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Profile of Embedded Validity Indicators in Criminal Defendants with Verified Valid Neuropsychological Test Performance. Arch Clin Neuropsychol 2022; 38:513-524. [DOI: 10.1093/arclin/acac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/21/2022] [Accepted: 08/09/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
Few studies have examined the use of embedded validity indicators (EVIs) in criminal-forensic practice settings, where judgements regarding performance validity can carry severe consequences for the individual and society. This study sought to examine how various EVIs perform in criminal defendant populations, and determine relationships between EVI scores and intrapersonal variables thought to influence performance validity.
Method
Performance on 16 empirically established EVI cutoffs were examined in a sample of 164 criminal defendants with valid performance who were referred for forensic neuropsychological evaluation. Subsequent analyses examined the relationship between EVI scores and intrapersonal variables in 83 of these defendants.
Results
Half of the EVIs (within the Wechsler Adult Intelligence Scale Digit Span Total, Conners’ Continuous Performance Test Commissions, Wechsler Memory Scale Logical Memory I and II, Controlled Oral Word Association Test, Trail Making Test Part B, and Stroop Word and Color) performed as intended in this sample. The EVIs that did not perform as intended were significantly influenced by relevant intrapersonal variables, including below-average intellectual functioning and history of moderate–severe traumatic brain injury and neurodevelopmental disorder.
Conclusions
This study identifies multiple EVIs appropriate for use in criminal-forensic settings. However, based on these findings, practitioners may wish to be selective in choosing and interpreting EVIs for forensic evaluations of criminal court defendants.
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Cheng Y, Zhang Y, Zhang Y, Wu YH, Zhang S. Reliability and validity of the Rowland Universal Dementia Assessment Scale for patients with traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:1160-1166. [PMID: 33321049 DOI: 10.1080/23279095.2020.1856850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective and accurate cognitive assessment scales are essential for guiding cognitive rehabilitation following traumatic brain injury (TBI). The aim of this study was to evaluate the reliability and validity of the Rowland Universal Dementia Assessment Scale (RUDAS) for TBI and to verify the clinical application value. Fifty patients with TBI and 32 matched controls were assessed using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a newly developed Chinese version of RUDAS. These scales were then compared for internal consistency, inter-rater reliability, test‒retest reliability, content validity, construct validity, and diagnostic efficacy. Among the TBI group, the RUDAS demonstrated acceptable internal consistency (Cronbach's α = 0.733), high inter-rater reliability (intraclass correlation coefficients [ICCs] of 0.910‒0.999), and high test‒retest reliability (total score ICC = 0.938). The correlation coefficients between RUDAS total score and individual subscores were all > 0.5 except for body orientation (r = 0.363), indicating generally good content validity. Total RUDAS scores were moderately correlated with both MMSE total scores (r = 0.701, p < 0.001) and MoCA total scores (r = 0.778, p < 0.001), indicating good construct validity. Receiving operating characteristic curve analysis yielded comparable areas under the curve for diagnostic efficacy (RUDAS, 0.844; MMSE, 0.769; MoCA, 0.824; all p > 0.05). A RUDAS score cutoff of 23.5 distinguished TBI patients from controls with 60% sensitivity and 100% specificity. Therefore, the RUDAS demonstrates both good reliability and validity for evaluating cognitive impairments in TBI patients.
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Affiliation(s)
- Yun Cheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
| | - Yu Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ye-Huan Wu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shuang Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
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3
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Uiterwijk D, Stargatt R, Crowe SF. Objective Cognitive Outcomes and Subjective Emotional Sequelae in Litigating Adults with a Traumatic Brain Injury: The Impact of Performance and Symptom Validity Measures. Arch Clin Neuropsychol 2022; 37:1662-1687. [PMID: 35704852 DOI: 10.1093/arclin/acac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined the relative contribution of performance and symptom validity in litigating adults with traumatic brain injury (TBI), as a function of TBI severity, and examined the relationship between self-reported emotional symptoms and cognitive tests scores while controlling for validity test performance. METHOD Participants underwent neuropsychological assessment between January 2012 and June 2021 in the context of compensation-seeking claims related to a TBI. All participants completed a cognitive test battery, the Personality Assessment Inventory (including symptom validity tests; SVTs), and multiple performance validity tests (PVTs). Data analyses included independent t-tests, one-way ANOVAs, correlation analyses, and hierarchical multiple regression. RESULTS A total of 370 participants were included. Atypical PVT and SVT performance were associated with poorer cognitive test performance and higher emotional symptom report, irrespective of TBI severity. PVTs and SVTs had an additive effect on cognitive test performance for uncomplicated mTBI, but less so for more severe TBI. The relationship between emotional symptoms and cognitive test performance diminished substantially when validity test performance was controlled, and validity test performance had a substantially larger impact than emotional symptoms on cognitive test performance. CONCLUSION Validity test performance has a significant impact on the neuropsychological profiles of people with TBI, irrespective of TBI severity, and plays a significant role in the relationship between emotional symptoms and cognitive test performance. Adequate validity testing should be incorporated into every neuropsychological assessment, and associations between emotional symptoms and cognitive outcomes that do not consider validity testing should be interpreted with extreme caution.
