Correlates of invalid neuropsychological test performance after traumatic brain injury.
OBJECTIVE
To investigate external correlates of invalid test performance after traumatic brain injury, as assessed by the California Verbal Learning Test - Second Edition (CVLT-II) and Word Memory Test (WMT).


METHODS
Consecutive 2-year series of rehabilitation referrals with a diagnosis of traumatic brain injury (n = 87).


METHODS
Logistic regression analysis was used to determine which demographic and neurological variables best differentiated those with vs. without actuarial CVLT-II or WMT evidence for invalid responding.


RESULTS
Twenty-one participants (about 24%) performed in the invalid range. The combination of a premorbid psychiatric history with minimal or no coma was associated with an approximately four-fold increase in the likelihood of invalid performance.


CONCLUSIONS
Premorbid psychosocial complicating factors constitute a significant threat to validity of neuropsychological test results after (especially mild) traumatic brain injury. At the same time, care should be taken to not routinely assume that all persons with mild traumatic brain injury and premorbid psychiatric histories are simply malingering. The WMT appears to be a promising instrument for the purpose of identifying those cases where neuropsychological test results are confounded by factors not directly related to acquired cerebral impairment.
Donders
Jacobus
J
Psychology Service, Mary Free Bed Rehabilitation Hospital. Grand Rapids, MI, USA. jacobus.donders@maryfreebed.com
Boonstra
Tyler
T
D000293:Adolescent; D000328:Adult; D001288:Attention; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D015331:Cohort Studies; D035881:Compensation and Redress; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology; D009042:Motivation; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors