A comparison of mildly head-injured, malingering, and non-head-injured adult South Africans : neuropsychological performance and post-concussion symptoms.

[摘要] The study reviews the literature concerning mild headinjury and post concussion symptoms. It then investigatesthe applicability of international findings to SouthAfrican patients. Three groups of subjects are compared:mildly injured, noninjured, and instructed malingerers. Thestudy establishes base rates of postconcussive symptoms inthe noninjured subjects, scores on tests of cognitiveability among the noninjured subjects, expectationsregarding postconcussive sequelae among the noninjuredsubjects, the perceptions of injured subjects of their preandpostmorbid status, and relationships betweensubjectively experienced symptoms and cognitive deficitsam.ong injured subjects. Injured subgroups are examined toinvestigate pre-, peri-, and post-injury factors associatedwith development of postconcussive complaints. Nodifferences in cognitive performance were found between theinjured and noninjured groups. Time since injury did notaffect cognitive performance, apart from on a copy task. Itwas found that injured subjects reported lower pre-injurylevels of incidence of symptoms than those reported bynoninjured subjects. No differences were found betweenpost-injury reporting of postconcussive complaints andthose symptoms reported by noninjured controls. Somepostconcussive symptoms were nevertheless found tocorrelate with certain measures of cognitive performance.Instructed malingerers responded differently noninjured injured and not injured subjects, reporting fewer pre-injury complaints and mere post-injury complaints. They also performed more poorly on several cognitive measures. Test scores that effectively identified malingerers were then re-examined, and cut-off rates suggested for differentiating malingerers from genuinely injured subjects.

[发布机构] University of the Witwatersrand