Research Reports - Cogniphobia in mild traumatic brain injury
J Neurotrauma. 2017 Jan 23. doi: 10.1089/neu.2016.4719. [Epub ahead of print]
Silverberg ND(1), Iverson GL(2,)(3), Panenka W(4).
Cogniphobia refers to avoidance of mental exertion due to a fear of developing or
exacerbating a headache. Headaches are very common after mild traumatic brain
injury (MTBI) and often become chronic. Cogniphobia is hypothesized to contribute
to poor cognitive test performance and persistent disability in some patients
with MTBI. Eighty patients with MTBI and post-traumatic headaches were recruited
from specialty outpatient clinics. They completed a battery of questionnaires
(including a cogniphobia scale) and neuropsychological tests (the National
Institutes of Health Toolbox Cognition Battery and the Medical Symptom Validity
Test) at 2-3 months post injury, in a cross-sectional design. Participants with
more severe headaches reported higher levels of cogniphobia. Cogniphobia was
associated with lower performance on memory testing (but not other cognitive
tests), independent of headache severity. Participants who avoided mental
exertion also tended to avoid physical activity and traumatic stress triggers.
The findings provide preliminary support for the role of cogniphobia in
persistent cognitive difficulties after MTBI, and suggest that cogniphobia may
reflect a broader avoidant coping style.