AFFECTIVE-DISORDERS FOLLOWING MILD-TO-MODERATE BRAIN INJURY - INTERPRETIVE HAZARDS OF THE SCL-90-R

This article describes an analysis of the Symptom Checklist-90-Revised (SCL-90-R), a self-report measure of emotional distress, demonstratin g potentially misleading scale elevations (ie, psychopathology) in dat a from 23 patients with mild to moderate traumatic brain injury (initi al Glasgow Coma Scale score range = 9-15). Average scores were signifi cantly higher than those for the normative control group on 88 of 90 s ymptoms, seven of nine individual dimensions, and three summary indice s. A considerable portion of these elevations was attributable to endo rsement of 14 items (15.5%) identified by experts as ''usual consequen ces'' of traumatic head injury. The Obsessive-Compulsive, Hostility, a nd Depression scales were especially weighted with brain injury sympto ms. These findings corroborate previous reports concerning the hazards of applying to neurological patients psychological instruments that w ere normed on physically healthy populations. Scores that would indica te pathological abnormality in the latter group may hold substantially different diagnostic significance for the former group. Clinicians sh ould inspect individual responses to self-report questionnaires and se ek confirmation from additional sources.