Development of a symptom expectation questionnaire for minor head injury

Background and objective:Expectations and beliefs are important predictors of outcome following minor head injury.In this paper,the primary purpose is to develop a simple symptom expectation questionnaire for minor head injury for use in future research studies.Methods:An existing database of 179 injury-naive subjects who completed a 56-item checklist of expected symptoms for minor head injury was analyzed to determine which items could correctly identify an a priori case definition of an expecter (a subject who expected at least one of these symptoms would remain chronic following minor head injury).A total of six of the 56 items were found to be discriminatory,and these were tested in additional subject groups against the original questionnaire.Results:From the original database of 179 subjects completing a 56-item symptom expectation checklist,135 expected that at least one of the 56 symptoms would be chronic following minor head injury.The 135 expecters,however,all chose at least one of six items:headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain.Using these six items,in two new groups of subjects,all those who endorsed one of the 56 symptoms as likely to be chronic following minor head injury (expecters) could also be identified on the 6-item checklist.Conclusions:A shortened (6-item) symptom expectation checklist of commonly reported symptoms following minor head injury (headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain) correctly identifies subjects who expect that at least one symptom will be chronic following minor head injury (i.e.,an expecter).