Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Master of Science (MS)

Document Type

Master's Thesis


Arts and Sciences



First Advisor

Dr. Justin E. Karr


Following sport-related concussions, a multidimensional symptom interpretation may identify athletes with domain-specific problems when beginning to return-to-play (RTP). This study investigated whether a four-factor model of post-concussion symptoms (i.e., cognitive, physical, affective, and sleep-arousal) would identify student-athletes with persistent concerns not reflected by their total symptom score. Collegiate student-athletes (N=24,696) from the Concussion Assessment Research and Education consortium completed the Sport Concussion Assessment Tool – 3rd edition Symptom Evaluation at baseline and two post-injury follow-ups (i.e., beginning RTP and 6-month). Confirmatory factor analysis was used to compare one- and four-factor models of post-concussions symptoms. Normative reference data were compared across stratifications (e.g., sex and number of pre-existing health conditions) using Mann-Whitney U tests, and elevation rates (i.e., ≥84th percentile) for subscales and the total score were recorded. The four-factor model fit well before and after injury (CFIs>.95). Greater symptom severity on the subscale and total scores was associated with female sex (psps

Digital Object Identifier (DOI)

Funding Information

This study was supported by the University of Kentucky's Lyman T. Johnson Fellowship in 2021, in addition to the University of Kentucky's UNited in True racial Equity Predoctoral Fellowship in 2022.

Available for download on Sunday, December 01, 2024