To Tell or Not to Tell? Understanding Adult Sport-Related Concussion Reporting Behavior

Abstract

Concussion is a common sports-related injury, especially among adolescent and young-adults. Although most concussion symptoms resolve quickly, many people experience symptoms up to a year post-injury. Concussion leads to increased risk of future concussions and other injuries. Repeated concussion is associated with negative long-term outcomes (i.e., depression and dementia). To mitigate negative outcomes, it is crucial that athletes seek treatment, which requires awareness of concussion symptoms and risks. Efforts have been made to enhance sport safety and spread concussion education. However, underreporting of concussion remains a barrier to treatment and prevention. Research indicates that knowledge alone is not enough to motivate reporting, and there are many reasons that athletes may underreport symptoms. A key factor may be cultural norms among athletes (i.e., concussion attitudes, desire to play, dedication to team, and avoiding social repercussions). The aim of the current study was to investigate factors that may predict individual’s likelihood of reporting sport-related concussion symptoms. Concussion reporting behavior was assessed through hypothetical concussion scenarios with participants reporting how likely they would be to report symptoms in that situation. Participants were 256 adults from student and community populations. It was hypothesized that concussion attitudes, knowledge, athletic setting (i.e., access to a coach/trainer), personality traits, depression/anxiety symptoms, and health behavior would significantly predict likelihood of reporting concussion. The results partially supported these hypothesized relationships. Concussion attitudes, knowledge, current depressive symptoms, and trait agreeableness were each associated with concussion reporting. Overall, concussion attitudes remained the strongest predictor, suggesting that athletes who hold safer concussion attitudes are more likely to report symptoms. This study shed more light on the complex decision-making process that athletes engage in when experiencing concussion symptoms and further supports that knowledge alone is not the sole predictor. This can help guide interventions for athletes that go beyond concussion education alone. While concussion knowledge is important, public health efforts would benefit from targeting psychological factors (i.e., attitudes and depression).