Validation of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) on Patients Injured in High Impact Car Accidents

Background: The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is used widely in clinical assessments. Its 16 items describe subjective neuropsychological symptoms. This study evaluates the criterion validity, convergent validity, and internal consistency of the RPQ in a sample of survivors of high impact motor vehicle accidents (MVAs).

Method: De-identified data on 65 post-MVA patients (mean age 38.1 years, SD=13.1; 24 men, 41 women) were available. Their data include scores on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Subjective Neuropsychological Symptoms Scale (SNPSS), Insomnia Severity Index (ISI), Whetstone’s and Steiner’s measures of post-MVA driving anxiety, and the PCL-5 measure of PTSD. The data also included ratings of the worst pain, least pain, and of average pain (Items 3, 4, and 5 of the Brief Pain Inventory) and ratings of depression, anger, and of anxiety (Items 10 to 12 of the Whiplash Disability Questionnaire).

Results: The patients’ average RPQ score was 45.5 (SD=9.8) and that of the normal controls 8.3 (13.2): the effect size corresponds to point biserial coefficient of .84, thus indicating a very satisfactory criterion validity. The convergent validity is also satisfactory (r=.79 to the SNPSS). Cronbach alpha coefficient for the full 16 item RPQ was excellent (.97) and would not be improved by evaluating separately the first 3 RPQ items and the next 13 items.

Discussion and Conclusions: We recommend that the RPQ be employed jointly with SNPSS in clinical assessments and research. The SNPSS includes important post-concussive symptoms missing in the RPQ as well as other subjective neuropsychological symptoms.

Keywords: concussion, post-concussion syndrome, mTBI, whiplash syndrome.