title: Utility of the mild brain injury atypical symptoms scale as a screening measure for symptom over-reporting in operation enduring freedom/operation iraqi freedom service members with post-concussive complaints.
abstract: Evaluation of post-deployment conditions such as post-concussive syndrome (PCS) and posttraumatic stress disorder (PTSD) frequently relies upon brief, self-report checklists which are face valid and highly susceptible to potential symptom validity issues such as symptom exaggeration. We investigated the psychometric prope1rties of a 5-item measure of symptom exaggeration (mild brain injury atypical symptoms [mBIAS] scale) embedded in commonly used PCS and PTSD screening instruments in a sample of 403 patients seen in a brain injury clinic at a large military medical center. Exploratory factor analysis, examining measures of posttraumatic stress, post-concussive symptoms, and symptom over-reporting revealed a 6-factor model with the mBIAS scale items representing a unique factor. Analysis of psychometric properties demonstrated that a score of 8 on the mBIAS was optimal for the detection of symptom over-reporting (sensitivity = 0.94, specificity = 0.92) and appears to be the most favorable cut score for interpretive use. The findings provide a strong initial support for the use of the mBIAS in post-deployment populations.
authors.affiliation: Traumatic Brain Injury Service, Department of Orthopedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX 78234–6200, USA. douglas.b.cooper@us.army.mil
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Cooper
authors.forename: Lonnie
authors.initials: L
authors.lastname: Nelson
authors.forename: Patrick
authors.initials: P
authors.lastname: Armistead-Jehle
authors.forename: Amy O
authors.initials: AO
authors.lastname: Bowles
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000704:Analysis of Variance; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology; D016009:Chi-Square Distribution; D003130:Combat Disorders / Q000175:diagnosis*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D038223:Post-Concussion Syndrome / Q000175:diagnosis*; D011237:Predictive Value of Tests; D025341:Principal Component Analysis; D011594:Psychometrics / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D014728:Veterans; D055815:Young Adult