Electronic Theses and Dissertations

Date

2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

Committee Chair

Frank Andrasik

Committee Member

Brook Marcks

Committee Member

Helen Sable

Committee Member

Brandon C Baughman

Abstract

This dissertation investigates the neuropsychological outcomes of retired NFL athletes with a history of multiple concussions, focusing on race-norming practices and their associations with cognitive outcomes. The primary objective was to investigate whether race-norming in neuropsychological assessment impacts ratings of cognitive impairment in this population. A secondary goal was to determine if concussion history and other health-related conditions could predict cognitive impairment status. To explore these aims, a comprehensive approach was adopted, involving a detailed review of existing literature, data collection from retired NFL players with a history of multiple concussions (including comprehensive neuropsychological examination), and rigorous statistical analysis. Participants’ neuropsychological data was normed using both norms that did and did not account for race. Cognitive impairment outcomes were then compared between sets of norms. Player health histories were also qualitatively examined and coded for quantitative analysis of the ability of health-related factors (cardiovascular risk factors, sleep, pain, and mental health factors) to predict cognitive impairment. The main findings of this research indicate significant discrepancies in cognitive functioning scores between differing norms used. Specifically, Black athletes demonstrated a higher incidence of cognitive impairment when assessed without race-norming, suggesting that current race-norming practices have potential to mask true cognitive deficits in this group. These findings underscore the need for re-evaluating neuropsychological assessment practices to ensure they are equitable and accurately reflect cognitive functioning across diverse populations. Additionally results indicated that concussion history factors, contrary to expectations, did not significantly predict cognitive impairment in any domain. Instead, cardiovascular risk factors emerged as the sole significant predictor for cognitive impairment in attention, processing speed, learning, and memory domains when using race-neutral norms. Interestingly, the predictive power of cardiovascular risk factors diminished when race-based norms were applied, suggesting that race-norming may obscure the influence of health disparities affecting racial minority populations. In conclusion, while concussion history was not a significant predictor of cognitive outcomes, cardiovascular risk factors played a pivotal role among retired NFL athletes. These findings advocate for a broader focus on cardiovascular health in this population and call for alternative approaches to race-norming practices.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest.

Notes

Open Access

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