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Objective Versus Subjective Cognitive Status Following Mild Traumatic Brain Injury: The Role of Psychological Factors
Gabrielle A Hromas1, Marlina A Novoa, Jeremy J Davis
1Author Affiliations: The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Conditions, San Antonio, Texas (Drs Hromas and Novoa); and Department of Neurology, University of Texas Health Science Center, San Antonio, Texas (Dr Davis).
The Journal of Head Trauma Rehabilitation
|July 18, 2025
Summary
Mild traumatic brain injury (mTBI) patients report more cognitive issues than objective tests show, especially with higher emotional distress. Psychological support is crucial for recovery after mTBI.
Area of Science:
- Neuroscience
- Psychology
- Rehabilitation Medicine
Background:
- Mild traumatic brain injury (mTBI) is a common injury with significant long-term consequences.
- Cognitive deficits and subjective complaints are frequently reported after mTBI.
- The relationship between objective cognitive function and subjective experience, and the role of mental health, requires further investigation.
Purpose of the Study:
- To investigate the association between objective cognitive performance and self-reported cognitive status in individuals with mTBI.
- To examine the influence of mental health symptoms on the relationship between objective and subjective cognitive status after mTBI.
Main Methods:
- A secondary analysis utilized data from the Federal Interagency Traumatic Brain Injury Research Informatics System.
- A final sample of 614 participants (138 controls, 476 mTBI) was analyzed after exclusions.
- Objective cognitive status was assessed using the Brief Test of Cognition by Telephone (BTACT), and subjective status via the Rivermead Postconcussion Symptoms Questionnaire (CC). Cognitive discrepancy was calculated, and linear regression models were used to identify predictors including mental health status.
Main Results:
- Individuals with mTBI reported more affective symptoms and cognitive complaints compared to controls, but objective cognitive abilities did not differ.
- Affective symptoms were higher in mTBI individuals with greater subjective cognitive complaints than predicted by objective scores.
- Older age, female gender, and increased emotional distress were linked to a larger cognitive discrepancy in the overall sample.
Conclusions:
- Elevated psychological symptoms correlate with higher subjective cognitive complaints relative to objective cognitive abilities in mTBI.
- These findings underscore the importance of addressing psychological well-being in the recovery process for individuals with mTBI.
- Psychological interventions are essential for comprehensive post-mTBI care.
