A Behavior Analytic Interpretation of Concussion Reporting in Athletes: How the Field of Behavior Analysis Can Help Make Athletes Safer.

Concussion resulting from athletic activities is a frequent occurrence in youth, collegiate, and professional sports. The first step in concussion treatment is usually the self-reporting of concussion symptoms by athletes. Unfortunately, over the past decade, concussion nondisclosure has remained a prominent concern in concussion identification. This review begins with a summary of the prominent theories being used to explain the deficit in concussion reporting (ie, lack of concussion knowledge, negative attitudes toward reporting, and socioecological models). Unfortunately, current literature indicates that these theories may not often lead to effective treatments for reporting behavior. We then present an alternative model of concussion reporting, one based on the theories of behavior analysis. The deficit in concussion reporting by athletes may be explained in a comprehensive yet parsimonious way through the behavior analytic principles of differential reinforcement and punishment. We also discuss directions for potential intervention strategies based on behavioral theory.