Performance validity and neuropsychological outcomes in litigants and disability claimants.
This study examined the relationship of performance validity and neuropsychological outcomes in a sample of individuals referred for independent neuropsychological examination in the context of reported traumatic brain injury (82% mild). Archival data were examined on 175 participants aged 20 to 65 who were administered at least two performance validity measures. Participants who passed all effort measures (Pass; n = 61) outperformed those who failed two or more (Fail; n = 70) on the majority of tests in the neuropsychological battery. The Fail group showed a higher percentage of impaired test scores than the Pass group with impairment defined at three levels (T scores < 40, 35, and 30). At the most conservative impairment cutoff (T < 30), 16% of the Pass group demonstrated impaired scores on more than three measures, while 79% of the Fail group showed impaired scores on more than three measures. The number of effort measures failed correlated highly with the overall test battery mean (r = -.73). On cognitive domain summary scores, effect sizes based on levels of effort (d = 1.12 to 1.86) were higher than those based on injury severity (d = 0.03 to 0.36).
Rehabilitation Institute of Michigan, Detroit, USA. jeremy.davis@hsc.utah.edu
Jeremy J
JJ
Davis
Tara S
TS
McHugh
Bradley N
BN
Axelrod
Robin A
RA
Hanks
D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000175:diagnosis* / Q000523:psychology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D055815:Young Adult