Clinical Neuropsychology Research Group, School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.
J Head Trauma Rehabil. 2012 Jul-Aug;27(4):293-301. doi: 10.1097/HTR.0b013e31822123ce.
This study examined the robustness of the postconcussion syndrome (PCS) expectation-as-etiology hypothesis using a variation on the typical study design and different symptom assessment methods.
Participants were 51 university students with no history of brain injury or neurological disease. Participants reported expected PCS symptoms after being exposed to an established vignette in which they were asked to imagine that they had had a car accident (expectation condition). One week later, they reported their current symptoms (control condition). Symptoms were elicited in both test sessions using each of 3 methods administered in the following fixed order: an open-ended question (eg, how have you been feeling over the past couple of weeks?), prompted interview questions (eg, have you experienced any troubling physical symptoms over the past few weeks?), and checklist (the British Columbia Postconcussion Symptom Inventory). All 3 methods were administered in a paper-and-pencil format.
Findings revealed that (a) when responding to structured interview questions or the checklist, participants expected more PCS symptoms from an imagined mild traumatic brain injury when compared with their baseline, (b) the expectation effect was not present when symptoms were elicited by an open-ended question, and (c) almost all participants (approximately 98% of those reporting expected symptoms) met a caseness criterion when symptoms were assessed using a checklist or structured interview. Contrary to predictions, personal knowledge of someone with mild traumatic brain injury did not alter PCS expectancies.
The expectation-as-etiology hypothesis, which is one of several factors that has been associated with PCS, may be partly dependent on method of symptom assessment.
本研究使用典型研究设计的变体和不同的症状评估方法，检验脑震荡后综合征（PCS）预期病因假说的稳健性。
参与者为 51 名无脑损伤或神经病史的大学生。在暴露于既定情景模拟后，他们报告预期的 PCS 症状，要求他们想象自己发生了车祸（预期条件）。一周后，他们在控制条件下报告当前的症状。在两个测试阶段，使用以下固定顺序依次实施的 3 种方法中的每一种来引出症状：开放式问题（例如，过去几周你的感觉如何？）、提示性访谈问题（例如，过去几周你是否经历过任何困扰身体的症状？）和检查表（不列颠哥伦比亚省脑震荡后症状清单）。所有 3 种方法均以纸质形式进行。
研究结果表明：（a）当回答结构化访谈问题或检查表时，与基线相比，参与者在想象轻度创伤性脑损伤时预期会出现更多的 PCS 症状；（b）当使用开放式问题引出症状时，不存在预期效应；（c）当使用检查表或结构化访谈评估症状时，几乎所有参与者（大约 98%报告预期症状的参与者）都符合病例标准。与预测相反，个人对轻度创伤性脑损伤患者的了解并未改变 PCS 的预期。
PCS 相关的几个因素之一的预期病因假说可能部分取决于症状评估方法。
