Psychogenic stuttering and other acquired nonorganic speech and language abnormalities.

Three cases are presented of peculiar speech and language abnormalities that were evaluated in the context of personal injury lawsuit or workers compensation claims of brain dysfunction after mild traumatic brain injuries. Neuropsychological measures of effort and motivation showed evidence of suboptimal motivation or outright malingering. The speech and language abnormalities of these cases probably were not consistent with neurogenic features of dysfluent speech including stuttering or aphasia. We propose that severe dysfluency or language abnormalities persisting after a single, uncomplicated, mild traumatic brain injury are unusual and should elicit suspicion of a psychogenic origin.

Independent validation of the MMPI-2-RF Somatic/Cognitive and Validity scales in TBI Litigants tested for effort.

The MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) is replacing the MMPI-2 as the most widely used personality test in neuropsychological assessment, but additional validation studies are needed. Our study examines MMPI-2-RF Validity scales and the newly created Somatic/Cognitive scales in a recently reported sample of 82 traumatic brain injury (TBI) litigants who either passed or failed effort tests (Thomas & Youngjohn, 2009). The restructured Validity scales FBS-r (restructured symptom validity), F-r (restructured infrequent responses), and the newly created Fs (infrequent somatic responses) were not significant predictors of TBI severity. FBS-r was significantly related to passing or failing effort tests, and Fs and F-r showed non-significant trends in the same direction. Elevations on the Somatic/Cognitive scales profile (MLS-malaise, GIC-gastrointestinal complaints, HPC-head pain complaints, NUC-neurological complaints, and COG-cognitive complaints) were significant predictors of effort test failure. Additionally, HPC had the anticipated paradoxical inverse relationship with head injury severity. The Somatic/Cognitive scales as a group were better predictors of effort test failure than the RF Validity scales, which was an unexpected finding. MLS arose as the single best predictor of effort test failure of all RF Validity and Somatic/Cognitive scales. Item overlap analysis revealed that all MLS items are included in the original MMPI-2 Hy scale, making MLS essentially a subscale of Hy. This study validates the MMPI-2-RF as an effective tool for use in neuropsychological assessment of TBI litigants.

Let's not get hysterical: comparing the MMPI-2 validity, clinical, and RC scales in TBI litigants tested for effort.

The MMPI-2 restructured clinical (RC) scales replace the traditional clinical scales in the MMPI-2 restructured form (MMPI-2-RF). Few studies to date have examined the MMPI-2 RC scales in traumatic brain injury (TBI) litigants. We compared MMPI-2 validity, clinical, and RC scales profiles of 83 mild, complicated mild, and moderate/severe TBI litigants who were tested for effort. Past research shows that patients referred for neuropsychological evaluations with mild TBIs paradoxically have higher MMPI-2 clinical scale elevations than patients with moderate/severe TBIs. Failure on cognitive symptom validity tests (SVTs) has also been associated with elevated validity and clinical scales profiles. The "conversion V" (elevated Hs and Hy, followed by D) is the most frequent elevated profile configuration in mild TBI and/or SVT failure. We sought to determine if these patterns of symptom reporting would replicate on the RC scales profile. Archival data from independent neuropsychological examinations were used to correlate TBI severity, cognitive test effort as indicated by SVTs, and MMPI-2 profiles. Results suggest that the validity, clinical, and RC scales profiles all correlate well with indices of cognitive test effort (namely that failure on SVTs is correlated with elevated symptom reporting). In addition, the validity scales profile, but not the clinical or RC scales profiles, was significantly inversely related to TBI severity. Discriminant function analyses suggest that the MMPI-2 RC scales can aid in the diagnosis of over-reported TBI symptomatology. However, RC3-the RC equivalent of the Hy scale-no longer appears to serve as a marker of somatization and/or malingering.

New adult age-and education-correction norms for the benton visual retention test.

Adult age-and education-corrected norms for the Revised Visual Retention Test (BVRT) are presented. Our sample included 1,128 healthy individuals, ranging in age across the adult life span. Stepwise multiple regression analyses demonstrated significant negative associations between age and BVRT performance and significant positive associations between education and BVRT performance. Gender was not associated with performance. Both the regression equations, for predicting expected levels of performance in individuals, and tabular data are presented.