title: The Repeatable Battery for the Assessment of Neuropsychological Status effort scale.
abstract: The measurement of effort is now considered to be an important component of neuropsychological assessment. In addition to stand-alone measures, built-in, or embedded measures of effort have been derived for a limited number of standard neurocognitive tests. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief battery, employed as a core diagnostic tool in dementia and as a neurocognitive screening battery or tracking/outcome measure in a variety of other disorders. An effort index (EI) for the RBANS has been published previously (Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. 2007. An EI for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical Neuropsychology, 21 (5), 841-854), but it has been reported to result in high false positive rates when applied to patients with "true" amnesia (e.g., Alzheimer's disease). We created a new effort scale (ES) for the RBANS based on the observation of patterns of free recall and recognition performance in amnesia versus inadequate effort. The RBANS ES was validated on a sample of patients with amnestic disorders and a sample of mild traumatic brain injury participants who failed a separate measure of effort. The sensitivity and specificity of the new ES was compared with the previously published EI. Receiver-operating characteristic analyses demonstrated much better sensitivity and specificity of the ES, with a marked reduction in false positive errors. Application and limitations of the RBANS ES, including indications for its use, are discussed.
authors.affiliation: Department of Psychology,  Rosalind Franklin University of Medicine and Science, North Chicago, IL,  USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Novitski
authors.forename: Shelly
authors.initials: S
authors.lastname: Steele
authors.forename: Stella
authors.initials: S
authors.lastname: Karantzoulis
authors.forename: Christopher
authors.initials: C
authors.lastname: Randolph
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications; D000647:Amnesia / Q000150:complications; D019540:Area Under Curve; D001930:Brain Injuries / Q000150:complications; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012372:ROC Curve; D021641:Recognition, Psychology