Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T04:32:55.889Z Has data issue: false hasContentIssue false

Patterns of Cognitive Test Scores and Symptom Complaints in Persons with TBI Who Failed Performance Validity Testing

Published online by Cambridge University Press:  27 May 2020

Mark Sherer*
Affiliation:
TIRR Memorial Hermann, Houston, TX, USA
Angelle M. Sander
Affiliation:
TIRR Memorial Hermann, Houston, TX, USA H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine & Harris Health System, Houston, TX, USA
Jennie Ponsford
Affiliation:
Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
Leia Vos
Affiliation:
Acute Mental Health, Neuropsychology, Zablocki (Milwaukee) VA Medical Center, Milwaukee, WI, USA Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
Julia M.P. Poritz
Affiliation:
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
Esther Ngan
Affiliation:
Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
Luis Leon Novelo
Affiliation:
Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Houston, TX, USA
*
*Correspondence and reprint requests to: Mark Sherer, TIRR Research Center, 1333 Moursund, Houston, TX77030. E-mail: [email protected]

Abstract

Objective:

To determine clinically meaningful subgroups of persons with traumatic brain injury (TBI) who have failed performance validity testing.

Method:

Study participants were selected from a cohort of 674 participants with definitive medical evidence of TBI. Participants were those who failed performance validity testing (the Word Memory Test, using the standard cutoffs). Participants were administered cognitive tests and self-report questionnaires. Test and questionnaire results were summarized as 12 dimension scores. Cluster analysis using the k-means method was performed.

Results:

Cluster analysis for the 143 retained participants indicated three subgroups. These subgroups differed on patterns of scores. Subgroup 1 was impaired for memory and had no excessive complaints. Subgroup 2 had impaired memory and processing speed as well as concern regarding cognition function. Subgroup 3 showed impairment on all cognitive tests and excess complaints in multiple areas.

Conclusions:

These results provide a preliminary basis for improved understanding of poor performance validity.

