Unexpected symptoms after concussion: Potential links to functional neurological and somatic symptom disorders, 2021, Picon, Perez et al

Abstract

Objective
Reporting of unexpected symptoms after concussion might, in some people, reflect a Functional Neurological Disorder (FND), Somatic Symptom Disorder (SSD), or exaggeration (feigning).

This study aimed to determine whether reporting unexpected symptoms after concussion was associated with risk factors for FND/SSD, exaggeration, or both.

Method
Adults with persistent symptoms following concussion (N = 77; 61% women) rated the presence and severity of unexpected neurological symptoms (from the Screening for Somatoform Symptoms scale, e.g., paralysis) and somatic symptoms (from the Patient Health Questionnaire-15, e.g., stomach pain) that did not overlap with post-concussion symptom scale items. The independent variables were risk factors for exaggeration (neuropsychological performance validity test failure and personal injury litigation) and predisposing and perpetuating factors for developing FND and/or SSD (e.g., fear avoidance behavior).

Results
When adjusting for all covariates, fear avoidance behavior was most strongly related to unexpected neurological symptoms (B = 0.11, 95% confidence interval = 0.05–0.18, p < .001), while current anxiety scores were most strongly related to unexpected somatic symptoms (B = 0.34, 95% confidence interval = 0.15–0.52, p < .001). Performance validity test failure and litigation were not significant predictors in either model.

Conclusion
Unexpected neurological and other somatic symptoms after concussion should not be dismissed as exaggeration. Psychological factors thought to perpetuate FND and SSD (e.g., fear avoidance behavior) may contribute to unexpected symptoms following concussion. More research is needed at the intersection of FND, SSD, and persistent post-concussive symptoms.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0022399921003068

 

I can't be bothered pointing out the problems with this. FND just keeps on and on with the same lack of science.

 

“unexpected symptoms”
Unexpected by whom?
I expect people to have some problems with their bodies following brain trauma. I expect patients to feel quite bad after having their brain matter collide with their skull. I expect that when a hard object impacts the skull it may cause lasting damage.

I feel that perhaps I should share this information with researchers they seem pretty perplexed about the whole thing. What does everyone think?

Unless…. They aren’t confused just unethical monsters who relish cruelty or profit off the suffering of others?

No couldn’t be. I better share my advanced theory on the biology involved in a blow to the head ASAP.

Shall I simplify it perhaps in language they will feel most comfortable with something like;

Boink + Noggin =Ouch Ouch. ^EXPECT SYMPTOMS.

 

Like @Mithriel, its feels like a broken record to comment (but thanks for posting @Andy, its good to know about this work).

Er, cause/effect??

Are you wanting to make clams about faking/exaggerating or about psychosomatic factors? If the latter, a good first move would be to exclude people with ongoing litigation.

Pain catastrophisation is there again. Possibly the cruellest concept in the world. Surely a core component of severe pain - particularly unexplained pain - is that it is all-consuming, and defies your attempts to step outside of it and see beyond it. To cast that as some sort of psychological weakness is just cruel. But no, apparently, people who experience this need the help of a healthy person - who's never experienced severe pain whose cause and duration are completely unknown - to correct their unhelpful cognitions.

 

I think we need a study of all the researchers in this area to look at their own health experiences….