Skip to main content Accessibility help
×
Home

Perception of illness: Nonspecificity of Postconcussion Syndrome symptom expectation

  • JOHN GUNSTAD (a1) and JULIE A. SUHR (a1)

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, memory/cognitive 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.)

Copyright

Corresponding author

Reprint requests to: J.A. Suhr, Department of Psychology, Ohio University, 200 Porter Hall, Athens, OH 45701. E-mail: suhr@ohiou.edu

References

Hide All

REFERENCES

Alves, W., Macciocchi, S., & Barth, J. ( 1993). Postconcussive symptoms after uncomplicated mild head injury. Journal of Head Trauma Rehabilitation, 8, 4859.
Barth, J., Alves, W., Ryan, T., Macciocchi, S., Rimel, R., Jane, J., & Nelson, W. ( 1989). Mild head injury in sports: Neuropsychological sequelae and recovery of function. In H. Levin, H. Eisenberg, & A. Benton (Eds.), Mild head injury (pp. 257275). New York: Oxford University Press.
Binder, L., Storzbach, D., Anger, W., Campbell, K., Rohlman, & D., Portland Environmental Hazards Research Center. ( 1999). Subjective cognitive complaints, affective distress, and objective cognitive performance in Persian Gulf War veterans. Archives of Clinical Neuropsychology, 14, 531536.
Bohnen, N., Twijnstra, A., & Jolles, J. ( 1992). Post-traumatic and emotional symptoms in different subgroups of patients with mild head injury. Brain Injury, 6, 481487.
Centers for Disease Control and Prevention ( 1999). Epidemiology of Traumatic Brain Injury in the United States. Retrieved December 6, 1999 from www.cdc.gov/ncipc/dacrrdp/tbiohta.
Dunn, J., Lees-Haley, P., Brown, R., Williams, C., & English, L. ( 1995). Neurotoxic complaint base rates of personal injury claimants: Implications for neuropsychological assessment. Journal of Clinical Psychology, 51, 577584.
Errico, A., Nixon, S., Parsons, O., & Tassey, J. ( 1990). Screening for neuropsychological impairment in alcoholics. Psychological Assessment, 2, 4550.
Evans, R. ( 1992). The postconcussion syndrome and sequelae of mild head injury. Neurologica Clinics, 10, 815847.
Ferguson, R., Mittenberg, W., Barone, D., & Schneider, B. ( 1999). Postconcussion syndrome following sports-related head injury: Expectation as etiology. Neuropsychology, 13, 582589.
Fox, D., Lees-Haley, P., Earnest, K., & Dolezal-Wood, S. ( 1995a). Base rates of postconcussive symptoms in health maintenance organization patients and controls. Neuropsychology, 9, 606611.
Fox, D., Lees-Haley, P., Earnest, K., & Dolezal-Wood, S. ( 1995b). Postconcussive symptoms: Base rates and etiology in psychiatric patients. Clinical Neuropsychologist, 9, 8992.
Gouvier, W., Cubic, B., Jones, G., Brantley, P., & Cutlip, Q. ( 1992). Postconcussion symptoms and daily stress in normal and head-injured college populations. Archives of Clinical Neuropsychology, 7, 193211.
Gouvier, W., Uddo-Crane, M., & Brown, L. ( 1988). Base rates of post-concussional symptoms. Archives of Clinical Neuropsychology, 3, 273278.
Gunstad, J. & Suhr, J.A. ( 2001). “Expectation as etiology” versus the “good old days”: Postconcussion syndrome symptom reporting in athletes, headache sufferers, and depressed individuals. Journal of the International Neuropsychological Society, 7, 323333.
Hahn, R. ( 1997). The nocebo phenomenon: Concept, evidence, and implications for public health. Preventive Medicine, 26, 607611.
Hahn, R. ( 1999). Expectations of sickness: Concept and evidence of the nocebo phenomenon. In I. Kirsch (Ed.), How expectancies shape experience (pp. 333356). Washington, DC: American Psychological Association.
Hanks, R., Temkin, N., Machamer, J., & Dikmen, S. ( 1999). Emotional and behavioral adjustment after traumatic brain injury. Archives of Physical Medicine Rehabilitation, 80, 991999.
Hochstrasser, B. & Angst, J. ( 1996). The Zurich study: Epidemiology of gastrointestinal complaints and comorbidity with anxiety and depression. European Archives of Clinical Neuroscience, 246, 261272.
Holm, S. ( 1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 6570.
Iverson, G. & McCracken, L. ( 1997). ‘Postconcussive’ symptoms in persons with chronic pain. Brain Injury, 11, 783790.
Kibby, M. & Long, C. ( 1996). Minor head injury: Attempts at clarifying the confusion. Brain Injury, 10, 159168.