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Affiliation(s)
- Daniel Uiterwijk
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Robyn Stargatt
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Simon F Crowe
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Victoria, Australia
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4
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The Relationship Between Cognitive Functioning and Symptoms of Depression, Anxiety, and Post-Traumatic Stress Disorder in Adults with a Traumatic Brain Injury: a Meta-Analysis. Neuropsychol Rev 2021; 32:758-806. [PMID: 34694543 DOI: 10.1007/s11065-021-09524-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 09/09/2021] [Indexed: 12/12/2022]
Abstract
A thorough understanding of the relationship between cognitive test performance and symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD) in people with traumatic brain injury (TBI) is important given the high prevalence of these emotional symptoms following injury. It is also important to understand whether these relationships are affected by TBI severity, and the validity of test performance and symptom report. This meta-analysis was conducted to investigate whether these symptoms are associated with cognitive test performance alterations in adults with a TBI. This meta-analysis was prospectively registered on the PROSPERO International Prospective Register of Systematic Reviews website (registration number: CRD42018089194). The electronic databases Medline, PsycINFO, and CINAHL were searched for journal articles published up until May 2020. In total, 61 studies were included, which enabled calculation of pooled effect sizes for the cognitive domains of immediate memory (verbal and visual), recent memory (verbal and visual), attention, executive function, processing speed, and language. Depression had a small, negative relationship with most cognitive domains. These relationships remained, for the most part, when samples with mild TBI (mTBI)-only were analysed separately, but not for samples with more severe TBI (sTBI)-only. A similar pattern of results was found in the anxiety analysis. PTSD had a small, negative relationship with verbal memory, in samples with mTBI-only. No data were available for the PTSD analysis with sTBI samples. Moderator analyses indicated that the relationships between emotional symptoms and cognitive test performance may be impacted to some degree by exclusion of participants with atypical performance on performance validity tests (PVTs) or symptom validity tests (SVTs), however there were small study numbers and changes in effect size were not statistically significant. These findings are useful in synthesising what is currently known about the relationship between cognitive test performance and emotional symptoms in adults with TBI, demonstrating significant, albeit small, relationships between emotional symptoms and cognitive test performance in multiple domains, in non-military samples. Some of these relationships appeared to be mildly impacted by controlling for performance validity or symptom validity, however this was based on the relatively few studies using validity tests. More research including PVTs and SVTs whilst examining the relationship between emotional symptoms and cognitive outcomes is needed.
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5
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How immersive virtual reality methods may meet the criteria of the National Academy of Neuropsychology and American Academy of Clinical Neuropsychology: A software review of the Virtual Reality Everyday Assessment Lab (VR-EAL). COMPUTERS IN HUMAN BEHAVIOR REPORTS 2021. [DOI: 10.1016/j.chbr.2021.100151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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6
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Abeare CA, Hurtubise JL, Cutler L, Sirianni C, Brantuo M, Makhzoum N, Erdodi LA. Introducing a forced choice recognition trial to the Hopkins Verbal Learning Test – Revised. Clin Neuropsychol 2020; 35:1442-1470. [DOI: 10.1080/13854046.2020.1779348] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | - Laura Cutler
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | | | - Maame Brantuo
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Nadeen Makhzoum
- Department of Psychology, University of Windsor, Windsor, ON, Canada
| | - Laszlo A. Erdodi
- Department of Psychology, University of Windsor, Windsor, ON, Canada
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7
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Calvillo M, Irimia A. Neuroimaging and Psychometric Assessment of Mild Cognitive Impairment After Traumatic Brain Injury. Front Psychol 2020; 11:1423. [PMID: 32733322 PMCID: PMC7358255 DOI: 10.3389/fpsyg.2020.01423] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) can be serious partly due to the challenges of assessing and treating its neurocognitive and affective sequelae. The effects of a single TBI may persist for years and can limit patients’ activities due to somatic complaints (headaches, vertigo, sleep disturbances, nausea, light or sound sensitivity), affective sequelae (post-traumatic depressive symptoms, anxiety, irritability, emotional instability) and mild cognitive impairment (MCI, including social cognition disturbances, attention deficits, information processing speed decreases, memory degradation and executive dysfunction). Despite a growing amount of research, study comparison and knowledge synthesis in this field are problematic due to TBI heterogeneity and factors like injury mechanism, age at or time since injury. The relative lack of standardization in neuropsychological assessment strategies for quantifying sequelae adds to these challenges, and the proper administration of neuropsychological testing relative to the relationship between TBI, MCI and neuroimaging has not been reviewed satisfactorily. Social cognition impairments after TBI (e.g., disturbed emotion recognition, theory of mind impairment, altered self-awareness) and their neuroimaging correlates have not been explored thoroughly. This review consolidates recent findings on the cognitive and affective consequences of TBI in relation to neuropsychological testing strategies, to neurobiological and neuroimaging correlates, and to patient age at and assessment time after injury. All cognitive domains recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are reviewed, including social cognition, complex attention, learning and memory, executive function, language and perceptual-motor function. Affect and effort are additionally discussed owing to their relationships to cognition and to their potentially confounding effects. Our findings highlight non-negligible cognitive and affective impairments following TBI, their gravity often increasing with injury severity. Future research should study (A) language, executive and perceptual-motor function (whose evolution post-TBI remains under-explored), (B) the effects of age at and time since injury, and (C) cognitive impairment severity as a function of injury severity. Such efforts should aim to develop and standardize batteries for cognitive subdomains—rather than only domains—with high ecological validity. Additionally, they should utilize multivariate techniques like factor analysis and related methods to clarify which cognitive subdomains or components are indeed measured by standardized tests.
