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A Comparison of Long-Term Postconcussive Symptoms between University Students with and without a History of Mild Traumatic Brain Injury or Orthopedic Injury

Published online by Cambridge University Press:  10 February 2012

Mark L. Ettenhofer  and
David M. Barry
Mark L. Ettenhofer*
Affiliation:
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
David M. Barry
Affiliation:
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
Correspondence and reprint requests to: Mark L. Ettenhofer, Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814-4712. E-mail: [email protected]
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Abstract

Mild traumatic brain injury (mild TBI) is often associated with postconcussive symptoms such as headache, memory problems, and irritability. However, high rates of similar symptoms in groups without a history of TBI raise questions about the clinical validity of the postconcussive syndrome. This study was conducted to address these issues through systematic examination of symptoms reported by those with and without a history of mild TBI or orthopedic injury. Responses to the Postconcussion Syndrome Checklist (PCSC), demographic information, and medical history were collected via online questionnaire from 3027 non-referred university students (2280 without a history of mild TBI or orthopedic injury, 491 with a history of orthopedic injury, and 256 with post-acute mild TBI). Although the mild TBI group reported higher mean levels of symptoms, confirmatory factor analyses demonstrated that symptoms clustered into parallel cognitive, somatic, affective, and sensory factors in all three groups. Despite modestly higher mean symptoms among those with a history of mild TBI, symptom clusters did not differ from non-TBI groups. These findings cast doubts about the clinical validity of the “postconcussive syndrome” and raise questions about pathways by which mild TBI and other factors may influence the expression of chronic symptoms. (JINS, 2012, 18, 451–460)

Keywords

Traumatic brain injuryConcussionPostconcussive symptomsPost-Concussion SyndromeChronicOrthopedic injuryPostconcussional Disorder
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 3 , May 2012 , pp. 451 - 460
Copyright
Copyright © The International Neuropsychological Society 2012

