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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

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Gender differences in concussion-related knowledge, attitudes and reporting-behaviours among high school student-athletes

Lindsay Sullivan
  • Corresponding author
  • Health Promotion Research Centre, National University of Ireland Galway, School of Health Sciences, Galway, Ireland, Phone: +353 85 8147150
  • School of Health Sciences, National University of Ireland Galway, Discipline of Health Promotion, Galway, Ireland
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Michal Molcho
  • Social Sciences and Celtic Studies, National University of Ireland Galway, College of Arts, Galway, Ireland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-10-24 | DOI: https://doi.org/10.1515/ijamh-2018-0031



Sport-related concussion is associated with various short- and long-term health consequences, especially among adolescent athletes. Yet, many concussions go unreported and/or unrecognised. The purpose of this study was to assess high school athletes’ concussion-related knowledge, attitudes, intentions and reporting behaviours, and to explore whether gender differences are evident.


A total of 435 high school athletes (52.2% female; mean age, 14.55 ± 1.67 years) participated in the survey. Questions assessed athletes’ knowledge, attitudes, reporting intention and reporting behaviours, in respect to sports-related concussion. Comparisons between male and female athletes were explored using Mann-Whitney tests and chi-squared (χ2) tests as appropriate.


We found that 60% of the participants stated that they have played in practice or during a game (this season) with concussion symptoms. Males expressed more negative outcomes of concussion reporting and lower concussion reporting intention, compared to females. We found no significant gender differences in concussion-reporting behaviours.


Our findings suggest that knowledge, favourable attitudes towards reporting and reporting intention alone are not enough to create an environment that encourages the disclosure of concussion symptoms. Health promotion communication campaigns, coupled with concussion education and awareness programmes, should be utilised to further highlight the importance of timely concussion management, and to create a culture in which the reporting of concussion is considered normative.

Keywords: adolescence; concussion; gender; Ireland; sports


  • [1]

    Thurman DJ, Branche CM, Sniezek JE. The epidemiology of sports-related traumatic brain injuries in the United States: recent developments. J Head Trauma Rehabil. 1998;13(2):1–8.CrossrefPubMedGoogle Scholar

  • [2]

    Bryan MA, Rowhani-Rahbar A, Comstock RD, Rivara F. Sports-and recreation-related concussions in US youth. Pediatrics. 2016;138(1):e20154635.Web of SciencePubMedGoogle Scholar

  • [3]

    McCrory P, Meeuwisse W, Dvorak J, Aubry M, Bailes J, Broglio S, Consensus statement on concussion in sport – the 5th International Conference on Concussion in Sport held in Berlin, October 2016. Br J Sports Med. 2017;0:1–10.Web of ScienceGoogle Scholar

  • [4]

    Kerr ZY, Register-Mihalik JK, Marshall SW, Evenson KR, Mihalik JP, Guskiewicz KM. Disclosure and non-disclosure of concussion and concussion symptoms in athletes: review and application of the socio-ecological framework. Brain Inj. 2014;28(8):1009–21.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [5]

    Guskiewicz KM, McCrea M, Marshall SW, Cantu RC, Randolph C, Barr W, et al. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003;290(19):2549–55.CrossrefPubMedGoogle Scholar

  • [6]

    Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Cantu RC, Randolph C, et al. Association between recurrent concussion and late-life cognitive impairment in retired professional football players. Neurosurgery. 2005;57(4):719–26.PubMedCrossrefGoogle Scholar

  • [7]

    Guskiewicz KM, Marshall SW, Bailes J, McCrea M, Harding HP, Matthews A, et al. Recurrent concussion and risk of depression in retired professional football players. Med Sci Sports Exerc. 2007;39(6):903.Web of SciencePubMedCrossrefGoogle Scholar

  • [8]

    Kerr ZY, Marshall SW, Harding Jr HP, Guskiewicz KM. Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players. Am J Sports Med. 2012;40(10):2206–12.CrossrefWeb of SciencePubMedGoogle Scholar