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Affiliation(s)
- Maria Calvillo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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8
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Tanev KS, Federico LE, Greenberg MS, Orr SP, Goetter EM, Resick PA, Pitman RK. Baseline Cognitive Performance and Treatment Outcomes From Cognitive-Behavioral Therapies for Posttraumatic Stress Disorder: A Naturalistic Study. J Neuropsychiatry Clin Neurosci 2020; 32:286-293. [PMID: 31948321 PMCID: PMC8887025 DOI: 10.1176/appi.neuropsych.19020032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Approximately 5%-20% of U.S. troops returning from Iraq and Afghanistan have posttraumatic stress disorder (PTSD), and another 11%-23% have traumatic brain injury (TBI). Cognitive-behavioral therapies (CBTs) are empirically validated treatment strategies for PTSD. However, cognitive limitations may interfere with an individual's ability to adhere to as well as benefit from such therapies. Comorbid TBI has not been systematically taken into consideration in PTSD outcome research or in treatment planning guidance. The authors hypothesized that poorer pretreatment cognitive abilities would be associated with poorer treatment outcomes from CBTs for PTSD. METHODS This study was designed as a naturalistic examination of treatment as usual in an outpatient clinic that provides manualized CBTs for PTSD to military service members and veterans. Participants were 23 veterans, aged 18-50 years, with combat-related PTSD and a symptom duration of more than 1 year. Of these, 16 participants had mild TBI (mTBI). Predictor variables were well-normed objective tests of cognitive ability measured at baseline. Outcome variables were individual slopes of change of the PTSD Checklist for DSM-5 (PCL-5) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) over weeks of treatment, and of pretreatment-to-posttreatment change in PCL-5 and CAPS-5 (ΔPCL-5 and ΔCAPS-5, respectively). RESULTS Contrary to prediction, neither pretreatment cognitive performance nor the presence of comorbid mTBI predicted poorer response to CBTs for PTSD. CONCLUSIONS These results discourage any notion of excluding patients with PTSD and poorer cognitive ability from CBTs.
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Affiliation(s)
- Kaloyan S. Tanev
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston,Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Lydia E. Federico
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston,Department of Psychiatry, Massachusetts General Hospital, Boston
| | | | - Scott P. Orr
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Elizabeth M. Goetter
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Boston,Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Patricia A. Resick
- Department of Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, N.C
| | - Roger K. Pitman
- Department of Psychiatry, Massachusetts General Hospital, Boston
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9
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Hwang KS, Jang SH, Soh MJ, Lee HJ, Lee SY. Cognitive Decline in Korean Patients with Neurocognitive Disorder due to Traumatic Brain Injury: A Control for Premorbid Intelligence. Psychiatry Investig 2019; 16:889-895. [PMID: 31711280 PMCID: PMC6933136 DOI: 10.30773/pi.2019.0129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/30/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Previous studies of cognitive decline in patients with neurocognitive disorder due to traumatic brain injury (NCD-TBI) have often failed to control for baseline factors such as premorbid intelligence. The purpose of the current study was to estimate and compare cognitive function among three groups (controls, complicated mild/moderate TBI, and severe TBI) after controlling for premorbid intelligence. METHODS Severity of TBI was classified as complicated mild/moderate or severe based on duration of loss of consciousness and brain neuroimaging results. Premorbid intelligence quotients (IQs) were estimated with the Oklahoma Premorbid Intelligence Estimate. There were no differences in premorbid intelligence between the groups, which were also matched for age and education. Current cognitive function was evaluated with the Wechsler Adult Intelligence Scale-Fourth Edition. RESULTS Comparison of current cognitive function among the three groups indicated significant group differences for all indexes and subtest scores. Processing speed showed the highest effect size. However, only working memory differed significantly between the two NCD-TBI groups. CONCLUSION The present findings suggest that mental memory manipulation processes seem to be more sensitive to TBI severity than are perceptual-motor processes. Specifically, both auditory rehearsal/discrimination and mental alertness/manipulation will be most strongly influenced by TBI severity.
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Affiliation(s)
- Kyu-Sic Hwang
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea.,Korea Brain-Behavior Mental Health Institute, Iksan, Republic of Korea
| | - Seung-Ho Jang
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea.,Korea Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.,Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Min-Jung Soh
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea.,Korea Brain-Behavior Mental Health Institute, Iksan, Republic of Korea
| | - Hye-Jin Lee
- Department of Public Health, Wonkwang University Graduate School, Iksan, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Republic of Korea.,Korea Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.,Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
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10
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A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:342-353. [PMID: 29385014 DOI: 10.1097/htr.0000000000000373] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify barriers and supports that caregivers of individuals with military-related traumatic brain injury (TBI) encounter when navigating the military healthcare system; this information will be used as the foundation of a new patient-reported outcome measure. SETTING Community. PARTICIPANTS Forty-five caregivers of service members and veterans (SMV) who sustained a medically documented mild, moderate, severe, or penetrating TBI. DESIGN Latent content analysis. MAIN MEASURES Nine focus group discussions of barriers and supports to navigating the military healthcare system and community resources. RESULTS Latent content analysis indicated that caregivers discussed barriers (66%) and supports (34%) to obtaining care within the military healthcare system and the community. Caregivers most frequently discussed SMVs' interactions with healthcare, their own interactions with healthcare, family care, and community organizations. CONCLUSIONS Caregivers confront numerous challenges while pursuing healthcare services. Although much of the discussion focused on barriers and perceived unmet needs within the military healthcare system, caregivers also recognized supports within the military healthcare system and general community. Increased attention to accessibility and quality of services, as well as reducing financial burden, can lead to improved health-related quality of life for caregivers and their SMVs.
