Psychological and neuropsychological correlates of Postconcussional Disorder

Chronic symptoms of Postconcussional Disorder (PCD) occur in a significant minority of mild brain injury patients. The latest research suggests an interactionistic perspective as the most logical and empirically supported pathogenesis for the development and maintenance of PCD. The interactionistic perspective implicates organic factors in the development of acute symptoms of PCD, and psychological factors in the maintenance of chronic symptoms. Possible psychological factors relevant in the maintenance of PCD symptoms include a grief response, a coping hypothesis, and the development of dysfunctional coping loops. Providing support for a psychological etiology of symptom maintenance is research indicating reduction of chronic symptoms using cognitive behavioral techniques. The present study examined the effects of mild traumatic brain injury (MTBI), postconcussion symptom status, stress, and psychological distress on Paced Auditory Serial Addition Test (PASAT) performance. There were no significant main effects or interactions affecting PASAT performance. Secondarily, a modified distress index was developed using the subscales of the Personality Assessment Inventory (PMDI), based the scoring of the Brief Symptom Inventory Positive Symptom Distress Index. Postconcussive symptoms were moderately correlated with PMDI scores and with specific scales on the PAI (anxiety, anxiety related disorders, depression, somatic complaints, borderline features, stress, and nonsupport). In addition, a 2 (MTBI status) X 2 (PCD symptom status) X 2 (stress) ANOVA with PMDI as the dependent variable yielded main effects of stress and symptom status, but not MTBI, on PMDI scores. Limitations of this study and implications for future research are discussed