Substance Use and Childhood Environment in Adolescent Head Injury: Examining the Effects of Race

Authors

• Jessica A. Phelps, University of Nebraska-LincolnFollow

First Advisor

Kimberly A. Tyler

Committee Members

Lisa Kort-Butler, Seulki Kim

Date of this Version

5-2026

Document Type

Thesis

Citation

A thesis presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of requirements for the degree of Master of Arts

Major: Sociology

Under the supervision of Professor Kimberly A. Tyler

Lincoln, Nebraska, May 2026 

Comments

Copyright 2026, Jessica A. Phelps. Used by permission

Abstract

Adolescents participating in sports are at an increased risk of concussion, which is particularly important given the difficulties with cognitive function, emotion regulation, and impulsivity that may occur as a result of this brain injury. These symptoms can predispose adolescents to subsequent concussions, leading to further damage during a critical time in neurodevelopment which can result in mental health disorder development in adulthood. It is crucial to understand what factors may predispose youth to increased rates of concussion for these reasons. As such, this paper explored whether race/ethnicity, gender, grade in school, childhood environment, and risk-taking behaviors were associated with sports- and physical activity-related concussions (SPAC) in adolescents using the 2023 Youth Risk Behavior Survey, a nationally representative sample of youth in grades 9-12. Results from logistic regression indicated that respondents who were male were more likely to have reported receiving at least one SPAC in the past 12 months compared to females. White youth were more likely to have reported at least one SPAC in the past year compared to Asian youth. No other race/ethnic differences were significant. For childhood environmental factors, youth reporting experiences of sexual abuse and having a parent or guardian with a mental illness were more likely to have reported SPACs in the past 12 months than those who did not, whereas youth who reported having their basic needs met and whose parent more often knew their location were less likely to have reported SPACs in the past year. Finally, for risk-taking behaviors, youth who participated in more sports teams, got into one or more physical fights at school, experienced racial discrimination, and had used illicit drugs or vaped in their lifetime were more likely to report SPACs in the past year than those without these experiences. Youth who engaged in lifetime marijuana use were less likely to have reported a SPAC in the past year. Study results have implications for targeted interventions to assist adolescents who play sports in preventing and assessing brain injuries that occur as a result.

Advisor: Kimberly A. Tyler