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11
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Executive (dys)function after traumatic brain injury: special considerations for behavioral pharmacology. Behav Pharmacol 2019; 29:617-637. [PMID: 30215621 PMCID: PMC6155367 DOI: 10.1097/fbp.0000000000000430] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Executive function is an umbrella term that includes cognitive processes such as decision-making, impulse control, attention, behavioral flexibility, and working memory. Each of these processes depends largely upon monoaminergic (dopaminergic, serotonergic, and noradrenergic) neurotransmission in the frontal cortex, striatum, and hippocampus, among other brain areas. Traumatic brain injury (TBI) induces disruptions in monoaminergic signaling along several steps in the neurotransmission process - synthesis, distribution, and breakdown - and in turn, produces long-lasting deficits in several executive function domains. Understanding how TBI alters monoamingeric neurotransmission and executive function will advance basic knowledge of the underlying principles that govern executive function and potentially further treatment of cognitive deficits following such injury. In this review, we examine the influence of TBI on the following measures of executive function - impulsivity, behavioral flexibility, and working memory. We also describe monoaminergic-systems changes following TBI. Given that TBI patients experience alterations in monoaminergic signaling following injury, they may represent a unique population with regard to pharmacotherapy. We conclude this review by discussing some considerations for pharmacotherapy in the field of TBI.
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12
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Jurick SM, Crocker LD, Keller AV, Hoffman SN, Bomyea J, Jacobson MW, Jak AJ. The Minnesota Multiphasic Personality Inventory-2-RF in Treatment-Seeking Veterans with History of Mild Traumatic Brain Injury. Arch Clin Neuropsychol 2019; 34:366-380. [PMID: 29850866 DOI: 10.1093/arclin/acy048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/26/2018] [Accepted: 05/09/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined the Minnesota Multiphasic Personality Inventory-Second Edition-Restructured Form (MMPI-2-RF) to better understand symptom presentation in a sample of treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with self-reported history of mild traumatic brain injury (mTBI). METHOD Participants underwent a comprehensive clinical neuropsychological battery including performance and symptom validity measures and self-report measures of depressive, posttraumatic, and post-concussive symptomatology. Those with possible symptom exaggeration (SE+) on the MMPI-2-RF were compared with those without (SE-) with regard to injury, psychiatric, validity, and cognitive variables. RESULTS Between 50% and 87% of participants demonstrated possible symptom exaggeration on one or more MMPI-2-RF validity scales, and a large majority were elevated on content scales related to cognitive, somatic, and emotional complaints. The SE+ group reported higher depressive, posttraumatic, and post-concussive symptomatology, had higher scores on symptom validity measures, and performed more poorly on neuropsychological measures compared with the SE- group. There were no group differences with regard to injury variables or performance validity measures. Participants were more likely to exhibit possible symptom exaggeration on cognitive/somatic compared with traditional psychopathological validity scales. CONCLUSIONS A sizable portion of treatment-seeking OEF/OIF Veterans demonstrated possible symptom exaggeration on MMPI-2-RF validity scales, which was associated with elevated scores on self-report measures and poorer cognitive performance, but not higher rates of performance validity failure, suggesting symptom and performance validity are distinct concepts. These findings have implications for the interpretation of clinical data in the context of possible symptom exaggeration and treatment in Veterans with persistent post-concussive symptoms.
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Affiliation(s)
- S M Jurick
- Department of Psychiatry, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.,Veterans Medical Research Foundation, San Diego, CA, USA
| | - L D Crocker
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - A V Keller
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - S N Hoffman
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - J Bomyea
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - M W Jacobson
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - A J Jak
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA.,Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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13
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Evaluation of extent and pattern of neurocognitive functions in mild and moderate traumatic brain injury patients by using Montreal Cognitive Assessment (MoCA) score as a screening tool: An observational study from India. Asian J Psychiatr 2019; 41:60-65. [PMID: 30396805 DOI: 10.1016/j.ajp.2018.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Cognitive impairment is one of the most important culprit influencing the long-term neurological outcome commonlyobserved in TBI survivors. AIMS To examine the performance of patients with Mild and Moderate traumatic brain injury (TBI) on the Montreal Cognitive Assessment (MoCA) using as a screening tool. RESULTS Total 228 (127 Mild TBI & 101 Moderate TBI) patients were recruited in this study. Results showed that patients with moderate TBI had lower score on the MoCA as compared to patients with mild TBI (p Value = 0.031). This difference was observed statistically significant among mild and moderate TBI for the cube copy (p = 0.039) and clock (p = 0.017) i.e. visuospatial/executive function, Digit span test (p value = 0.040) i.e. concentration and recall memory (p = 0.04). MoCA Score were higher for patients with higher GCS score at admission. Education status was also correlated with MoCA scores; those patients with higher level of education had significant association with higher MoCA scores (p value = 0.012). This study showed that age and gender were insignificant variables to determine cognitive function. CONCLUSION Assessment of cognitive impairment should be considered as a mandatory protocol while evaluating post TBI patients, even in cases of mild TBI. Visuospatial/Executive function, memory and attention are the most commonly impaired cognitive functions in patients of TBI, and these are the main domain of cognition which differentiates mild impairment from moderate impairment. This information enables us and provides insight to our experience to predict the burdens of problem and plan to develop post TBI dedicated rehabilitating programme.
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14
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Tonks J, Whitfield CK, Williams WH, Slater AM, Frampton IJ. "Must try harder." Is effort and performance validity testing a necessary part of pediatric neuropsychological assessment? APPLIED NEUROPSYCHOLOGY-CHILD 2018; 9:97-105. [PMID: 30583707 DOI: 10.1080/21622965.2018.1524766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Neuropsychological assessments results have significant implications for pediatric populations, based upon the assumption that the young person has adopted an effortful approach and has engaged in assessment. There is a commonly-accepted risk to assuming the validity of neuropsychological assessment results with adults, and, therefore, performance validity testing (PVT) has become a major topic of research and investigation and has become an accepted part of routine assessment. The same approach has not been adopted in assessment with children and a paucity of studies has focused on PVT in children. We review studies that demonstrate that children are equal to adults in their ability to use deception and that clinicians cannot detect false-effort without use of validity tests. We explore how frequently such tests are used and how well they work in assessment with children, and the limits, complexities, and constraints of adapting adult tests. We advocate that adequate performance validity testing is essential in order to maximize confidence in the results and we hypothesize that assessment with pediatric populations should take into account a range of influences, such as neuro-developmental factors associated with age of the child and suitability of proposed measures according to the evidence-base.
