title: Detecting suboptimal cognitive effort: classification accuracy of the Conner's Continuous Performance Test-II, Brief Test Of Attention, and Trail Making Test.
abstract: Many cognitive measures have been studied for their ability to detect suboptimal cognitive effort; however, attention measures have not been extensively researched. The current study evaluated the classification accuracy of commonly used attention/concentration measures, the Brief Test of Attention (BTA), Trail Making Test (TMT), and the Conners' Continuous Performance Test (CPT-II). Participants included 413 consecutive patients who completed a comprehensive neuropsychological evaluation. Participants were separated into two groups, identified as either unbiased responders or biased responders as determined by performance on the TOMM. Based on Mann-Whitney U results, the two groups differed significantly on all attentional measures. Classification accuracy of the BTA (.83), CPT-II omission errors (OE; .76) and TMT B (.75) were acceptable; however, classification accuracy of CPT-II commission errors (CE; .64) and TMT A (.62) were poor. When variables were combined in different combinations, sensitivity did not significantly increase. Results indicated for optimal cut-off scores, sensitivity ranged from 48% to 64% when specificity was at least 85%. Given that sensitivity rates were not adequate, there remains a need to utilize highly sensitive measures in addition to these embedded measures. Results were discussed within the context of research promoting the need for multiple measures of cognitive effort.
authors.affiliation: Washington School of Professional Psychology, Seattle, WA 98121, USA. michelle.busse@hotmail.com
authors.forename: Michelle
authors.initials: M
authors.lastname: Busse
authors.forename: Douglas
authors.initials: D
authors.lastname: Whiteside
mesh_terms: D000328:Adult; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity; D014145:Trail Making Test