Postconcussion Syndrome: Symptom Management

The present study explored the explanatory power of Mittenberg's “expectation as etiology” theory for the persistence of postconcussion syndrome (PCS) complaints. One hundred forty-one participants completed a PCS symptom checklist under 2 conditions. Normal controls, healthy athletes and depressed individuals reported current symptoms and symptoms expected following a hypothetical mild head injury. Head-injured athletes, chronic headache sufferers, and a 2nd sample of normal controls reported current symptoms and retrospective symptoms (prior to their injury/illness or from some point in the past). Depressed individuals reported more current symptoms than normal controls and healthy athletes, demonstrating that “PCS” symptoms are not specific to PCS. All groups expected more symptoms following mild head injury than currently experienced, supporting the idea that individuals expect negative consequences following head injury. However, healthy athletes expected fewer symptoms than normals or depressed individuals, possibly due to preexisting expectations for speedy recovery. Both head-injured athletes and headache sufferers reported more current symptoms than the past, but not at a rate lower than baseline of normal controls. Results suggest that the “expectation as etiology” hypothesis may be too specific, and that, following any negative event, people may attribute all symptoms to that negative event (the “good old days” hypothesis). (JINS, 2001, 7, 323–333.)

Download Full-text

Older Adult Population

10.1093/med/9780190059996.003.0017 ◽

2021 ◽

pp. 320-343

Author(s):

Harry S. Strothers ◽

Dipenkumar Patel

Keyword(s):

Palliative Care ◽

End Of Life ◽

Older Adult ◽

Symptom Management ◽

Older Patients ◽

Adult Population ◽

Geriatric Medicine ◽

Physician Assistants ◽

Syndrome Symptom ◽

Older Adult Population

Geriatric medicine is a specialty of medicine concerned with physical, mental, functional, and social conditions in acute, chronic, rehabilitative, preventive, and end-of-life care in older patients. Geriatric palliative care integrates the complementary specialties of geriatrics and palliative care to provide comprehensive care for older patients entering the later stage of their lives and their families. This chapter provides physician assistants with an overview of palliative care in older adults, the differences between palliative care and hospice, the understanding and managing of geriatrics syndrome, symptom management in older patients and the complexities of end of life, discussion of goals of care, and communicating with geriatric patients and families.

Download Full-text

Perception of illness: Nonspecificity of Postconcussion Syndrome symptom expectation

Journal of the International Neuropsychological Society ◽

10.1017/s1355617701020045 ◽

2002 ◽

Vol 8 (1) ◽

pp. 37-47 ◽

Cited By ~ 6

Author(s):

JOHN GUNSTAD ◽

JULIE A. SUHR

Keyword(s):

Head Injury ◽

Posttraumatic Stress ◽

Psychological Disorders ◽

Postconcussion Syndrome ◽

Symptom Report ◽

Relative Lack ◽

Orthopedic Injury ◽

Affective Symptoms ◽

Head Injured ◽

Syndrome Symptom

A growing number of studies show postconcussion syndrome (PCS) symptom report is influenced by factors other than head injury, suggesting symptoms typically associated with PCS may not be specific to head injury. Given the role that symptom expectation has been hypothesized to play in PCS symptom etiology, a comparison of symptoms expected for various disorders seems overdue. The present study asked 82 undergraduates to report the symptoms they currently experience, and then to report the symptoms they would expect to experience if they had had suffered either a head injury, an orthopedic injury, posttraumatic stress, or depression. No current differences in overall symptoms or in symptom subscales emerged. Results showed individuals portraying head injury, posttraumatic stress, and depression expected an increase in total symptoms, though individuals portraying an orthopedic injury did not expect such an increase. Results also showed simulators of head injury, posttraumatic stress, and depression expected equivalent rates of overall symptoms, memory/cognitive complaints, somatic concerns, and distracter symptoms, though head-injured individuals reported fewer affective symptoms than those portraying psychological disorders. In all, these findings suggest that individuals have a relative lack of specificity in symptom expectation for various disorders, with the implication that symptom checklists for “PCS” may not be useful for diagnosis. (JINS, 2002, 8, 37–47.)

Download Full-text