Anxiety sensitivity and alexithymia as mediators of postconcussion syndrome following mild traumatic brain injury

J Head Trauma Rehabil. 2014 Jan-Feb;29(1):E9-E17. doi: 10.1097/HTR.0b013e31827eabba.

Abstract

Objective: To examine the influence of anxiety sensitivity (AS) and alexithymia as potential mediators for the development of psychological distress and postconcussion syndrome after mild traumatic brain injury (mTBI).

Participants: Sixty-one patients with mTBI assessed at a mean of 2.38 weeks after injury and demographically matched healthy controls (n = 61).

Measures: Twenty-item Toronto Alexithymia Scale, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Rivermead Post Concussion Questionnaire.

Results: The mTBI group reported significantly higher levels of AS, alexithymia, psychological distress, and postconcussion (PC) symptom scores than controls. High AS and alexithymia in the mTBI group were associated with a greater number of PC symptoms and higher levels of psychological distress than patients scoring low on these measures and controls. In the mTBI group, a combination of AS and low mood explained 52.6% of the variance in PC symptom reporting. A combination of trait-anxiety, alexithymia, and PC symptoms explained 77.2% of the variance in levels of mood.

Conclusion: A combination of low mood and high AS may act as a psychological diathesis for the development of persisting PC symptoms. Early identification could provide a focus for early intervention to prevent the development of postconcussion syndrome after mTBI.

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms / diagnosis*
  • Affective Symptoms / psychology*
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology*
  • Brain Injuries / diagnosis*
  • Brain Injuries / psychology*
  • Cohort Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Personality Inventory / statistics & numerical data
  • Post-Concussion Syndrome / diagnosis*
  • Post-Concussion Syndrome / psychology*
  • Psychometrics
  • Reference Values
  • Risk Factors
  • Surveys and Questionnaires
  • Wales
  • Young Adult