Concussion Exposure and Suicidal Ideation, Planning, and Attempts Among US High School Students

The article “Concussion Exposure and Suicidal Ideation Planning and Attempts Among US High School Students” by Jacob J. M. Kay and colleagues investigates the association between the frequency of self-reported concussions and nonfatal suicidal behaviors among youth, with a focus on the interaction of biological sex. This retrospective cross-sectional survey utilized data from the National Youth Risk Behavior Surveillance System, involving 28,442 United States secondary school students.

The study’s primary outcome measures were based on the frequency of sport- or recreation-related concussions reported in the previous 12 months (categorized as 0, 1, or 2 concussions), and outcomes related to feelings of sadness or hopelessness, and suicidal ideation, planning, and attempts. Covariates included age, sex, race and ethnicity, bullying victimization, sexual orientation, and physical activity.

Key findings include:

• Students who reported two concussions were significantly more likely to report suicidal attempts (adjusted odds ratio [AOR] = 2.03; 95% CI = 1.43, 2.88) compared with students reporting a single concussion during the past 12 months. This association was more pronounced in males, suggesting the increase from single to multiple concussions did not significantly affect the strength of associations among females.
• Adolescents with a history of concussion were at increased odds of reporting poor mental health and suicidal behaviors.
• An increased number of concussive events is associated with significantly greater odds of reporting suicidal attempts, particularly among males.

The study concludes that health care professionals should closely monitor the mental health of adolescents with repetitive concussions, especially those occurring in close temporal proximity, irrespective of the adolescent’s sex. This research adds to the growing body of literature on the link between concussion and suicidal behaviors among adolescents by examining how the frequency of concussions within a 12-month period relates to suicidality and highlights the importance of considering sex differences in these associations.

Kay, J. J. M., Harrison, A., Tavakoli, A. S., Torres-McGehee, T., Broglio, S. P., & Robert, D. M. (2023). Concussion exposure and suicidal ideation, planning, and attempts among US high school students. Journal of Athletic Training, 58(9), 751-758. doi:https://doi.org/10.4085/1062-6050-0117.22