Postconcussion syndrome following sports-related head injury: Expectation as etiology

Mild head trauma is often complicated by a persistent set of symptoms known as postconcussion syndrome (PCS). Past research has suggested that an expe ctancy-guided, retrospective-recall bias may account for much of the varian ce in PCS symptom reporting. The present study examined the influence of sy mptom expectations on mild head trauma symptom reports among participants i n contact sports. Head-injured athletes reported symptom rates that did not differ from those of uninjured athletes but consistently underestimated th e preinjury incidence of symptoms. Athletes with no head trauma history ove restimated the expected degree of pre- to postinjury change in symptom stat us. Results suggest that individuals with mild head injury tend to overesti mate postconcussion symptom change in a manner consistent with their sympto m expectations. A cognitive-behavioral model that explains the persistence of PCS is proposed.