Date of Award


Document Type

Doctoral Research Paper

Degree Name


Organizational Unit

Graduate School of Professional Psychology

First Advisor

Kimberly Gorgens

Second Advisor

Marybeth Lehto

Third Advisor

Laura Meyer

Fourth Advisor

Ann-Charlotte Granholm-Bentley


Baseline concussion symptom scores, Athlete sex, Gender, Sport contact level, ImPACT PCSS, Preseason assessment


Introduction: The use of baseline or preseason cognitive testing, including symptom endorsement, to quantify post-injury changes, is a practice supported by most major sports associations. In the absence of baseline data, normative data are used for this purpose and research suggests that those data often fail to accurately represent some groups of athletes, particularly non-concussed female athletes in all sports. In clinical practice, inaccurate normative scores can mask or exaggerate post-injury changes which can result in mismanaged athlete care and inaccurate return-to-play decisions. This study examines differences in baseline symptom scores between male and female athletes in different types of sports and makes comparisons to the extant literature on score differences in the normative dataset. Method: This study used retrospective baseline Post-Concussion Symptom Score data from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The sample included NCAA collegiate athletes over the age of 18 without a history of concussion (n=119). A novel multi-level modeling approach was used to examine the relationship between an athlete’s sex, contact-level of the sport played, and their baseline concussion symptom scores. Covariates identified in previous research were included to assess their effect on the baseline total symptom score. Results: A history of psychiatric treatment was found to have a significant effect on baseline total symptom score. There were no significant differences between sexes in the severity of symptoms reported at baseline. A significant negative correlation was found between sport contact level and affective symptoms. There was no statistically significant difference by sex within each level of sport contact. Conclusions: The current findings diverge from the normative data and suggest instead that an athlete’s sex is unrelated to baseline symptom score reporting. Here, only athletes in contact sports were significantly different and reported fewer mood symptoms.

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