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The path from trait anxiety to post-concussion symptoms and posttraumatic stress symptoms in children with mTBI: the moderating role of alexithymia.

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Title: The path from trait anxiety to post-concussion symptoms and posttraumatic stress symptoms in children with mTBI: the moderating role of alexithymia.
Authors: Aviv, Irit (AUTHOR), Shorer, Maayan (AUTHOR), Fennig, Silvana (AUTHOR), Aviezer, Hillel (AUTHOR), Singer-Harel, Dana (AUTHOR), Apter, Alan (AUTHOR), Pilowsky Peleg, Tammy (AUTHOR)
Source: Child Neuropsychology. Nov2025, Vol. 31 Issue 8, p1302-1323. 22p.
Subjects: Alexithymia, Postconcussion syndrome, State-Trait Anxiety Inventory, School children, Brain injuries, Psychological factors, Post-traumatic stress
Abstract: Post-concussion symptoms (PCS) and posttraumatic stress symptoms (PTSS) are common after mild traumatic brain injuries (mTBI) in children. Psychological factors, especially pre-injury trait anxiety, are associated with the development of PCS and PTSS. However, the underlying mechanisms are understudied. The current study aimed to explore whether alexithymia (difficulty in identifying and describing emotions) moderates the associations between children's pre-injury trait anxiety and PCS, as well as PTSS in bothchildren and parents following mTBI. Participants were 53 children aged 8–16 with mTBI and their parents, recruited from the Emergency Department. Immediate mTBI symptoms were assessed by the Emergency Department physician within 24 hours post-injury. One-week post-injury, acute PTSS (children and parents), children's pre-injury trait anxiety, and alexithymia were measured using self-reported questionnaires. PCS were measured by symptom reports (including a baseline; reported by parents) and neuropsychological tests assessing cognitive functioning, including performance validity tests. PCS and cognitive functioning were assessed one-week and four-month post-injury. We found that alexithymia significantly moderated the associations between children's pre-injury trait anxiety and both PCS and PTSS in children and parents at one-week post-injury. Higher levels of alexithymia strengthened these associations. Alexithymia was found significantly associated with PCS at four-month post-injury. However, alexithymia did not moderate the association between pre-injury trait anxiety and PCS at four-month post-injury or cognitive functioning at one-week or four months. In conclusion, pre-injury trait anxiety and alexithymia are crucial in mTBI outcomes, being associated with PCS and PTSS development. Therefore, addressing emotional factors is important in TBI recovery. [ABSTRACT FROM AUTHOR]
Copyright of Child Neuropsychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The path from trait anxiety to post-concussion symptoms and posttraumatic stress symptoms in children with mTBI: the moderating role of alexithymia.
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  Data: <searchLink fieldCode="AR" term="%22Aviv%2C+Irit%22">Aviv, Irit</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shorer%2C+Maayan%22">Shorer, Maayan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fennig%2C+Silvana%22">Fennig, Silvana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aviezer%2C+Hillel%22">Aviezer, Hillel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singer-Harel%2C+Dana%22">Singer-Harel, Dana</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Apter%2C+Alan%22">Apter, Alan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pilowsky+Peleg%2C+Tammy%22">Pilowsky Peleg, Tammy</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Child+Neuropsychology%22">Child Neuropsychology</searchLink>. Nov2025, Vol. 31 Issue 8, p1302-1323. 22p.
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  Data: <searchLink fieldCode="DE" term="%22Alexithymia%22">Alexithymia</searchLink><br /><searchLink fieldCode="DE" term="%22Postconcussion+syndrome%22">Postconcussion syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22State-Trait+Anxiety+Inventory%22">State-Trait Anxiety Inventory</searchLink><br /><searchLink fieldCode="DE" term="%22School+children%22">School children</searchLink><br /><searchLink fieldCode="DE" term="%22Brain+injuries%22">Brain injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+factors%22">Psychological factors</searchLink><br /><searchLink fieldCode="DE" term="%22Post-traumatic+stress%22">Post-traumatic stress</searchLink>
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  Data: Post-concussion symptoms (PCS) and posttraumatic stress symptoms (PTSS) are common after mild traumatic brain injuries (mTBI) in children. Psychological factors, especially pre-injury trait anxiety, are associated with the development of PCS and PTSS. However, the underlying mechanisms are understudied. The current study aimed to explore whether alexithymia (difficulty in identifying and describing emotions) moderates the associations between children's pre-injury trait anxiety and PCS, as well as PTSS in bothchildren and parents following mTBI. Participants were 53 children aged 8–16 with mTBI and their parents, recruited from the Emergency Department. Immediate mTBI symptoms were assessed by the Emergency Department physician within 24 hours post-injury. One-week post-injury, acute PTSS (children and parents), children's pre-injury trait anxiety, and alexithymia were measured using self-reported questionnaires. PCS were measured by symptom reports (including a baseline; reported by parents) and neuropsychological tests assessing cognitive functioning, including performance validity tests. PCS and cognitive functioning were assessed one-week and four-month post-injury. We found that alexithymia significantly moderated the associations between children's pre-injury trait anxiety and both PCS and PTSS in children and parents at one-week post-injury. Higher levels of alexithymia strengthened these associations. Alexithymia was found significantly associated with PCS at four-month post-injury. However, alexithymia did not moderate the association between pre-injury trait anxiety and PCS at four-month post-injury or cognitive functioning at one-week or four months. In conclusion, pre-injury trait anxiety and alexithymia are crucial in mTBI outcomes, being associated with PCS and PTSS development. Therefore, addressing emotional factors is important in TBI recovery. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of Child Neuropsychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/09297049.2025.2482826
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        Text: English
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      – SubjectFull: Alexithymia
        Type: general
      – SubjectFull: Postconcussion syndrome
        Type: general
      – SubjectFull: State-Trait Anxiety Inventory
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      – SubjectFull: Brain injuries
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      – SubjectFull: Post-traumatic stress
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      – TitleFull: The path from trait anxiety to post-concussion symptoms and posttraumatic stress symptoms in children with mTBI: the moderating role of alexithymia.
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              M: 11
              Text: Nov2025
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