Open Collections

UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

The role of illness perceptions in mental health treatment-seeking and outcomes after mild traumatic brain injury Otamendi, Thalia


Mental health complications are common but undertreated after mild traumatic brain injury (mTBI). Patient-related barriers to the use of mental health treatment after mTBI are unclear. According to the Common Sense Model of Self-Regulation, how individuals understand their health condition (i.e., illness perceptions) influences their coping strategies (e.g., treatment-seeking), and in turn, clinical outcomes. This research program had three objectives: 1) To understand the association between patients’ illness perceptions (e.g., about the cause, prognosis, consequences of their symptoms) and their perceived need for mental health care after mTBI; 2) To determine if the influence of illness perceptions on mTBI clinical outcomes is mediated by individuals’ access to mental health treatment; 3) To develop an explanatory model, rooted in the lived experiences of people with persistent symptoms after mTBI, that describes treatment-seeking decisions, including for mental health. The first two objectives were addressed with secondary analyses of a prospective inception cohort of adults with mTBI (N = 308 to 506) and the third objective with qualitative interviews (N = 17). Participants who believed their symptoms were threatening (OR = 1.16; 95% CI: 1.02 – 1.31) and caused by mental health difficulties (OR = 1.04; 95% CI: 1.02 – 1.05) were more likely to perceive the need for mental health care. Perceived threat (B = 0.02; 95% CI: 0.01- 0.03) and poor mental health as a cause for symptoms (B = 0.19; 95% CI: 0.09 – 0.29) were also associated with subsequent access to mental health treatment. Accessing mental health treatment did not mediate the relationship between illness perceptions and subsequent symptoms, likely due to a study design that did not allow sufficient time to capture treatment benefits. Qualitative data suggested that people can view mental health problems as a consequence, rather than a potential cause of ongoing mTBI symptoms, which might dissuade them from prioritizing mental health treatment. This research program demonstrates the relevance of illness perceptions on treatment-seeking after mTBI. Findings point to a potential barrier to the recommended use of mental health care when it does not align with patients’ beliefs about what is causing their symptoms.

Item Media

Item Citations and Data


Attribution-NonCommercial-NoDerivatives 4.0 International