Prediction of Anxiety and Depression Using Preconcussion Screening Assessments in Collegiate Athletes

Accurate identification of anxiety and depression in collegiate athletes is critical to timely intervention. Baseline concussion testing, such as the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), may provide a unique, practical avenue for screening mental health concerns. The objective of this study was to determine whether the symptom cluster scores from ImPACT can predict anxiety and depression in collegiate athletes. 560 athletes (43.7% female; 16% ADHD) completed baseline assessments preseason. Symptom clusters (e.g., affective) were derived from ImPACT and compared with scores on the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Hierarchical regression analyses examined whether ImPACT clusters and demographic factors could predict anxiety and depression. Gender and ADHD explained a small but significant portion of the variance in depression (R ² change = 0.040, p < 0.001), cognitive clusters (R ² change = 0.018, p < 0.001), and affective clusters (R ² change = 0.259, p < 0.001). In the prediction of anxiety, the affective cluster was again the strongest predictor, contributing to a substantial increase in explained variance (R ² change = 0.257, p < 0.001), followed by demographic factors, sex, and ADHD, which explained a smaller portion of the variance (R ² change = 0.035, p < 0.001). ImPACT concussion symptom clusters appear to be a useful tool for preemptive screening of anxiety and depression in collegiate athletes. Including this utility in existing concussion protocols, which ubiquitously use ImPACT, may facilitate earlier identification of at-risk individuals for a more targeted intervention to support student-athletes' psychological well-being.