Symptom Reporting and Associations With Compensation Status, Self-Awareness, Causal Attributions, and Emotional Wellbeing Following Traumatic Brain Injury

Tamara Ownsworth, Jennifer M. Fleming, Sascha Hardwick
2006 Brain Impairment  
I ndividuals seeking compensation following traumatic brain injury (TBI) are often found to report a disproportionately high level of symptoms relative to objective indicators of impairment. Previous studies highlight that level of symptom reporting is also related to self-awareness, causal attribution, and emotional wellbeing. Therefore, the reasons for high symptom reporting in the context of compensation are generally unclear. This study aimed to identify whether self-awareness, causal
more » ... ution, and emotional wellbeing are significantly associated with level of symptom reporting after controlling for compensation status. A sample of 54 participants with TBI comprised two groups, namely, claimants (n = 27) and non-claimants (n = 27), who were similar in terms of demographic and neuro-cognitive variables. Participants completed the Symptom Expectancy Checklist, Hospital Anxiety Depression Scale, Awareness Questionnaire and a causal attribution scale. A series of independent t tests and Pearson's correlations identified that a higher level of symptom reporting was associated with the following: seeking compensation, less severe TBI, increased age, greater self-awareness, increased post-injury changes reported by relatives, a higher level of mood symptoms, and a tendency to blame other people. Multivariate analysis identified that after controlling for demographic, injury, and compensation status variables, level of mood symptoms and self-awareness were significantly associated with level of symptom reporting. The findings suggest that mood symptoms and heightened self-awareness are significantly related to high symptom reporting independent of compensation status, thus supporting the need for clinicians to interpret symptom reporting within a biopsychosocial context. Individuals seeking compensation following traumatic brain injury (TBI) often report more symptoms than non-claimants (Gasquoine, 1997b; McKinlay, Brooks, & Bond, 1983; Paniak et al., 2002) and the level of reported symptomatology may increase over time (Cartlidge, 1978) . A common explanation for excessive symptom reporting is that individuals misrepresent their BRAIN IMPAIRMENT VOLUME 7 NUMBER 2 SEPTEMBER 2006 pp. 95-106 ❚
doi:10.1375/brim.7.2.95 fatcat:ggsdr75x3rfl7and2b7bfu6c3e