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Effects of “Diagnosis Threat” on Cognitive and Affective Functioning Long After Mild Head Injury

Published online by Cambridge University Press:  08 December 2010

Lana J. Ozen*
Affiliation:
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
Myra A. Fernandes
Affiliation:
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
*
Correspondence and reprint requests to: Lana Ozen, Department of Psychology, 200 University Ave. W., University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada. E-mail: [email protected]

Abstract

Persistent cognitive complaints are common following a mild head injury (MHI), but deficits are rarely detected on neuropsychological tests. Our objective was to examine the effect of symptom expectation on self-report and cognitive performance measures in MHI individuals. Prior research suggests that when MHI participants are informed they may experience cognitive difficulties, they perform worse on neuropsychological tests compared to MHI participants who are uninformed. In this study, undergraduate students with and without a prior MHI were either informed that the study's purpose was to investigate the effects of MHI on cognitive functioning (“diagnosis threat” condition) or merely informed that their cognitive functioning was being examined, with no mention of status (“neutral” condition). “Diagnosis threat” MHIs self-reported more attention failures compared to “diagnosis threat” controls and “neutral” MHIs, and more memory failures compared to “diagnosis threat” controls. In the “neutral” condition, MHIs reported higher anxiety levels compared to controls and compared to “diagnosis threat” MHIs. Regardless of condition, MHIs performed worse on only one neuropsychological test of attention span. “Diagnosis threat” may contribute to the prevalence and persistence of cognitive complaints made by MHI individuals found in the literature, but may not have as strong of an effect on neuropsychological measures. (JINS, 2011, 17, 219–229)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2010

