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OBJECTIVE: To investigate the factor structure of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) among individuals seen as part of routine follow-up following traumatic brain injury. METHODS: RPQ data from 168 participants was examined (mean age 35.2, SD 14.3; 89% with post traumatic amnesia duration<24 hours) six months after admission to an Accident & Emergency Department following TBI. Structural equation modelling was carried out to evaluate proposed models of the underlying structure of post-concussion symptoms (PCS). RESULTS: The results support the existence of separate cognitive, emotional and somatic factors, although there was a high degree of covariation between the three factors. A two-factor model that collapsed the emotional and somatic factors together showed a similar goodness-of-fit to the data, whilst a one-factor model proved a poor fit. CONCLUSION: The results support the notion of post-concussion symptoms as a collection of associated but at least partially separable cognitive, emotional and somatic symptoms, although questions persist regarding symptom specificity. The use of the RPQ is discussed, and classification bands for use in clinical practice are suggested.

Original publication




Journal article


J Neurol

Publication Date





1603 - 1614


Adolescent, Adult, Cognition, Emotions, Factor Analysis, Statistical, Female, Follow-Up Studies, Humans, Male, Middle Aged, Post-Concussion Syndrome, Sensitivity and Specificity, Severity of Illness Index, Statistics, Nonparametric, Surveys and Questionnaires