History of Concussion Diagnosis, Differences in Concussion Reporting Behavior, and Self-Described Reasons for Non-Report

in Journal of Clinical Sport Psychology
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Purpose: Assess whether athletes with a prior concussion diagnosis are more likely to continue play with a possible concussion. Additionally, explore whether reasons for concussion under-reporting are different among athletes with a prior concussion when compared to other athletes. Methods: Cross-sectional survey of 328 collegiate athletes. Results: Athletes with a prior concussion diagnosis had significantly greater relative risk of continuing play while symptomatic of a possible concussion during their most recent season compared to athletes without prior concussion diagnosis. Significant differences exist in the reasons that athletes provided for not reporting by history of concussion. Conclusions: Findings suggest that learning may have occurred as a result of the prior diagnosis; however, this learning did not appear to result in safer reporting behavior. Additional research is necessary to clarify why athletes who have been previously diagnosed with a concussion are more likely to continue playing while experiencing concussion symptoms.

Kroshus and Chrisman are with the Dept. of Pediatrics, Seattle Children’s Research Institute, Center for Child Health, Behavior and Development, Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA. Milroy is with the Dept. of Public Health Education, Institute to Promote Athlete Health & Wellness, University of North Carolina Greensboro, Greensboro, NC. Baugh is with the Division of Sports Medicine, Interfaculty Initiative in Health Policy, Boston Children’s Hospital, Harvard University, Cambridge, MA.

Address author correspondence to Jeffrey J. Milroy at jjmilroy@uncg.edu.
Journal of Clinical Sport Psychology
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References
  • AskenB.M.BauerR.M. & GuskiewiczK.M. (2018). Immediate removal from activity after sport-related concussion is associated with shorter clinical recovery and less severe symptoms in collegiate student-athletes. The American Journal of Sports Medicine 46(6) 14651474. PubMed ID: 29558195 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BanduraA. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, Inc.

  • BaughC.M.KroshusE.DaneshvarD.H. & SternR.A. (2014). Perceived coach support and concussion symptom-reporting: Differences between freshmen and non-freshmen college football players. The Journal of Law Medicine & Ethics 42(3) 314322. PubMed ID: 25264089 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • BellJ.M.TaylorC.A. & BreidingM.J. (2015). The public health approach to TBI. Journal of Head Trauma Rehabilitation 30(3) 148149. PubMed ID: 25955701 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ChrismanS.P.QuitiquitC. & RivaraF.P. (2013). Qualitative study of barriers to concussive symptom reporting in high school athletics. Journal of Adolescent Health 52(3) 330335.e3. PubMed ID: 23427783 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • DaviesS.C. & BirdB.M. (2015). Motivations for underreporting suspected concussion in college athletics. Journal of Clinical Sport Psychology 9(2) 101115. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • DelaneyJ.S.LamfookonC.BloomG.A.Al-KashmiriA. & CorreaJ.A. (2015). Why university athletes choose not to reveal their concussion symptoms during a practice or game. Clinical Journal of Sports Medicine 25(2) 113125. PubMed ID: 24949831 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • EcknerJ.T.KutcherJ.S.BroglioS.P. & RishardsonJ.K. (2014). Effect of sport-related concussion on clinically measured simple reaction time. British Journal of Sports Medicine 48(2) 112118. PubMed ID: 23314889 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • FidanE.LewisJ.KlineA.E.GarmanR.H.AlexanderH.ChengJ.P.BayırH. (2016). Repetitive mild traumatic brain injury in the developing brain: Effects on long-term functional outcome and neuropathology. Journal of Neurotrauma 33(7) 641651. PubMed ID: 26214116 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • FignerB.MackinlayR.J.WilkeningF. & WeberE.U. (2009). Affective and deliberative processes in risky choice: Age differences in risk taking in the Columbia Card Task. Journal of Experimental Psychology: Learning Memory and Cognition 35(3) 709730. PubMed ID: 19379045 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • FraasM.R.CoughlanG.F.HartE.C. & McCarthyC. (2014). Concussion history and reporting rates in elite Irish rugby union players. Physical Therapy in Sport 15(3) 136142. PubMed ID: 24035483 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • GerrardM.GibbonsF.X.HoulihanA.E.StockM.L. & PomeryE.A. (2008). A dual-process approach to health risk decision making: The prototype willingness model. Developmental Review 28(1) 2961. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • GulliverA.GriffithsK.M. & ChristensenH. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry 10(1) 113. PubMed ID: 21192795 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • GulliverA.GriffithsK.M. & ChristensenH. (2012). Barriers and facilitators to mental health help-seeking for young elite athletes: A qualitative study. BMC Psychiatry 12(1) 157. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • HealesL.J.LimE.C.W.HodgesP.W.VicenzinoB. Sport Concussion Assessment Tool—3rd edition, SCAT-3. (2013). British Journal of Sports Medicine 47259262. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KerrZ.Y.Register-MihalikJ.K.KroshusE.BaughC.M. & MarshallS.W. (2016). Motivations associated with non-disclosure of recalled concussions in former collegiate athletes. American Journal of Sports Medicine 44(1) 220225. PubMed ID: 26582799 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.BaughC.M.DaneshvarD.H. & ViswanathK. (2014). Understanding concussion reporting using a model based on the theory of planned behavior. Journal of Adolescent Health 54(3) 269274.e2. PubMed ID: 24560034 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.BaughC.M.SteinC.J.AustinS.B.CalzoJ.P. (2017). Concussion reporting, sex, and conformity to traditional gender norms in young adults. Journal of Adolescence 54110119.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.DaneshvarD.H.BaughC.M.NowinskiC.J. & CantuR.C. (2014). NCAA concussion education in ice hockey: An ineffective mandate. British Journal of Sports Medicine 48(2) 135140. PubMed ID: 23956336 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.GarnettB.R.BaughC.M. & CalzoJ.P. (2015a). Engaging teammates in the promotion of concussion help seeking. Health Education and Behavior 43(4) 442451. PubMed ID: 27405801 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.GarnettB.R.BaughC.M. & CalzoJ.P. (2015b). Social norms theory and concussion education. Health Education Research 30(6) 10041013. PubMed ID: 26471918 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KroshusE.GarnettB.HawrilenkoM.BaughC.M. & CalzoJ.P. (2015). Concussion under-reporting and pressure from coaches, teammates, fans, and parents. Social Science & Medicine 1346675. PubMed ID: 25917137 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • KundaZ. (1990). The case for motivated reasoning. Psychological Bulletin 108(3) 480498. PubMed ID: 2270237 doi:

