Resilience and coping as defenders or drivers of symptom severity following mild traumatic brain injury. — The Association Specialists
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Resilience and coping as defenders or drivers of symptom severity following mild traumatic brain injury. (22045)

Melissa G Papini 1 2 3 , Jacinta Thorne 2 3 4 , Aleksandra Gozt 5 , André Avila 1 2 3 , Caerwen Beaton 1 2 3 , Geena Gill 6 , Elizabeth Thomas 7 8 , Francesca Buhagiar 9 , Alexander Ring 4 10 , Glenn Arendts 11 , Antonio Celenza 12 13 , Dan Xu 1 14 , Gill Cowen 2 3 , Carmela Pestell 4 9 , Daniel Fatovich 15 16 , Michael Bynevelt 17 , Melinda Fitzgerald 2 3 , Sarah C Hellewell 2 3
  1. Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
  2. Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  3. Perron Institute of Neurological and Translational Science, Nedlands, Western Australia, Australia
  4. School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
  5. Connectivity, Traumatic Brain Injury Australia, Nedlands, Western Australia, Australia
  6. Curtin University, Nedlands, WA, Australia
  7. Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
  8. Division of Surgery, School of Medicine, University of Western Australia, Nedlands, Western Australia, Australia
  9. School of Psychological Science, The University of Western Australia, Nedlands, Western Australia, Australia
  10. Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
  11. Emergency Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  12. Emergency Department, Sir Charles Gardiner Hospital, Nedlands, Western Australia, Australia
  13. Division of Emergency Medicine, School of Medicine, The University of Western Australia, Nedlands, Western Australia, Australia
  14. The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
  15. Emergency Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
  16. Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
  17. The Neurological Intervention & Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia

Objectives: Resilience and adaptive coping strategies may mitigate the impact of psychological distress on symptom severity after mild traumatic brain injury (mTBI). This study investigates how resilience and coping styles moderate the relationship between acute psychological distress and symptom severity at 3-, 6-, and 12-months post injury.

Methods: 31 participants (13F, 36.6±13.5y) recruited ≤7d post-mTBI as part of the Concussion REcovery STudy completed self-reports: Depression Anxiety and Stress Scale-21 (total: psychological distress), Brief Resilience Scale (low: ≥x̄-1SD, high: ≥x̄+1SD) and Utrecht Coping List (coping styles: active, passive, avoidant, palliative, emotion, social, reassuring thoughts). Post-Concussion Symptom Scale total scores (PCSS) at 3-(n=30), 6-(n=29) and 12-months (n=28) determined severity.

Findings: Elevated distress at ≤7d post-injury predicted greater PCSS scores at 3-(β=0.754, p<0.001), 6-(β=0.486, p=0.022) and 12-months (β=0.438, p=0.026). Hayes PROCESS assessed moderating influences of resilience and coping style. Resilience moderated distress effects at 3-months (b=0.0538, p<0.05); low resilience increased PCSS scores (b=0.734, p<0.001), high resilience mitigated these effects. At all levels, resilience moderated increased 6-month PCSS scores (b=0.4054, p<0.05). Lower passive coping increased influence of distress, worsening 6-month PCSS scores (b=1.233, p=0.008). Higher emotion-based coping augmented effects of distress intensifying 3-month PCSS scores (b=1.141, p<0.001). Neither resilience nor coping style moderated relationships at 12-months.

Conclusions: Psychological distress at the time of injury increases vulnerability to elevated long-term symptoms. Resilience and coping style may buffer or exacerbate this relationship depending on recovery stage. Implementing early interventions focused on fostering adaptive coping strategies could be critical in attenuating symptom severity and improving long-term outcomes.