"J Sport Exerc Psychol","first-page":"379","article-title":"Development and validation of a multidimensional measure of sport-specific psychological skills: the Athletic Coping Skills Inventory-28","volume":"17","author":"Smith","year":"1995","unstructured":"Smith RE,\nSchutz RW,\nSmoll FL,\nPtacek JT. Development and validation of a multidimensional measure of sport-specific psychological skills: the Athletic Coping Skills Inventory-28. J Sport Exerc Psychol. 1995;17(4):379\u2013398. doi:10.1123\/jsep.17.4.379"},{"issue":"11","key":"i1938-162X-60-10-713-b23","series-title":"Br J Sports Med","first-page":"838","article-title":"Consensus statement on concussion in sport\u2014the 5th International Conference on Concussion in Sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","unstructured":"McCrory P,\nMeeuwisse W,\nDvo\u0159\u00e1k J, et al. Consensus statement on concussion in sport\u2014the 5th International Conference on Concussion in Sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838\u2013847. doi:10.1136\/bjsports-2017-097699"},{"issue":"11","key":"i1938-162X-60-10-713-b24","series-title":"Br J Sports Med","first-page":"848","article-title":"The Sport Concussion Assessment Tool 5th Edition (SCAT5): background and rationale","volume":"51","author":"Echemendia","year":"2017","unstructured":"Echemendia RJ,\nMeeuwisse W,\nMcCrory P, et al. The Sport Concussion Assessment Tool 5th Edition (SCAT5): background and rationale. Br J Sports Med. 2017;51(11):848\u2013850. doi:10.1136\/bjsports-2017-097506"},{"issue":"2","key":"i1938-162X-60-10-713-b25","series-title":"J Biomed Inform","first-page":"377","article-title":"Research Electronic Data Capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","unstructured":"Harris PA,\nTaylor R,\nThielke R,\nPayne J,\nGonzalez N,\nConde JG. Research Electronic Data Capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377\u2013381. doi:10.1016\/j.jbi.2008.08.010"},{"issue":"1","key":"i1938-162X-60-10-713-b26","series-title":"Educ Psychol Meas","first-page":"107","article-title":"Eta-squared and partial eta-squared in fixed factor ANOVA designs","volume":"33","author":"Cohen","year":"1973","unstructured":"Cohen J. Eta-squared and partial eta-squared in fixed factor ANOVA designs. Educ Psychol Meas. 1973;33(1):107\u2013112. doi:10.1177\/001316447303300111"},{"key":"i1938-162X-60-10-713-b27","series-title":"Front Neurol","first-page":"1136367","article-title":"A review of brain regions and associated post-concussion symptoms","volume":"14","author":"Danielli","year":"2023","unstructured":"Danielli E,\nSimard N,\nDeMatteo CA,\nKumbhare D,\nUlmer S,\nNoseworthy MD. A review of brain regions and associated post-concussion symptoms. Front Neurol. 2023;14:1136367. doi:10.3389\/fneur.2023.1136367"},{"issue":"12","key":"i1938-162X-60-10-713-b28","series-title":"Am J Sports Med","first-page":"3087","article-title":"Preliminary validation of an abbreviated acute concussion symptom checklist using item response theory","volume":"48","author":"Wilmoth","year":"2020","unstructured":"Wilmoth K,\nMagnus BE,\nMcCrea MA,\nNelson LD. Preliminary validation of an abbreviated acute concussion symptom checklist using item response theory. Am J Sports Med. 2020;48(12):3087\u20133093. doi:10.1177\/0363546520953440"},{"issue":"1","key":"i1938-162X-60-10-713-b29","series-title":"Br J Sports Med","first-page":"15","article-title":"American Medical Society for Sports Medicine position statement: concussion in sport","volume":"47","author":"Harmon","year":"2013","unstructured":"Harmon KG,\nDrezner JA,\nGammons M, et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013;47(1):15\u201326. doi:10.1136\/bjsports-2012-091941"},{"issue":"1","key":"i1938-162X-60-10-713-b30","series-title":"J Appl Sport Psychol","first-page":"46","article-title":"An integrated model of response to sport injury: psychological and sociological dynamics","volume":"10","author":"Wiese-Bjornstal","year":"1998","unstructured":"Wiese-Bjornstal DM,\nSmith AM,\nShaffer SM,\nMorrey MA. An integrated model of response to sport injury: psychological and sociological dynamics. J Appl Sport Psychol. 1998;10(1):46\u201369. doi:10.1080\/10413209808406377"},{"issue":"2","key":"i1938-162X-60-10-713-b31","series-title":"Clin J Sport Med","first-page":"63","article-title":"A longitudinal examination of athletes\u2019 emotional and cognitive responses to anterior cruciate ligament injury","volume":"9","author":"Morrey","year":"1999","unstructured":"Morrey MA,\nStuart MJ,\nSmith AM,\nWiese-Bjornstal DM. A longitudinal examination of athletes\u2019 emotional and cognitive responses to anterior cruciate ligament injury. Clin J Sport Med. 1999;9(2):63\u201369. doi:10.1097\/00042752-199904000-00004"}],"container-title":["Journal of Athletic Training"],"original-title":[],"link":[{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/60\/10\/article-p713.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jat\/article-pdf\/doi\/10.4085\/1062-6050-0467.24\/3516715\/10.4085_1062-6050-0467.24.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/60\/10\/article-p713.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/nata.kglmeridian.com\/downloadpdf\/journals\/attr\/60\/10\/article-p713.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:30:53Z","timestamp":1761265853000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/60\/10\/article-p713.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":31,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-0467.24","relation":{},"ISSN":["1938-162X","1062-6050"],"issn-type":[{"type":"electronic","value":"1938-162X"},{"type":"print","value":"1062-6050"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}