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Personality Characteristics and Acute Symptom Response Predict Chronic Symptoms After Mild Traumatic Brain Injury

Published online by Cambridge University Press:  29 January 2021

Hillary A. Parker Open the ORCID record for Hillary A. Parker [Opens in a new window] ,
Jana Ranson Open the ORCID record for Jana Ranson [Opens in a new window] ,
Michael A. McCrea ,
James Hoelzle ,
Terri deRoon-Cassini  and
Lindsay D. Nelson Open the ORCID record for Lindsay D. Nelson [Opens in a new window]
Hillary A. Parker
Affiliation:
Department of Neurology, Mount Carmel Health System, Columbus, OH, USA Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA
Jana Ranson
Affiliation:
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
Michael A. McCrea
Affiliation:
Clement J. Zablocki VA Medical Center, Milwaukee, WI, USA Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
James Hoelzle
Affiliation:
Department of Psychology, Marquette University, Milwaukee, WI, USA
Terri deRoon-Cassini
Affiliation:
Department of Surgery, Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
Lindsay D. Nelson*
Affiliation:
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
*
*Correspondence and reprint requests to: Lindsay Nelson, PhD, Medical College of Wisconsin, 8701 West Watertown Plank Road, Milwaukee, WI53226, USA. Email: linelson@mcw.edu.
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Abstract

Objective:

Despite consensus that personality influences mild traumatic brain injury (mTBI) recovery, it has been underexamined. We evaluated the extent to which diverse personality and psychiatric symptom dimensions predict mTBI recovery.

Methods:

This prospective cohort study involved psychological assessments of hospital patients with mTBI (n = 75; median = 2 days post-injury, range = 0–12 days) and orthopedic trauma controls (OTC; n = 79) who were used for comparison in mediation modeling. Chronic symptoms were evaluated at 3 months after mTBI (n = 50) using the Sport Concussion Assessment Tool (SCAT) symptom checklist. Linear regression analyses were used to identify the predominant predictors of chronic symptoms in mTBI. Modern mediation analyses tested the hypothesis that personality traits predict chronic symptoms through acute psychological response to injury.

Results:

In mTBI, trait psychoticism directly predicted chronic mTBI symptoms and was the strongest personality predictor overall. Furthermore, an internalizing personality dimension emphasizing negative affect/emotionality and detachment predicted chronic mTBI symptoms indirectly through enhancement of acute somatic complaints. In OTC, internalizing personality acted through the same mediator as in mTBI, whereas the effect of psychoticism was also mediated through acute somatic complaints. There was varying support for a moderated direct effect of personality traits at low levels of positive emotionality across models.

Conclusion:

These causal models provide novel insights about the role of personality in mTBI symptom recovery, highlighting the complexity of how psychological processes may interact to affect recovery and revealing that some of these processes may be non-specific to brain injury.

Keywords

Brain concussionPost-concussion syndromeHuman characteristicsPsychologyAffectRecovery of function
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Issue 10 , November 2021 , pp. 992 - 1003
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

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