A self-report of symptoms after a traumatic brain injury is an important part of the assessment process. But, how does a clinician interpret inconsistencies between self-reported symptoms and the objective neuropsychological evaluation?
One problem is that the severity of the brain injury can affect the way the patient talks about symptoms. For instance, a person with a more severe brain injury may have problems with awareness and thus deny having any symptoms. Or, they may have more problems with communication and memory that can limit their report. Conversely, a person with a mild brain injury often shows better awareness and communication about their deficits, but may also have problems such as depression, anxiety, or insomnia that can make these deficits more intense.
A recent study compared neuropsychological test results to self-reported symptoms between groups of people with mild or severe traumatic brain injuries. People with both mild and severe brain injuries reported significant memory problems, however only the severe brain injury group had test scores that showed significant memory impairment. People with both mild and severe brain injuries showed problems with attention during the neuropsychological tests, but only those with mild brain injury group were aware of and reported it.
Jamora CW, Young A, & Ruff RM. Comparison of subjective cognitive complaints with neuropsychological tests in individuals with mild vs. severe traumatic brain injuries. Brain Injury. (January 2012).