Coping Strategies as a Predictor of Post-concussive Symptoms in Children with Mild Traumatic Brain Injury versus Mild Orthopedic Injury

Abstract

This study examined whether children’s coping strategies are related to post-concussive symptoms following mild traumatic brain injury (TBI) versus orthopedic injury (OI). Participants were 8- to 15-year-old children with mild TBI (n =167) or OI (n =84). They rated their current preferred coping strategies and post-injury symptoms at 2 weeks (baseline) and 1, 3, and 12 months post-injury. Children’s reported use of coping strategies did not vary significantly over time, so their baseline coping ratings were examined as predictors of post-concussive symptoms across time. Self-ratings of symptoms were positively related to emotion-focused strategies and negatively related to problem-focused engagement after both mild TBI and OI. Higher problem-focused disengagement predicted larger group differences in children’s ratings of symptoms, suggesting that problem-focused disengagement moderates the effects of mild TBI. Coping strategies collectively accounted for approximately 10–15% of the variance in children’s post-concussive symptoms over time. The findings suggest that coping may play an important role in accounting for children’s perceptions of post-concussive symptoms after mild TBI.

Symptoms of Persistent Behavior Problems in Children With Mild Traumatic Brain Injury

“…41,42 As part of our larger project, we administered a coping questionnaire to children and found associations of coping style with PCS. 43 A further possibility is that parents were more negatively affected by transient changes in the children’s level of physical discomfort, behavior, or mentation, and may have reacted in ways that exacerbated or failed to normalize the child’s longer-term adjustment. 44 …”

A review of post-concussion syndrome and psychological factors associated with concussion

“…In addition to affective factors (e.g. neuroticism, depression and anxiety) [39], coping style also has been found to contribute to the perception of post-concussive symptoms in children, where emotion-focused strategies were positively associated with symptom report and problem-focused strategies were negatively associated with symptom report across mTBI and orthopaedic groups [53]. Similarly, pre-injury resilience and depression were predictive of 1-month post-injury anxiety and post-concussive symptoms [54].…”

Feasibility and Potential Benefits of a Web-Based Intervention Delivered Acutely After Mild Traumatic Brain Injury in Adolescents: A Pilot Study

“…This self-management of pacing return to activities encourages the participant to actively take control of their recovery, thus encouraging a more active coping style, which has been linked to improved recovery after mTBI in adolescents. 46 Furthermore, it encourages participants to titrate activities based on symptoms. This idea of titrating activities is in agreement with other research that has demonstrated moderate and sub-symptom exacerbation activities may help recovery after mTBI.…”