Comparison of subjective cognitive complaints with neuropsychological tests in individuals with mild vs more severe traumatic brain injuries

Primary objective: The aim of this study was to examine the complex inter-relationship between subjective reports of cognitive impairments and neuropsychological performances in compensation-seeking individuals with traumatic brain injury (TBI) of differing severities. Specifically, this study examined: (a) the participants' neuropsychological test scores and self-reported ratings according to TBI severity; (b) whether there was a predictive relationship between self-report and cognitive test scores; and (c) the influence of emotional functioning on self-reported cognitive functioning. Research design: A multi-group comparative research design was employed. Methods and procedure: An outpatient sample of 61 patients with TBIs using neuropsychological testing, RNBI (Ruff Neurobehavioral Inventory) and clinical interviews. Main outcomes and results: The mild TBI group exhibited greater attentional impairments, while the moderate-to-severe group exhibited greater memory and learning impairments on neuropsychological tests. The mild group reported more cognitive symptoms than their more severely damaged counterparts. The mild TBI participants reported significantly more symptoms of post-traumatic stress disorder (PTSD). Conclusions: Individuals with moderate-to-severe TBI were more accurate when reporting their memory and learning difficulties, whereas individuals with mild TBI were more accurate when reporting attentional difficulties. It is likely that the occurrence of PTSD worsens the outcome of a mild TBI. There likely is a cumulative effect between the PTSD symptoms and the emotional residuals in the mild TBI population.