A review of post-concussion syndrome and psychological factors associated with concussion
Abstract
OBJECTIVE: This study reviewed several topics related to post-concussion syndrome and psychological factors associated with concussion. Topics include neurobiological perspectives, psychological predictors of post-concussion syndrome including pre-morbid anxiety, anxiety sensitivity and cognitive biases and misattribution. In addition, the iatrogenic effects of excessive rest are reviewed and treatment options are discussed briefly. MAIN RESULTS: Animal models of concussion and mild traumatic brain injury suggest that a concussion can result in anxiety and fear reactions. The pathophysiology of depression following a concussion appears to be consistent with the cortico-limbic model of depression. Additionally, some individuals may be at risk for neurobiological depression and/or anxiety following a concussion. The literature also demonstrates that pre-morbid and concurrent anxiety increases the risk for prolonged concussion recovery. Cognitive biases and misattribution of symptoms contribute to lengthy recovery from concussion. In addition, medically prescribed excessive cognitive and physical rest may contribute to a protracted concussion recovery. Supervised and graduated physical activity, the introduction of anxiety reduction techniques and cognitive-behavioural therapy of cognitive biases and misattribution are effective means of shortening the length of post-concussion syndrome. CONCLUSIONS: Understanding, assessing and treating the psychological factors associated with concussion are effective means of preventing or shortening the length of post-concussion syndrome.
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Psychological factors, alongside demographic variables and clinical indicators of brain injury severity, have consistently emerged as robust predictors of PPCS.
“Psychological factors, when considered alongside demographic variables and clinical indicators of brain injury severity, have consistently emerged as robust predictors of PPCS.”
From Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study (2025) · cites this paper as [12]
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- Authors
- Broshek, D. K., De Marco, A. P., & Freeman, J. R.
- Affiliations
- University of Virginia (US)
- Corresponding author
- Broshek, Donna K.
- ORCID
- Broshek, Donna K.
- Venue
- Brain Injury
- Publisher
- Informa UK Limited
- Published
- 2014-11-10
- Volume
- 29
- Issue
- 2
- Pages
- 228-237
- ISSN
- 0269-9052 (ISSN-L)
- 1362-301X
- OpenAlex
- W2074202258
- Cited by
- 379
- References
- 86
- Citations by year
- 2026: 17 · 2025: 29 · 2024: 35 · 2023: 35 · 2022: 36 · 2021: 54 · 2020: 45 · 2019: 49 · 2018: 22 · 2017: 27 · 2016: 26 · 2015: 4
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain Injury (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- post-concussion syndrome, concussion, mild traumatic brain injury, anxiety, depression, anxiety sensitivity, cognitive biases, concussion recovery, cognitive behavioral therapy
- MeSH terms
- Animals, Anxiety, Depression, Disease Models, Animal, Humans, Neuropsychological Tests, Predictive Value of Tests, Reaction Time, Post-Concussion Syndrome, Cognitive Dysfunction
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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