Everywhere you look these days, stories abound in the popular media (e.g., television, newspapers, magazines, internet articles) regarding the short and long-term effects of concussions (mild traumatic brain injuries). While there is no doubt that concussions need to be taken seriously, particularly with regards to the neurological risks of repeat concussions before the person has fully recovered from the first, there is rarely a discussion of the many non-neurological factors that can lead to reported symptom persistence in some individuals. This is a topic that is well known outside of the media and the public, via peer-reviewed published research articles in scientific journals, most of which were written by neuropsychologists.
Neuropsychologists are specialized doctoral level health care providers who objectively evaluate the relationship between brain functioning, thinking skills, emotions, and behaviors. This is partly done by administering cognitive tests known to differentiate patients with brain injury from normal controls and administering reliable and valid tests of personality and emotional pathology. The profession integrates knowledge of the neurological sciences with the psychological sciences, which is important since psychological factors can often mimic neurological signs and symptoms. This is why neurologists often refer to stress as “the great imitator.”
Neuropsychology is the profession that has developed and published the most research on the assessment of symptom validity and performance validity in patients who report persisting problems (i.e., more than 3 months) after concussion. However, outside of neuropsychology, many health care providers who struggle for years to treat these patients are unaware that such assessment methods exist and how much the use of such methods can drastically alter case conceptualization, treatment, and the proper allocation of health care resources. The book, Mild Traumatic Brain Injury: Symptom Validity Assessment and Malingering is the first dedicated entirely to this specific topic and should be a very useful resource for all health care providers assessing such patients.
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