title: Evaluating the clinical utility of the Validity-10 for detecting amplified symptom reporting for patients with mild traumatic brain injury and comorbid psychological health conditions.
abstract: The objective of this study was to compare the Validity-10 scale with the PAI Negative Impression Management Scale (PAI-NIM) for detecting exaggerated symptom reporting in active-duty military service members (SMs) admitted with unremitting mild TBI symptoms and comorbid psychological health conditions (mTBI/PH). Data were analyzed from 254 SMs who completed the Neurobehavioral Symptom Inventory (NSI) and Personality Assessment Inventory (PAI) as a part of a larger battery of self-report symptom scales upon admission to the intensive-outpatient TBI treatment program at a military medical center. Symptom exaggeration was operationalized using the PAI Negative Impression Management Scale (PAI-NIM). A PAI-NIM score of ≥73 was categorized as positive for symptom exaggeration (SVTpos), while a lower score was categorized as negative for symptom exaggeration (SVTneg). SMs in the SVTpos group (n = 34) had significantly higher scores (p ≤ .004) on the PAI clinical scales as well as on the NSI total score (range: d = 0.59-1.91) compared to those who were SVTneg (n = 220). The optimal cut-score for the NSI Val-10 scale to identify possible symptom exaggeration was ≥26 (sensitivity = .29, specificity = .95, PPP = .74, NPP = .71). In patients suffering from mTBI/PH, the Validity-10 requires a higher cut-score than previously reported to be useful as a metric of exaggerated symptom reporting.
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.|b Human Dimension Division , Headquarters US Army Training and Doctrine Command , Fort Eustis , VA , USA.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Dretsch
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Williams
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Staver
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Grammer
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bleiberg
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: DeGraba
authors.affiliation: a National Intrepid Center of Excellence , Walter Reed National Military Medical Center , Bethesda , MD , USA.|c Defense and Veterans Brain Injury Center , Bethesda , MD , USA.
authors.forename: Rael T
authors.initials: RT
authors.lastname: Lange
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000523:psychology*; D008396:Maryland / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology*; D008889:Military Personnel / Q000523:psychology*; D009483:Neuropsychological Tests; D010555:Personality Inventory; D055815:Young Adult
keywords: Mild traumatic brain injury; Validity-10; neurobehavioral symptom inventory; post-concussive symptoms