  • LlewellynT.BurdetteG.T.JoynerA.B. & BuckleyT.A. (2014). Concussion reporting rates at the conclusion of an intercollegiate athletic career. Clinical Journal of Sports Medicine 24(1) 7679. PubMed ID: 24157468 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McCroryP.MeeuwisseW.H.AubryM.CantuB.DvorˇákJ.EchemendiaR.J.TurnerM. (2012). Consensus statement on concussion in sport: The 4th International Conference on Concussion in Sport held in Zurich, November 2012. British Journal of Sports Medicine 47(5) 250258. PubMed ID: 23479479 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MeehanW.P.IIIMannixR.C.O’BrienM.J. & CollinsM.W. (2013). The prevalence of undiagnosed concussions in athletes. Clinical Journal of Sports Medicine 23(5) 339342. PubMed ID: 23727697 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • MrazikM.DennisonC.R.BrooksB.L.YeatesK.O.BabulS. & NaiduD. (2015). A qualitative review of sports concussion education: Prime time for evidence-based knowledge translation. British Journal of Sports Medicine 49(24) 15481553. PubMed ID: 26307498 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • National Collegiate Athletic Association. (2013). 2013–2014 NCAA sports sponsorship and participate rates report. Retrieved from http://www.ncaapublications.com/p-4368-2013-14-ncaa-sports-sponsorship-and-participation-rates-report.aspx?CategoryID=0&SectionID=0&ManufacturerID=0&DistributorID=0&GenreID=0&VectorID=0&

    • Search Google Scholar
    • Export Citation
  • National Collegiate Athletic Association. (2015). 2014–2015 NCAA sports medicine handbook. Retrieved from https://www.ncaapublications.com/p-4374-2014-15-ncaa-sports-medicine-handbook.aspx

    • Search Google Scholar
    • Export Citation
  • National Federation of High School Sports. (2013). 2013–2014 High school athletics participation survey. Retrieved from http://www.nfhs.org/ParticipationStatics/PDF/2013-14_Participation_Survey_PDF.pdf

    • Search Google Scholar
    • Export Citation
  • OuelletteJ.A. & WoodW. (1998). Habit and intention in everyday life: The multiple processes by which past behavior predicts future behavior. Psychological Bulletin 124(1) 5474. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • PrinsM.L.AlexanderD.GizaC.C. & HovdaD.A. (2013). Repeated mild traumatic brain injury: Mechanisms of cerebral vulnerability. Journal of Neurotrauma 30(1) 3038. PubMed ID: 23025820 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Register-MihalikJ.K.GuskiewiczK.M.McLeodT.C.LinnanL.A.MuellerF.O. & MarshallS.W. (2013). Knowledge, attitude, and concussion-reporting behaviors among high school athletes: A preliminary study. Journal of Athletic Training 48(5) 645653. PubMed ID: 23848520 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • ReynaV.F. & FarleyF. (2006). Risk and rationality in adolescent decision making implications for theory, practice, and public policy. Psychological Science in the Public Interest 7(1) 144. PubMed ID: 26158695 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • StataCorp. (2017). Statastatistical software: release 12. College Station, TX: StataCorp LLC.

  • TorresD.M.GalettaK.M.PhillipsH.W.DziemianowiczE.M.WilsonJ.A.DormanE.S.BalcerL.J. (2013). Sports-related concussion anonymous survey of a collegiate cohort. Neurology: Clinical Practice 3279287. PubMed ID: 24195017doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • VogelD.L.Heimerdinger-EdwardsS.R.HammerJ.H. & HubbardA. (2011). “Boys don’t cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counselling Psychology 58(3) 368382. PubMed ID: 21639615 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
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