A – 31 Attention-Deficit/Hyperactivity Disorder Network Comparison on the Post-Concussion Symptom Scale

Abstract Objective Studies suggest athletes with ADHD endorse more concussion symptoms than those without, but no studies have used network analysis to determine if symptom relationships also differ. This study examines differences between athletes with and without ADHD on Post-Concussion Symptom Scale (PCSS) item interactions using network analysis. Method High school athletes (n=1,638; 23% female; Mage=14.8 in each group) who completed the PCSS at baseline were included. Groups were matched on age, gender, and sport type. Network analysis was conducted on PCSS scores, where nodes represented items and edges represented partial correlations. Expected influence was calculated to determine symptom importance. Network comparison tests evaluated differences in structure, connectivity, and expected influence. Results Group comparisons indicated the ADHD group endorsed significantly more symptoms. Networks did not significantly differ between groups. The network edges for non-ADHD (M=0.036) and ADHD (M=0.039) groups were generally positive, suggesting that increased severity of one PCSS item was associated with increased severity of other items. Conclusion No significant differences were found between groups, suggesting differences in symptom endorsements do not coincide with differences in symptom interactions. Future research could explore community network analyses to determine if concussive cognitive symptoms cluster more strongly within the ADHD group, potentially revealing differences in symptom interactions not captured by current analyses.