Perception of illness: Nonspecificity of Postconcussion Syndrome symptom expectation

Abstract

A growing number of studies show postconcussion syndrome (PCS) symptom report is influenced by factors other than head injury, suggesting symptoms typically associated with PCS may not be specific to head injury. Given the role that symptom expectation has been hypothesized to play in PCS symptom etiology, a comparison of symptoms expected for various disorders seems overdue. The present study asked 82 undergraduates to report the symptoms they currently experience, and then to report the symptoms they would expect to experience if they had had suffered either a head injury, an orthopedic injury, posttraumatic stress, or depression. No current differences in overall symptoms or in symptom subscales emerged. Results showed individuals portraying head injury, posttraumatic stress, and depression expected an increase in total symptoms, though individuals portraying an orthopedic injury did not expect such an increase. Results also showed simulators of head injury, posttraumatic stress, and depression expected equivalent rates of overall symptoms, memory0cognitive complaints, somatic concerns, and distracter symptoms, though head-injured individuals reported fewer affective symptoms than those portraying psychological disorders. In all, these findings suggest that individuals have a relative lack of specificity in symptom expectation for various disorders, with the implication that symptom checklists for " PCS" may not be useful for diagnosis. (JINS, 2002, 8, 37-47.)

The Rivermead Post Concussion Symptoms Questionnaire

“…Further specification might be necessary: expectations of symptoms may be more specific, or be differentially affected by different precipitating events. Indeed in one study [30] undergraduate students predicted that they would experience more total symptoms if they had had a head injury, posttraumatic stress or depression compared with an orthopaedic injury, but fewer emotional symptoms after head injury compared with depression and posttraumatic stress vignettes. Whilst expectations of cognitive symptoms were not relatively elevated by a prospective head injury compared with the depression and posttraumatic stress vignettes, expectations regarding increased need to use compensatory memory strategies were elevated for the head injury vignette in that study.…”

Post-concussion syndrome: Prevalence after mild traumatic brain injury in comparison with a sample without head injury

“…Significantly, it also established that postconcussion-like symptoms are present to such a degree that diagnosis of PCS is similar in a self-selected sample of persons with and without mTBI (Figure 1). Combined with the detailed analysis of the data discussed below, this suggests that PCS (as currently defined) is associated with, but not specific to, mTBI [23,53,70]. This is important, as the symptoms used to define PCS must be specific enough to distinguish from populations without head injury (i.e.…”

Rates of symptom reporting following traumatic brain injury

“…Research also suggests that expectation may also play a role in symptom endorsement. In other words, people may be more likely to report symptoms they expect to occur with the condition they have, in this case, following brain injury (Gunstad & Suhr, 2002 ). These fi ndings indicate that while those with TBI report greater symptoms, these symptoms are not suffi ciently sensitive or specifi c to be used to diagnose a brain injury.…”