Self-reported cognitive symptoms following mild traumatic brain injury are poorly associated with neuropsychological performance in OIF/OEF veterans

• Published in: Journal of rehabilitation research and development 2010-01, Vol.47 (6), p.521-530
• Main Authors: Spencer, Robert J, Drag, Lauren L, Walker, Sara J, Bieliauskas, Linas A
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Afghan Campaign 2001; Brain; Brain damage; Brain Injuries - complications; Brain Injuries - diagnosis; Brain Injuries - epidemiology; Brain Injuries - psychology; Cognition & reasoning; Cognition disorders; Cognition Disorders - epidemiology; Cognition Disorders - etiology; Cognition Disorders - rehabilitation; Cognitive ability; Complications and side effects; Data collection; Diagnosis; Educational Status; Head injuries; Health aspects; Humans; Injuries; Iraq War, 2003-2011; Male; Medical imaging; Middle Aged; Military Personnel - psychology; Neuropsychological Tests; Psychometrics; Risk factors; Self Report; Stress; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - psychology; Surveys and Questionnaires; Trauma; Trauma Severity Indices; United States - epidemiology; United States Department of Veterans Affairs; Veterans; Veterans - psychology
• ISSN: 0748-7711; 1938-1352
• DOI: 10.1682/JRRD.2009.11.0181

Mild traumatic brain injury (mTBI) is not uncommon among Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans, and many individuals within this group report lingering cognitive difficulties following their injury. For Department of Veterans Affairs clinicians, an accurate assessment of cognitive symptoms is important in providing appropriate clinical care. Although self-assessment is commonly employed to screen for difficulties in cognitive functioning, little is known about the accuracy of self-report in this population. This study collected cognitive, psychiatric, and self-report data from 105 OIF/OEF veterans with mTBI to examine the relationship between self-reported cognitive functioning and objective neuropsychological test performance. Additionally, clinicians who frequently work with OIF/OEF veterans were asked to predict the magnitude of these associations. Self-reported cognitive functioning was not significantly correlated with objective cognitive abilities, suggesting that objective neuropsychological testing should be used when cognitive weakness is suspected. Perceived cognitive deficits were associated with depression, anxiety, and posttraumatic stress disorder, illustrating the additional importance of adequate assessment and treatment of psychiatric symptoms. Clinicians tended to overestimate the association between self-report and test performance.