Research Reports - Psychological predictors of postconcussive symptoms following traumatic injury

J Head Trauma Rehabil. 2017 Oct 27. doi: 10.1097/HTR.0000000000000347. [Epub
ahead of print]

Sullivan KA(1), Edmed SL, Greenslade JH, White M, Chu K, Lukin B, Lange RT, Lurie
JK.

OBJECTIVE: To determine the contribution of demographics, injury type, pain, and
psychological factors on postconcussive symptoms.
SETTING AND PARTICIPANTS: Recently injured (n = 54) and noninjured (n = 184)
adults were recruited from a hospital emergency department or the community.
Thirty-eight individuals met the diagnostic criteria for a mild traumatic brain
injury and 16 individuals received treatment for a minor traumatic non-brain
injury.
MAIN MEASURES: Standardized tests were administered to assess 4 postconcussion
symptom types and theorized predictors including a "physiogenic" variable (injury
type) and "psychogenic" variables (symptoms of anxiety, depression, and stress)
within 1 month of the injury.
RESULTS: In the injured sample, after controlling for injury type, demographics,
and pain (chronic and current), a hierarchical regression analysis revealed that
the combination of psychological symptoms predicted affective (F10,42 = 2.80, P =
.009, Rchange = 0.27) but not other postconcussion symptoms types. Anxiety (β =
.48), stress (β = .18), and depression (β = -.07) were not statistically
significant individual predictors (P > .05). Cognitive and vestibular
postconcussion symptoms were not predicted by the modeled factors, somatic
sensory postconcussion symptoms were predicted by demographic factors only, and
the pattern of predictors for the symptom types differed for the samples.
CONCLUSIONS: Traditional explanatory models do not account for these findings.
The predictors are multifactorial, different for injured versus noninjured
samples, and symptom specific. 

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