The Nature and Clinical Significance of Preinjury Recall Bias Following Mild Traumatic Brain Injury

Abstract

The recall bias was stronger and more likely clinically significant in MTBI patients with high postinjury symptoms. Multiple mechanisms appear to contribute to recall bias after MTBI, including the reattribution of preexisting symptoms to MTBI as well as processes that are not specific to MTBI (eg, related to compensation-seeking).

Rating of pre-injury symptoms over time in patients with mild traumatic brain injury: the good-old-days bias revisited

“…included injured workers who received compensation benefits. Such a population might be more vulnerable to a true good-old-days bias (20) or might distort or misrepresent their pre-injury symptoms and functioning in relation to their compensation claim.…”

“…Furthermore, some selfreport instruments (e.g., the Rivermead post-concussion questionnaire (RPQ) (19)) investigate a comparison of current symptoms with symptoms experienced before injury. The reliability and validity of pre-injury symptom ratings might be complicated because patients may not remember symptoms that occurred months earlier in an accurate manner (20). Moreover, following a negative event, patients may have the tendency to underestimate past problems and to view oneself as healthier in the past, which is referred to as the 'good-old-days' bias (21).…”

“…Moreover, following a negative event, patients may have the tendency to underestimate past problems and to view oneself as healthier in the past, which is referred to as the 'good-old-days' bias (21). Previous studies examined the occurrence of the 'good-old-days bias' in patients with mTBI (20)(21)(22)(23)(24). They consistently found that patients with mTBI remembered their pre-injury functioning as better compared to healthy controls.…”

“…As a consequence of this cognitive bias, patients may misattribute the experience of common symptoms to the mTBI, and thereby increase the possibility of an incorrect PCS diagnosis (25). These previous studies assessing the reliability and validity of pre-injury symptom ratings are, however, limited by small sample sizes (20,23,24) and the use of non-representative patient groups (21,22). In addition, previous studies assessed the pre-injury symptom-level only once or twice (24), whereas repeated measurements may provide further insight into the test-retest reliability of preinjury ratings.…”

Conventional and retrospective change in health-related quality of life of trauma patients: an explorative observational follow-up study

“…Recall bias of HRQL has been observed among patients with e.g. multiple sclerosis, psoriasis, cancer, injury and total hip arthroplasty [14][15][16][17] A study among patients with traumatic brain showed that recall bias was stronger in patients with high symptoms, which include memory problems [18]. This indicates that the size of recall bias may be higher among patients who experience memory problems compared to their counterparts.…”