Faculty Collaboration Database

The underreporting of self-reported symptoms following sports-related concussion. J Sci Med Sport 2015 Sep;18(5):507-11

Date

08/26/2014

Pubmed ID

25150463

DOI

10.1016/j.jsams.2014.07.008

Scopus ID

2-s2.0-84938747610 (requires institutional sign-in at Scopus site)   154 Citations

Abstract

OBJECTIVES: This cohort study was conducted to examine patterns of symptom reporting in concussed athletes in two different testing environments.

DESIGN: A prospective cohort study was conducted with repeated measures.

METHODS: Self-reported symptoms collected by team athletic trainers using the ImPACT Post-Concussion Scale (PCS) were compared to symptoms collected in a confidential setting using structured interviews for depression and anxiety. Ratings were scaled to match scoring of the PCS and categorized into symptom-domains. Scores collected 2 days post-concussion were compared across different rating scales. Confidential self-report scores approximately 9 days post-concussion in cleared athletes were compared to PCS scores collected during return-to-play decisions. Finally, confidential self-report scores collected 9 days post-concussion were compared between cleared and not cleared athletes.

RESULTS: Athletes self-reported significantly fewer symptoms to team athletic trainers using the ImPACT test compared to self-reported symptoms collected in a confidential setting during the acute phase of concussion using standard psychiatric interviews. Athletes cleared to play continued to underreport symptoms 9 days post-concussion, particularly psychiatric symptoms. Finally, cleared athletes self-reported similar magnitude of symptoms than non-cleared athletes 9 days post-concussion in confidential research setting.

CONCLUSIONS: The systematic underreporting of post-concussion symptoms may represent motivated behavior or differences in self-reporting data acquisition. By underreporting symptoms, many cleared athletes are still symptomatic over 1-week post-concussion. This study highlights the need for objective measures for somatic and psychiatric symptoms.

Author List

Meier TB, Brummel BJ, Singh R, Nerio CJ, Polanski DW, Bellgowan PS

Author

Timothy B. Meier PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Analysis of Variance
Anxiety
Athletic Injuries
Brain Concussion
Depression
Female
Humans
Male
Neuropsychological Tests
Prospective Studies
Return to Sport
Self Report
Young Adult