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Postconcussive Complaints, Cognition, Symptom Attribution and Effort among Veterans

Published online by Cambridge University Press:  12 November 2012

Eric B. Larson ,
Bethany R. Kondiles ,
Christine R. Starr  and
Felise S. Zollman
Eric B. Larson*
Affiliation:
Brain Injury Medicine and Rehabilitation Program, Rehabilitation Institute of Chicago, Chicago, Illinois Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Bethany R. Kondiles
Affiliation:
Brain Injury Medicine and Rehabilitation Program, Rehabilitation Institute of Chicago, Chicago, Illinois
Christine R. Starr
Affiliation:
Brain Injury Medicine and Rehabilitation Program, Rehabilitation Institute of Chicago, Chicago, Illinois
Felise S. Zollman
Affiliation:
Department of Neurology, NorthShore University Health System, Glenview, Illinois
*
Correspondence and reprint requests to: Eric Larson, Rehabilitation Institute of Chicago, Brain Injury Medicine and Rehabilitation Program, 345 E. Superior Street, Chicago, IL 60611. E-mail: elarson@ric.org
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Abstract

The etiology of postconcussive symptoms is not clearly understood. Development of etiological models of those symptoms will be helpful for accurate diagnosis and for planning effective treatment. Such a model should characterize the role of subject characteristics (education, premorbid intelligence), social psychological factors and symptom validity. Toward that end, the present study examined the association of postconcussive complaints and cognitive performance with symptom attribution and level of effort on testing. In a sample of 155 veterans, attribution to concussion was associated with endorsement of more severe postconcussive complaints, after controlling for the effects of other factors such as subject characteristics. Similarly, effort was associated with cognitive performance after controlling for the effects of these other factors. The present findings are consistent with previous reports that illness perception and effort on testing are associated with postconcussive complaints. This supports previous recommendations to routinely educate all concussion patients immediately after injury to reduce distorted perceptions and related persistent complaints. Finally, these findings highlight a need for routine assessment of patients’ perception of their injury to identify cases that may require psychotherapy to address any misattributions that develop. (JINS, 2013, 19, 1–8)

Keywords

Postconcussion syndromeBrain concussion – diagnosisBrain concussion – complicationsNeuropsychological tests – methodsDiagnosis threatSymptom attribution
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 1 , January 2013 , pp. 88 - 95
Copyright
Copyright © The International Neuropsychological Society 2012

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