Citation

Lange RT, Brickell TA, French LM, Ivins B, Bhagwat A, Pancholi S, Iverson G. J. Neurotrauma 2013; 30(4): 237-246.

Affiliation

Walter Reed National Military Medical Center, Defense and Veterans Brain Injury Center, Bethesda, Maryland, United States; rael.lange@gmail.com.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2685

PMID

23126461

Abstract

The purpose of this study was to identify factors that are predictive of, or associated with, postconcussion symptom reporting following traumatic brain injury (TBI) in the US military. Participants were 125 US military service members (Age: M=29.6, SD=8.9, range=18-56) who sustained a TBI, divided into two groups based on symptom criteria for Postconcussional disorder (PCD): PCD-Present (n=65) and PCD-Absent (n=60). Participants completed a neuropsychological evaluation at Walter Reed Army Medical Center (M=9.4 months following injury, SD = 9.9; range: 1.1 to 44.8). Factors examined included demographic characteristics, injury-related variables, psychological testing, and effort testing. There were no significant group differences for age, gender, education, race, estimated premorbid intelligence, number of deployments, combat versus non-combat related injury, or mechanism of injury (p >.098 for all). There were significant main effects for severity of bodily injury, duration of loss of consciousness, duration of post-traumatic amnesia, intracranial abnormality, time tested post injury, possible symptom exaggeration, poor effort, depression, and traumatic stress (p<.044 for all). PCD symptom reporting was most strongly associated with possible symptom exaggeration, poor effort, depression, and traumatic stress. PCD rarely occurred in the absence of depression, traumatic stress, possible symptom exaggeration, or poor effort (n=7, 5.6%). Many factors unrelated to brain injury were influential in self-reported postconcussion symptoms in this sample. Clinicians cannot assume uncritically that endorsement of items on a postconcussion symptom checklist is indicative of residual effects from a brain injury.

Language: en