@article{ref1,
title="The Postconcussion Symptom Scale: utility of a three-factor structure",
journal="Medicine and science in sports and exercise",
year="2014",
author="Joyce, Aisha S. and Labella, Cynthia R. and Carl, Rebecca L. and Lai, Jin-Shei and Zelko, Frank A.",
volume="47",
number="6",
pages="1119-1123",
abstract="PURPOSE: To determine the factor structure of a 19-item Post-Concussion Symptom Scale (PCSS) and examine associations between factor scores and gender, previous history of concussion, and length of time since injury. <br><br>METHODS: Retrospective medical record review of pediatric patients with concussion seen in a sports medicine clinic from April 2008 to September 2012. We performed an exploratory factor analysis (EFA) followed by a confirmatory factor analysis (CFA). Analysis of variance (ANOVA) and regression analysis were used to examine associations between factor scores and gender, previous history of concussion, mood disorder, anxiety disorder or attention deficit disorder (ADD), and length of time since injury. <br><br>RESULTS: EFA supported a 3-factor solution for post-concussive symptoms employing 18 of the original 19 scale items. Factor 1 consisted of eight cognition-related items, factor 2 consisted of six somatic-related items, and factor 3 consisted of four emotional-related items. CFA results confirmed the unidimensionality of factors 1 (neurocognitive), 2 (somatic) and 3 (emotional), with factor 3 being considered borderline. Females and patients with anxiety disorders had significantly worse (higher) scores on all three factors. Patients seen more than 14 days following the concussive injury had worse (higher) factor 3 (emotional) scores than those seen fewer than 14 days after the injury. There was no significant difference in post-concussion symptom factor structures between those with and without a previous history of concussion. <br><br>CONCLUSION: Our investigation demonstrates a consistent symptom 3-factor structure of the PCSS in pediatric patients with concussions. Females and patients with anxiety disorders had higher scores than males for all 3 factors. Patients seen more than 14 days following concussive injury had higher scores for emotional symptoms, suggesting that prolonged concussion symptoms may affect emotional health.<p /> <p>Language: en</p>",
language="en",
issn="0195-9131",
doi="10.1249/MSS.0000000000000534",
url="http://dx.doi.org/10.1249/MSS.0000000000000534"
}