Mild Head Injury, Significant Impairment on Neuropsychological Test Scores, and Psychiatric Disability

Abstract

Typically there is a positive correlation between severity of known brain injury and level of performance on neuropsychological tests, particularly tests of memory and speed of information processing. This paper will discuss in detail nine individuals who had a history of mild head injury, but who presented with significant neuropsychological deficits on testing. In each case, evidence of significant psychiatric disability and/or malingering was present and seemed to better explain the poor neuropsychological test findings than did the trauma. All nine patients showed evidence of significant premorbid stressors, an ''atypical'' response style on neuropsychological tests, and vague and unusual somatic complaints. The importance of interpreting test findings within the context of an adequate history via record review and a thorough clinical interview is stressed.