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The NCAA has published an article by a professor in the Department of Neurological Surgery and the Director of Neuropsychological Services and Research at the University of Washington Sports Concussion Program, which looks at the Psychological Aspects Of Sports Concussion

Author David B. Coppel, PhD, focuses on the emotional and psychological aspects of sports-related concussion (SRC), which “can emerge related to a student-athlete’s response to injury and/or their response to recovery.”

“The emotional symptoms that emerge from SRC can prolong recovery and often reflect  predisposing or premorbid factors,” he wrote. “These factors can include prior depression or anxiety disorders, traumatic stress history, prior head injuries or other neurological vulnerabilities, learning issues, hypervigilance or somatic focus, or personality characteristics or disorders (Silverberg & Iverson, 2011).  Psychological factors associated with prolonged or persistent post-concussive symptoms include ineffective and maladaptive coping styles, sleep disturbance often due to mental activation, anxiety and stress/rumination, nocebo effect (adverse effects created or maintained by  negative expectations (Hahn, 1997; Scudellari, 2013)) and other expectation effects, and family or social network/support problems. Since the primary tool in the medical management of SRC involves tracking symptoms over time, one must wonder if focusing on symptoms on a daily or regular basis produces hypervigilance to symptoms and can result in reinforced illness behavior and iatrogenic effects resulting in prolonged post-concussion symptoms.”


Hahn, R. (1997)  The Nocebo Phenomenon:  Concept, Evidence and Implications for Public Health.  Preventive Medicine, 26, 607-611.

Silverberg, N. & Iverson,G. (2011) Etiology of the post-concussion syndrome:  Physiogenesis and psychogenesis revisited.  NeuroRehabilitation, 29, 317-329.

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