Subjective symptomatology after traumatic head injury

Background: Controversy persists regarding the reasons for persistent subje ctive complaints after mild traumatic head injury (THI). Statement of purpose: To evaluate the influence of injury severity, psychol ogical factors, and financial contingencies on symptomatology after THI. Methods: Subjective complaints about cognitive, emotional, and somatic symp toms, as assessed by a standardized self-report inventory (Minnesota Multip hasic Personality Inventory-2; MMPI-2) were evaluated in 150 patients with THI. Results: Individuals with mild THI demonstrated paradoxically greater sympt omatology on the MMPI-2 than patients with moderate-to-severe THI. Furtherm ore, specific actuarial criteria for possible symptom magnification (Fake B ad Scale) were met about twice as often in patients with mild THI who were seeking financial compensation for alleged acquired dysfunction than in pat ients with mild THI without such external contingencies. Conclusion: The evaluation of persistent subjective complaints after THI sh ould consider injury severity in concert with psychological and financial/m otivational factors. Great caution should be taken in attributing persisten t symptomatology after mild THI to cerebral dysfunction.