Worrying about Concussions and Brain Health is Strongly Associated with Psychological Distress in Former Elite Rugby League Players

Objective Former collision sport athletes may worry and ruminate about their brain health, which might contribute to psychological distress. We hypothesized there would be a strong association between being very worried about this and current psychological distress. Method This cross-sectional study examined former elite/professional Australian rugby league players (n = 235; Mean age = 52.37) who completed the Depression, Anxiety, and Stress Scale-21 (DASS-21), Brief Pain Inventory, and Connor-Davidson Resilience Scale. On average, they played 8.65 years of rugby league professionally (SD = 4.68) and had 23.37 years of total lifetime rugby league participation (SD = 5.66). Results There were 29.8% who reported being very worried about the possible effects of past concussion(s) on their memory and thinking skills as they get older. There were 29.2% who reported moderate–severe depression, anxiety, or stress on the DASS-21. A logistic regression predicting moderate–severe psychological distress was significant (p < .001, Nagelkerke R2 = 0.37) and revealed that number of lifetime concussions (odds ratio [OR] = 1.01, 95% confidence interval [CI] = 1.00–1.03), lifetime history of depression (OR = 3.20, 95% CI = 1.44–7.14), lower resilience (OR = 0.96, 95% CI = 0.93–0.99), and being very worried about their concussion history (OR = 3.29, 95% CI = 1.49–7.23) were independent predictors. Total years of participation in rugby league, years of participation at the professional level, and life interference due to chronic pain were not associated with psychological distress in the regression analysis. Conclusion These results have implications for the psychological health and quality of life of former collision sport athletes. Providing a multimodal approach to treatment, including psychological interventions, prescribed exercise, and medications, might lead to considerable improvement in their psychological health and quality of life.