Journal of the International Neuropsychological Society

Further exploration of the effect of “diagnosis threat” on cognitive performance in individuals with mild head injury

JULIE A.  SUHR  a1 c1 and JOHN  GUNSTAD  a2
a1 Department of Psychology, Ohio University, Athens, Ohio
a2 Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island

Article author query
suhr ja   [PubMed][Google Scholar] 
gunstad j   [PubMed][Google Scholar] 


The present study further explored the phenomenon of “diagnosis threat” (Suhr & Gunstad, 2002), by examining the potential explanatory roles of anxiety, effort, and depression. Individuals with mild head injury history were randomly assigned to receive either neutral instructions (controls, N = 25) or to have attention called to their head injury history as a reason for invitation into the study (diagnosis threat, N = 28). Depression was measured at baseline. Following the neuropsychological battery, ratings of effort, test pressure, and state anxiety were completed. The diagnosis threat group performed worse than controls on attention/working memory, psychomotor speed, and memory tasks, but not on measures of executive functioning, post-test anxiety, or effort. Effort, anxiety and depression were not related to cognitive performance, nor did depression interact with expectations in explaining group differences in performance. Results provide further support for the “diagnosis threat” effect, but offer no support for effort, anxiety, or depression explanations for diminished performance. (JINS, 2005, 11, 23–29.)

(Received December 2 2003)
(Revised June 24 2004)
(Accepted July 27 2004)

Key Words: Head injury; Memory; Expectations; Depression; Anxiety.

c1 Reprint requests to: Julie Suhr, Ph.D., Associate Professor, Department of Psychology, 200 Porter Hall, Ohio University, Athens, OH 45701. E-mail: