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Post-Concussion Syndrome, Stress, and Coping

A great deal of debate has arisen in the last few years over the nature of post-concussion syndrome (PCS). Some believe that the condition is purely psychological—a type of malingering aimed at gaining compensation when there is no real injury. Others believe that the condition is real—the result of brain lesions—and that the symptoms are related to those injuries to the central nervous system.

This current study suggests that the truth lies somewhere in between—PCS is most likely a condition that has some physical attributes that are mediated by psychological issues.

The authors of this study examined the role of stress in the symptoms of 188 undergraduate students with PCS. The subjects completed questionnaires that measured stress events and perceived stress, as well as symptoms reported.

The authors found that it was not the number of stressful events in the subjects' lives that resulted in increased symptoms, but how that individual responded to the stressful events:

"Our results are also consistent with an emerging literature on postconcussive syndrome, which proposes that pre-existing characterological features that are subclinical and do not differentiate individuals under stable, nonstressful conditions come to the forefront under stressful situations...In other words, normal variance in individuals' response to stress in most environmental conditions is exaggerated when they are faced with more challenging, and often confusing, environmental conditions, such as mild traumatic brain injury."

Machulda MM, Bergquist TF, Ito V, Chew S. Relationship between stress, coping, and postconcussion symptoms in a healthy adult population. Archives of Clinical Neuropsychology 1998;13(5):415-424.