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Affiliation(s)
- James Tonks
- 1University of Exeter Medical School, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Charlotte Katie Whitfield
- 2School of Psychology, Cardiff University, Cardiff, United Kingdom of Great Britain and Northern Ireland
| | - W Huw Williams
- 3School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Alan M Slater
- School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
| | - Ian J Frampton
- School of Psychology, Washington Singer Laboratories, University of Exeter College of Life and Environmental Sciences, Exeter, United Kingdom of Great Britain and Northern Ireland
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15
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Terry DP, Brassil M, Iverson GL, Panenka WJ, Silverberg ND. Effect of depression on cognition after mild traumatic brain injury in adults. Clin Neuropsychol 2018; 33:124-136. [DOI: 10.1080/13854046.2018.1459853] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Douglas P. Terry
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- , Spaulding Rehabilitation Hospital, Boston, MA, USA
- , Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA
- , MassGeneral Hospital for Children Sport Concussion Program, Boston, MA, USA
| | - Michelle Brassil
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- , Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Grant L. Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- , Spaulding Rehabilitation Hospital, Boston, MA, USA
- , Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA
- , MassGeneral Hospital for Children Sport Concussion Program, Boston, MA, USA
| | - William J. Panenka
- British Columbia Neuropsychiatry Program, University of British Columbia, Vancouver, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Noah D. Silverberg
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Division of Physical Medicine & Rehabilitation, University of British Columbia,Vancouver, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, GF Strong Rehab Centre, Vancouver, Canada
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Lippa SM. Performance validity testing in neuropsychology: a clinical guide, critical review, and update on a rapidly evolving literature. Clin Neuropsychol 2017; 32:391-421. [DOI: 10.1080/13854046.2017.1406146] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sara M. Lippa
- Defense and Veterans Brain Injury Center, Silver Spring, MD, USA
- Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Bethesda, MD, USA
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Carlozzi N, Goodnight S, Casaletto K, Goldsmith A, Heaton R, Wong A, Baum C, Gershon R, Heinemann A, Tulsky D. Validation of the NIH Toolbox in Individuals with Neurologic Disorders. Arch Clin Neuropsychol 2017; 32:555-573. [PMID: 28334392 PMCID: PMC5860275 DOI: 10.1093/arclin/acx020] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 02/03/2017] [Accepted: 02/28/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Individuals with spinal cord injury (SCI), traumatic brain injury (TBI), and stroke experience a variety of neurologically related deficits across multiple domains of function. The NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIHTB) examines motor, sensation, cognition, and emotional functioning. The purpose of this paper is to establish the validity of the NIHTB in individuals with neurologic conditions. METHODS Community-dwelling individuals with SCI (n = 209), TBI (n = 184), or stroke (n = 211) completed the NIHTB. Relative risks for impaired performance were examined relative to a matched control groups. RESULTS The largest group differences were observed on the Motor domain and for the Fluid Cognition measures. All groups were at increased risk for motor impairment relative to normative standards and matched controls. Fluid cognitive abilities varied across groups such that individuals with stroke and TBI performed more poorly than individuals with SCI; increased relative risks for impaired fluid cognition were seen for individuals in the stroke and TBI groups, but not for those in the SCI group. All three neurologic groups performed normally on most measures in the Sensation Battery, although TBI participants evidenced increased risk for impaired odor identification and the stroke group showed more vision difficulties. On the Emotion Battery, participants in all three groups showed comparably poor psychological well-being, social satisfaction, and self-efficacy, whereas the TBI group also evidenced slightly increased negative affect. CONCLUSIONS Data provide support for the validity of the NIHTB in individuals with neurologic conditions.
