Impact of diagnosis threat on academic self-efficacy in mild traumatic brain injury

Abstract

The current study examined the effect of diagnosis threat on self-efficacy and neuropsychological performance in mild traumatic brain injury (TBI). Forty-nine participants with a history of mild TBI were randomized to a diagnosis threat or control group. The diagnosis threat group were told they were selected based on their history of TBI, while control group participants were told to perform their best. Individuals in the diagnosis threat group reported significantly lower academic self-efficacy than control participants. The groups performed differently on only one neuropsychological measure. These results suggest that diagnosis threat may have a greater impact on psychological factors than on cognitive performance.

Effects of Media Sensationalization on Cognitive Performance and Post Concussive Symptoms

“…Bayesian analysis was used so that we could incorporate previous knowledge about the effects of diagnosis threat on cognition in mTBI (Blaine et al, 2013; Carter-Allison et al, 2016; Kinkela, 2008; Kit et al, 2014; Ozen & Fernandes, 2011; Suhr & Gunstad, 2002, 2005; Trontel et al, 2013) with the current results, through the use of priors.…”

“…Our prior estimate of the effect of diagnosis threat on cognition in those with a history of mTBI was obtained by performing a meta-analysis of the studies mentioned above (Blaine et al, 2013; Carter-Allison et al, 2016; Kinkela, 2008; Kit et al, 2014; Ozen & Fernandes, 2011; Suhr & Gunstad, 2002, 2005; Trontel et al, 2013). We used all available cognitive performance data, as reported by the original authors, and used a multivariate regression model with random effects (Konstantopoulos, 2011) to account for the nesting inherent in the data (level 1: test variables; level 2: tests; level 3: studies; level 4: research laboratories).…”

“…Seminal studies focusing on diagnosis threat found that this phenomenon was associated with a reduction in cognitive test scores of roughly .36 (Suhr & Gunstad, 2002) to .44 (Suhr & Gunstad, 2005) standard deviations compared to controls. However, subsequent studies have not consistently replicated those original findings (Blaine, Sullivan, & Edmed, 2013; Carter-Allison, Potter, & Rimes, 2016; Kinkela, 2008; Kit, Mateer, Tuokko, & Spencer-Rodgers 2014; Ozen & Fernandes, 2011; Trontel, Hall, Ashendorf, & O’Connon, 2013). Therefore, there is a need to better estimate the true magnitude of the diagnosis threat effect on those with a history of mTBI, as well as to understand whether diagnosis threat (or related phenomena) can be elicited by actual media reporting.…”

Self- and Informant Ratings of Executive Functioning After Mild Traumatic Brain Injury

“…43 In this context, the fact that our participants generally did well on several laboratory measures of executive functioning, despite rating themselves poorly on the BRIEF-A, is consistent with previous findings in the literature that suggested that diagnosis threat affects primarily perceived self-efficacy and not necessarily actual cognitive test performance. 44 Neither the self-ratings nor the informant ratings correlated with the results from the WCST or TOL. This was consistent with hypothesis 4.…”

Symptom over-reporting ≠ malingering

“…That the effect is subtle becomes all the more obvious when looking at the weighted effect sizes for each of the cognitive and self-reported domains of functioning: all were small, with the exception of one domain (i.e., intellectual ability). Importantly, intellectual ability was assessed in only two out of six studies Trontel et al, 2013) and to our knowledge there is no compelling existing rationale why diagnosis threat -or the label of MHI -would particularly affect this domain. Our supplementary analysis, which incorporated the findings of two alternative samples, also provided only modest support for the idea that labels such as MHI have serious detrimental effects.…”