Method of assessment and symptom reporting in veterans with mild traumatic brain injury

Abstract

Objectives: We hypothesized that in a sample of veterans (1) frequency and consistency of post-concussive symptom endorsement would differ across assessment methods (detailed physician interview, brief screening interview, or self-report questionnaire checklist) and (2) that participants would endorse more symptoms on the self-report checklist than the screening interview or the physician interview. Methods: To assess the presence and severity of post-concussive symptoms, veterans and current military service members were recruited via newspaper advertisement for a research project to assess history of traumatic brain injury. Participants underwent evaluation, including a brief screening interview (the Rehabilitation Institute of Chicago Military Traumatic Brain Injury Screening Instrument), a detailed physician interview, and completion of a self-report questionnaire (the Rivermead Post-concussion Questionnaire). Results: Symptom reporting significantly differed across assessment methods for headaches [Q(2) = 65.45, p < .001], dizziness [Q(2) = 52.55, p < .001], and nausea [Q(2) = 58.58, p < .001]. Symptoms were most likely to be reported in a brief screening interview followed by the self-report questionnaire, followed by a physician interview. Consistency of symptom reporting also differed: reporting of dizziness was more discordant across assessment methods than reporting of nausea or headaches. Discussion: Our findings support our first hypothesis, but provided only partial support for our second hypothesis. That is, the data confirm that differences exist in post-concussion symptom reporting based on data gathering technique and type of symptom. Yet, contrary to our expectations, participants endorsed more symptoms during a brief screening interview than on a self-report questionnaire. These findings may have implications for optimizing assessment of complaints after concussion, especially within a veteran population.

Keywords:

• post-concussive symptoms
• questionnaire
• checklist
• symptom reporting

Funding

This study was funded by grants from the Robert M. McCormick Tribune Foundation, the Julius N. Frankel Foundation, the Joseph G. Nicholas Foundation, and the Barker Welfare Foundation.