Perceptions of Concussion and Associated Anxiety in Irish Collegiate Athletes

Abstract

Background: Concussion nondisclosure and poor management after a concussion are a concern in Irish collegiate sports. How athletes perceive concussions and appraise their own concussion may affect their decisions and behaviors after a suspected concussion. However, this has yet to be examined in an Irish context. This study aimed to (1) establish concussion perceptions and associated anxiety in Irish collegiate athletes; (2) examine how sex, concussion, and mood disorder history influenced their perceptions; and (3) investigate factors associated with higher anxiety perceptions. Hypothesis: Irish collegiate athletes will display negative concussion perceptions and anxiety related to concussion, especially in female athletes and those without a concussion history. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Irish collegiate athletes [n = 268 (141 women,127 men), mean age = 21.5 ± 2.2 years] from high-risk sports completed a survey including the Perceptions of Concussion Inventory for Athletes (PCI-A), demographics, diagnosed concussion history, self-reported mood disorder history, and a concussion knowledge assessment. Differences in concussion perceptions by sex, concussion history, mood disorder history were examined using Mann-Whitney U tests, and factors associated with anxiety-related concussion perceptions were identified using multivariate logistic regression. Results: Over half (53.0%, n = 142) of participants reported concerns regarding concussion. The thoughts of sustaining a concussion made participants feel upset (63.4%, n = 170), fearful (47.7%, n = 128), and anxious (35.1%, n = 94). Women reported significantly higher anxiety ( P < 0.01, r = 0.23), effects ( P = 0.04, r = 0.12), and clarity ( P = 0.01, r = 0.16) perception scores. Participants with a diagnosed concussion history displayed greater symptom variability perception scores ( P = 0.04, r = 0.12), but lower anxiety ( P = 0.03, r = 0.13) and treatment ( P < 0.01, r = 0.19) beliefs on the PCI-A. No differences were observed for those with a history of a mood disorder ( P > 0.05). A significant multivariate model was established (χ2 = 55.44, P < 0.01), with female sex [odds ratio (OR) = 1.53], concussion history (OR = 0.63), effects (OR = 1.31), and treatment (OR = 1.15) subscales associated with greater anxiety. Conclusion: Concerns about sustaining a concussion are prevalent in Irish collegiate athletes. Women displayed more negative perceptions and those with a concussion history displayed fewer perceived benefits of treatment. Clinical Relevance: The findings support the need for concussion awareness campaigns to provide accurate concussion information to mitigate anxiety-related concussion perceptions and injury belief misconceptions.

Hazardous Times

“…Taking concussion as an example, a review by O’Connor et al 3 in this issue of Sports Health documents the concerns that Irish collegiate athletes have about concussion even before sustaining that injury. Women displayed more negative perceptions, and those who had already experienced a concussion downplayed the benefits of treatment, suggesting a loss of confidence in their medical care.…”