Improving health outcomes for concussed athletes and others requires self-reporting symptoms; not reporting risks second-impact syndrome and death. However, concussions in adolescents and young adults are often underreported. We treat reporting as a risky decision, extending predictions of fuzzy-trace theory (FTT). We hypothesize that low SES indirectly interferes with the development of cognitive skills that reduce unhealthy risky decision making. Specifically, we expect that SES may be related to intentions to report a concussion because low SES delays development of cognitive gist processing that reduces risk-taking. Adolescents in high-school and young adults in college (n = 1211) answered questions about concussion knowledge, concussion attitudes, and cognitive scales based on FTT: categorical thinking and endorsement of gist principles about risk. Overall, for each of the two age groups, and for athletes as well as nonathletes, SES was associated with reporting intentions, and this association was mediated by the three psychological predictors we tested: gist processing, concussion knowledge, and concussion attitudes. Results are consistent with lower SES reducing opportunities for normative cognitive development, the latter characterized by developmental increases in gist processing about risk. Hence, consistent with hypotheses, gist processing, concussion knowledge, and healthier attitudes about concussions were each associated with greater intentions to report concussions. Although educational initiatives currently focus on rote knowledge and healthy attitudes, future interventions to reduce concussion underreporting could benefit from explaining the gist of risk, especially to low SES youth, adapting successful FTT-based risk-reduction curricula from other domains.

中文翻译：

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社会经济状况和脑震荡报告：要点处理、知识和态度的独特和中介作用

改善脑震荡运动员和其他人的健康结果需要自我报告症状；不报告二次影响综合征和死亡风险。然而，青少年和年轻人的脑震荡经常被低估。我们将报告视为一种冒险的决定，扩展了模糊跟踪理论 (FTT) 的预测。我们假设低 SES 会间接干扰认知技能的发展，从而减少不健康的风险决策。具体来说，我们预计 SES 可能与报告脑震荡的意图有关，因为低 SES 会延迟认知要点处理的发展，从而减少冒险。高中青少年和大学青年（n = 1211) 回答了有关基于 FTT 的脑震荡知识、脑震荡态度和认知量表的问题：分类思维和对风险要点的认可。总体而言，对于两个年龄组中的每一个，对于运动员和非运动员，SES 与报告意图相关，并且这种关联由我们测试的三个心理预测因素介导：要点处理、脑震荡知识和脑震荡态度。结果与较低的 SES 减少规范认知发展的机会一致，后者的特点是关于风险的要点处理的发展增加。因此，与假设一致，要点处理、脑震荡知识和对脑震荡的更健康态度都与报告脑震荡的更大意图相关。