Estimating the diagnostic value of the trail making test for suboptimal effort in acquired brain injury rehabilitation patients.
This investigation explored the classification accuracy of Trail Making Test (TMT; Reitan & Wolfson, 1992) indices for suboptimal effort in a sample of non-litigious acquired brain injury patients seeking outpatient rehabilitation. Patients who exhibited optimal effort completed TMT A and B faster than suboptimal effort patients. Although TMT A time to completion demonstrated adequate sensitivity to suboptimal effort, positive predictive value was fair to poor unless the base rate of suboptimal effort was inflated to 40%. TMT B time to completion yielded poor sensitivity and positive predictive value for suboptimal effort. While TMT A time to completion appears to have some value as a validity indicator, no TMT validity indicator should replace more precise symptom validity tests during neuropsychological assessment.
Neuroscience Center, Waukesha Memorial Hospital, Waukesha, WI 53188, USA. matthew.powell@phci.org
Matthew R
MR
Powell
Dona E C
DE
Locke
Jeffrey S
JS
Smigielski
Michael
M
McCrea
D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012720:Severity of Illness Index; D014145:Trail Making Test