The Role of Blame Attribution in Post-Concussion Syndrome Morbidity: A Retrospective Analysis of Patients at a Subspecialty Clinic

Neurology
Graeme Battigelli, Mohammed Wasif Hussain

Abstract

To compare the presentation of Post-Concussion Syndrome (PCS) based on whom the patient blames for the initial concussion. Psychological risk factors, such as pre-injury psychiatric disease and ongoing litigation, are associated with worsened PCS. We investigated whether blame attribution is another one of these psychological risk factors. 111 new patients presenting with PCS at a Canadian subspecialty concussion clinic were seen over 2 years. 91 patients (56 females, 35 males) were included. 20 patients were excluded for inability to define specific causative event (n = 13), underlying structural lesion (n = 1) or evidence of intracranial bleed (n = 6). Patients were separated into three groups: those attributing external blame (n = 70) those describing the incident as accidental (n = 20) and those attributing internal blame (n = 1). Patient observations included: subjective percentage of recovery (SPR), presence and severity of both headaches and psychiatric symptoms, and duration of symptoms at initial presentation. Psychiatric symptoms were graded 0-3 (0-absence, 1-mild, 2-moderate, 3-severe). Headache frequency was graded 0-4 (0-absence, 1-rare, 2-episodic, 3-chronic, 4-persistent). More patients belonged to the External g...Continue Reading

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