RESUMO
This study examined the efficacy of CVLT-3 response bias (i.e., parametric and nonparametric response bias) indices in differentiating between a clinical sample with traumatic brain injury and a litigating sample with poor performance validity.Participants included 106 individuals, divided into two groups: clinical group with TBI (n = 56) and a litigating group who demonstrated inadequate performance validity (n = 50), as measured by failure on at least two performance validity tests. Archival CVLT-II data was rescored utilizing the CVLT-3 scoring and normative data. Receiver operator characteristic (ROC) curve analysis was used to evaluate the diagnostic discriminability of the two response bias indices.Both parametric and nonparametric bias indices showed acceptable levels of diagnostic discrimination: AUC = .791 for parametric response bias and AUC = .753 for nonparametric response bias.Parametric response bias' discrimination was statistically superior to the nonparametric responses bias' discrimination. The CVLT-3 response bias score demonstrated good sensitivity and specificity when differentiating between individuals in a clinical sample with TBI and individuals in litigation who demonstrated inadequate performance validity.
Assuntos
Lesões Encefálicas Traumáticas , Humanos , Testes Neuropsicológicos , Lesões Encefálicas Traumáticas/diagnóstico , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To explore the neuropsychological sequelae of blast-induced mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), several neuropsychological tests and self-reported measures of cognitive and emotional functioning were administered to 138 Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans. We hypothesized that veterans affected by mTBI and PTSD would manifest differences in neuropsychological testing and self-report measures compared to a group of healthy veteran controls and to veterans with only PTSD. METHOD: Participants included 3 groups of veterans: (a) healthy controls (n = 43); (b) PTSD only (n = 48); and (c) comorbid blast-induced mTBI and PTSD (n = 47). An exploratory factor analysis (EFA) was used to extract a smaller number of latent dimensions for group comparison. RESULTS: The EFA supported an 8-factor model. A multivariate analysis of variance on the 8 factor scores demonstrated 3 significant factor mean differences: (a) perceived cognitive complications (PCC), (b) perceived emotional distress (PED), and (c) processing speed (PS). Post hoc analyses showed significant group mean difference in PS between the comorbid and the control groups. In addition, the comorbid group presented with the highest levels of PCC and PED. CONCLUSIONS: Results suggest that among OIF/OEF veterans with blast-induced mTBI, PTSD with its accompanying emotional distress may be a significant determinant of subjective sense of well-being both cognitively and emotionally. The objective discrepancy in PS between the comorbid group and the healthy controls also appears largely due to PTSD more so than the remote blast-induced mTBI, as the group mean difference in PS became negligible after controlling for PTSD levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).