Diagnosis Threat and Injury Beliefs after Mild Traumatic Brain Injury

Abstract

Background Diagnosis threat is a psychosocial factor proposed to contribute to poor cognitive outcomes following mild traumatic brain injury (mTBI). The current research explored diagnosis threat impact on objective and subjective cognitive performance in a "high risk" population of athletes. Two possible moderators of diagnosis threat - injury beliefs and suggestibility - were also investigated. Method Seventy-six participants with a history of mTBI were recruited through sports clubs and randomized to a months threat group (instructions drew attention to mTBI history) or a control group (no mention of mTBI). They completed a battery of neuropsychological tests and questionnaires regarding day-to-day cognitive abilities. Measures of depression, anxiety, illness beliefs and suggestibility were also collected. Results No significant group differences were found on any neuropsychological tasks, nor on self-report of cognitive difficulties. Illness beliefs were not found to play a moderating role in general, although the majority of the study sample did not report negative mTBI beliefs and expectations: concern about the consequences of injury was associated with weaker performance on one test, WAIS-III Digit Span performance. Suggestibility was also found to have a significant affect on this test. Conclusions Diagnosis threat did not appear to have a marked affect on objective or subjective cognitive performance after mTBI in athletes. Differing injury beliefs between the study's athlete population and the general population is a possible explanation for different findings in the area. This and other sources of potential variation in the affect of diagnosis threat are discussed.