  • [9]

    LaRoche AA, Nelson LD, Connelly PK, Walter KD, McCrea MA. Sport-related concussion reporting and state legislative effects. Clin J Sport Med. 2016;26(1):33.Web of SciencePubMedCrossrefGoogle Scholar

  • [10]

    McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sports Med. 2004;14(1):13–7.CrossrefGoogle Scholar

  • [11]

    Meehan III WP, Mannix RC, O’brien MJ, Collins MW. The prevalence of undiagnosed concussions in athletes. Clin J Sports Med. 2013;23(5):339.CrossrefGoogle Scholar

  • [12]

    Register-Mihalik JK, Guskiewicz KM, McLeod TC, Linnan LA, Mueller FO, Marshall SW. Knowledge, attitude, and concussion-reporting behaviors among high school athletes: a preliminary study. J Athl Train. 2013;48(5):645–53.Web of ScienceCrossrefPubMedGoogle Scholar

  • [13]

    Chrisman SP, Quitiquit C, Rivara FP. Qualitative study of barriers to concussive symptom reporting in high school athletics. J Adolesc Health. 2013;52(3):330–5.CrossrefWeb of SciencePubMedGoogle Scholar

  • [14]

    Bramley H, Patrick K, Lehman E, Silvis M. High school soccer players with concussion education are more likely to notify their coach of a suspected concussion. Clin Pediatr. 2012;51(4):332–6.Web of ScienceCrossrefGoogle Scholar

  • [15]

    Kaut KP, DePompei R, Kerr J, Congeni J. Reports of head injury and symptom knowledge among college athletes: implications for assessment and educational intervention. Clin J Sport Med. 2003;13(4):213–21.CrossrefPubMedGoogle Scholar

  • [16]

    Sye G, Sullivan SJ, McCrory P. High school rugby players’ understanding of concussion and return to play guidelines. Br J Sports Med. 2006;40(12):1003–5.CrossrefPubMedGoogle Scholar

  • [17]

    Bagley AF, Daneshvar DH, Schanker BD, Zurakowski D, d’Hemecourt CA, Nowinski CJ, et al. Effectiveness of the SLICE program for youth concussion education. Clin J Sport Med. 2012;22(5):385–9.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [18]

    Kroshus E, Baugh CM, Stein CJ, Austin SB, Calzo JP. Concussion reporting, sex, and conformity to traditional gender norms in young adults. J Adolesc. 2017;54:110–9.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [19]

    Kurowski B, Pomerantz WJ, Schaiper C, Gittelman MA. Factors that influence concussion knowledge and self-reported attitudes in high school athletes. J Trauma Acute Care Surg. 2014;77(3 Suppl 1):S12.Web of ScienceCrossrefPubMedGoogle Scholar

  • [20]

    Miyashita TL, Diakogeorgiou E, Hellstrom B, Kuchwara N, Tafoya E, Young L. High school Athletes’ perceptions of concussion. Orthop J Sports Med. 2014;2(11):1–5.Google Scholar

  • [21]

    Sanderson J, Weathers M, Snedaker K, Gramlich K. “I was able to still do my job on the field and keep playing”: an investigation of female and male athletes’ experiences with (not) reporting concussions. Commun Sports. 2017;5(3):267–87.CrossrefGoogle Scholar

  • [22]

    Roe M, Blake C, Gissane C, Collins K. Injury scheme claims in Gaelic games: a review of 2007–2014. J Athl Train. 2016;51(4):303–8.Web of ScienceCrossrefGoogle Scholar

  • [23]

    Blake C, O’Malley E, Gissane C, Murphy JC. Epidemiology of injuries in hurling: a prospective study 2007–2011. BMJ Open. 2014;4(6):e005059.PubMedWeb of ScienceGoogle Scholar

  • [24]

