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.