Postconcussive complaints, cognition, symptom attribution and effort among veterans

Eric B. Larson*, Bethany R. Kondiles, Christine R. Starr, Felise S. Zollman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The etiology of postconcussive symptoms is not clearly understood. Development of etiological models of those symptoms will be helpful for accurate diagnosis and for planning effective treatment. Such a model should characterize the role of subject characteristics (education, premorbid intelligence), social psychological factors and symptom validity. Toward that end, the present study examined the association of postconcussive complaints and cognitive performance with symptom attribution and level of effort on testing. In a sample of 155 veterans, attribution to concussion was associated with endorsement of more severe postconcussive complaints, after controlling for the effects of other factors such as subject characteristics. Similarly, effort was associated with cognitive performance after controlling for the effects of these other factors. The present findings are consistent with previous reports that illness perception and effort on testing are associated with postconcussive complaints. This supports previous recommendations to routinely educate all concussion patients immediately after injury to reduce distorted perceptions and related persistent complaints. Finally, these findings highlight a need for routine assessment of patients' perception of their injury to identify cases that may require psychotherapy to address any misattributions that develop.

Original languageEnglish (US)
Pages (from-to)88-95
Number of pages8
JournalJournal of the International Neuropsychological Society
Issue number1
StatePublished - Jan 2013


  • Brain concussion - complications
  • Brain concussion - diagnosis
  • Diagnosis threat
  • Neuropsychological tests - methods
  • Postconcussion syndrome
  • Symptom attribution

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Clinical Psychology
  • General Neuroscience


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