Predictors of Postconcussive Symptoms 3 Months After Mild Traumatic Brain Injury Jennie Ponsford Monash University; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital; and National Trauma Research Institute, Melbourne, Australia Peter Cameron and Mark Fitzgerald Monash University; Alfred Hospital; and National Trauma Research Institute, Melbourne, Australia Michele Grant Monash University; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital; and National Trauma Research Institute, Melbourne, Australia Antonina Mikocka-Walus Monash University, National Trauma Research Institute and University of South Australia Michael Schönberger Monash University; Monash-Epworth Rehabilitation Research Centre, Epworth Hospital; and University of Freiburg Objective: There is continuing controversy regarding predictors of poor outcome following mild traumatic brain injury (mTBI). This study aimed to prospectively examine the influence of preinjury factors, injury-related factors, and postinjury factors on outcome following mTBI. Method: Participants were 123 patients with mTBI and 100 trauma patient controls recruited and assessed in the emergency department and followed up 1 week and 3 months postinjury. Outcome was measured in terms of reported postconcussional symptoms. Measures included the ImPACT Post-Concussional Symptom Scale and cognitive concussion battery, including Attention, Verbal and Visual memory, Processing Speed and Reaction Time modules, pre- and postinjury SF-36 and MINI Psychiatric status ratings, VAS Pain Inventory, Hospital Anxiety and Depression Scale, PTSD Checklist–Specific, and Revised Social Readjustment Scale. Results: Presence of mTBI predicted postconcussional symptoms 1 week postin- jury, along with being female and premorbid psychiatric history, with elevated HADS anxiety a concurrent indicator. However, at 3 months, preinjury physical or psychiatric problems but not mTBI most strongly predicted continuing symptoms, with concurrent indicators including HADS anxiety, PTSD symptoms, other life stressors and pain. HADS anxiety and age predicted 3-month PCS in the mTBI group, whereas PTSD symptoms and other life stressors were most significant for the controls. Cognitive measures were not predictive of PCS at 1 week or 3 months. Conclusions: Given the evident influence of both premorbid and concurrent psychiatric problems, especially anxiety, on postinjury symptoms, managing the anxiety response in vulnerable individuals with mTBI may be important to minimize ongoing sequelae. Keywords: traumatic brain injury, concussion, outcome assessment Mild traumatic brain injury (mTBI) is a prevalent neurological condition, affecting 100 –300 out of 100,000 annually (Cassidy et al., 2004; Hirtz et al., 2007). Although studies have shown that most cases make a full recovery within 3 months of injury, approximately 15%–25% of cases experience ongoing symptoms, which may cause significant disability (Carroll et al., 2004; Pons- ford et al., 2000), with frequencies varying according to population studied, setting, and timing of recruitment (Belanger, Curtiss, Demery, Lebowitz, & Vanderploeg, 2005). The term postconcus- sion syndrome (PCS) refers to the somatic, cognitive, emotional, motor, or sensory symptoms ascribed to a concussion or head injury (Benton, 1989). These symptoms commonly include head- This article was published Online First April 2, 2012. Jennie Ponsford and Michele Grant, Monash University, Monash- Epworth Rehabilitation Research Centre, Epworth Hospital, and National Trauma Research Institute, Melbourne, Australia; Peter Cameron, Monash University, Alfred Hospital, and National Trauma Research Institute, Mel- bourne, Australia; Mark Fitzgerald, Monash University, Alfred Hospital, and National Trauma Research Institute, Melbourne, Australia; Antonina Mikocka-Walus, Monash University, School of Nursing and Midwifery, University of South Australia, National Trauma Research Institute, Mel- bourne, Australia; and Michael Schönberger, Monash University, Monash- Epworth Rehabilitation Research Centre, Epworth Hospital, and Depart- ment of Rehabilitation Psychology, Institute of Psychology, University of Freiburg, Germany. This research was funded by a grant from the Victorian Neurotrauma Initiative. The authors also gratefully acknowledge the assistance of staff in the Alfred Hospital Emergency and Trauma Care Department. Correspondence concerning this article should be addressed to Pro- fessor Jennie Ponsford, School of Psychology and Psychiatry, Monash University, Clayton, Victoria 3800, Australia. E-mail: jennie.ponsford@ monash.edu Neuropsychology © 2012 American Psychological Association 2012, Vol. 26, No. 3, 304 –313 0894-4105/12/$12.00 DOI: 10.1037/a0027888 304