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The Discrepancy Between Cognitive Complaints and Neuropsychological Test Findings in Persons With Traumatic Brain
Leia Vos1, Michael W Williams, Julia M P Poritz
1Zablocki VA Medical Center, Milwaukee, Wisconsin (Dr Vos); TIRR Memorial Hermann, Brain Injury Research Center, Houston, Texas (Drs Williams and Sherer); Department of Psychology, University of Houston, Houston, Texas (Dr Williams); Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston (Dr Poritz); Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston (Ms Ngan and Dr Leon-Novelo); and Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Dr Sherer).
Depression impacts how traumatic brain injury (TBI) survivors perceive their cognitive abilities. Understanding these discrepancies is key for effective TBI treatment planning and rehabilitation.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Traumatic brain injury (TBI) survivors often experience a disconnect between their subjective cognitive complaints and objective neuropsychological test results.
- Identifying factors influencing these discrepancies is crucial for accurate assessment and effective treatment planning in TBI rehabilitation.
Purpose of the Study:
- To identify variables associated with discrepancies between subjective cognitive complaints and objective neuropsychological findings in adult TBI survivors.
- To explore the role of depression and other factors in the under- or overestimation of cognitive abilities post-TBI.
Main Methods:
- A prospective cohort observational study was conducted with 504 community-dwelling adult TBI survivors.
- Cognitive functions were assessed using standardized tests (e.g., WAIS-IV Digit Span, RAVLT, TMT-B, WMT).
- Mood and symptom inventories (e.g., PHQ-9, NSI) and quality of life measures were also administered.
Main Results:
- Multiple factors were linked to discrepancies in attention, memory, and executive functions between subjective reports and objective findings.
- Depression was consistently associated with the underestimation of cognitive abilities.
- Discrepancies varied by cognitive domain and were influenced by other factors related to ability over- or underestimation.
Conclusions:
- Reconciling subjective-objective cognitive discrepancies is vital for TBI case conceptualization and treatment planning.
- Depression is a significant patient characteristic to consider, particularly when TBI survivors underestimate their cognitive abilities.
- Assessing mood through self-report inventories is important, as it is a modifiable factor influencing TBI outcomes.
