Anxiety-Related Concussion Perceptions of Collegiate Athletes.

Beidler E, Eagle S, Wallace J, Anderson M, Schmitt A, Siobhan O, & Kontos A. Journal of Science and Medicine in Sports. 2021. doi: 10.1016/j.jsams.2021.06.011.

Take-Home Message

Many collegiate athletes have anxiety-related perceptions of concussions, especially females and people concerned about the long-term effects of concussions or who believe they have control over outcomes of concussions.


Concussions have become a global concern. This concern has lent itself to enhance awareness, education, identification, treatment, and prevention strategies. However, this greater attention on concussions may lead to anxiety among athletes about concussions, which can increase the risk of slower recovery from a concussion. There is an urgent need to understand the effects of both negative and positive emotions toward concussions to determine if we need to adapt educational strategies to raise awareness but avoid anxiety-related perceptions. 

Study Goal

Beidler and colleagues surveyed college athletes to identify anxiety-related concussion perceptions and the factors related to greater anxiety towards concussions.


The authors surveyed 482 (303 males) NCAA Division I, II, and III collegiate athletes between 18 and 26 years of age. They categorized athletes into high-concussion risk and low-concussion risk sports. Any participant that had sustained a concussion in the previous three- months, was currently being treated for a concussion, or had lingering symptoms of concussion was excluded. The authors gathered data on demographics, preferred concussion information sources, baseline concussion knowledge, medical history of concussion, and survey results from the Perceptions of Concussion Inventory for Athletes.


Overall, the authors discovered that collegiate athletes had moderate levels of anxiety-related perceptions regarding concussion. Three out of five collegiate athletes reported that the possibility of sustaining a concussion was upsetting. Furthermore, about half of the athletes reported they were worried about concussions. Key factors related to anxiety-related perceptions of a concussion were being female, greater perception of control over concussion outcomes, and a greater belief that concussions have long-term effects.


The authors of this cross-sectional study identified that many athletes have anxiety-related views of concussions that may be influenced by the athlete being female, the athlete’s perception of internal control over their recovery, and the athlete’s belief of the long-term consequences of concussions. The authors suggest that these findings should inform the development of education and management strategies to help mitigate the presence of anxiety. This is especially applicable during the initial phases of concussion when reducing someone’s anxiety could positively affect their recovery. The authors recommended educating athletes 1) on the effects of continued sport participation while concussed, 2) that concussions are treatable, and 3) that most people do not experience long-term adverse outcomes if diagnosed early and properly managed. Future researchers should examine the paradoxical findings surrounding the relationship between perception of control and anxiety and verify these findings in other populations (e.g., high school athletes).   

Clinical Implications

Clinicians should acknowledge that anxiety towards concussions is common. This anxiety may be influenced by sex, perception of control, and perception of long-term consequences. We need evidence-based concussion education addressing how to best reduce the risk of long-term consequences by early diagnosis of concussion and deployment of evidence-based treatment plans. This education could mitigate the prevalence of anxiety amongst collegiate athletes and thereby reduce the number of people with delayed concussion recovery.

Questions for Discussion

How would these findings change your perspective on the importance of concussion education requirements for athletic organizations? What are your thoughts on emotional wellness training for athletes?  How would you use this information in your practice? 

Related Posts

  1. It’s Not the Number of Head Impacts but the Intensity
  2. Females Not Only Have Increased Risk of Concussions But More Severe Concussions
  3. Selected Issues in Sport-Related Concussions (SRC | Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement

Written By: Jeremy Howard
Reviewed by: Jeffrey Driban

Evidence-Based Assessment of Concussion Course - 5 EBP CEUs