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Despite suggestions that emotions influence recovery from injury, there is little research into the emotional sequelae of mild traumatic brain injury (MTBI), or “concussion,” in sport. This examination compares emotional functioning of college athletes with MTBI to that of uninjured teammates and undergraduates. A short version of the Profile of Mood States (POMS; Grove & Prapavessis, 1992) assessed baseline emotions in all groups, and serial emotional functioning in the MTBI and undergraduate groups. Whereas preinjury profiles were similar across groups, the MTBI group showed a significant postinjury spike in depression, confusion, and total mood disturbance that was not seen for the other groups. The elevated mood disturbances subsided within 3 weeks postinjury. Given that concussed athletes were highly motivated to return to play, these data could be used as a benchmark of normal emotional recovery from MTBI. Findings are discussed in relation to current literature on emotional reaction to injury and directions for future research.

This article reviews the essential components of a practical, evidenced-based approach to the management of sport-related concussion in an ambulatory care setting. The model presented is based on the core philosophy that concussion assessment and management be approached from the biopsychosocial perspective, which recognizes the medical/physiological, psychological, and sociological factors that influence recovery and outcome following concussion. Based on the biopsychosocial paradigm, we outline a care delivery model that emphasizes an interdisciplinary approach in which the clinical neuropsychologist is a key participant. We discuss the importance of nonmedical, psychoeducational interventions introduced during the acute phase to facilitate recovery after sport-related concussion. Finally, using the local experience of our “Concussion Clinic” as a backdrop, we offer two separate case studies that demonstrate the value of this model in evaluating and managing athletes after sport-related concussion. The overall objective of this paper is to provide an adaptable template that neuropsychologists and other healthcare providers can use to improve the overall care of athletes with sport-related concussion and civilians with mild traumatic brain injury.

Sport concussion has been thrust into the national spotlight with growing concern over both the acute and chronic risk for injury. While much has been learned and applied to medical practice in the previous decade, how the injury may affect individuals years later remains largely unknown. The opaqueness of the unknown has led some to ask if certain sports should be banned. Without immediate answers, what is currently known must be extrapolated and the risks and benefits of sport participation must be balanced.

Along with the ever growing awareness among the scientific community and the general public that concussion is a serious health care issue at all levels of sport, with potentially devastating long term health effects, the number of concussion surveillance clinical monitoring programs has significantly increased internationally over the past 10–15 years. An effective concussion program (a “best practice” model) is clinically prudent and evidence-based, one that is an interdisciplinary model involving health professionals who manage, educate, and provide psychosocial support to athletes. The integration of neuropsychological assessment is a component of many present day programs, and therefore, the neuropsychologist is an integral member of the concussion management team. The University of Toronto Concussion Program, operational since 1999, integrates best practices and current evidence into a working model of concussion management for university athletes. The model uses an interdisciplinary approach to monitor and assess athletes with concussions, as well as to educate its athletes, coaches, and administrators. A research component is also integral to the program.

Depression, fatigue, irritability, confusion, and general mood disturbance are frequently reported after cerebral concussion in sport. Recent trends in research point to the importance of examining postconcussive emotional disturbances more thoroughly, empirically, and clinically. An overview of the complexity of human emotion and its study is provided herein, followed by a review of emotional correlates identified in the existing sparse literature. The significance and clinical implications of identifying emotional correlates of concussion in sport and athletics are discussed.

Knowledge and awareness of sport concussion has been forwarded by research modeled on the neuropsychological testing paradigm associated with Barth’s “sport as laboratory” assessment model. The purpose of this paper is to elucidate lessons learned from that research. Key considerations for planning and implementing large-scale studies of concussion in sport while making adequate provision for the clinical needs of concussed athletes are reviewed. Toward that end, logistical, methodological, and ethical considerations are discussed within the context of research conducted in a university setting. Topics addressed include culture of sport and risk; research planning and design; communication with strategic partners; defining injury; choosing a test battery; data management, outcomes, and analyses; dissemination of results; and finally, clinical and ethical implications that may arise during the research enterprise. The paper concludes with a summary of the main lessons learned and directions for future research.

Concussions resulting from sports and recreational activities are a significant concern in the pediatric population. The number of children and adolescents sustaining sport-related concussions is increasing and, as a result, legislation has been passed in all 50 states to ensure appropriate recognition and referral of pediatric athletes following concussion. The developing brain may make the diagnosis, assessment, and management of concussion more challenging for health care providers and requires the use of specific age-appropriate assessment tools. Concussion management must also include considerations for cognitive and physical rest, a collaborative concussion management team that includes medical and school personnel, and more conservative stepwise progressions for returning to school and to physical activity.

The psychology of sport concussions consists of psychological, psychiatric, and psychosocial factors that contribute to sport concussion risks, consequences, and outcomes. The purpose of this paper is to present a sport concussion-adapted version of the integrated model of psychological response to sport injury and rehabilitation (Wiese-Bjornstal, Smith, Shaffer, & Morrey, 1998) as a framework for understanding the roles of psychological, psychiatric, and psychosocial factors in sport concussions. Elements of this model include preinjury psychological risk factors, postinjury psychological response and rehabilitation processes, and postinjury psychological care components. Mapped onto each element of this model are findings from the research literature through a narrative review process. An important caveat is that the subjective nature of concussion diagnoses presents limitations in these findings. Future research should examine psychological contributors to concussion risk, influences of physical factors on psychological symptoms and responses, and efficacy of psychological treatments utilizing theory-driven approaches.