A Framework for Understanding the Contribution of Psychosocial Factors in Biopsychosocial Explanatory Models of Persistent Postconcussion Symptoms
Abstract
Biopsychosocial models are currently used to explain the development of persistent postconcussion symptoms (PPCS) following concussion. These models support a holistic multidisciplinary management of postconcussion symptoms. One catalyst for the development of these models is the consistently strong evidence pertaining to the role of psychological factors in the development of PPCS. However, when applying biopsychosocial models in clinical practice, understanding and addressing the influence of psychological factors in PPCS can be challenging for clinicians. Accordingly, the objective of this article is to support clinicians in this process. In this Perspective article, we discuss current understandings of the main psychological factors involved in PPCS in adults and summarize these into 5 interrelated tenets: preinjury psychosocial vulnerabilities, psychological distress following concussion, environment and contextual factors, transdiagnostic processes, and the role of learning principles. With these tenets in mind, an explanation of how PPCS develop in one person but not in another is proposed. The application of these tenets in clinical practice is then outlined. Guidance is provided on how these tenets can be used to identify psychosocial risk factors, derive predictions, and mitigate the development of PPCS after concussion from a psychological perspective within biopsychosocial conceptualizations. IMPACT: This Perspective helps clinicians apply biopsychosocial explanatory models to the clinical management of concussion, providing summary tenets that can guide hypothesis testing, assessment, and treatment.
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PPCS have a biopsychosocial conceptualisation.
“it has been argued that PPCS have a biopsychosocial conceptualisation.”
From Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study (2025) · cites this paper as [16]
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- Authors
- Faulkner, J. W., & Snell, D. L.
- Affiliations
- Victoria University of Wellington (NZ)
- University of Otago (NZ)
- Corresponding author
- Faulkner, Josh W
- Venue
- Physical Therapy
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-11-09
- Volume
- 103
- Issue
- 2
- ISSN
- 0031-9023 (ISSN-L)
- 1538-6724
- OpenAlex
- W4308715499
- Cited by
- 21
- References
- 75
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 6 · 2023: 2
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Research Council of New Zealand Foxley Clinical Fellowship (20/041)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- concussion, biopsychosocial model, psychosocial factors, psychological distress, contextual factors, transdiagnostic mechanisms, learning principles, psychosocial risk factors
- MeSH terms
- Models, Biopsychosocial, Adult, Brain Concussion, Humans, Risk Factors, Post-Concussion Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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