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The Effect of Injury Diagnosis on Illness Perceptions and Expected Postconcussion Syndrome and Posttraumatic Stress Disorder Symptoms

Sullivan, Karen A. BA (Hons), PhD; Edmed, Shannon L. BA, BBehavSc(Psych), BBehavSc(HonsPsych); Kempe, Chloe BbehavSc(Psych), BbehavSc(HonsPsych)

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

The Journal of Head Trauma Rehabilitation: January/February 2014 - Volume 29 - Issue 1 - p 54–64
doi: 10.1097/HTR.0b013e31828c708a
Original Articles

Objective: To determine if systematic variation of diagnostic terminology (ie, concussion, minor head injury [MHI], mild traumatic brain injury [mTBI]) following a standardized injury description produced different expected symptoms and illness perceptions. We hypothesized that worse outcomes would be expected of mTBI, compared with other diagnoses, and that MHI would be perceived as worse than concussion.

Method: 108 volunteers were randomly allocated to conditions in which they read a vignette describing a motor vehicle accident–related mTBI followed by a diagnosis of mTBI (n = 27), MHI (n = 24), concussion (n = 31), or, no diagnosis (n = 26). All groups rated (a) event “undesirability,” (b) illness perception, and (c) expected postconcussion syndrome (PCS) and posttraumatic stress disorder (PTSD) symptoms 6 months after injury.

Results: There was a statistically significant group effect on undesirability (mTBI > concussion and MHI), PTSD symptomatology (mTBI and no diagnosis > concussion), and negative illness perception (mTBI and no diagnosis > concussion).

Conclusion: In general, diagnostic terminology did not affect anticipated PCS symptoms 6 months after injury, but other outcomes were affected. Given that these diagnostic terms are used interchangeably, this study suggests that changing terminology can influence known contributors to poor mTBI outcome.

Clinical Neuropsychology Research Group, School of Psychology and Counselling (Dr Sullivan and Mss Edmed and Kempe) and Institute of Health and Biomedical Innovation (Dr Sullivan and Ms Edmed), Queensland University of Technology, Brisbane, Australia.

Corresponding Author: Karen A. Sullivan, BA (Hons), PhD, O Block, B Wing, Kelvin Grove Campus, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, 4059, Queensland, Australia (

The Human Research Ethics Committee of Queensland University of Technology (QUT-HREC 1000000311) approved this research. This project was granted an occupational workplace health and safety clearance. Funding for this project was provided by the School of Psychology and Counselling, Queensland University of Technology. Parts of this project were presented at the Australian Psychological Society, College of Clinical Neuropsychology Conference, Launceston Tasmania, November 22-25, 2012.

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins