Most people who sustain a mild traumatic brain injury (mTBI), or concussion, make a full recovery within three months. However, some patients may suffer from post-concussion syndrome, a condition characterized by long-term mTBI symptoms that may persist for months or years after the expected recovery period. The exact mechanisms underlying post-concussion syndrome are unknown, but current evidence suggests that psychosocial factors—such as anxiety and depression—may play a role in the development of this condition. As a result, researchers have hypothesized that psychological interventions to decrease anxiety and depression may reduce the likelihood that an individual experiences persistent concussion symptoms.
A Canadian research team tested this hypothesis by studying the effects of a coping skills intervention for adults with severe, prolonged post-concussion syndrome. First, the patients attended a two-hour group education session about mTBI, symptom self-management, and emotional health. Then, over the course of three weeks, small groups of these patients attended weekly 90-minute sessions with an occupational therapist. During these sessions, the patients learned coping skills such as mindful planning, reframing negative mindsets, stress management, and relaxation strategies. The research team then administered the Rivermead Post Concussion Symptoms Questionnaire (RPQ) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS) to assess the patients’ symptom burden and level of disability.
After analyzing their data, the research team found that patients who completed the coping skills intervention did not show significant improvements in disability or symptom burden compared to patients who completed other traditional interventions, such as classic psychoeducation. However, the patients reported high satisfaction with the quality of the intervention, and 91 percent would recommend the intervention to a friend with concussion. Additionally, patients who completed the coping skills intervention were more likely to pursue injury litigation or compensation claims.
Advancements in the field of TBI are driven by innovative research designs. Although the coping skills intervention was not significantly more beneficial than traditional interventions, the results of this study represent important progress towards optimizing treatments for patients with severe post-concussion syndrome. Going forward, the research team plans to expand the curriculum of the coping skills intervention to maximize positive outcomes for these patients.
Ali JI, Mahoney P, Dance D, & Silverberg ND. Outcomes of a brief coping skills intervention for adults with severe post-concussion symptoms. Concussion. (November 2019.)