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CSME|CAPDA Medico-Legal Summit - Angela Sekely
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The Effects of Diagnostic Terminology on Cognitive, Emotional and Somatic Outcomes Following Mild Brain Injury
Angela Sekely, MA, Sonya Dhillon, MA., Konstantine K. Zakzanis, PhD., R. Michael Bagby, PhD.

While used interchangeably to represent similar acute injury characteristics, mild traumatic brain injury (mTBI) and concussion often result in different functional outcomes. Though acute effects can be explained at the neuropathological level (Bigler, 2008), the discrepancy in functional outcomes is poorly understood by physiological explanations. Thus, these outcomes are increasingly being interpreted in a psychosocial framework. Several psychosocial factors, including expectation as etiology, diagnosis threat, and iatrogenic reactions, may play a crucial role in explaining this discrepancy.

In this simulation study, the influence of diagnostic terminology on cognitive, emotional, and somatic performance was examined. It was hypothesized that the term mTBI would be associated with higher levels of depression, anxiety and post-concussion symptomatology endorsement, as well as greater cognitive impairment, compared to concussion and no diagnosis. Our pilot data suggest that somatic symptoms are susceptible to differences in diagnostic terminology, with mTBI being perceived as being significantly worse than concussion and no diagnosis. This is consistent with previous research which has shown that concussion is perceived as less alarming than mTBI. Thus, this preliminary data suggests that clinicians should adopt the word concussion in order to promote health and recovery instead of perceived impairment. This expectation of greater impairment may help explain longer recovery times of mTBI versus concussion

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