Post concussion syndrome ebb and flow: longitudinal effects and management
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Updated: Jul 11, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Roger J Rees1, Michelle L Bellon
1Disability Studies, School of Medicine, Flinders University, Adelaide, Australia. rees1@iinet.net.au
Abstract:
This research identified persistent post concussion symptoms (PCS) in a group of 20 adult subjects. PCS generally lasted for two years with a mean of 3.35 years. Typical symptoms included physical and cognitive fatigue, depressive behaviors, sensitivity to noise, social withdrawal, irritability, concentration and problem solving difficulties, loss of libido and much difficulty making decisions at even the simplest strategic level. They represented a hard core group for whom the original symptoms persisted well beyond the 6~month period. Participants identified their PCS according to sensory, somatic affective and cognitive items immediately following their trauma (01) and two years later (02). Counseling and psychotherapy intervention took place between 01 and 02. Items on the PCS schedules and the Beck Depression Inventory (II) demonstrated significant decline in the presence of overall symptoms most noticeably in reduction of agitation, irritability and suicidal wishes. However, subjects throughout generally experienced the feeling that they were being punished which equated with behaviors comparable with learned helplessness. The PCS group considered themselves to be different people after trauma. They had different goals, changing lifestyle, relationships and employment and were more often in a dependent state. Comparability with other conditions such as PTSD and chronic fatigue syndrome (CFS) was demonstrated by individuals who experienced persistent and invasive post concussion symptoms.
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