Anxiety sensitivity and psychological distress in acute post-concussion symptom reporting following mild traumatic...

Post-concussion symptoms (PCS) are commonly reported following mild traumatic brain injury (mTBI) and may reflect both injury and psychosomatic factors. This cross-sectional study examined whether anxiety sensitivity (i.e., the fearful misinterpretation of anxiety-related sensations) is associated with acute PCS after controlling for variables previously implicated in PCS symptom reporting (e.g., psychological distress and symptoms of post-traumatic stress). Participants were 169 consecutive trauma admissions to a Level 1 emergency department in Sydney, Australia (100 mTBI; 69 orthopaedic trauma controls), who were assessed a mean of 4.64 days post-injury. The primary outcome was self-reported PCS while other variables consisted of clinical, somatic (pain), psychological (i.e., depression, anxiety, trauma) and cognitive appraisal (i.e., anxiety sensitivity) factors. Distress variables accounted for a large proportion of variance in PCS. Anxiety sensitivity explained a small additional increment beyond demographics, clinical factors, injury status, and distress (ΔR² = 0.012). In the final model, anxiety sensitivity to physical concerns was the only anxiety sensitivity subscale independently associated with PCS. The final model explained 77.7% of variance in PCS. Overall, acute PCS are strongly related to general psychological distress following injury, with anxiety sensitivity to physical sensations contributing an additional, modest independent association with PCS. These findings support a role for symptom-appraisal processes, alongside injury status, in early PCS reporting after trauma.