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Affiliation(s)
- N.E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48109, USA
| | - S. Goodnight
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48109, USA
| | - K.B. Casaletto
- Department of Neurology, University of California, San Francisco, CA 94122, USA
| | - A. Goldsmith
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
| | - R.K. Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, USA
| | - A.W.K. Wong
- Occupational Therapy and Department of Neurology, Washington University, St. Louis, MO 63108, USA
| | - C.M. Baum
- Occupational Therapy and Department of Neurology, Washington University, St. Louis, MO 63108, USA
| | - R. Gershon
- Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA
- Department of Preventative Medicine, Northwestern University, Chicago, IL 60611, USA
| | - A.W. Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - D.S. Tulsky
- Department of Physical Therapy, Center for Assessment Research and Translation, University of Delaware, Newark, DE 19713, USA
- Kessler Foundation, West Orange, NJ 07052, USA
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Avramović P, Kenny B, Power E, McDonald S, Tate R, Hunt L, MacDonald S, Heard R, Togher L. Exploring the relationship between cognition and functional verbal reasoning in adults with severe traumatic brain injury at six months post injury. Brain Inj 2017; 31:502-516. [DOI: 10.1080/02699052.2017.1280854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Petra Avramović
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
| | - Belinda Kenny
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Emma Power
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of NSW, Sydney, Australia
| | - Robyn Tate
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Louise Hunt
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
| | | | - Rob Heard
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, The University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
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Nandrajog P, Idris Z, Azlen WN, Liyana A, Abdullah JM. The use of event-related potential (P300) and neuropsychological testing to evaluate cognitive impairment in mild traumatic brain injury patients. Asian J Neurosurg 2017; 12:447-453. [PMID: 28761523 PMCID: PMC5532930 DOI: 10.4103/1793-5482.180921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: The aim of the study is to compare the amplitude and latency of the P300 event-related potential (ERP) component between a control group and patients after mild traumatic brain injury (mTBI) during 1–7 days (short duration) and 2–3 months (long duration), and to compare the outcome of neuropsychological tests between the long duration postinjury and control study groups. Materials and Methods: We studied responses to auditory stimulation in two main and one subgroups, namely the control healthy group (19 patients, both ERP and neuropsychology test done), the mTBI 1 group (17 patients, only ERP done within 7 days after injury), and the mTBI 2 subgroup (the 17 mTBI 1 patients in whom a repeated ERP together with neuropsychological testing was done at 2–3 months postinjury). Auditory evoked responses were studied with two different stimuli (standard and target stimuli), where the P300 amplitude and latency were recorded from three midline sites and results were compared between the groups, as were the neuropsychological test results. Results: There was a significant prolongation of the target P300 latency values shown by the MBI 1 group measured at the central electrode when compared to the control group, which was also seen when the mTBI 1 and mTBI 2 groups were compared. The results of the P300 amplitude values measured at the frontal electrode showed the control group to have higher readings during the presentation of standard tones when compared to the mTBI 1 group. The mTBI 2 group performed better on some neuropsychological tests. Conclusion: The latency of P300 was significantly prolonged in early mTBI patients who improved over time, and the neuropsychological testing on mTBI 2 patients showed them to be comparable to the control group. The study indicates that ERP should be used as an additional modality of investigation in mTBI patients.
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Affiliation(s)
- Puneet Nandrajog
- Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Department of Neurosurgery, Kuala Lumpur Hospital, Malaysia
| | - Zamzuri Idris
- Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Center for Neuroscience Services and Research, University of Science Malaysia, Jalan Sultanah Zainab 2, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
| | - Wan Nor Azlen
- Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Alwani Liyana
- Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, University of Science Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.,Center for Neuroscience Services and Research, University of Science Malaysia, Jalan Sultanah Zainab 2, Kubang Kerian, Kota Bharu, Kelantan, Malaysia
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Armistead-Jehle P, Green P. Model for the effects of invalid styles of response. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 23:449-58. [DOI: 10.1080/23279095.2016.1178646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Paul Green
- Private Practice, Edmonton, Alberta, Canada
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Grills CE, Armistead-Jehle P. Performance validity test and neuropsychological assessment battery screening module performances in an active-duty sample with a history of concussion. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 23:295-301. [DOI: 10.1080/23279095.2015.1079713] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Armistead-Jehle P, Cooper DB, Vanderploeg RD. The role of performance validity tests in the assessment of cognitive functioning after military concussion: A replication and extension. APPLIED NEUROPSYCHOLOGY-ADULT 2015; 23:264-73. [DOI: 10.1080/23279095.2015.1055564] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Douglas B. Cooper
- Defense and Veterans Brain Injury Center, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA
| | - Rodney D. Vanderploeg
- Mental Health and Behavioral Sciences–Psychology Service, James A. Haley VAMC, Tampa, Florida, USA
- Defense and Veterans Brain Injury Center, Tampa, Florida, USA
- Departments of Psychology & Psychiatry, University of South Florida, Tampa, Florida, USA
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Carlozzi NE, Kirsch NL, Kisala PA, Tulsky DS. An examination of the Wechsler Adult Intelligence Scales, Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate and Severe traumatic brain injury (TBI). Clin Neuropsychol 2015; 29:21-37. [PMID: 25646823 DOI: 10.1080/13854046.2015.1005677] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n = 35 complicated mild or moderate TBI; n = 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). Individuals with complicated mild/moderate TBI performed more poorly than controls on the Working Memory Index (WMI), Processing Speed Index (PSI), and Full Scale IQ (FSIQ), and on four subtests: the two processing speed subtests (SS, CD), two working memory subtests (AR, LN), and a perceptual reasoning subtest (BD). Participants with severe TBI had significantly lower scores than the complicated mild/moderate TBI on PSI, and on three subtests: the two processing speed subtests (SS and CD), and the new visual puzzles test. Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI.
