Illness perceptions predict subjective cognitive complaints independently of sex and psychological distress in post-acute mTBI.

Abstract

Cognitive symptoms are common after mild traumatic brain injury (mTBI) and can interfere with return to work. Factors underlying these symptoms are poorly understood. This prospective observational study explored relationships between illness perceptions, coping style, and cognitive symptom reporting in mTBI, including when controlling for sex and psychological distress. Individuals with mTBI (n = 70) and trauma controls (n = 42) were assessed 6-10 weeks post-injury. Measures included the Brief-COPE, the Illness Perceptions Questionnaire-Revised (IPQ-R), and subjective cognitive and post-concussion symptom scales. Six of the nine IPQ-R subscales showed robust bivariate correlations with cognitive symptoms in the mTBI group (|r| = .24-.55). Illness perceptions contributed to cognitive symptom reporting over and above the effects of sex and psychological distress (F(2,64) = 4.12, p = .021); significant, robust independent predictors were psychological distress (β = .344, p = .003), and IPQ-Consequences (β = .276, p = .025). Relationships with general post-concussion symptoms, and in trauma controls, were also explored. This research demonstrates that illness perceptions have important relationships with cognitive symptoms after mTBI, which persist when controlling for pre-established predictors of these symptoms. This indicates that illness perceptions are a unique predictor of cognitive symptoms after mTBI and suggests that, alongside psychological distress, these perceptions may be a useful target for intervention in individuals with prolonged recovery.