Pilots and athletes: Different concerns, similar concussion non-disclosure

Abstract

Objectives Concussion non-disclosure research has focused almost exclusively on athletes. The focus on athletic populations has been sensible considering athletes’ demonstrated susceptibility to sustaining and concealing concussions. Nevertheless, the habitual use of athletic populations has allowed researchers and practitioners to omit the development of generalized perceived costs and perceived rewards as critical determinants of concussion self-disclosure. We hypothesized that perceiving concussion disclosure as generally more costly than rewarding would predict negative attitudes towards disclosure and decreased intent to disclose. We also hypothesized that generalized perceived costs and rewards could explain concussion non-disclosure in different populations, athletes and future pilots specifically, even when those populations perceive concussion self-disclosure as costly for different specific reasons. Methods We examined concussion disclosure using 2,504 cadets at the United States Air Force Academy. Cadets completed anonymous surveys assessing their intention to self-disclose undiagnosed concussions ( Anticipated Concussion Disclosure ) as well as several variables potentially related to concussion self-disclosure: perceived cost, perceived reward, personal identity, attitudes, normative behavior, social support, and self-efficacy. Results The results demonstrate that concussion non-disclosure develops when a population perceives disclosure as more costly (i.e. directly or emotionally) and less rewarding. Perceived Cost and Perceived Reward variables alone accounted for 50% of the variance in Anticipated Conclusion Disclosure ( Adjusted R 2 = 0.50, F (2,2312) = 1,145.31, p < 0.001). As expected, Anticipated Conclusion Disclosure developed for different reasons within different sub-populations. Consistent with existing research, cadet intercollegiate athletes reported being primarily concerned that concussion self-disclosure would cause them to miss practice or game time ( t (736.7) = 14.20, p < .001, Cohen’s d = 0.96). In contrast, cadet future pilots reported being primarily concerned that concussion self-disclosure would have negative United States Air Force career repercussions ( t (1828) = 10.25, p < .001, Cohen’s d = 0.50). Conclusions These results suggest that cultures of concussion non-disclosure can develop in any population where disclosure is perceived as having undesirable consequences, not just athletic populations. Concussion researchers and practitioners should devote more attention...

Concussion-Recovery Trajectories Among Tactical Athletes: Results From the CARE Consortium

“…A cadet with a previous concussion may have increased concussion knowledge that alters his or her disclosure behavior. For example, Foster et al 27 found that US Air Force cadets were concerned that having a concussion would prohibit them from becoming pilots. Thus, because concussions are perceived to influence military placement, disclosure was also a concern among cadets.…”

A social dilemma model of information self-disclosure, applied to the concussion domain

“…A study involving United States Air Force Academy cadets provides a nice example. 17 Women reported greater willingness to self-disclose concussions than did men. A subsequent analysis revealed that this gender effect occurred because a greater portion of men intended to become pilots, and these future pilots were concerned that disclosure could influence their careers.…”

“…A subsequent analysis revealed that this gender effect occurred because a greater portion of men intended to become pilots, and these future pilots were concerned that disclosure could influence their careers. 17 In other words, there was a gender effect, but it was rooted in the perceived direct costs associated with wanting to become pilots.…”

Developing a Comprehensive, Interdisciplinary Concussion Program

“…Perceptions of the negative consequences of injury disclosure are targets for future studies and public health initiatives. 42 Similarly, prevention, across the spectrum, is insufficient. 43 With attention focused on building comprehensive concussion programs, such as the CCM, education, outreach, and research will continue to further promote concussion awareness and management.…”