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PCS, Iatrogenic Symptoms, and Malingering Following Concussion

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Abstract

In postconcussive syndrome (PCS), subjective experience of symptoms seems to surpass objective evidence of those symptoms. For many years, clinicians and researchers have suspected both neurologic and psychologic forces in PCS. While the neurologic symptoms tend to resolve, psychological factors appear to have a more complex and difficult to characterize course. We argue in this paper that this complexity leads to diagnostic problems when considering PCS. We review several difficulties with current nosology regarding PCS and related conditions, as well as the inter-related and complicating roles of iatrogenic factors and malingering. We conclude that PCS is of insufficient diagnostic specificity and that it is prone to misdiagnosis, even causing new and possibly unrelated symptoms to develop in some cases. Further research on PCS and the factors that affect its course is needed.

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Notes

  1. The DSM-IV-TR uses the term “Post-concussional disorder” but generally refers to the same symptoms as PCS.

  2. They also noted the same problem with regard to PTSD.

  3. Controls were asked to endorse symptoms based on their functioning over the past 2 weeks.

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Authors and Affiliations

  1. University of Virginia, Charlottesville, VA, USA

    Scott D. Bender & Marlena Matusewicz

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  1. Scott D. Bender
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  2. Marlena Matusewicz
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Correspondence to Scott D. Bender.

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Bender, S.D., Matusewicz, M. PCS, Iatrogenic Symptoms, and Malingering Following Concussion. Psychol. Inj. and Law 6, 113–121 (2013). https://doi.org/10.1007/s12207-013-9156-9

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