Relationship between subjective test feedback provided by high-school athletes during computer-based assessment of baseline cognitive functioning and self-reported symptoms.

Subjective feedback about distractions or problems encountered during computerized assessment was provided by 538 out of a pool of 1659 high-school athletes who completed baseline testing using ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Three types of feedback were included: (a) environmental, (b) computer-based (mechanical), and (c) instruction-based (associated with difficulty understanding test instructions). One-way analyses of variance were conducted and revealed relationships between greater symptom reporting and any type of feedback, environmental feedback, and instruction-based feedback. Increased symptom reporting was noted for female students. Additional relationships were noted between providing computer-based feedback and faster reaction time; and between history of concussion and providing instruction-based feedback. Athletes endorsing more symptoms at baseline scored significantly worse on ImPACT, as reflected in decreased visual memory performance. Results suggest that feedback provided during computerized assessment may yield information about symptom reporting and test-taking style, which may also be of particular interpretive utility when athletes minimize their symptoms.