Survey of NCAA Student Athletes’ Valuation of Experienced Symptoms: A Missing Link Between Concussion Symptomology and Reporting Behavior

It is estimated that more than 3.8 million sport-related concussions occur annually in the United States, with potentially up to 43% of these unreported and untreated. The purpose of this study was to determine whether any particular sub-group of NCAA athletes is more at-risk to underreport symptoms, events deemed less-severe than concussions, or suspected concussions. We further aimed to assess reasons for not reporting suspected concussive events following a head impact. Student-athletes from 127 NCAA institutions completed an online survey to assess the influence of race, gender, socioeconomic factors, NCAA division, and sport category on the reporting of “sub-concussive” and concussive events, as well as the concussion symptoms they had experienced in sport. The survey also included questions designed to gauge student-athletes’ general knowledge of and attitudes about concussions, and to determine any discrepancies between ideal and actual behavior when faced with hypothetical situations involving concussionlike symptoms. Results indicated that collision sport athletes and those competing at the Division II level were particularly at-risk for not reporting symptoms and potential concussive events. Furthermore, student-athletes who listed higher symptom severity to indicate concussion also reported fewer self-defined “sub-concussive events”, highlighting a missing link in understanding reporting behavior.