The effects of level and duration of play on cognition, mood and behavior among former football players
Bourlas, Alexandra P.
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Interest in the short and long-term effects of concussions has drastically increased due to the recent high-profile deaths of former National Football League (NFL) players. However, research on this subject, especially at the youth level, has moved at a much slower rate. Second Impact Syndrome (SIS), Postconcussive Syndrome (PCS) and Chronic Traumatic Encephalopathy (CTE) are three major consequences that have the potential to negatively affect athletes participating in contact sports immediately or years after their athletic careers are over. The goal of this study is to examine whether the level of first exposure and/or duration of exposure has an effect on a player’s cognition, mood and behavior years after his football career is complete. I hypothesized that the age of onset of exposure to football would have a significant effect on cognition, mood and behavior later in life, and that those who started playing football prior to high school would self-report more problems in all three domains compared to those who started playing in high school when matched for the total number of years played. In order to test my hypotheses, analysis was completed on n=154 cases, all of whom played football at some level. Results showed that age of onset of exposure to football did have a significant effect on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) assessment, specifically the Global Executive Composite (GEC) (p = .018), Behavioral Regulation Index (BRI) (p = .014) scores and three of the nine clinical subscales (Inhibit [p = .025], Shift [p = .015] and Self-Monitor [p = .048]). Age of onset of exposure to football was also found significant for the mood and behavior assessment scores, the Apathy Evaluation Scale (AES) (p = .024) and Center for Epidemiological Studies Depression Scale CES-D (p = .011). No significant difference in assessment scores was found for level of onset of exposure when matched by number of years of football played. BRIEF-A GEC, BRI and MI raw scores were significantly different than published normative data for each age group, except the 70-79 and 80-90 year olds, both of which had very small sample sizes. Significant differences in all BRIEF-A index scores and all nine clinical subscores were found for the 40-49, 50-59 and 60-69 age groups. Finding significant differences in these age groups is somewhat unsurprising, given that CTE symptoms tend to begin decades after the end of exposure. Also consistent with this idea, the 30-39 years old age group showed a significant difference with the normative data in six of the nine clinical subscales, while the 18-29 years old age group showed a significant difference in three of the nine subscales. Longitudinal studies will need to be conducted to validate these findings and further understand the relationship between level of onset of play and long-term deleterious effects as a result of repetitive brain trauma (RBT).
Thesis (M.A.)--Boston University