Context: Recent researchers have reported that athletes' knowledge of sport-related concussion (SRC) has increased but that athletes still lack knowledge of all the signs and symptoms of SRC. Understanding the signs and symptoms of SRC and the dangers of playing while symptomatic are critical to reporting behaviors in high school athletes.Objective: To examine sex differences in knowledge of SRC symptoms and reasons for not reporting a suspected SRC to an authoritative figure in high school athletes.Design: Cross-sectional study. 2%]).Main Outcome Measure(s): A validated knowledge-of-SRC survey consisted of demographic questions, a list of 21 signs and symptoms of SRC, and reasons why athletes would not report their SRC. The independent variable was sex. Athlete knowledge of SRC symptoms was assessed by having participants identify the signs and symptoms of SRC from a list of 21 symptoms. Knowledge scores were calculated by summing the number of correct answers; scores ranged from 0 to 21, with a score closer to 21 representing greater knowledge. Reporting-behavior questions asked athletes to choose reasons why they decided not to report any possible SRC signs and symptoms to an authoritative figure.Results: A sex difference in total SRC symptom knowledge was found (F 286 ¼ 4.97, P ¼ .03, d ¼ 0.26). Female high school athletes had more total SRC symptom knowledge (mean 6 standard deviation ¼ 15.06 6 2.63; 95% confidence interval ¼ 14.54, 15.57) than males (14.36 6 2.76; 95% confidence interval ¼ 13.97, 14.74). Chi-square tests identified significant relationships between sex and 8 different reasons for not reporting an SRC.Conclusions: High school males and females had similar SRC symptom knowledge; however, female athletes were more likely to report their concussive symptoms to an authoritative figure.Key Words: mild traumatic brain injuries, secondary school, sport culture Key PointsHigh school males and females had similar concussion knowledge, but females were more likely to use that knowledge to report a sport-related concussion. Males were 4 to 11 times more likely than females to not report a sport-related concussion for reasons focused on the reactions and perceptions of others. Large percentages of male and female athletes did not report a sport-related concussion because they did not think it was serious. Theory-based interventions are warranted to overcome the stigmas associated with the male sport culture.

Context:  Previous literature on sport-related concussion (SRC) knowledge and reporting behaviors has been limited to high school and National Collegiate Athletic Association collegiate athletes; however, knowledge regarding collegiate club-sport athletes is limited. Objective:  To determine the level of SRC knowledge and reporting behaviors among collegiate club-sport athletes and to investigate differences between athletes in traditional and nontraditional sports. Design:  Cross-sectional study. Setting:  Survey. Patients or Other Participants:  A total of 410 athletes (247 males, 163 females) involved in traditional (n = 244) or nontraditional (n = 165) collegiate club sports. Main Outcome Measure(s):  The survey consisted of demographics, recognition of SRC signs and symptoms, general SRC knowledge, and reasons why athletes would not report SRCs. The independent variable was sport type. Sport-related concussion signs and symptoms and general knowledge were assessed by the frequency of correct answers to SRC signs and symptoms and general knowledge questions. Sport-related concussion-reporting behavior frequencies were evaluated by asking participants to indicate reasons why they did not or would not report an SRC. Results:  The SRC signs and symptoms knowledge score was 23.01 ± 3.19 and general SRC knowledge score was 36.49 ± 4.16 (maximal score = 43). No differences were present for SRC signs and symptoms knowledge (F1,408 = 1.99, P = .16) or general SRC knowledge (F1,408 = 3.28, P = .07) between athletes in traditional and nontraditional collegiate club sports. The most common reason for not reporting an SRC was not recognizing it as a serious injury (n = 165, 40.3%). Chi-square tests demonstrated significant relationships between sport type and 5 reasons for not reporting an SRC. Conclusions:  The participants displayed moderate to high levels of knowledge of SRCs but indicated they had failed to or would fail to report SRCs for a variety of reasons. The lack of sports medicine coverage and disconnect between knowledge and injury recognition may make collegiate club-sport athletes more likely to participate while concussed.

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Objective: The ability of athletes in underserved communities to recognise sport-related concussion (SRC) may be complicated by the lack of a qualified professional, such as an athletic trainer, present. An active learning educational activity (Concussion Bingo) was developed to assist in SRC identification. This study examined learning outcomes following the use of this activity by athletes in two US Title I (low socioeconomic status) high schools. Design: Cross-sectional study. Setting: High school sports. Methods: Participants ( n = 102 athletes) completed 10-minute SRC knowledge of concussion surveys before and after participating in a Concussion Bingo activity. The 45-question survey assessed SRC knowledge through questions about SRC signs/symptoms, general injury information relating to loss of consciousness, the injured anatomical structure, complications of multiple SRCs and premature return to play. Participants had to mark key SRC terms on a Bingo card as they appeared throughout an SRC presentation including content from published consensus/position statements. Descriptive and parametric statistics were used to analyse the data. Results: Analysis of covariance revealed significant differences between pre- and post-Concussion Bingo scores. Athletes had the greatest knowledge increase of fogginess ( n = 30, 29.5%), mood changes ( n = 29, 28.5%), nausea ( n = 27; 26.5%) and sleep problems ( n = 27, 29.5%). On questions pertaining to the injury itself, athletes had the greatest increase on ‘you have to be hit in the head to get a concussion’ ( n = 51, 50%), ‘what kind of an injury is a concussion’ ( n = 31, 40.2%) and a concussion only occurs if you ‘black out’ ( n = 24, 23.4%). Conclusion: Concussion Bingo increased Title I high school athletes’ knowledge of SRCs, suggesting that it may be an effective active learning tool for increasing SRC knowledge.

The physical effects of sport-related concussion (SRC) on the health and well-being of youth and collegiate athletes have been well documented. However, the psychological aspects of SRC in youth and collegiate athletes continue to be largely unknown due to scant research on the subject matter. The majority of studies to date that have examined psychological consequences of injury have done so with those involving the musculoskeletal system, revealing consequential findings. The following review paper provides a synthesis of the literature examining the psychological consequences and effects of SRC in youth athletes, while also discussing future research areas. This paper will review psychological issues such as mood disturbance, anxiety, depression, suicide, and negative coping behaviors that could be detrimental to an athletes' sport participation. In addition, social support and malingering will also be examined for their influence on motivation and recovery from SRC, including the psychological factors that may emerge from the injury.