Structural Validity of a Self-Report Concussion-Related Symptom Scale


Medicine & Science in Sports & Exercise: January 2006 - Volume 38 - Issue 1 - pp 27-32
Clinical Sciences: Clinically Relevant

Purpose: This study evaluated the factorial validity of a self-report measure of concussion-related symptom severity among a large sample of male, high-school athletes.

Methods: Participants (N = 1089) were nonconcussed, male, high-school football players. All participants completed a single baseline self-report measure of concussion-related symptom severity, namely the graded symptom checklist (GSC). We tested the factorial validity of the measure with confirmatory factor analysis using LISREL 8.50.

Results: The analysis indicated that a theoretically derived, three-factor model provided a good, but not excellent, fit for the 16-item GSC. Excellent model-data fit was demonstrated for the three-factor model for a 9-item version of the GSC. In both instances, the three factors were best described by a single second-order factor, namely concussion symptomatology.

Conclusions: This study provides additional evidence for the factorial validity of a summative self-reported measure of concussion-related symptoms. The factor structure represents a cohesive group of nine symptoms that can be explained by three underlying latent variables, namely somatic symptoms, neurobehavioral symptoms, and “cognitive” symptoms, subsumed under a single higher-order factor, namely concussion symptoms.

1School of Human Performance and Recreation, University of Southern Mississippi, Hattiesburg, MS; 2Department of Kinesiology, University of Illinois at Urbana-Champaign, Champaign, IL; 3Department of Exercise and Sport Science, University of Carolina at Chapel Hill, Chapel Hill, NC; 4Neuroscience Center, Waukesha Memorial Hospital, Waukesha, WI; and 5Department of Exercise Science, St. Mary's Athletic Training Education and Research Laboratory, University of Georgia, Athens, GA

Address for correspondence: Scott G. Piland, The University of Southern Mississippi, School of Human Performance and Recreation, 118 College Drive #5142, Hattiesburg, MS., 39406-0001; E-mail:

Submitted for publication February 2005.

Accepted for publication August 2005.

©2006The American College of Sports Medicine