title: The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury.
abstract: This retrospective chart review study explored the relationship between suboptimal effort and post-concussion symptoms in pediatric mild traumatic brain injury (mTBI). Participants were 382 clinically referred children and adolescents between 8 and 16 years of age who sustained an mTBI. Suboptimal effort was identified using reliable digit span and age-corrected scaled scores from the Numbers subtest of the Children's Memory Scale (CMS); 20% of the sample were classified as non-credible performers. Chi-square analyses and t-tests were used to examine differences in post-concussion symptoms and neuropsychological test performance between credible and non-credible performers. Linear regression was used to examine whether CMS Numbers performance predicted post-concussion symptoms after controlling for baseline symptoms and other relevant demographic- and injury-related factors. We found that non-credible performers presented with a greater number of post-concussion symptoms as compared with credible performers. Additionally, non-credible performers demonstrated comparatively poorer performance on neuropsychological tests of focused attention and processing speed. These results suggest that children and adolescents with mTBI who fail effort testing might have a greater tendency to exaggerate post-concussion symptoms and cognitive impairment. The clinical implications of these findings are discussed.
authors.affiliation: a Department of Psychology and Neuropsychology , Nationwide Children's Hospital and The Ohio State University College of Medicine , Columbus , OH , USA.
authors.forename: Gabriel C
authors.initials: GC
authors.lastname: Araujo
authors.forename: Tanya N
authors.initials: TN
authors.lastname: Antonini
authors.forename: Kerry
authors.initials: K
authors.lastname: Monahan
authors.forename: Carl
authors.initials: C
authors.lastname: Gelfius
authors.forename: Karl
authors.initials: K
authors.lastname: Klamar
authors.forename: Michelle
authors.initials: M
authors.lastname: Potts
authors.forename: Keith O
authors.initials: KO
authors.lastname: Yeates
authors.forename: Doug
authors.initials: D
authors.lastname: Bodin
mesh_terms: D000293:Adolescent; D001288:Attention; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008568:Memory; D009042:Motivation; D009483:Neuropsychological Tests; D038223:Post-Concussion Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D012189:Retrospective Studies; D015599:Trauma Severity Indices
keywords: Children; Effort; Mild traumatic brain injury; Neuropsychology.; Post-concussion symptoms