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References

Beck, A.T., Steer, R.A., Brown, G.K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
Belanger, H.G., Curtiss, G., Demery, J.A., Lebowitz, B.K., Vanderploeg, R.D. (2005). Factors moderating neuropsychological outcomes following mild traumatic brain injury: A meta-analysis. Journal of the International Neuropsychological Society, 11, 215227.CrossRefGoogle ScholarPubMed
Bernstein, D.M. (2002). Information processing difficulty long after self-reported concussion. Journal of the International Neuropsychological Society, 8, 673682.CrossRefGoogle ScholarPubMed
Binder, L.M., Rohling, M. (1996). Money matters: A meta-analytic review of the effects of financial incentives on recovery after closed-head injury. American Journal of Psychiatry, 153, 710.Google ScholarPubMed
Binder, L.M., Rohling, M.L., Larrabee, G.J. (1997). A review of mild head trauma. Part I. Meta-analytic review of neuropsychological studies. Journal of Clinical and Experimental Neuropsychology, 19, 421431.CrossRefGoogle ScholarPubMed
Broadbent, D.E., Cooper, P.F., FitzGerald, P., Parkes, K.R. (1982). The cognitive failures questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology, 21, 116.CrossRefGoogle ScholarPubMed
Carriere, J.S.A., Cheyne, J., Smilek, D. (2008). Everyday attention lapses and memory failures: The affective consequences of mindlessness. Consciousness and Cognition, 17, 835847.CrossRefGoogle ScholarPubMed
Chan, R.C.K. (2002). Attention deficits in patients with persisting postconcussive complaints: A general deficit or specific component deficit? Journal of Clinical and Experimental Neuropsychology, 24, 10811093.CrossRefGoogle ScholarPubMed
Cicerone, K.D. (1996). Attention deficits and dual task demands after mild traumatic brain injury. Brain Injury, 10, 7989.CrossRefGoogle ScholarPubMed
Davis, C.H. (2002). Self-perception in mild traumatic brain injury. American Journal of Physiological Medicine Rehabilitation, 81, 609621.CrossRefGoogle ScholarPubMed
Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A. (1987). The California Verbal Learning Test. San Antonio, TX: The Psychological Corporation.Google Scholar
Dischinger, P.C., Ryb, G.E., Kufera, J.A., Auman, K.M. (2009). Early predictors of postconcussive syndrome in a population of trauma patients with mild traumatic brain injury. The Journal of Trauma, 66, 289297.Google Scholar
Edna, T.H., Cappelen, J. (1987). Return to work and social adjustment after traumatic head injury. Acta Neurochirurgica, 85, 4043.CrossRefGoogle ScholarPubMed
Fann, J.R., Uomoto, J.M., Katon, W.J. (2001). Cognitive improvement with treatment of depression following mild traumatic brain injury. Psychosomatics, 42, 4854.CrossRefGoogle ScholarPubMed
Gunstad, J., Suhr, J.A. (2001). “Expectation as etiology” versus “the good old days”: Post-concussion syndrome symptom reporting in athletes, headache sufferers, and depressed individuals. Journal of International Neuropsychological Society, 7, 323333.CrossRefGoogle Scholar
Gunstad, J., Suhr, J.A. (2004). Cognitive factors in post-concussion syndrome symptom report. Archives of Clinical Neuropsychology, 19, 391405.CrossRefGoogle Scholar
Iverson, G.L., Lange, R.T., Brooks, B.L., Rennison, A. (2010). ‘Good old day’ bias following mild traumatic brain injury. The Clinical Neuropsychologist, 24, 1737.CrossRefGoogle Scholar
Iverson, G.L., Zasler, N.D., Lange, R.T. (2007). Post-concussive disorder. In Zasler, N.D., Katz, D.I., Zafonte, R.D. (Eds.), Brain injury medicine: Principles and practice (pp. 373403). New York: Demos Medical Publishing.Google Scholar
Kay, T., Harrington, D.E., Adams, R., Anderson, T., Berrol, S., Cicerone, K. (1993). Report of the mild traumatic brain injury committee of the head injury interdisciplinary special interest group of the american congress of rehabilitation medicine: Definition of mild traumatic injury. Journal of Head Trauma Rehabilitation, 8, 8687.Google Scholar
Lange, R.T., Iverson, G.L., Rose, A. (2010). Post-concussion symptom reporting and the “good-old-days” bias following mild traumatic brain injury. Archives of Clinical Neuropsychology, 25, 442450.CrossRefGoogle ScholarPubMed
McAllister, T.W., Saykin, A.J., Flashman, L.A., Sparling, M.B., Johnson, S.C., Guerin, S.J., Yanofsky, N. (1999). Brain activation during working memory 1 month after mild traumatic brain injury: A functional MRI study. Neurology, 53, 13001311.CrossRefGoogle ScholarPubMed
McAllister, T.W., Sparling, M.B., Flashman, L.A., Guerin, S.J., Mamourian, A.C., Saykin, A.J. (2001). Differential working memory load effects after mild traumatic brain injury. Neuroimaging, 14, 10041012.CrossRefGoogle ScholarPubMed
Messe, A., Caplain, S., Paradot, G., Garrigue, D., Mineo, J., Ares, G.S., Lehericy, S. (2010). Diffusion tensor imaging and white matter lesions at the subacute stage in mild traumatic brain injury with persistent neurobehavioral impairment. Human Brain Mapping, [Epub ahead of print].Google ScholarPubMed
Middleboe, T., Andersen, H.S., Birket-Smith, M., Friis, M.L. (1992). Minor head injury: Impact on general health after 1 year. A prospective follow-up study. Acta Neurologica Scandinavica, 85, 59.CrossRefGoogle ScholarPubMed
Mittenberg, W., DiGiulio, D.V., Perrin, S., Bass, A.E. (1992). Symptoms following mild head injury: Expectation as aetiology. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 200204.CrossRefGoogle ScholarPubMed
