title: Norms, athletic identity, and concussion symptom under-reporting among male collegiate ice hockey players: a prospective cohort study.
abstract: BACKGROUND
  Many athletes fail to report concussion symptoms to coaches or medical personnel, putting them at risk for potentially catastrophic neurologic consequences if additional brain trauma is sustained prior to full recovery.
  
  
  OBJECTIVE
  The purpose of this study was to determine whether concussion reporting norms prior to the start of the athletic season predicted reporting symptoms of a possible concussion during the season, and whether this association was moderated by athletic identity.
  
  
  METHODS
  Members of six National Collegiate Athletic Association Division 1 men's ice hockey teams (n = 116) completed written surveys before and after the 2012-2013 collegiate ice hockey season.
  
  
  RESULTS
  Participants who at pre-season perceived that "most athletes" were likely to report symptoms of a concussion were themselves more likely to report symptoms during the season. Athletic identity weakly moderated this association.
  
  
  CONCLUSIONS
  Perceived reporting norms may be an important target of interventions aimed at reducing symptom under-reporting among athletes.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA, emk329@mail.harvard.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Kroshus
authors.forename: Laura D
authors.initials: LD
authors.lastname: Kubzansky
authors.forename: Roberta E
authors.initials: RE
authors.lastname: Goldman
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D056352:Athletes / Q000523:psychology*; D001924:Brain Concussion / Q000175:diagnosis*; D007722:Health Knowledge, Attitudes, Practice; D006688:Hockey; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012933:Social Identification; D066262:Social Norms; D063189:Symptom Assessment; D055815:Young Adult