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Affiliation(s)
- Noelle E Carlozzi
- a Department of Physical Medicine and Rehabilitation , University of Michigan , Ann Arbor , Michigan 48109-2800 , USA
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Clark AL, Amick MM, Fortier C, Milberg WP, McGlinchey RE. Poor Performance Validity Predicts Clinical Characteristics and Cognitive Test Performance of OEF/OIF/OND Veterans in a Research Setting. Clin Neuropsychol 2014; 28:802-25. [DOI: 10.1080/13854046.2014.904928] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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King PR, Donnelly KT, Wade M, Donnelly JP, Dunnam M, Warner G, Kittleson CJ, Bradshaw CB, Alt M. The Relationships Among Premilitary Vocational Aptitude Assessment, Traumatic Brain Injury, and Postdeployment Cognitive Functioning in Combat Veterans. Arch Clin Neuropsychol 2014; 29:391-402. [DOI: 10.1093/arclin/acu011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Cooper DB, Vanderploeg RD, Armistead-Jehle P, Lewis JD, Bowles AO. Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings. ACTA ACUST UNITED AC 2014; 51:1023-34. [DOI: 10.1682/jrrd.2013.05.0140] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 03/26/2014] [Indexed: 11/05/2022]
Affiliation(s)
| | - Rodney D. Vanderploeg
- Defense and Veterans Brain Injury Center, Silver Spring, MD;James A. Haley Veterans’ Hospital, Tampa, FL; and Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, FL
| | | | - Jeffrey D. Lewis
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Amy O. Bowles
- Department of Orthopedics & Rehabilitation, Traumatic Brain Injury Service, San Antonio Military Medical Center, Fort Sam Houston, TX
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28
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Cooper DB, Vanderploeg RD, Armistead-Jehle P, Lewis JD, Bowles AO. Factors associated with neurocognitive performance in OIF/OEF servicemembers with postconcussive complaints in postdeployment clinical settings. ACTA ACUST UNITED AC 2014. [DOI: 10.1682/jrrd.2013.05.0104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Rodney D. Vanderploeg
- Defense and Veterans Brain Injury Center, Silver Spring, MD;James A. Haley Veterans’ Hospital, Tampa, FL; and Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, FL
| | | | - Jeffrey D. Lewis
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD
| | - Amy O. Bowles
- Department of Orthopedics & Rehabilitation, Traumatic Brain Injury Service, San Antonio Military Medical Center, Fort Sam Houston, TX
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29
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Sweet JJ, Goldman DJ, Guidotti Breting LM. Traumatic brain injury: guidance in a forensic context from outcome, dose-response, and response bias research. BEHAVIORAL SCIENCES & THE LAW 2013; 31:756-778. [PMID: 24019125 DOI: 10.1002/bsl.2088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/26/2013] [Accepted: 07/31/2013] [Indexed: 06/02/2023]
Abstract
Traumatic brain injury (TBI) occurs at a high incidence, involving millions of individuals in the U.S. alone. Related to this, there are large numbers of litigants and claimants who are referred annually for forensic evaluation. In formulating opinions regarding claimed injuries, the present review advises experts to rely on two sets of information: TBI outcome and neuropsychological dose-response studies of non-litigants and non-claimants, and response bias literature that has demonstrated the relatively high risk of invalid responding among examinees referred within a secondary gain context, which in turn has resulted in the development of specific assessment methods. Regarding prospective methods for detecting possible response bias, both symptom validity tests, for measuring over-reporting of symptoms on inventories and questionnaires, and performance validity tests, for measuring insufficient effort on ability tests, are considered essential.
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Affiliation(s)
- Jerry J Sweet
- University of Chicago, Pritzker School of Medicine, Chicago, IL; NorthShore University HealthSystem, Evanston, IL
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30
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Carlozzi NE, Grech J, Tulsky DS. Memory functioning in individuals with traumatic brain injury: An examination of the Wechsler Memory Scale–Fourth Edition (WMS–IV). J Clin Exp Neuropsychol 2013; 35:906-14. [DOI: 10.1080/13803395.2013.833178] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hampson NE, Kemp S, Coughlan† AK, Moulin CJA, Bhakta BB. Effort Test Performance in Clinical Acute Brain Injury, Community Brain Injury, and Epilepsy Populations. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 21:183-94. [DOI: 10.1080/09084282.2013.787425] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Natalie E. Hampson
- a Department of Neuropsychology , Salford Royal NHS Foundation Trust , Salford , United Kingdom
| | - Steven Kemp
- b Department of Neuropsychology , St. James's University Hospital , Leeds , United Kingdom
| | - Anthony K. Coughlan†
- b Department of Neuropsychology , St. James's University Hospital , Leeds , United Kingdom
| | | | - Bipin B. Bhakta
- d Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health , University of Leeds , Leeds , United Kingdom
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de Guise E, Alturki AY, LeBlanc J, Champoux MC, Couturier C, Lamoureux J, Desjardins M, Marcoux J, Maleki M, Feyz M. The Montreal Cognitive Assessment in Persons with Traumatic Brain Injury. APPLIED NEUROPSYCHOLOGY-ADULT 2013; 21:128-35. [DOI: 10.1080/09084282.2013.778260] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Elaine de Guise
- a Traumatic Brain Injury Program and Neurosurgery Department , McGill University Health Centre-Montreal General Hospital, Montreal , Quebec , Canada
| | - Abdulrahman Yaqub Alturki
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
- c Neurology and Neurosurgery , The National Neuroscience Institute , Riyadh , Saudi Arabia
| | - Joanne LeBlanc
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Marie-Claude Champoux
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Céline Couturier
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Julie Lamoureux
- e Social and Preventive Medicine Department , University of Montreal , Montreal , Quebec , Canada
| | - Monique Desjardins
- f Psychiatry Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Judith Marcoux
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Mohammed Maleki
- b Neurosurgery Department , McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
| | - Mitra Feyz
- d Traumatic Brain Injury Program, McGill University Health Centre-Montreal General Hospital , Montreal , Quebec , Canada
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Rzezak P, Antunes HKM, Tufik S, Mello MTD. Translation and cultural adaptation of the Game Dice Task to Brazilian population. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:929-33. [DOI: 10.1590/s0004-282x2012001200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 08/06/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The Game Dice Task (GDT) was developed to measure decision making under known risk. The aim of this study was to translate and adapt the GDT to a Brazilian population. METHOD: After the GDT was translated and back-translated to Brazilian Portuguese and evaluated by eight bilingual judges, 175 Brazilian adults were divided into two groups - 160 healthy volunteers and 15 traumatic brain injury (TBI) patients - and had completed the GDT. RESULTS: Differences between genders, but not age, were observed in the healthy volunteer sample. Males more frequently chose a combination of three dice while females preferred four dice. TBI patients were more impulsive than healthy volunteers; they less frequently chose a combination of three dice and made more risky decisions. CONCLUSION: Because of the rigorous process used to translate and adapt the GDT and the differences observed between patients with TBI and healthy volunteers, the Brazilian GDT was considered satisfactory for research purposes.
