The Relationship Between Self-reported Anxiety and Cognition in Individuals with Mild Traumatic Brain Injury

Research Objectives: To determine whether there is a significant difference between cognitive performance among adults with mTBI and anxiety compared to adults with mTBI and without anxiety. Hypothesis: We predict that adults with mTBI and anxiety will perform poorer on measures of cognitive performance when compared to adults with mTBI and without anxiety.

Design: Retrospective, cross-sectional study

Setting: Academic Medical Center

Participants: Study sample consisted of community-based adults aged 18-54 (47 males, 62 females) native English speakers, with normal to corrected vision and hearing. Exclusion criteria included history of neurological diseases, disorders or complication that may impact the brain, history of diagnosed speech/language problem, and use of medications that may affect the brain. Two groups were included in the study: mTBI with anxiety and mTBI without anxiety. Those who scored a 0 or 1 on the NSI questionnaire question #19, “feeling anxious or tense” were included in group one (mTBI – anxiety) and those who scored a 2, 3, or 4 were included in group two (mTBI + anxiety). A total of 109 individuals were included in the final sample with 75 participants in the no anxiety group and 34 in the anxiety group.

Interventions: n/a

Main Outcome Measures: Demographic and injury information was gathered from participants via clinical intake form. Standardized cognitive measures included the NIH Toolbox Cognition Battery Total Score, Control Oral Word Association Task (COWAT) and Weschler Adult Intelligence Scale (WAIS-IV) Processing Speed Index.

Results: Analyses revealed significantly different WAIS-IV processing speed scores [t(58.6) = 1.765, p = .041] and NIH cognition scores [t(50.278) = -1.828, p = .037] between participants with mTBI and anxiety and participants without anxiety. Pearson correlations revealed a negative correlation between anxiety and processing speed performance r = - .207, p< 0.05 (1-tailed).

Conclusions: Results of this study suggest that adults with mTBI without anxiety symptoms outperform those with mTBI and anxiety on measures of processing speed. However, we did not observe this phenomenon in measures of verbal fluency or general cognition. Future studies should further explore the significant connection between anxiety symptoms and processing speed in adults with mTBI in larger samples and include standardized measures of anxiety.

Author(s) Disclosures: No conflicts of interest to disclose