Every year, more than 2.8 million individuals sustain a traumatic brain injury (TBI) in the U.S. At least 75% of these are designated as mild TBI (mTBI). While most are expected to spontaneously recover within days to weeks, a substantial minority continue to experience various somatic, cognitive, and affective symptoms for months/years postinjury. Several biopsychosocial factors (e.g., cognitive reserve, psychiatric illness) may influence the persistence of postconcussive symptoms (PPCS). Adverse childhood experiences (ACE) may be another psychosocial factor that influences PPCS, but few studies have assessed the relationship between ACEs and TBI. This study aimed to replicate previous findings and was the first to extend the literature to evaluate the relationship between ACEs and PPCS. Fifty-eight individuals (34 males; M = 16.82 years; SD = 2.28), who presented for a neuropsychological evaluation due to PPCS, were included in this archival study. Of the predictors examined (i.e., sex, maternal education, previous mTBI, psychiatric illness, attention-deficit/hyperactivity disorder and learning disorder diagnosis), only parent-reported anxiety and depressive symptoms were significantly correlated with PPCS; higher reported anxiety and depressive symptoms were related to higher reported PPCS. Hierarchical regression revealed that ACEs did not account for additional significant variance in PPCS outcomes. Current findings highlight the possibility of clinicians assessing for parent-reported psychiatric factors to identify adolescents and young adults who may be at higher risk for prolonged symptoms. Inconsistencies with previous literature also highlight the need for standardized definitions of mTBI and PPCS, as well as prospective studies to establish temporal relationships among ACEs, other predictors, and PPCS.
","abstract_html":"<p>Every year, more than 2.8 million individuals sustain a traumatic brain injury (TBI) in the U.S. At least 75% of these are designated as mild TBI (mTBI). While most are expected to spontaneously recover within days to weeks, a substantial minority continue to experience various somatic, cognitive, and affective symptoms for months/years postinjury. Several biopsychosocial factors (e.g., cognitive reserve, psychiatric illness) may influence the persistence of postconcussive symptoms (PPCS). Adverse childhood experiences (ACE) may be another psychosocial factor that influences PPCS, but few studies have assessed the relationship between ACEs and TBI. This study aimed to replicate previous findings and was the first to extend the literature to evaluate the relationship between ACEs and PPCS. Fifty-eight individuals (34 males; <em>M</em> = 16.82 years; <em>SD</em> = 2.28), who presented for a neuropsychological evaluation due to PPCS, were included in this archival study. Of the predictors examined (i.e., sex, maternal education, previous mTBI, psychiatric illness, attention-deficit/hyperactivity disorder and learning disorder diagnosis), only parent-reported anxiety and depressive symptoms were significantly correlated with PPCS; higher reported anxiety and depressive symptoms were related to higher reported PPCS. Hierarchical regression revealed that ACEs did not account for additional significant variance in PPCS outcomes. Current findings highlight the possibility of clinicians assessing for parent-reported psychiatric factors to identify adolescents and young adults who may be at higher risk for prolonged symptoms. Inconsistencies with previous literature also highlight the need for standardized definitions of mTBI and PPCS, as well as prospective studies to establish temporal relationships among ACEs, other predictors, and PPCS.</p>","abstract_has_math":false,"creators":["Andersen, Tiffany"],"institution":null,"degree_name":"Doctor of Philosophy (PhD)","degree_level":"Open Access Dissertation","degree_discipline":"Psychology","degree_department":null,"school":null,"contributors":["Renee Lajiness-O’Neill, Ph.D.","Jin Bo, Ph.D.","Jamie Lawler, Ph.D."],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2021,"date_issued":"2021-01-01T08:00:00Z","date_published":"2021-01-01T08:00:00Z","updated_at":"2026-07-24T02:17:40Z","subjects":["adverse childhood experiences","concussion","mild traumatic brain injury","persistent postconcussive symptoms","postconcussive syndrome","Clinical Psychology"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://commons.emich.edu/theses/1098","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Renee Lajiness-O’Neill, Ph.D.","Jin Bo, Ph.D.","Jamie Lawler, Ph.D."]},{"key":"dc:creator","label":"Author","values":["Andersen, Tiffany"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2021-10-07T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Psychology"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Dissertation"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy (PhD)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["adverse childhood experiences","concussion","mild traumatic brain injury","persistent postconcussive symptoms","postconcussive syndrome","Clinical Psychology"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://commons.emich.edu/theses/1098"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Every year, more than 2.8 million individuals sustain a traumatic brain injury (TBI) in the U.S. At least 75% of these are designated as mild TBI (mTBI). While most are expected to spontaneously recover within days to weeks, a substantial minority continue to experience various somatic, cognitive, and affective symptoms for months/years postinjury. Several biopsychosocial factors (e.g., cognitive reserve, psychiatric illness) may influence the persistence of postconcussive symptoms (PPCS). Adverse childhood experiences (ACE) may be another psychosocial factor that influences PPCS, but few studies have assessed the relationship between ACEs and TBI. This study aimed to replicate previous findings and was the first to extend the literature to evaluate the relationship between ACEs and PPCS. Fifty-eight individuals (34 males; M = 16.82 years; SD = 2.28), who presented for a neuropsychological evaluation due to PPCS, were included in this archival study. Of the predictors examined (i.e., sex, maternal education, previous mTBI, psychiatric illness, attention-deficit/hyperactivity disorder and learning disorder diagnosis), only parent-reported anxiety and depressive symptoms were significantly correlated with PPCS; higher reported anxiety and depressive symptoms were related to higher reported PPCS. Hierarchical regression revealed that ACEs did not account for additional significant variance in PPCS outcomes. Current findings highlight the possibility of clinicians assessing for parent-reported psychiatric factors to identify adolescents and young adults who may be at higher risk for prolonged symptoms. Inconsistencies with previous literature also highlight the need for standardized definitions of mTBI and PPCS, as well as prospective studies to establish temporal relationships among ACEs, other predictors, and PPCS.
"]},{"key":"dc:title","label":"Title","values":["The role of premorbid factors and adverse childhood experiences in the persistence of symptoms post mild traumatic brain injury (persistent postconcussive symptoms)"]}]}],"canonical_facts":{"dc:contributor":["Renee Lajiness-O’Neill, Ph.D.","Jin Bo, Ph.D.","Jamie Lawler, Ph.D."],"dc:creator":["Andersen, Tiffany"],"dc:date.available":["2021-10-07T07:00:00Z"],"dc:description.abstract":["Every year, more than 2.8 million individuals sustain a traumatic brain injury (TBI) in the U.S. At least 75% of these are designated as mild TBI (mTBI). While most are expected to spontaneously recover within days to weeks, a substantial minority continue to experience various somatic, cognitive, and affective symptoms for months/years postinjury. Several biopsychosocial factors (e.g., cognitive reserve, psychiatric illness) may influence the persistence of postconcussive symptoms (PPCS). Adverse childhood experiences (ACE) may be another psychosocial factor that influences PPCS, but few studies have assessed the relationship between ACEs and TBI. This study aimed to replicate previous findings and was the first to extend the literature to evaluate the relationship between ACEs and PPCS. Fifty-eight individuals (34 males; M = 16.82 years; SD = 2.28), who presented for a neuropsychological evaluation due to PPCS, were included in this archival study. Of the predictors examined (i.e., sex, maternal education, previous mTBI, psychiatric illness, attention-deficit/hyperactivity disorder and learning disorder diagnosis), only parent-reported anxiety and depressive symptoms were significantly correlated with PPCS; higher reported anxiety and depressive symptoms were related to higher reported PPCS. Hierarchical regression revealed that ACEs did not account for additional significant variance in PPCS outcomes. Current findings highlight the possibility of clinicians assessing for parent-reported psychiatric factors to identify adolescents and young adults who may be at higher risk for prolonged symptoms. Inconsistencies with previous literature also highlight the need for standardized definitions of mTBI and PPCS, as well as prospective studies to establish temporal relationships among ACEs, other predictors, and PPCS.
"],"dc:identifier":["https://commons.emich.edu/theses/1098"],"dc:subject":["adverse childhood experiences","concussion","mild traumatic brain injury","persistent postconcussive symptoms","postconcussive syndrome","Clinical Psychology"],"dc:title":["The role of premorbid factors and adverse childhood experiences in the persistence of symptoms post mild traumatic brain injury (persistent postconcussive symptoms)"],"thesis:degree_discipline":["Psychology"],"thesis:degree_level":["Open Access Dissertation"],"thesis:degree_name":["Doctor of Philosophy (PhD)"]},"updated_at":"2026-07-24T02:17:40Z"}