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Webb JW, Batchelor J, Meares S, Taylor A, Marsh NV. Effort Test Failure: Toward a Predictive Model. Clin Neuropsychol 2012; 26:1377-96. [DOI: 10.1080/13854046.2012.728248] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Symptom validity testing (SVT) has become a major theme of contemporary neuropsychological research. However, many issues about the meaning and interpretation of SVT findings will require the best in research design and methods to more precisely characterize what SVT tasks measure and how SVT test findings are to be used in neuropsychological assessment. Major clinical and research issues are overviewed including the use of the “effort” term to connote validity of SVT performance, the use of cut-scores, the absence of lesion-localization studies in SVT research, neuropsychiatric status and SVT performance and the rigor of SVT research designs. Case studies that demonstrate critical issues involving SVT interpretation are presented.
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Bauer RM, Iverson GL, Cernich AN, Binder LM, Ruff RM, Naugle RI. Computerized neuropsychological assessment devices: joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology. Clin Neuropsychol 2012; 26:177-96. [PMID: 22394228 PMCID: PMC3847815 DOI: 10.1080/13854046.2012.663001] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting. These statements address (a) device marketing and performance claims made by developers of CNADs; (b) issues involved in appropriate end-users for administration and interpretation of CNADs; (c) technical (hardware/software/firmware) issues; (d) privacy, data security, identity verification, and testing environment; (e) psychometric development issues, especially reliability and validity; (f) cultural, experiential, and disability factors affecting examinee interaction with CNADs; (g) use of computerized testing and reporting services; and (h) the need for checks on response validity and effort in the CNAD environment. This paper is intended to provide guidance for test developers and users of CNADs that will promote accurate and appropriate use of computerized tests in a way that maximizes clinical utility and minimizes risks of misuse. The positions taken in this paper are put forth with an eye toward balancing the need to make validated CNADs accessible to otherwise underserved patients with the need to ensure that such tests are developed and utilized competently, appropriately, and with due concern for patient welfare and quality of care.
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Bauer RM, Iverson GL, Cernich AN, Binder LM, Ruff RM, Naugle RI. Computerized neuropsychological assessment devices: joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology. Arch Clin Neuropsychol 2012; 27:362-73. [PMID: 22382386 DOI: 10.1093/arclin/acs027] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting. These statements address (a) device marketing and performance claims made by developers of CNADs; (b) issues involved in appropriate end-users for administration and interpretation of CNADs; (c) technical (hardware/software/firmware) issues; (d) privacy, data security, identity verification, and testing environment; (e) psychometric development issues, especially reliability, and validity; (f) cultural, experiential, and disability factors affecting examinee interaction with CNADs; (g) use of computerized testing and reporting services; and (h) the need for checks on response validity and effort in the CNAD environment. This paper is intended to provide guidance for test developers and users of CNADs that will promote accurate and appropriate use of computerized tests in a way that maximizes clinical utility and minimizes risks of misuse. The positions taken in this paper are put forth with an eye toward balancing the need to make validated CNADs accessible to otherwise underserved patients with the need to ensure that such tests are developed and utilized competently, appropriately, and with due concern for patient welfare and quality of care.
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Lange RT, Pancholi S, Bhagwat A, Anderson-Barnes V, French LM. Influence of poor effort on neuropsychological test performance in U.S. military personnel following mild traumatic brain injury. J Clin Exp Neuropsychol 2012; 34:453-66. [PMID: 22273465 DOI: 10.1080/13803395.2011.648175] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The purpose of this study was to examine the influence of poor effort on neuropsychological test performance in military personnel following mild traumatic brain injury (MTBI). Participants were 143 U.S. service members who sustained a TBI, divided into three groups based on injury severity and performance on the Word Memory Test and four embedded markers of poor effort: MTBI-pass (n = 87), MTBI-fail (n = 21), and STBI-pass (n = 35; where STBI denotes severe TBI). Patients were evaluated at the Walter Reed Army Medical Center on average 3.9 months (SD = 3.4) post injury. The majority of the sample was Caucasian (84.6%), was male (93.0%), and had 12+ years of education (96.5%). Measures included the Personality Assessment Inventory (PAI) and 13 common neurocognitive measures. Patients in the MTBI-fail group performed worse on the majority of neurocognitive measures, followed by the Severe TBI-Pass group and the MTBI-pass group. Using a criterion of three or more low scores <10th percentile, the MTBI-fail group had the greatest rate of impairment (76.2%), followed by the Severe TBI-Pass group (34.3%) and MTBI-pass group (16.1%). On the PAI, the MTBI-fail group had higher scores on the majority of clinical scales (p < .05). There were a greater number of elevated scales (e.g., 5 or more elevated mild or higher) in the MTBI-fail group (71.4%) than in the MTBI-pass group (32.2%) and Severe TBI-Pass group (17.1%). Effort testing is an important component of postacute neuropsychological evaluations following combat-related MTBI. Those who fail effort testing are likely to be misdiagnosed as having severe cognitive impairment, and their symptom reporting is likely to be inaccurate.
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Affiliation(s)
- Rael T Lange
- Defense and Veterans Brain Injury Center, North Bethesda, MD 20852, USA.
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Armistead-Jehle P, Gervais RO, Green P. Memory Complaints Inventory Results as a Function of Symptom Validity Test Performance. Arch Clin Neuropsychol 2011; 27:101-13. [DOI: 10.1093/arclin/acr081] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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