Athletes' Knowledge and Perceptions of Sport Related Concussions and the Decision to Seek Treatment

The purpose of the study was to examine specific factors (namely knowledge, perceptions, and demographic characteristics including gender differences) that may influence an athlete's decision to report a sport related concussion (SRC). Participants were Division I and III soccer and lacrosse athletes (n: 618) who participated in an online assessment intended to evaluate knowledge of concussive symptoms and previous reporting behavior. Descriptive statistics were calculated to determine rates of reported (57.7%, 176/305) and unreported (42.3%, 129/305) concussions, as well as reasons why athletes failed to report SRCs. Athletes identified not wanting to be withheld from competition or practice (43.2%) and not thinking the injury was serious enough (40.6%) as the primary reasons for failing to report a prior SRC. Average scores on the concussion knowledge quiz were consistently high for athletes both with (90.2%) and without (87.4%) previous concussion history. Logistic regression analysis examined the main effects of the independent variables (knowledge, perceptions, and the demographic characteristics of gender, age, sport played, and division level of competition) on reporting behavior; specifically, which variables increased the prediction that an athlete would fail to report a SRC (p < .05). Significant variables that contributed to the model and the corresponding odds ratios (OR) that predicted failure to report SRC included: perceiving an expectation to play through or minimize injury in sport ('culture of risk') (OR : 2.12), an increase in age by one year (OR : 1.39), playing lacrosse (OR = 2.40), and competing at the Division III level (OR: 2.91). Chi-square tests revealed no significant overall association between the genders on failure to report a SRC, but posthoc analysis revealed that significantly more Division III male athletes failed to report concussions than females (X2 (1): 8.04, p < .01). Results from this study helps identify additional factors besides knowledge of SRC symptoms that may influence an athlete's decision to report SRC, specifically the previously uninvestigated influence of culture of risk and the potential influence of athletic identity. Results also expand the literature that currently debates whether male or female athletes sustain more SRC's (Dick, 2009). This information may help sports medicine professionals and sport psychology consultants target areas of intervention and education that can improve SRC management.