Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
J Int Neuropsychol Soc. 2022 Feb;28(2):143-153. doi: 10.1017/S1355617721000278. Epub 2021 Mar 23.
Mild traumatic brain injury (mTBI) symptoms are typically assessed via questionnaires in research, yet questionnaires may be more prone to biases than direct clinical interviews. We compared mTBI symptoms reported on two widely used self-report inventories and the novel Structured Interview of TBI Symptoms (SITS). Second, we explored the association between acquiescence response bias and symptom reporting across modes of assessment.
Level 1 trauma center patients with mTBI (N = 73) were recruited within 2 weeks of injury, assessed at 3 months post-TBI, and produced nonacquiescent profiles. Assessments collected included the SITS (comprising open-ended and closed-ended questions), Rivermead Post Concussion Symptoms Questionnaire (RPQ), Sport Concussion Assessment Tool-3 (SCAT-3) symptom checklist, and Minnesota Multiphasic Personality Inventory-2 Restructured Form True Response Inconsistency (TRIN-r) scale.
Current mTBI symptom burden and individual symptom endorsement were highly concordant between SITS closed-ended questions, the RPQ, and the SCAT-3. Within the SITS, participants reported significantly fewer mTBI symptoms to open-ended as compared to later closed-ended questions, and this difference was weakly correlated with TRIN-r. Symptom scales were weakly associated with TRIN-r.
mTBI symptom reporting varies primarily by whether questioning is open- vs. closed-ended but not by mode of assessment (interview, questionnaire). Acquiescence response bias appears to play a measurable but small role in mTBI symptom reporting overall and the degree to which participants report more symptoms to closed- than open-ended questioning. These findings have important implications for mTBI research and support the validity of widely used TBI symptom inventories.
轻度创伤性脑损伤（mTBI）的症状通常通过研究中的问卷进行评估，但问卷可能比直接临床访谈更容易出现偏差。我们比较了两种广泛使用的自我报告量表和新型创伤性脑损伤症状的结构访谈（SITS）报告的 mTBI 症状。其次，我们探讨了不同评估模式下的默许反应偏差与症状报告之间的关联。
在创伤后 2 周内招募了来自一级创伤中心的 mTBI 患者（N=73），在创伤后 3 个月进行评估，并产生了非默许的特征。评估包括 SITS（包括开放式和封闭式问题）、Rivermead 脑震荡后症状问卷（RPQ）、运动性脑震荡评估工具-3（SCAT-3）症状检查表和明尼苏达多相人格问卷-2 重新构建形式真实反应不一致性（TRIN-r）量表。
SITS 封闭式问题、RPQ 和 SCAT-3 之间当前的 mTBI 症状负担和个体症状的一致性很高。在 SITS 中，与后来的封闭式问题相比，参与者对开放式问题报告的 mTBI 症状明显减少，并且这种差异与 TRIN-r 呈弱相关。症状量表与 TRIN-r 呈弱相关。
mTBI 症状报告主要取决于问题是开放式还是封闭式，但与评估方式（访谈、问卷）无关。默许反应偏差似乎在整体 mTBI 症状报告中起着可衡量但较小的作用，以及参与者对封闭式问题比开放式问题报告更多症状的程度。这些发现对 mTBI 研究具有重要意义，并支持广泛使用的 TBI 症状量表的有效性。
