Relationship between
concussion history and concussion knowledge, attitudes, and disclosure behavior
in high school athletes

JK, Valovich McLeod TC, Linnan LA, Guskiewicz KM, Marshal SW. Clin J Sport Med. 2017; 27(3):321-324

Take Home Message: More targeted concussion
education for high school athletes with a history of concussion is needed. Athletes
with more prior concussions, especially negative experiences, are less likely
to disclose symptoms, more likely to play with symptoms, and have poorer attitudes
regarding concussion reporting.

disclosures of concussions and associated attitudes is an issue among high
school athletes, especially when an athlete had a previous negative experience.
Healthcare professionals rely on athletes to be truthful when self-reporting
symptoms so that an athlete can be evaluated or held from competition or
practice until symptom resolution. Unfortunately, an athlete with a prior diagnosed
concussion who experienced no negative impact to themselves, may not appreciate
the value of concussion self-reporting in future incidents; however, there is
little research to confirm if this is occurring. Hence, the researchers
expanded on
their prior investigation
to assess the connection between self-reported concussion history and
disclosure, knowledge, and attitudes of high school athletes. A convenience
sample of athletes from 25 high schools in six sports (167 athletes) filled out
a survey regarding demographics, previous concussion events, self-reporting of
concussions, and attitudes and knowledge of concussions during their high
school years. Among 44 athletes with at least one recalled concussion, less
than half of the 84 recalled concussions were reported to professionals. Furthermore,
32% of those athletes with unreported concussions participated in competition
and 26% participated in a formal practice while symptomatic. Athletes with a prior
concussion were less likely to disclose subsequent concussions and more likely
to continue sport participation while symptomatic. For every three recalled
concussions, the researchers found a decrease in overall attitude towards
concussions. They found no relationship between recalled concussions and
concussion knowledge.

withhold information about their concussion symptoms for a variety of reasons
that may include a previous negative experience (such as lost playing time);
societal behaviors and negative attitudes from parents, coaches or teammates;
or a lack of knowledge about the potential consequences of reporting their
concussion. Interestingly, the researchers do not believe disclosure can be
improved via concussion knowledge, probably because these athletes already have
sufficient information from previous concussion events. Instead efforts should
be targeted to changing attitudes toward concussions. The researchers admit
that the study failed to account for concussions sustained prior to high school
and the athletes surveyed were predominately football athletes. Regardless,
clinicians can still use these results across all high school athletes and the
information can be extrapolated to other sports and age-groups. Clinicians
should be mindful of their patient’s knowledge and attitudes pertaining to
their concussion history and should focus on the underlying factors or
attitudes behind an athlete’s failure to disclose symptoms. Building a good
relationship with parents, coaches, and athletes will improve trust and guide
efforts for education and improving attitudes toward reporting.
Questions for Discussion: Have you noticed concussion perception and reporting improved with
education? What methods do you use to increase self-reporting
of concussion signs and symptoms?

by: Catherine E. Lewis
by: Jeffrey Driban

Related Posts:

Register-Mihalik, J., Valovich McLeod, T., Linnan, L., Guskiewicz, K., & Marshall, S. (2017). Relationship Between Concussion History and Concussion Knowledge, Attitudes, and Disclosure Behavior in High School Athletes Clinical Journal of Sport Medicine, 27 (3), 321-324 DOI: 10.1097/JSM.0000000000000349