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Molly A. O'Reilly, Psy.D., is a 2026 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Katherine Evarts, PsyD, Chairperson
  • Rachel Chickerella, PhD, Committee Member
  • Jonathan Lichtenstein, PsyD, MBA, Committee Member

Keywords

concussion, mTBI, persisting symptoms, PSaC, recovery, qualitative research, pediatric concussions, pediatrics

Document Type

Dissertation

Publication Date

2026

Abstract

Concussions present complex diagnostic and treatment challenges, particularly for pediatric patients who may experience persisting symptoms. Psychological mechanisms, including patient expectations and beliefs about recovery and symptoms, play a critical role in shaping outcomes. However, there is limited research exploring these factors in pediatric populations, particularly using qualitative approaches. This study sought to address this gap by employing a qualitative phenomenological design with interpretive phenomenological analysis to examine the recovery expectations of pediatric patients with persisting symptoms following concussion, as well as caregivers’ perspectives. Using the nocebo effect as a conceptual framework, eight pediatric patients and their caregivers participated in semi-structured interviews to share their lived experiences of persisting symptoms after concussion and the recovery process. Emergent themes highlighted patterns of pre-existing expectations, the adjustment and revision of expectations over the course of recovery, and the various sources of information that shape expectations and recovery experiences. Findings also emphasized the role of healthcare providers and systems in influencing expectations, perceptions, and recovery trajectories, as well as the ways in which concussion and recovery impact beliefs about brain health and daily functioning. Overall, these findings provide nuanced insight into the personal and contextual factors influencing symptom experience and functioning in pediatric concussion. They further underscore the individualized nature of recovery and highlight the critical need for consistent, early, evidence-based psychoeducation (e.g., in pediatrics, primary care, assessment, and psychotherapeutic contexts) in acute concussion management to better support this population and potentially reduce the development of persisting symptoms. This dissertation is available in open access at Antioch University Repository and Archive (https://aura.antioch.edu) and OhioLINK Electronic Theses and Dissertations Center (https://etd.ohiolink.edu).

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ORCID iD: 0009-0003-0204-2255

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