Kirsch, I. ( 1985). Response expectancy as a determinant of experience and behavior. American Psychologist, 54, 504515.
Kirsch, I. ( 1999). Response expectancy: An introduction. In I. Kirsch (Ed.), How expectancies shape experience (pp. 315). Washington, DC: American Psychological Association.
Kraus, J., Fife, D., Cox, P., Ramstein, K., & Conroy, C. ( 1986). Incidence, severity, and external causes of pediatric brain injury. American Journal of Diseases of Children, 140, 687693.
Lancman, M., Asconape, J., Craven, W., Howard, G., & Penry, J. ( 1994). Predictive value of induction of psychogenic seizure by suggestion. Annals of Neurology, 35, 359361.
Levin, H., Mattis, S., Ruff, R., Eisenberg, H., Marshall, L., Tabaddor, K., High, W., & Frankowski, R. ( 1987). Neurobehavioral outcome following minor head injury: A three-center study. Journal of Neurosurgery, 66, 234243.
Luparello, T., Lyons, H., Bleecker, E., & McFadden, E. ( 1968). Influences of suggestion on airway reactivity in asthmatic subjects. Psychosomatic Medicine, 30, 819825.
Macciocchi, S., Barth, J., Alves, W., Rimel, R., & Jane, J. ( 1996). Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery, 39, 510514.
Maddux, J. ( 1999). Expectancies and the social–cognitive perspective: Basic principles, processes, and variables. In I. Kirsch (Ed.), How expectancies shape experience (pp. 1740). Washington, DC: American Psychological Association.
Mandel, S. ( 1989). Minor head injury may not be “minor.” Postgraduate Medicine, 85, 213225.
Mittenberg, W., DiGuilio, D., Perrin, S., & Bass, A. ( 1992). Symptoms following mild head injury: Expectation as aetiology. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 200204.
Mittenberg, W., Tremont, G., Zielinski, R., Fichera, S., & Rayls, K. ( 1996). Cognitive-behavioral prevention of postconcussion syndrome. Archives of Clinical Neuropsychology, 11, 139145.
Mittenberg, W., Zielinski, R., & Fichera, S. ( 1993). Recovery from mild head injury: A treatment manual for patients. Psychotherapy in Private Practice, 12, 3752.
NIH Consensus Development Panel on Rehabilitation of Persons with Traumatic Brain Injury. ( 1999). Rehabilitation of persons with traumatic brain injury. Journal of the American Medical Association, 282, 974983.
Powell, J. & Barber-Foss, K. ( 1999). Traumatic brain injury in high school athletes. Journal of the American Medical Association, 282, 958963.
Rattan, G., Strom, D., & Dean, R. ( 1987). The efficacy of a neuropsychological symptom inventory in the differential diagnosis of neurological, depressed, and normal patients. Archives of Clinical Neuropsychology, 2, 257264.
Rush, A., Giles, D., Schlesser, M., Fulton, C., Weissenberger, J., & Burns, C. ( 1986). The inventory for depressive symptomatology (IDS): Preliminary findings. Psychiatric Research, 18, 6587.
Rutherford, W. ( 1989). Postconcussion symptoms: Relationship to acute neurological indices, individuals differences, and circumstances of injury. In H. Levin, H. Eisenberg, & A. Benton (Eds.), Mild head injury (pp. 217228). New York: Churchill Livingstone.
Sawchyn, J., Brulot, M., & Strauss, E. ( 2000). Note on the use of the Postconcussion Syndrome Checklist. Archives of Clinical Neuropsychology, 15, 18.
Schweiger, A. & Parducci, A. ( 1981). Nocebo: The psychologic induction of pain. Pavlovian Journal of Biological Science, 16, 140143.
Seidenberg, M., Taylor, M., & Haltiner, A. ( 1994). Personality and self-report of cognitive functioning. Archives of Clinical Neuropsychology, 9, 353361.
Stern, R., Robinson, B., Thorner, A., Arruda, J., Prohaska, M., & Prange, A. ( 1996). A survey study of neuropsychiatric complaints in patients with Graves' disease. Journal of Neuropsychiatry and Clinical Neurosciences, 8, 181185.
Tiersky, L., Johnson, S., Lange, G., Natelson, B., & DeLuca, J. ( 1997). Neuropsychology of chronic fatigue syndrome: A critical review. Journal of Clinical and Experimental Neuropsychology, 19, 560586.
Wearden, A. & Appleby, L. ( 1996). Research on cognitive complaints and cognitive functioning in patients with chronic fatigue syndrome (CFS): What conclusions can we draw? Journal of Psychosomatic Research, 41, 197211.
Wong, J., Regennitter, R., & Barrios, F. ( 1994). Base rate and simulated symptoms among normals. Archives of Clinical Neuropsychology, 9, 411425.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed