Memory perfectionism is associated with persistent memory complaints after concussion

Objective: The etiology of persistent memory complaints after concussion is poorly understood. Memory perfectionism (highly valuing memory ability and intolerance of minor memory lapses) may help explain why some people report persistent subjective memory problems in the absence of corresponding objective memory impairment. The present study investigated the relationship between memory perfectionism and persistent memory complaints after concussion. Methods: Adults (N=77; 61% women) with persistent symptoms following concussion were recruited from outpatient specialty clinics. Participants completed the National Institutes of Health Toolbox Cognition Battery, Test of Memory Malingering-Trial 1, and questionnaires measuring memory perfectionism (Memory in Adulthood-Achievement subscale), forgetfulness and other post-concussion symptoms (Rivermead Postconcussion Symptoms Questionnaire; RPQ), and depression (Patient Health Questionnaire-2) at M=17.8 weeks post-injury. Patients with vs. without severe memory complaints (based on the RPQ) were compared. Results: Memory perfectionism was associated with severe memory complaint, after controlling for objective memory ability, overall cognitive ability, and depression (95% confidence interval for odds ratio = 1.11 to 1.40). Sensitivity analyses showed that this relationship did not depend on use of specific objective memory tests nor on inclusion of participants who failed performance validity testing. In a control comparison to test the specificity of identified relationships, memory perfectionism was not associated with severe fatigue (95% confidence interval for odds ratio = 0.91 to 1.07). Discussion: Memory perfectionism may predispose people to experience persistent memory symptoms and/or contribute to their perpetuation after concussion, with potential relevance to the spectrum of functional cognitive disorders more broadly.