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Associations between illness perceptions, distress, self-reported cognitive difficulties and cognitive performance after mild traumatic brain injury

Deborah Snell , Josh Faulkner , Jonathan Williman, Noah Silverberg, Alice Theadom, Lois Surgenor, Richard Siegert

Abstract

Objectives: To examine associations between subjective and objective cognitive problems, and factors potentially modifying these relationships, after mild traumatic brain injury (mTBI). Materials and Methods: Treatment seeking adults (n = 95), were assessed six-weeks (Time 1) and then six-months later (Time 2) after mTBI. Validated questionnaires assessed cognitive, emotional and somatic mTBI symptoms, distress, catastrophizing, beliefs about symptoms and recovery. Cognitive performance was measured using the National Institutes of Health Toolbox Cognition Battery. Using correlations and linear regression, we explored associations between psychological factors, objectively measured cognitive performance, and self-reported cognitive symptoms. Results: There were only modest correlations between subjective cognitive symptoms and objective cognitive performance at assessment timepoints. In contrast, there were medium to large correlations between subjective cognitive symptoms, post-concussion symptom burden and psychological factors. Post-concussion symptom burden and beliefs about symptoms and recovery at Time 1 predicted persisting self-reported cognitive symptoms at Time 2. Conclusions: High post-concussion symptom burden and non-recovery expectations may increase risk for persistent subjectively experienced cognitive symptoms. Our findings may guide targeted treatment efforts focusing on factors with potential to influence cognitive symptom reporting after mTBI.

IB24074  Accepted 03 July 2025

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