An exploration of diagnosis threat and group identification following concussion injury.

Cognitive performance can be impacted by many non-neurological factors, including preexisting expectations. The phenomenon of stereotype threat, or reduced cognitive performance due to preexisting beliefs, can apply to individuals following neurological injury (i.e., ‘‘diagnosis threat’’). We examined the effect of diagnosis threat on cognitive performance and symptom reporting following concussions while accounting for group identification (i.e., extent to which one’s identity is tied to being concussed). We also examined gender stereotype threat (i.e., women and math ability) to understand how these two related threat effects compare. Participants with a history of concussion were randomly assigned to one of three instructional sets emphasizing concussion history or gender, or neutral instructions. Individuals without a history of concussion served as a comparison group. Results revealed an effect of diagnosis threat on cognitive performance after group identification was taken into account, but only in male participants. In contrast, an underlying gender stereotype threat was observed in females across conditions, which was counteracted in the gender stereotype condition (i.e., stereotype reactance effect) due to the type of threat cues used. Also, controls exhibited greater symptom reporting than individuals with a concussion. Our findings highlight the importance of considering non-neurological factors impacting cognitive performance.