Examination of Subjective and Objective Cognitive Impairment Discrepancies in Sports-Related Concussion of Elite Athletes

  • Author / Creator
    Schultz, Hanna
  • Assessments of sports-related concussion (SRC) include tests of athletes’ cognitive performance and self-reports of perceived cognitive impairment. Both anecdotal and empirical evidence have shown occurrences of discrepancies between athletes’ subjective and objective indicators of cognitive impairment (SCI and OCI), which can pose challenges to clinical decisions of SRC diagnosis, management, treatment, and return-to-play (RTP) clearances. This dissertation is an examination of the relationship between SCI and OCI, an assessment of change in SCI and OCI scores between baseline and post-SRC assessments, and an examination of factors that may be associated with cognitive impairment discrepancies demonstrated in SRC assessments. Forty Canadian elite (i.e., collegiate and professional) football players concussed during the 2017 or 2018 seasons completed baseline and post-SRC assessments of cognitive functioning through objective testing (SAC and ImPACT) and subjective self-reports (S3SE), as well as a measure of psychological distress (BSI-18). Results from the study demonstrated overall high consistency between SCI and OCI; however, only post-injury S3SE endorsements of memory difficulties and/or confusion and ImPACT verbal memory scores were significantly related. From the cases of cognitive impairment discrepancies, higher post-injury psychological distress scores predicted SCI detection, whereas prior concussion history decreased the likelihood of SCI detection. Additionally, SCI, prior concussion history, psychological distress, and other personal factors did not predict OCI. Altogether, these findings suggest affective factors may play a more significant role to athletes’ perceived postconcussive dysfunction than cognitive factors. This interpretation implies considerations of including more measures and targets of intervention focused on psychological distress to address and treat SRC outcomes.

  • Subjects / Keywords
  • Graduation date
    Fall 2022
  • Type of Item
  • Degree
    Doctor of Philosophy
  • DOI
  • License
    This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.