The Relationship of Psychological and Personality Factors to Post-Concussive Symptoms (PCS) in Mild Traumatic Brain Injury (MTBI) Patients.

Abstract

Post-concussive symptoms (PCS) represent a constellation of somatic, cognitive and psychological complaints including headache, dizziness, fatigue, impaired memory problems, attentional dysfunction and personality changes that occur following a mild traumatic brain injury (MTBI). Such symptoms usually present within one to two weeks post-injury and resolve within three months, however, for some they persist beyond six months. Research has shown that the emergence, severity and duration of post-concussive symptoms (PCS) and persistent PCS (PPCS) are influenced by both injury (mostly neurological) and non-injury (mostly psychological) factors. However, the relative contributions of these factors, particularly the role of non-injury factors has not been comprehensively investigated. This thesis sought to elucidate the role of injury and non-injury factors in PCS and PPCS using a series of established measures in neurocognitive, personality and psychological (trait and state) domains. The findings showed that mild traumatic brain injury was associated with significantly greater dispositions toward trait anxiety, neuroticism and locus of control, as well as state depression and anxiety. Patients with moderate-severe PCS demonstrated higher scores on all personality and psychological measures except locus of control relative to mild PCS or no PCS patients at two months post-injury (baseline assessment) and five months post-injury (follow-up assessment). There was a positive linear relationship between both personality and psychological variables and PCS severity. In addition, trait anxiety, neuroticism and depression were greater in persistent PCS (PPCS) compared to recovered PCS patients at five months post-injury. In contrast, the majority of injury factors did not predict PCS and persistent PCS. In sum, non-injury factors such as personality and psychological variables appear to make a significant contribution to the manifestation and maintenance of PCS comparedto injury factors. The clinical implications of the findings are discussed. The present study highlights the importance of anxiety and associated personality and psychological disorders in the expression and persistence of PCS.