Mooney, G., Speed, J. (2001). The association between mild traumatic brain injury and psychiatric conditions. Brain Injury, 15, 865877.CrossRefGoogle ScholarPubMed
Niogi, S.N., Mukherjee, P. (2008). Diffusion tensor imaging of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 25, 241255.CrossRefGoogle Scholar
Pare, N., Rabin, L.A., Fogel, J., Pepin, M. (2008). Mild traumatic brain injury and its sequelae: Characterisation of divided attention deficits. Neuropsychological Rehabilitation, 19, 110137.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A., Nelms, R., Ng, K. (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of International Neuropsychological Society, 6, 568579.CrossRefGoogle ScholarPubMed
Potter, D.D., Jory, S.H., Bassett, M.R., Barrett, K., Mychalkiw, W. (2002). Effect of mild head injury on event-related potential correlates of stroop task performance. Journal of the International Neuropsychological Society, 8, 828837.CrossRefGoogle ScholarPubMed
Rapoport, M.J., McCullagh, S., Shammi, P., Feinstein, A. (2005). Cognitive impairment associated with major depression following mild and moderate traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 17, 6165.CrossRefGoogle ScholarPubMed
Reason, J.T., Mycielska, K. (1982). Absent-minded? The psychology of mental lapses and everyday errors. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Reitan, R.M., Wolfson, D. (1985). The Halstead-Reitan neuropsychological test battery. Tucson, AZ: Neuropsychological Press.Google Scholar
Rutherford, W.H., Merrett, J.D., McDonald, J.R. (1979). Symptoms at one year following concussion from minor head injuries. Injury, 10, 25230.CrossRefGoogle ScholarPubMed
Smits, M., Dippel, D.W.J., Houston, G.C., Wielopolski, P.A., Koudstaal, P.J., Hunink, M.G.M., Lugt, A. (2009). Postconcussion syndrome after minor head injury: Brain activation of working memory and attention. Human Brain Mapping, 30, 27892803.CrossRefGoogle ScholarPubMed
Solbakk, A., Reinvang, I., Neilsen, C., Sundet, K. (1999). ERP indicators of disturbed attention in mild closed head injury: A frontal lobe syndrome? Psychophysiology, 36, 802817.CrossRefGoogle ScholarPubMed
Sosin, D.M., Sniezek, J.E., Thurman, D.J. (1996). Incidence of mild and moderate brain injury in the United States, 1991. Brain Injury, 10, 4754.Google ScholarPubMed
Spencer, S.J., Steele, C.M., Quinn, D.M. (1999). Stereotype threat and women's math performance. Journal of Experimental and Social Psychology, 35, 428.CrossRefGoogle Scholar
Spiegel, H. (1997). Nocebo: The power of suggestibility. Preventive Medicine, 26, 616621.CrossRefGoogle ScholarPubMed
Spielberger, C.D., Gorsuch, R.L., Lushene, R.E. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Stein, M.B., McAllister, T.W. (2009). Exploring the convergence of posttraumatic stress disorder and mild traumatic brain injury. The American Journal of Psychiatry, 166, 768776.CrossRefGoogle ScholarPubMed
Stulemeijer, M., Vos, P.E., Bleijenberg, G., van der Werf, S.P. (2007). Cognitive complaints after mild traumatic brain injury: Things are not always what they seem. Journal of Psychosomatic Research, 63, 637645.CrossRefGoogle ScholarPubMed
Suhr, J.A., Gunstad, J. (2002). “Diagnosis threat”: The effect of negative expectations on cognitive performance in head injury. Journal of Clinical and Experimental Neuropsychology, 24, 448457.CrossRefGoogle ScholarPubMed
Suhr, J.A., Gunstad, J. (2005). Further exploration of the effect of “diagnosis threat” on cognitive performance in individuals with mild head injury. Journal of the International Neuropsychological Society, 11, 2329.CrossRefGoogle ScholarPubMed
Thurman, D.J. (2001). The epidemiology and economics of head trauma. In Miller, L., Hayes, R. (Eds.), Head trauma: Basic, preclinical, and clinical directions (pp. 327348). New York: John Wiley & Sons.Google Scholar
Tsanadis, J., Montoya, E., Hanks, R.A., Millis, S.R., Fichtenberg, N.L. (2008). Brain injury severity, litigation status, and self-report of postconcussive symptoms. The Clinical Neuropsychologist, 22, 10801092.CrossRefGoogle ScholarPubMed
Vanderploeg, R.D., Belanger, H.G., Curtiss, G. (2009). Mild traumatic brain injury and posttraumatic stress disorder and their associations with healthy symptoms. Archives of Physical Medicine and Rehabilitation, 90, 10841092.CrossRefGoogle ScholarPubMed
Vanderploeg, R.D., Curtiss, G., Belanger, H.G. (2005). Long-term neuropsychological outcomes following mild traumatic brain injury. The International Neuropsychological Society, 11, 228236.CrossRefGoogle ScholarPubMed
Vanderploeg, R.D., Curtiss, G., Luis, C.A., Salazar, A.M. (2007). Long-term morbidities following self-reported mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 29, 585598.CrossRefGoogle ScholarPubMed
Wechsler, D. (1997). Wechsler adult intelligence scale (3rd ed.). New York: The Psychological Corporation.Google Scholar
Westcott, M.C., Alfano, D.P. (2005). The symptom checklist-90-revised and mild traumatic brain injury. Brain Injury, 20, 12611267.CrossRefGoogle Scholar
Wheeler, S.C., Petty, R.E. (2001). The effects of stereotype activation on behavior: A review of possible mechanisms. Psychological Bulletin, 127, 797826.CrossRefGoogle ScholarPubMed
Zhang, K., Johnson, B., Pennell, D., Ray, W. (2010). Are functional deficits in concussed individuals consistent with white matter structural alterations: Combined fMRI and DTI study. Experimental Brain Research, 204, 5770.CrossRefGoogle ScholarPubMed