Type
Brief Communication
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bashem, J.R., Rapport, L.J., Miller, J.B., Hanks, R.A., Axelrod, B.N., & Millis, S.R. (2014). Comparison of five performance validity indices in bona fide and simulated traumatic brain injury. The Clinical Neuropsychologist, 28(5), 851875.10.1080/13854046.2014.927927CrossRefGoogle Scholar
Board of Directors. (2007). American Academy of Clinical Neuropsychology (AACN) practice guidelines for neuropsychological assessment and consultation. The Clinical Neuropsychologist, 21, 209231.10.1080/13825580601025932CrossRefGoogle Scholar
Bush, S.S., Ruff, R.M., Troster, A.I., Barth, J.T., Koffler, S.P., Pliskin, N.H., … Silver, C.H. (2005). Symptom validity assessment: Practice issues and medical necessity. Archives of Clinical Neuropsychology, 20(4), 419426.10.1016/j.acn.2005.02.002CrossRefGoogle ScholarPubMed
Caliński, T. & Harabasz, J. (1974). A dendrite method for cluster analysis. Communications in Statistics, 3(1), 127.Google Scholar
Chafetz, M.D., Williams, M.A., Ben-Porath, Y.S., Bianchini, K.J., Boone, K.B., Kirkwood, M.W., Larrabee, G.J., & Ord, J.S. (2015). Official position of the American Academy of Clinical Neuropsychology Social Security Administration Policy on validity testing: Guidance and recommendations for change. The Clinical Neuropsychologist, 29(6), 723740.10.1080/13854046.2015.1099738CrossRefGoogle Scholar
Cicerone, K.D. & Kalmar, K. (1995). Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 10(3), 117.10.1097/00001199-199510030-00002CrossRefGoogle Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Epstein, N.B., Baldwin, L., & Bishop, D.S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9, 171180.10.1111/j.1752-0606.1983.tb01497.xCrossRefGoogle Scholar
Frazier, T.W., Youngstrom, E.A., Naugle, R.I., Haggerty, K.A., Busch, R.M. (2007). The latent structure of cognitive symptom exaggeration on the Victoria Symptom Validity Test. Archives of Clinical Neuropsychology, 22, 197211.10.1016/j.acn.2006.12.007CrossRefGoogle ScholarPubMed
Gladsjo, J.A., Schuman, C.C., Evans, J.D., Peavy, G.M., Miller, S.W., & Heaton, R.K. (1999). Norms for letter and category fluency: Demographic corrections for age, education, and ethnicity. Assessment, 6, 147178.10.1177/107319119900600204CrossRefGoogle ScholarPubMed
Green, P. (2007). The pervasive influence of effort on neuropsychological tests. Physical Medicine and Rehabilitation Clinics of North America, 18, 4368.10.1016/j.pmr.2006.11.002CrossRefGoogle ScholarPubMed
Greher, M.R. & Wodushek, T.R. (2017). Performance validity testing in neuropsychology: Scientific basis and clinical application – a brief review. Journal of Psychiatric Practice, 23(2), 134140.10.1097/PRA.0000000000000218CrossRefGoogle ScholarPubMed
Heaton, R.K., Miller, S.W., Taylor, M.J., & Grant, I. (2004). Revised Comprehensive Norms for an Expanded Halstead-Reitan Battery: Demographically Adjusted Neuropsychological Norms for African American and Caucasian Adults. Lutz, FL: Psychological Assessment Resources.Google Scholar
Heilbronner, R.L., Sweet, J.J., Morgan, J.E., Larrabee, G.J., Millis, S.R., & Participants, Conference. (2009). American Academy of Clinical Neuropsychology consensus conference statement on the neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 23(7), 10931129.10.1080/13854040903155063CrossRefGoogle ScholarPubMed
Henry, G.K., Heilbronner, R.L., Suhr, J., Gornbein, J., Wagner, E., & Drane, D.L. (2018). Illness perceptions predict cognitive performance validity. Journal of the International Neuropsychological Society, 24(7), 735745.10.1017/S1355617718000218CrossRefGoogle ScholarPubMed
Larrabee, G.J. (2012). Performance validity and symptom validity in neuropsychological assessment. Journal of the International Neuropsychological Society, 18(4), 625630.10.1017/S1355617712000240CrossRefGoogle ScholarPubMed
Larrabee, G.J. (2014). Assessment of malingering. In Larrabee, G.J. (Ed.), Forensic Neuropsychology: A Scientific Approach (2nd ed.) (pp. 116159). New York: Oxford.Google Scholar
Lippa, S.M. (2018). Performance validity testing in neuropsychology: a clinical guide, critical review, and update on a rapidly evolving literature. The Clinical Neuropsychologist, 32(3), 391421.10.1080/13854046.2017.1406146CrossRefGoogle ScholarPubMed
Lippa, S.M., Pastorek, N.J., Romesser, J., Linck, J., Sim, A.H., Wisdom, N.M., & Miller, B.I. (2014). Ecological validity of performance validity testing. Archives of Clinical Neuropsychology, 29(3), 236244.10.1093/arclin/acu002CrossRefGoogle ScholarPubMed
Morin, R.T. & Axelrod, B.N. (2017). Use of latent class analysis to define groups based on validity, cognition, and emotional functioning. The Clinical Neuropsychologist, 31(6–7), 10871099.10.1080/13854046.2017.1341550CrossRefGoogle ScholarPubMed
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery: Theory and Clinical Interpretation. Tucson, Arizona: Neuropsychology Press.Google Scholar
Rey, A. (1958). L’examin Clinique en psychologie. Paris, France: Presses Universitaires de France.Google Scholar
Schmidt, M. (1996). Rey Auditory Verbal Learning Test (RAVLT): A Handbook. Los Angeles: Western Psychological Services.Google Scholar
Sherer, M., Nick, T.G., Sander, A.M., Melguizo, M., Hanks, R., Novack, T.A.Tang, X. (2017). Groupings of persons with traumatic brain injury: A new approach to classifying traumatic brain injury in the post-acute period. Journal of Head Trauma Rehabilitation, 32(2), 125133.10.1097/HTR.0000000000000207CrossRefGoogle ScholarPubMed
Sherer, M., Ponsford, J., Hicks, A., Leon-Novelo, L., Ngan, E., & Sander, A.M. (2017). Cross-validation of a classification system for persons with traumatic brain injury in the posthospital period. Journal of Head Trauma Rehabilitation, 32(5), E17E25.10.1097/HTR.0000000000000290CrossRefGoogle ScholarPubMed
Sherer, M., Sander, A.M., Nick, T. G., Melguizo, M.S., Tulsky, D.S., Kinsala, P., Hanks, R., & Novack, T.A. (2015). Key dimensions of impairment, self-report, and environmental supports in persons with traumatic brain injury. Rehabilitation Psychology, 60(2), 138146.10.1037/rep0000030CrossRefGoogle ScholarPubMed
Slick, D.J., Sherman, E.M.S., & Iverson, G.L. (1999). Diagnostic criteria for malingered neurocognitive dysfunction: Proposed standards for clinical practice and research. The Clinical Neuropsychologist, 13(4), 545561.10.1076/1385-4046(199911)13:04;1-Y;FT545CrossRefGoogle ScholarPubMed
Tibshirani, R., Walther, G., & Hastie, T. (2001). Estimating the number of clusters in a date set via the gap statistic. Journal of the Royal Statistical Society, Series B, 63(2), 411423.10.1111/1467-9868.00293CrossRefGoogle Scholar
Tulsky, D.S., Kisala, P.A., Lai, J.-S., Carlozi, N., Hammel, J., & Heinemann, A.W. (2015). Developing an item bank to measure economic quality of life for individuals with disabilities. Archives of Physical Medicine and Rehabilitation, 96(4), 604613.10.1016/j.apmr.2014.02.030CrossRefGoogle ScholarPubMed
Tulsky, D.S., Kisala, P.A., Victorson, D., Carlozzi, N., Bushnik, T., Sherer, M., … Cella, D. (2016). TBI-QOL: Development and calibration of items banks to measure patient reported outcomes following traumatic brain injury. Journal of Head Trauma Rehabilitation, 31(1), 4051.10.1097/HTR.0000000000000131CrossRefGoogle Scholar
Wechsler, D. (2008). Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV). San Antonio, Texas: Pearson.Google Scholar