Organic influences
| Prior head injury
Female
Age >40
Low IQ, dementia
Poor education
APOE-4 allele | Severity of head injury:
- GCS 13–14
- PTA >1 hour
- intracranial abnormality on imaging
- acute headache, dizziness, nausea
- anosmia
- “double”“double”double” trauma (intoxication, re-injury prior to recovery)
-serum S-100B | Psychotropic medication
Analgesic use
Alcohol use
Cannabis use |
Psychiatric influences
| Anxiety
Major depression | Traumatic memories of the event (traumatic memory) | Anxiety state
Post-traumatic stress disorder
Major depression |
Psychological influences
| | Expectation of disability
“Stress”
Inadequate information
Iatrogenic secondary to failed interventions (eg, return to work) | Deactivation
“Fear” avoidance
Secondary gain (personal, social, or financial gain from the impairments)
Litigation |