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References

Alexander, M.P. (1995). Mild traumatic brain injury: Pathophysiology, natural history, and clinical management. Neurology, 45(7), 1253–1260.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author.Google Scholar
Axelrod, B.N., Fox, D.D., Lees-Haley, P.R., Earnest, K., Dolezal-Wood, S., Goldman, R.S. (1996). Latent structure of the Postconcussion Syndrome Questionnaire. Psychological Assessment, 8(4), 422–427.CrossRefGoogle Scholar
Ayr, L.K., Yeates, K.O., Taylor, H.G., Browne, M. (2009). Dimensions of postconcussive symptoms in children with mild traumatic brain injuries. Journal of the International Neuropsychological Society, 15(01), 19–30.CrossRefGoogle ScholarPubMed
Bazarian, J.J., McClung, J., Shah, M.N., Cheng, Y.T., Flesher, W., Kraus, J. (2005). Mild traumatic brain injury in the United States, 1998--2000. Brain Injury, 19(2), 85–91.CrossRefGoogle ScholarPubMed
Benge, J.F., Pastorek, N.J., Thornton, G.M. (2009). Postconcussive symptoms in OEF-OIF veterans: Factor structure and impact of posttraumatic stress. Rehabilitation Psychology, 54(3), 270–278.CrossRefGoogle ScholarPubMed
Birnbaum, M.H. (2004). Human research and data collection via the Internet. [Review]. Annual Review of Psychology, 55, 803–832. doi:10.1146/annurev.psych.55.090902.141601CrossRefGoogle ScholarPubMed
Bohnen, N.J., Wijnen, G., Twijnstra, A., van Zutphen, W., Jolles, J. (1995). The constellation of late post-traumatic symptoms of mild head injury patients. Neurorehabilitation and Neural Repair, 9(1), 33–39. doi:10.1177/154596839500900105CrossRefGoogle Scholar
Brenner, L.A., Terrio, H., Homaifar, B.Y., Gutierrez, P.M., Staves, P.J., Harwood, J.E., Warden, D. (2010). Neuropsychological test performance in soldiers with blast-related mild TBI. Neuropsychology, 24(2), 160–167 .CrossRefGoogle ScholarPubMed
Caplan, L.J., Ivins, B., Poole, J.H., Vanderploeg, R.D., Jaffee, M.S., Schwab, K. (2010). The structure of postconcussive symptoms in 3 US military samples. Journal of Head Trauma Rehabilitation, 25(6), 447–458.CrossRefGoogle Scholar
Cassidy, J.D., Carroll, L.J., Peloso, P.M., Borg, J., von Holst, H., Holm, L., Coronado, V.G. (2004). Incidence, risk factors and prevention of mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl.), 28–60.CrossRefGoogle Scholar
Cheung, G., Rensvold, R. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255.CrossRefGoogle Scholar
Cicerone, K.D., Kalmar, K. (1995). Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 10(3), 1–17. doi:http://dx.doi.org/10.1097/00001199-199510030-00002CrossRefGoogle Scholar
Dikmen, S., Levin, H. (1993). Methodological issues in the study of mild head injury. Journal of Head Trauma Rehabilitation, 8(3), 30–37.CrossRefGoogle Scholar
Dikmen, S., Machamer, J., Temkin, N. (2001). Mild head injury: Facts and artifacts. Journal of Clinical and Experimental Neuropsychology, 23(6), 729–738.CrossRefGoogle Scholar
Faul, M., Xu, L., Wald, M.M., Coronado, V.G. (2010). Traumatic brain injury in the United States: Emergency department visits, hospitalizations, and deaths. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.Google Scholar
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(3), 193–211. doi:0887-6177(92)90162-G [pii]CrossRefGoogle ScholarPubMed
Gouvier, W., Uddo-Crane, M., Brown, L.M. (1988). Base rates of post-concussional symptoms. Archives of Clinical Neuropsychology, 3(3), 273–278.CrossRefGoogle ScholarPubMed
Gunstad, J., Suhr, J.A. (2002). Perception of illness: Nonspecificity of postconcussion syndrome symptom expectation. Journal of the International Neuropsychological Society, 8(1), 37–47.CrossRefGoogle ScholarPubMed
Herrmann, N., Rapoport, M., Rajaram, R., Chan, F., Kiss, A., Ma, A., Lanctôt, K.L. (2009). Factor analysis of the Rivermead Post-Concussion Symptoms Questionnaire in mild-to-moderate traumatic brain injury patients. The Journal of Neuropsychiatry and Clinical Neurosciences, 21(2), 181–188.CrossRefGoogle ScholarPubMed
Iverson, G.L. (2005). Outcome from mild traumatic brain injury. Current Opinion in Psychiatry, 18(3), 301–317.CrossRefGoogle ScholarPubMed
Iverson, G.L. (2006). Misdiagnosis of the persistent postconcussion syndrome in patients with depression. Archives of Clinical Neuropsychology, 21(4), 303–310.CrossRefGoogle ScholarPubMed
Iverson, G.L., Lange, R.T. (2003). Examination of “postconcussion-like” symptoms in a healthy sample. Applied Neuropsychology, 10(3), 137–144.CrossRefGoogle Scholar
Lees-Haley, P.R., Fox, D.D., Courtney, J.C. (2001). A comparison of complaints by mild brain injury claimants and other claimants describing subjective experiences immediately following their injury. Archives of Clinical Neuropsychology, 16(7), 689–695. doi:S0887-6177(00)00092-5 [pii]CrossRefGoogle ScholarPubMed
Masson, F., Maurette, P., Salmi, L.R., Dartigues, J.F., Vecsey, J., Destaillats, J.M., Erny, P. (1996). Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome. Brain Injury, 10(7), 487–497.CrossRefGoogle ScholarPubMed
McCrea, M. (2008). Mild traumatic brain injury and postconcussion syndrome: The new evidence base for diagnosis and treatment. Oxford: Oxford University Press.Google Scholar
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(3), 200–204.CrossRefGoogle ScholarPubMed
Piland, S.G., Motl, R.W., Ferrara, M.S., Peterson, C.L. (2003). Evidence for the factorial and construct validity of a self-report concussion symptoms scale. Journal of Athletic Training, 38(2), 104–112.Google ScholarPubMed
Potter, S., Leigh, E., Wade, D., Fleminger, S. (2006). The Rivermead Post Concussion Symptoms Questionnaire: A confirmatory factor analysis. Journal of Neurology, 253(12), 1603–1614. doi:10.1007/s00415-006-0275-zCrossRefGoogle ScholarPubMed
Satz, P.S., Alfano, M.S., Light, R.F., Morgenstern, H.F., Zaucha, K.F., Asarnow, R.F., Newton, S. (1999). Persistent Post-Concussive Syndrome: A proposed methodology and literature review to determine the effects, if any, of mild head and other bodily injury. Journal of Clinical and Experimental Neuropsychology, 21(5), 620–628.CrossRefGoogle ScholarPubMed
Sigurdardottir, S., Andelic, N., Roe, C., Jerstad, T., Schanke, A.K. (2009). Post-concussion symptoms after traumatic brain injury at 3 and 12 months post-injury: A prospective study. Brain Injury, 23(6), 489–497.CrossRefGoogle ScholarPubMed
Sterr, A., Herron, K.A., Hayward, C., Montaldi, D. (2006). Are mild head injuries as mild as we think? Neurobehavioral concomitants of chronic post-concussion syndrome. BMC Neurology, 6, 7.CrossRefGoogle ScholarPubMed
Suhr, J.A., Gunstad, J. (2002). Postconcussive symptom report: The relative influence of head injury and depression. Journal of Clinical and Experimental Neuropsychology, 24(8), 981–993.CrossRefGoogle ScholarPubMed
Sullivan, K., Garden, N. (2011). A comparison of the psychometric properties of 4 postconcussion syndrome measures in a nonclinical sample. Journal of Head Trauma Rehabilitation, 26(2), 170–176. doi:10.1097/HTR.0b013e3181e47f95CrossRefGoogle Scholar
Thornhill, S., Teasdale, G.M., Murray, G.D., McEwen, J., Roy, C.W., Penny, K.I. (2000). Disability in young people and adults one year after head injury: Prospective cohort study. British Medical Journal, 320(7250), 1631–1635.CrossRefGoogle ScholarPubMed
Wong, J.L., Regennitter, R.P., Barrios, F. (1994). Base rate and simulated symptoms of mild head injury among normals. Archives of Clinical Neuropsychology, 9(5), 411–425.CrossRefGoogle ScholarPubMed
World Health Organization (1992). International statistical classification of diseases and related health problems (10th ed.). Geneva, Switzerland: World Health Organization.Google Scholar