The effect of diagnostic terminology on cognitive, emotional, and post-concussive sequelae following mild brain injury

Abstract

Objective

We sought to determine whether the diagnostic terms ‘mild traumatic brain injury (mTBI)’ and ‘concussion’ result in differences in perceived cognitive, emotional, and post-concussive sequelae.

Method

A total of 81 healthy university students (79% female; 69% of Asian descent) were randomly assigned to one of two conditions: mTBI (n = 41), or concussion (n = 40), and were instructed to simulate on a battery of cognitive (Neuropsychological Assessment Battery – Screening Module), emotional (Beck Anxiety Inventory, Beck Depression Inventory-II), and post-concussive (Rivermead Postconcussive Symptoms Questionnaire) measures.

Results

There were no significant group differences between expected cognitive, emotional, or post-concussive consequences. However, both groups received poorer scores than the normative data.

Conclusions

These results suggest that diagnostic terminology does not appear to influence anticipated recovery following mild brain injury. However, the presentation of information about the injury itself may impact recovery outcomes. This study provides preliminary support for the potential negative effects that may arise as a result of providing participants with non-evidence based information about mild brain injuries.

Keywords:

• Concussion
• diagnosis threat
• diagnostic terminology
• expectations as etiology
• mild traumatic brain injury

Acknowledgments

The authors would like to thank Alex Koppel, Angelica Palantzas, Jaishree Nayyar, Niroshica Mohanathas, Nour Yassine, Shalini Bahl, and Tyler Brown for their assistance with data collection. The authors report no financial support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 History of previous head injury was defined as the participant’s self-reported concussion, mTBI, moderate TBI, severe TBI, and history of previous psychiatric or neurological disorder was defined as previous or current diagnosis for any mental health disorder or neurological disorder.

2 One individual endorsed previous head injury and previous neurological or psychiatric disorder.

3 Preliminary analyses were conducted to ensure no violation of the normality assumption. If the normality assumption was violated, non-parametric analyses were run. Significance was evaluated using a Bonferroni-corrected alpha level.

4 Guidelines for interpretation indicate an effect size of 0.2 to be “small”, 0.5 to be “medium”, and 0.8 to be “large” (Cohen, 1988).