The influence of injury cause, contact-sport participation, and personal knowledge on expectation of outcome from mild traumatic brain injury

Abstract

Objective: This study investigated the influence of injury cause, contact-sport participation, and prior knowledge of mild traumatic brain injury (mTBI) on injury beliefs and chronic symptom expectations of mTBI. Method: A total of 185 non-contact-sport players (non-CSPs) and 59 contact-sport players (CSPs) with no history of mTBI were randomly allocated to one of two conditions in which they read either a vignette depicting a sport-related mTBI (mTBI_sport) or a motor-vehicle-accident-related mTBI (mTBI_MVA). The vignettes were otherwise standardized to convey the same injury parameters (e.g., duration of loss of consciousness). After reading a vignette, participants reported their injury beliefs (i.e., perceptions of injury undesirability, chronicity, and consequences) and their expectations of chronic postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms. Results: Non-CSPs held significantly more negative beliefs and expected greater PTSD symptomatology and greater PCS affective symptomatology from an mTBI_MVA vignette thann mTBI_sport vignette, but this difference was not found for CSPs. Unlike CSPs, non-CSPs who personally knew someone who had sustained an mTBI expected significantly less PCS symptomatology than those who did not. Despite these different results for non-CSPs and CSPs, overall, contact-sport participation did not significantly affect injury beliefs and symptom expectations from an mTBI_sport. Conclusions: Expectations of persistent problems after an mTBI are influenced by factors such as injury cause even when injury parameters are held constant. Personal knowledge of mTBI, but not contact sport participation, may account for some variability in mTBI beliefs and expectations. These factors require consideration when assessing mTBI outcome.

Keywords:

• Concussion
• Mild traumatic brain injury
• Expectation
• Postconcussion syndrome
• Athlete

Declarations of interest

The authors report no declarations of interest.

Notes

¹ The original scale used “over the past month” as its timeframe.

² To assess effort, three instructional manipulation checks (e.g., please select “not at all” as your answer for this question) were interspersed throughout the survey as per Oppenheimer, Meyvis, and Davidenko (2009). Participants were excluded if their responses indicated that they were not reading instructions—specifically, if they failed two or more of the instructional manipulation checks.

³ Participants were excluded if (a) they stated that they did not understand study instructions; (b) their open-text response indicated that they misunderstood the study instructions (e.g., reported expected acute symptoms); (c) they failed two or more of the vignette comprehension questions; or (d) they indicated that they did not respond to the symptom items “in character.”

⁴ There were no differences to the statistical significance of our results when data were analyzed before and after imputation, with the exception of a small number of comparisons that are acknowledged in the table where the data are presented.

⁵ When parametric assumptions were breached, a nonparametric equivalent test was reported. However, parametric tests were also conducted. No differences in the significance of the results were noted when parametric tests were used, with the exception of a small number of comparisons that are acknowledged in the table where the data are presented.

⁶ Note: Italics indicate where changes were made from the original mTBI_MVA vignette to manipulate injury cause.