The present study explored the explanatory power of
Mittenberg's “expectation as etiology”
theory for the persistence of postconcussion syndrome (PCS)
complaints. One hundred forty-one participants completed
a PCS symptom checklist under 2 conditions. Normal controls,
healthy athletes and depressed individuals reported current
symptoms and symptoms expected following a hypothetical
mild head injury. Head-injured athletes, chronic headache
sufferers, and a 2nd sample of normal controls reported
current symptoms and retrospective symptoms (prior to their
injury/illness or from some point in the past). Depressed
individuals reported more current symptoms than normal
controls and healthy athletes, demonstrating that “PCS”
symptoms are not specific to PCS. All groups expected more
symptoms following mild head injury than currently experienced,
supporting the idea that individuals expect negative consequences
following head injury. However, healthy athletes expected
fewer symptoms than normals or depressed individuals, possibly
due to preexisting expectations for speedy recovery. Both
head-injured athletes and headache sufferers reported more
current symptoms than the past, but not at a rate lower
than baseline of normal controls. Results suggest that
the “expectation as etiology” hypothesis may
be too specific, and that, following any negative event,
people may attribute all symptoms to that negative event
(the “good old days” hypothesis). (JINS,
2001, 7, 323–333.)