Rumination, but Not Reflection, Predicts the Reporting of Post-concussive Symptoms in a Non-clinical Sample

Arch Clin Neuropsychol. 2025 Sep 8:acaf078. doi: 10.1093/arclin/acaf078. Online ahead of print.

ABSTRACT

OBJECTIVE: Although traditionally associated with mild head trauma, post-concussive symptoms are commonly reported across both healthy and other clinical populations. Existing research indicates that individuals with depression report high levels of post-concussive symptoms, though the underlying causes of this association remain unknown. The current study aimed to explore potential factors underlying this relationship: specifically, how maladaptive and adaptive self-focused cognitive coping styles, namely, rumination and reflection, respectively, differentially contribute to post-concussive symptoms.

METHOD: 489 undergraduate students and 136 community participants with no history of head trauma completed the Rivermead Post-Concussion Symptom Questionnaire, the Depression Anxiety and Stress Scales-21 Items, and the Rumination and Reflection Questionnaire.

RESULTS: Rumination significantly predicted post-concussive symptoms after controlling for the effects of depression, demographic variables, and confounding factors. However, reflection did not predict lowered symptom reporting as hypothesized. Overall, the final model explained 42.5% of the variance in reported symptoms. Rumination, female gender, prior history of headaches, pre-existing diagnosis of attention-deficit/hyperactivity disorder, and depression were significant predictors of elevated post-concussive symptoms.

CONCLUSIONS: These findings suggest that rumination, a negative coping style linked to depression, plays a key role in influencing post-concussive symptom endorsement. Future research should examine combinations of rumination and reflection, as well as other cognitive coping styles, that affect symptom reporting. Clinically, assessment of an individual’s ruminative tendency following head trauma and the potential incorporation of rumination-focused treatment is recommended to improve recovery outcomes.

PMID:40919725 | DOI:10.1093/arclin/acaf078