1. 9/12/2013
Traumatic brain injury and athletes: A Clinical Sport Psychological Perspective
Kendra Ogletree Cusaac, Ph.D.
Licensed Clinical Psychologist
Sport Psychologist
University of South Carolina

2. OBJECTIVES
To understand the context of sport, TBI, and its importance in sport
To understand the psychological, emotional, and cognitive consequences of TBI on athletes and sport environment
To understand the role of the clinical sport psychologist and other sport medicine personnel

3. NFL to spend $765M to settle concussion lawsuits
9/12/2013
NFL to spend $765M to settle concussion lawsuits

4. A little history…. “No evidence” of concussions’ impact 1990s
9/12/2013
A little history….
“No evidence” of concussions’ impact
1990s
New commissioner and increasing pressure
2006
Funding for research, major rule changes, new committee
2009

5. Sport CULTURE perspective
Expectations of athletes
How concussions are perceived
Which sports are most at risk?
Developmental issues

6. prevalence
The Centers for Disease Control and Prevention reported that 200,000 sports-related head injuries are treated in emergency departments annually within the United States and that sports related concussions accounts for approximately 20% of all TBIs per year.

7. Boxing #1 sport FOR Mtbi incidence
"Punch drunk" syndrome 1928
"dementia pugilistica"
1984
Chronic Traumatic Encephelopathy
(CTE)
2000s

8. PREVALENCE
A history of concussion among athletes varies by sport (from highest upper estimates to lowest):
Equestrian (3%-91%)
Boxing (1%-70%)
Rugby (2%-25%)
Soccer (4%-22%)
American football (2%-20%)

9. Developmental issues TBI: Athletes vs. Nonathletes
Concussions occur at all levels of play
Young athletes (under 18 years old) vs. older athletes (over 18 years old)
Male athletes vs. female athletes
NCAA
Multiple Concussions
Second Impact Syndrome
KROLL’S PERSONALITY PERFORMANCE PYRAMID
ELITE
OLYMPIC
NATIONAL
COLLEGIATE
SCHOLASTIC
ENTRANCE

10. Multiple concussions
Athletes who have previously sustained a concussion are more than two times likely to sustain a second concussion and may be more likely to experience a greater number and perceived severity of post concussive symptoms.

11. 9/12/2013
Effects of Tbi
360&locale=en_US&o=15527&chn=retail&ver=20&tpr=10
Jim McMahon 10 minutes

12. SIGNS OF TBI Signs are behaviors/events that are observable by others:
Loss of consciousness
A dazed or vacant look
Motor incoordination/balance problems
On-field confusion/disorientation

13. PSYCHOLOGICAL/EMOTIONAL
SYMPTOMS OF TBI
SOMATIC
COGNITIVE
PSYCHOLOGICAL/EMOTIONAL
SLEEP DISTURBANCE

14. Somatic symptoms OF TBI
Headache
Nausea/vomiting
Balance problems
Dizziness
Fuzzy/blurry vision
Low energy/fatigue
Light/noise sensitivity

15. COGNITIVE SYMPTOMS OF TBI
Memory Dysfunction
Attention Problems
Mental “fogginess”
Cognitive slowing
Fatigue

16. Psychological/EMOTIONAL SYMPTOMS OF TBI
More emotional
Sadness
Anxiety
Irritability
Negative/pessimistic attitude
Personality changes

17. Sleep and other disturbances
Difficulty falling asleep
Sleeping more/less than usual
Sexual disorders and problems
Loss of interest in sex
Relationship difficulties
Substance use and abuse

18. ATHLETES VS. NONATHLETES AND TBI
Motivation
Return to play pressures and desires
Underreporting of symptoms/symptom minimization

19. Assessment and management of tbi
Acute evaluation on the field
Sideline or locker room evaluation
Formal postacute neurocognitive assessment
Graded progression of physical exertion
Unrestricted return to play

20. Emotional sequelae of tbi in athletes
The research reports on short- term emotional distress following concussion reveal transient depression, feelings of fatigue and reduced energy levels, confusion, and overall mood disturbance.
Depression
Perceived Fatigue
Anxiety
Confusion

21. Psychologists’ responsibilities
To educate athletes, their families, coaches, physicians, athletic trainers, and policy makers to recognize and appropriately manage this complex injury. In doing so, we will more effectively enhance player safety and prevent disabling symptoms.

22. prevention Equipment New prototype helmets Rule changes
Penalties and fines
On the field evaluation
Return to play
Successive head trauma
Education: Athletes, Coaches, Parents

23. QUESTIONS???

24. Traumatic brain injury and athletes: A Clinical Sport Psychological Perspective
Kendra Ogletree Cusaac, Ph.D.
Licensed Clinical Psychologist
Sport Psychologist
University of South Carolina