Towards an embedded symptom validity indicator for the rivermead postconcussion symptom questionnaire.

Area of Science:

• Neuroscience
• Psychology
• Clinical Assessment

Background:

• Mild traumatic brain injury (mTBI) can lead to persistent post-concussion symptoms (PCS).
• Accurate symptom reporting is crucial for diagnosis and treatment, but symptom exaggeration can complicate assessments.
• Existing tools may not sufficiently differentiate genuine PCS from feigned symptoms.

Purpose of the Study:

• To develop and validate an embedded symptom validity indicator for the Rivermead Post Concussion Symptoms Questionnaire (RPQ).
• To create a modified RPQ (mRPQ) incorporating atypical symptoms to identify potential over-reporting.

Main Methods:

• Seven mTBI experts generated 15 atypical postconcussion symptoms.
• These were embedded into the standard 16 RPQ items, forming the mRPQ.
• Eighty-four mTBI simulators were assigned to symptom-exaggeration or simulation-only groups, completing the mRPQ, Test of Memory Malingering (TOMM), and Recognition Memory Test (RMT).

Main Results:

• No significant interaction between group allocation and item type was found.
• The symptom-exaggeration group scored higher on the mRPQ than the simulation-only group.
• Standard symptoms were endorsed more frequently than atypical symptoms.

Conclusions:

• The modified RPQ (mRPQ) shows potential as a tool to screen for over-reporting of post-concussion symptoms.
• Further development could enhance its utility in clinical settings for mild traumatic brain injury assessments.