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Sport-Related Concussion Reporting and Coach-Athlete Attachment Among Collegiate Student-Athletes

Jeffrey J. Milroy, Stephen Hebard, Emily Kroshus, and David L. Wyrick

Between 2001 and 2015, 3.4 million traumatic brain injury (TBI) occurrences in the U.S. were accounted for by sport participation. It is estimated between 12% and 60% of athletes delay seeking care after sustaining a concussion. Differences in sport-related concussion (SRC) reporting have been attributed to several different factors. Whereas prior research related to SRC reporting behavior focus on normative and competitive pressures to continue play, less attention is given to the interpersonal context in which reporting takes place. Grounded in attachment theory, this study investigated relationships between coach-athlete attachment and help-seeking behavior. Findings suggest that as coach-athlete anxiousness increases, not reporting increases. and as coach-athlete secureness increases, not reporting decreases. Logistic regression analyses indicate that secure coach attachment significantly predicts greater likelihood of SRC reporting. These findings underscore the important role coach-athlete relationships may have on care-seeking behaviors of student-athletes and can inform individual and group interventions promoting SRC reporting.

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

Emily Kroshus, Sara P.D. Chrisman, Jeffrey J. Milroy, and Christine M. Baugh

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.