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Anxiety Sensitivity and Alexithymia as Mediators of Postconcussion Syndrome Following Mild Traumatic Brain Injury

Wood, Rodger Ll. PhD; O'Hagan, Geraldine MSc; Williams, Claire PhD; McCabe, Michael FRCS; Chadwick, Nicole MSc

The Journal of Head Trauma Rehabilitation: January/February 2014 - Volume 29 - Issue 1 - p E9–E17
doi: 10.1097/HTR.0b013e31827eabba
Original Articles

Objective: To examine the influence of anxiety sensitivity (AS) and alexithymia as potential mediators for the development of psychological distress and postconcussion syndrome after mild traumatic brain injury (mTBI).

Participants: Sixty-one patients with mTBI assessed at a mean of 2.38 weeks after injury and demographically matched healthy controls (n = 61).

Measures: Twenty-item Toronto Alexithymia Scale, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Rivermead Post Concussion Questionnaire.

Results: The mTBI group reported significantly higher levels of AS, alexithymia, psychological distress, and postconcussion (PC) symptom scores than controls. High AS and alexithymia in the mTBI group were associated with a greater number of PC symptoms and higher levels of psychological distress than patients scoring low on these measures and controls. In the mTBI group, a combination of AS and low mood explained 52.6% of the variance in PC symptom reporting. A combination of trait-anxiety, alexithymia, and PC symptoms explained 77.2% of the variance in levels of mood.

Conclusion: A combination of low mood and high AS may act as a psychological diathesis for the development of persisting PC symptoms. Early identification could provide a focus for early intervention to prevent the development of postconcussion syndrome after mTBI.

Brain Injury Research Group, College of Human and Health Sciences, Swansea University (Drs Wood and Williams and Mss O'Hagan and Chadwick); and Accident & Emergency Department, Morriston Hospital (Dr Wood and Mr McCabe), Swansea, Wales.

Corresponding Author: Rodger Ll. Wood, PhD, Brain Injury Research Group, Department of Psychology, College of Human and Health Sciences, Swansea University, Swansea SA2 8PP, Wales (

This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins