Early stress response: a vulnerability framework for functional impairment following mild traumatic brain injury.
Nearly 64% of people with mild traumatic brain injury (MTBI) experience prolonged symptoms and functional impairments lasting months or years postinjury. Explanations for delayed recovery have varied and lacked a guiding framework, hindering intervention science. Using theory substruction and adapting McLean and associates' biopsychosocial model for chronic pain after trauma, we suggest that perceived psychological stress and associated neurobiological responses may predict risk for functional impairment. This model can be tested using a biopsychosocial approach to determine the interplay of psychological stress and neurobiological responses implicated in functional impairments after MTBI. Testing of this model will advance understanding of pathways to postconcussion syndrome.
Bay
Esther H
EH
Michigan State University, USA. baye@msu.edu
Liberzon
Israel
I
D000311:Adrenal Glands / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008954:Models, Biological; D016294:Models, Nursing; D008960:Models, Psychological; D024802:Nurse's Role; D010146:Pain / Q000209:etiology; D010902:Pituitary Gland / Q000503:physiopathology; D038223:Post-Concussion Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D020127:Recovery of Function; D019145:Rehabilitation Nursing; D018570:Risk Assessment; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology
D006854:Hydrocortisone