Influence of diagnosis threat and illness cognitions on the cognitive performance of people with acquired brain injury

Illness cognitions ? cognitive representations of illness ? have been found to influence health outcomes in chronic diseases: more adaptive illness cognitions generally lead to better outcomes. Concomitantly, diagnosis threat (DT) is a phenomenon whereby participants with acquired brain injury (ABI) underperform on neuropsychological tasks due to stereotype activation. This randomised study examined the impact of illness cognitions and DT on cognitive performance. People with ABI completed the Illness Cognitions Questionnaire and were then exposed to either a DT condition or a reduced DT condition (in which stereotype cues were reduced). They then completed memory and attentional tasks. Control participants performed only the tasks under one of the two conditions. Under the reduced DT condition, higher adaptive illness cognitions were associated with better memory and attentional performance. However, the DT condition diminished memory (but not attentional) performance in participants with a high level of adaptive illness cognitions, often leading to performance at the pathological level. This study confirms the detrimental impact of DT in people with ABI and highlights the necessity for clinicians to consider psychosocial influences when assessing and treating this population.