Date of Award

Summer 2020

Document Type


Degree Name

Doctor of Philosophy (PhD)




Clinical Psychology

First Advisor

Hoelzle, James B.

Second Advisor

Kaugars, Astrida

Third Advisor

Loman, Michelle


Mild traumatic brain injury (mTBI) is a significant public health concern, particularly for children and adolescents. Existing research suggests that pre-injury and injury-related factors influence recovery. The current study simultaneously considered variables relevant to recovery from pediatric mTBI, including pre-injury diagnoses, symptom burden, neuropsychological and emotional functioning, performance validity, and medical service utilization in an archival sample of children referred to a multidisciplinary concussion clinic. Consistent with a broad literature, female sex and initial symptom burden predicted referral for neuropsychological evaluation. Initial symptom burden also predicted neuropsychological performance and service utilization. A meaningful proportion of the sample reported clinically significant symptoms of anxiety and/or depression, which negatively influenced neuropsychological functioning. After excluding patients with suspect performance validity, the rate at which individuals obtained impaired neuropsychological scores status-post injury decreased. Finally, this research documented rates of medical service utilization in a sample of children experiencing prolonged recovery from concussion. On average, participants in this sample completed approximately 9 medical visits related to their injury, and initial symptom burden predicted increased service utilization. The current study provides further evidence for the biopsychosocial model of recovery from mTBI and underscores the importance of considering symptom reporting and emotional functioning, as well as routinely assessing performance validity in pediatric mTBI sample.

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Psychology Commons