Research Reports - Examination of outcome after mild traumatic brain injury: The contribution of injury beliefs and Leventhal's Common Sense Model

Neuropsychol Rehabil. 2013 Jan 22

Snell DL, Hay-Smith EJ, Surgenor LJ, Siegert RJ

Associations between components of Leventhal's common sense model of health
behaviour (injury beliefs, coping, distress) and outcome after mild traumatic
brain injury (MTBI) were examined. Participants (n = 147) were recruited within
three months following MTBI and assessed six months later, completing study
questionnaires at both visits (Illness Perceptions Questionnaire Revised, Brief
COPE, Hospital Anxiety and Depression Scale). Outcome measures included the
Rivermead Post-Concussion Symptoms Questionnaire and Rivermead Head Injury
Follow-Up Questionnaire. Univariate and multivariate (logistic regression)
analyses examined associations between injury beliefs, coping and distress at
baseline, and later outcome. Participants endorsing stronger injury identity
beliefs (p < .01), expectations of lasting severe consequences (p < .01), and
distress (p < .01) at time one, had greater odds of poor outcome at time two.
Coping styles were also associated with later outcome although variability in
findings limited interpretability. Associations between psychological variables
and outcome were examined and 76.5% of cases were correctly classified by the
model. Consistent with Leventhal's model, participant beliefs about their injury
and recovery had significant associations with outcome over time. Coping also
appeared to have important associations with outcome but more research is
required to examine these. Current reassurance-based interventions may be
improved by targeting variables such as injury beliefs, coping and adjustment
soon after injury.

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