    Murphy JC, O’Malley E, Gissane C, Blake C. Incidence of injury in Gaelic football: a 4-year prospective study. Am J Sports Med. 2012;40(9):2113–20.Web of SciencePubMedCrossrefGoogle Scholar

  • [25]

    Sullivan L, Thomas AA, Molcho M. An evaluation of Gaelic Athletic Association (GAA) athletes’ self-reported practice of playing while concussed, knowledge about and attitudes towards sports-related concussion. Int J Adolesc Med Health. 2016;29(3): 20150084.PubMedGoogle Scholar

  • [26]

    Williamson IJ, Goodman D. Converging evidence for the under-reporting of concussions in youth ice hockey. Br J Sports Med. 2006;40(2):128–32.CrossrefPubMedGoogle Scholar

  • [27]

    Rosenbaum AM, Arnett PA. The development of a survey to examine knowledge about and attitudes toward concussion in high-school students. J Clin Exp Neuropsychol. 2010;32(1):44–55.Web of ScienceCrossrefPubMedGoogle Scholar

  • [28]

    Kroshus E, Baugh CM, Daneshvar DH, Viswanath K. Understanding concussion reporting using a model based on the theory of planned behavior. J Adolesc Health. 2014;54(3):269–74.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [29]

    Kelly JP, Rosenberg JH. The development of guidelines for the management of concussion in sports. J Head Trauma Rehabil. 1998;13(2):53–65.PubMedCrossrefGoogle Scholar

  • [30]

    Dick RW. Is there a gender difference in concussion incidence and outcomes? Br J Sports Med. 2009;43(Suppl 1):i46–50.CrossrefWeb of ScienceGoogle Scholar

  • [31]

    Chiang Colvin A, Mullen J, Lovell MR, Vereeke West R, Collins MW, Groh M. The role of concussion history and gender in recovery from soccer-related concussion. Am J Sports Med. 2009;37(9):1699–704.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [32]

    Baker JG, Leddy JJ, Darling SR, Shucard J, Makdissi M, Willer BS. Gender differences in recovery from sports-related concussion in adolescents. Clin Pediatr. 2016;55(8):771–5.Web of ScienceCrossrefGoogle Scholar

  • [33]

    Stone S, Lee B, Garrison JC, Blueitt D, Creed K. Sex differences in time to return-to-play progression after sport-related concussion. Sports Health. 2017;9(1):41–4.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [34]

    Broglio SP, Vagnozzi R, Sabin M, Signoretti S, Tavazzi B, Lazzarino G. Concussion occurrence and knowledge in Italian football (soccer). J Sports Sci Med. 2010;9(3):418.PubMedGoogle Scholar

  • [35]

    Covassin T, Elbin RJ. The female athlete: the role of gender in the assessment and management of sport-related concussion. Clin Sports Med. 2011;30(1):125–31.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [36]

    Granito VJ. Psychological aspects of athletic injury: themes and gender differences. Diss Abstr Int Sect B: Sci Eng. 2000;61:530.Google Scholar

  • [37]

    Sackett PR, Larson JR. Research strategies and tactics in industrial and organizational psychology. In Handbook of industrial and organizational psychology. Palo Alto, CA, USA: Consulting Psychologists Press, 1990; pp. 419–489.Google Scholar

About the article

Received: 2018-01-31

Accepted: 2018-05-27

Published Online: 2018-10-24

Funding Source: Government of Ireland Postgraduate Scholarship Scheme

Award identifier / Grant number: GOIPG/2014/914

This work was supported by the Government of Ireland Postgraduate Scholarship Scheme [Grant number GOIPG/2014/914, Funder Id: 10.13039/501100002081].

Competing interests: We declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Contributions: LS and MM contributed to the formulation of the idea. LS acquired the data. LS and MM contributed to analysis and interpretation of data. LS and MM contributed to the drafting and revision of the manuscript, and approved the final version.

Citation Information: International Journal of Adolescent Medicine and Health, 20180031, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2018-0031.

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