title: Consistency of Self-Reported Concussion History in Adolescent Athletes.
abstract: Relying on self-reported concussion injury history is common in both clinical care and research. However, young athletes may not provide consistent medical information. To date, little is known about the reliability of self-reported concussion history in high school students. This study examined whether student athletes reported their lifetime history of concussions consistently over time. Self-reported concussion history was examined in 4792 student athletes (ages 13-18) from Maine who completed a preseason health survey on two occasions (median re-test interval = 23.7 months; standard deviation = 7.3; interquartile range = 12.4-24.5). Consistency of self-reported concussion history was determined by differences in the number of concussions reported during the second survey. Inconsistent concussion history was defined primarily by a decrease in the number of lifetime concussions reported at the second testing, compared with at the first testing. The majority of the sample (80.3%) reported no change in the number of concussions between the two baseline assessments. A minority (15.9%; n = 763) reported more concussions during the second assessment. Only 3.8% (n = 181) of student athletes provided inconsistent concussion histories, defined as fewer concussions at the second assessment. Boys provided inconsistent concussion histories a little more frequently, compared with girls (5.3% and 2.0%, respectively; p < 0.001). Similarly, athletes with self-reported attention-deficit hyperactivity disorder (ADHD) provided inconsistent concussion histories somewhat more frequently, compared with those without ADHD (7.8% and 3.5%, respectively; p < 0.001). Of the athletes with inconsistent concussion histories, greater degree of inconsistency was associated with a greater number of concussions initially reported at baseline (rs= 0.54; p < 0.001). Only a small proportion of student athletes provided inconsistent concussion histories. Male gender, ADHD, and greater number of baseline concussions were significantly associated with inconsistency in reporting. Overall, these findings suggest that student athletes are quite consistent when reporting their concussion history when surveyed twice during high school.
authors.affiliation: 1 Department of Psychiatry, Harvard Medical School , Boston, Massachusetts.|2 Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts.|3 MassGeneral Hospital for Children Sports Concussion Program , Boston, Massachusetts.|4 Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wojtowicz
authors.affiliation: 2 Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts.|3 MassGeneral Hospital for Children Sports Concussion Program , Boston, Massachusetts.|4 Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts.|5 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital , Boston, Massachusetts.
authors.forename: Grant L
authors.initials: GL
authors.lastname: Iverson
authors.affiliation: 4 Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts.|5 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital , Boston, Massachusetts.|6 Division of Physical Medicine and Rehabilitation, University of British Columbia , Vancouver, British Columbia, Canada .|7 GF Strong Rehabilitation Centre , Vancouver, British Columbia, Canada .
authors.forename: Noah D
authors.initials: ND
authors.lastname: Silverberg
authors.affiliation: 8 Division of Emergency Medicine, Boston Children's Hospital , Boston, Massachusetts.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Mannix
authors.affiliation: 2 Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, Massachusetts.|3 MassGeneral Hospital for Children Sports Concussion Program , Boston, Massachusetts.|4 Red Sox Foundation and Massachusetts General Hospital Home Base Program , Boston, Massachusetts.|5 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital , Boston, Massachusetts.|9 Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital , Boston, Massachusetts.|10 Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.affiliation: 11 Department of Computer Science, Colby College , Waterville, Maine.
authors.forename: Bruce
authors.initials: B
authors.lastname: Maxwell
authors.affiliation: 12 Health Services, Colby College , Waterville, Maine.|13 Department of Biology, Colby College , Waterville, Maine.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Berkner
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000523:psychology; D001265:Athletic Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D001924:Brain Concussion / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008281:Maine / Q000453:epidemiology; D008297:Male; D057566:Self Report / Q000592:standards*
keywords: assessment tools; head trauma; pediatric brain injury