Brain drain: Psychosocial factors influence recovery following mild traumatic brain injury—3 recommendations for clinicians assessing psychosocial factors

Abstract

U SYNOPSIS: Mild traumatic brain injury is a major global public health concern. While most people recover within days to months, 1 in 5 people with mild traumatic brain injury report persistent, disabling symptoms that interfere with participation in work, school, and sport. People with injuries to regions other than the head may report similar symptoms. The biopsychosocial model of health explains this phenomenon in terms of factors associated with recovery that are not biomedical. Important psychosocial factors include poor recovery expectations and pretraumatic and posttraumatic psychological symptoms. Recent clinical practice guidelines recommend that clinicians examine all relevant biopsychosocial factors that may contribute to persistent postconcussive symptoms and consider them when helping their patients make health-management decisions. However, because clinical training continues to prioritize biomedical symptoms, clinicians may not feel confident in the psychosocial domain. Our objective is to provide 3 recommendations for clinicians to assess psychosocial factors in patients after concussion, and to argue a case for clinicians to improve their skills in assessing psychosocial factors.