“Alone in the dark”: A qualitative study of treatment experiences among young adults with a recent concussion and anxiety

ABSTRACT

Purpose

Young adults with anxiety are vulnerable to developing persistent symptoms following concussions. In order to develop psychosocial interventions to prevent persistent post-concussion symptoms, we need to understand patients’ 1) experiences with treatments offered by health care providers; 2) experiences with attempted concussion management strategies; and 3) needs after their injury.

Methods

We conducted in-depth interviews with 17 young adults with recent (≤ 10 weeks) concussions who have at least mild anxiety (Generalized Anxiety Disorder Assessment-7 ≥ 5). We used a hybrid deductive-inductive approach to thematic analysis.

Results

Findings provide insight into recommended treatments (e.g., active/avoidant strategies, accommodations, referrals), attempted strategies (e.g., lifestyle changes, pacing, relationships, acceptance-based coping skills), and patient needs (e.g., education, accommodations, referrals for cognitive and emotional skills). Participants frequently expressed that treatment recommendations were confusing and difficult to implement. They initiated non-prescribed strategies that helped promote recovery and expressed a desire for more interdisciplinary treatment and education on concussions.

Conclusion

Patients’ perceptions of health care provider recommendations after concussions did not fully meet patients’ perceived needs. Young adults with concussions and anxiety would benefit from more education, guidance, and psychosocial and rehabilitation services. Addressing these gaps may help align treatments with patients’ needs and therefore help optimize their recovery.

KEYWORDS:

• Concussion
• mTBI
• Treatment
• Anxiety
• Young adults
• Qualitative research

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, JG, upon reasonable request.

Additional information

Funding

This work has been funded by the National Center for Complementary and Integrative Health [grants no #K23AT01065301A1 to JG, #K24AT009465 to GY, and #1K24AT011760-01 to AMV]. VG is supported by a National Institutes of Health T32 fellowship [grant no #T32MH112485].