Knowledge and expectation of postconcussion symptoms in the general population

Mulhern, Sharon; McMillan, T. M.

doi:10.1016/j.jpsychores.2006.03.004

Cited by 44 publications

(36 citation statements)

References 31 publications

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“…Our results suggested that, over time, participants, regardless of outcome, changed their perception of the impact of MTBI and appeared to see the injury as more serious than they did earlier following injury. These results are consistent with research that has suggested that people in general know little about MTBI and the PCS (MacKenzie & McMillan, 2005;Mulhern & McMillan, 2006). As a result of this knowledge gap participants may have initially minimised the implications of their injury.…”

Section: Csm Components (Injury Perceptions Coping Distress) and Ousupporting

confidence: 89%

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

Snell

Hay‐Smith

Surgenor

et al. 2013

Neuropsychological Rehabilitation

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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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Section: Csm Components (Injury Perceptions Coping Distress) and Ousupporting

confidence: 89%

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

Snell

Hay‐Smith

Surgenor

et al. 2013

Neuropsychological Rehabilitation

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“…Similar findings have been replicated in some (Gunstad & Suhr, 2004;Iverson, Lange, Brooks, & Rennison, 2009;Lange, Iverson, & Rose, 2010) but not all studies (Gunstad & Suhr, 2002). Although the experimental methodology has been critiqued, especially as to whether controls can predict post-concussional-type symptoms or are responding to methodological biases (Mackenzie & McMillan, 2005;Mulhern & McMillan, 2006), such research suggests that cognitive biases may influence how individuals perceive and respond to symptoms following injury. "Expectation as aetiology" has influenced the development of prophylactic psychoeducational programmes (in the initial hours, days and weeks after injury), emphasising the common nature of post-concussional symptoms and the expectation that the symptoms improve over time, and with some positive results in reducing persistent symptoms (Mittenberg et al, 2001;Ponsford et al, 2002).…”

Section: Relevant Themes From the Literaturementioning

confidence: 79%

Cognitive behavioural therapy and persistent post-concussional symptoms: Integrating conceptual issues and practical aspects in treatment

Potter

Brown

2012

Neuropsychological Rehabilitation

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This paper seeks to integrate research findings in mild traumatic brain injury (MTBI) around three central themes relevant to psychological therapies for persistent post-concussional symptoms (PCS). These are (1) the relative lack of symptom specificity, (2) the extent to which subjective (but not necessarily objective) cognitive difficulties predominate, and (3) the role of psychological (especially cognitive-behavioural) processes in the evolution and maintenance of symptoms. Evidence-based models guiding cognitive-behavioural therapy (CBT) for similar symptoms in other clinical groups are considered in relation to persistent PCS, as well as some of the practical considerations in applying CBT with this client group. Outstanding research issues are identified and discussed, including the opportunities and risks of combining CBT and cognitive rehabilitation approaches.

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“…Both groups reported symptoms of post-concussion syndrome; headache was at the top of the list, although the methodology of this study has been questioned. 29 Canadians and Lithuanians who had not been injured were asked a similar question. and Greeks were also much lower than in Canadians.…”

Section: Clinical Featuresmentioning

confidence: 99%

Chronic Post-traumatic Headache—Understanding the Complexities and Treatment Options

Solomon¹

2010

US Neurology

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The complexities of chronic post-traumatic headache (CPTH) date back to its initial recognition. By the mid-1800s the persistence of headache after head injury was acknowledged as a manifestation of brain injury or 'molecular derangement.' However, with the advent of financial compensation for these injuries, the psychologic aspects were thought to be predominant, hence such terms as 'compensation neurosis.' The latter concept persisted into the early decades of the 20th century with more sophisticated terms as 'somatization' and 'conversion disorder'.However, by the late 1800s 'post-concussion syndrome' was considered to be a legitimate ailment comprising the triad of headache, dizziness, and alcohol intolerance. In recent decades, post-traumatic headache has been recognized as having an organic or pathophysiologic basis as well as associated psychologic factors. Terminology and CriteriaThe term CPTH implies an underlying cerebral trauma that is part of the post-concussion syndrome. The International Classification of Headache Disorders, 2nd edition (IHCD) divides criteria for CPTH into pain attributed to moderate or severe head injury and pain attributed to mild head injury.1 The term 'concussion' in Table 1 is not defined, but would include symptoms such as dazed, confused, memory impairment, and dizziness, in addition to headache or brief loss of consciousness, or both. However, mild head injury without concussion or any other of the IHCD criteria can trigger headache. Examples are migraine with aura evoked by heading a ball during soccer or hemiplegic migraine provoked by trivial head trauma. In addition head trauma need not be direct, such as during blast or whiplash injuries. Trauma may be psychologic, as in chronic post-traumatic stress disorder (PTSD). The time limits indicated in the IHCD criteria have been disputed. Many agree that CPTH may develop more than seven days after trauma, but there is evidence that headache beginning more than three months after concussion is a primary headache (migraine or tension-type) rather than due to brain trauma. 2Until there are biologic markers for the condition, seven days is a logical limit. Similarly, the classification of 'chronic' if the headache lasts for more than three months has been disputed as being too short. Criteria of other illnesses define chronic as having a duration of more than six months. The numbers in the classification criteria are arbitrary but necessary operational criteria for research purposes. EpidemiologyThe prevalence of CPTH is uncertain because 80-90% of head injuries are mild and unreported. Studies of prevalence in people who had reported to an emergency department or doctor's office found CPTH prevalence to range from 15 to 42%. 3,4 Women are somewhat more prone to develop CPTH than men. KeywordsPost-concussion syndrome, diffusion tensor imaging, tension-type headache, post-traumatic stress disorder, behavioral medicine Disclosure: The author has no conflicts of interest to declare.

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Knowledge and expectation of postconcussion symptoms in the general population

Cited by 44 publications

References 31 publications

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

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

Cognitive behavioural therapy and persistent post-concussional symptoms: Integrating conceptual issues and practical aspects in treatment

Chronic Post-traumatic Headache—Understanding the Complexities and Treatment Options

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