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Updated: May 28, 2026

Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials
Published on: April 27, 2021
Introspective Ratings of Biopsychosocial Status Are Associated With Sport-Related Injuries
Gary B Wilkerson1, Marisa A Colston1, Shellie N Acocello1
1Department of Health and Human Performance, University of Tennessee at Chattanooga.
Context:
Injury risk screening has historically focused on physical factors and neglected the influence of interrelated biopsychosocial factors.
Objective:
To assess the internal consistency and predictive validity of a concise electronic screening survey designed to efficiently acquire introspective distress ratings (IDRs) for biopsychosocial factors believed to contribute to sport-related injury risk.
Design:
Retrospective and prospective cohort study.
Setting:
National Collegiate Athletic Association (Division I Football Championship Subdivision) university athletic program.
Patients Or Other Participants:
One hundred forty-three college athletes (97 football, 26 women's soccer, and 20 women's volleyball).
Main Outcome Measures:
Associations between sport-related injury occurrences and IDRs derived from Global Well-Being Index (GWBI) survey responses acquired immediately prior to the start of preseason practice sessions.
Results:
Good internal consistency among survey responses was found (Cronbach α = 0.714) as well as meaningful retrospective and prospective associations with both core or lower extremity injury (CLEI) and sport-related concussion (SRC). All bivariate correlations among IDRs for 5 different categories of biopsychosocial problems were statistically significant (P < .001 to P = .05). Sleep-related IDR was strongly associated with both CLEI and SRC both retrospectively and prospectively. The strongest finding was an interaction of Sleep-IDR with starter status that prospectively predicted CLEI occurrence during the sport season (odds ratio = 16.94; P < .001).
Conclusions:
The GWBI survey provides a concise and psychometrically sound instrument for assessment of interrelated biopsychosocial factors that are highly relevant to injury risk among college athletes participating in football, soccer, and volleyball.
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