ABSTRACT
Motor measures are sensitive to central lesions, but they are also affected by peripheral injury and motivation. The motor skills profiles of proven brain injury clients were compared with the profiles of healthy postconcussion patients. The chief result was a double dissociation: The traumatic brain injury (TBI) group produced a motor dysfunction gradient consistent with upper motor neuron disease, while the compensation-seeking postconcussion group produced a nonphysiologic pattern. Objective measures of behavioral pain and emotional distress did not correlate with the findings. Motor skill deficiencies in postconcussion syndrome (PCS) are probably functional in nature.
Subject(s)
Brain Concussion/diagnosis , Brain Damage, Chronic/diagnosis , Brain Injuries/diagnosis , Neuropsychological Tests , Psychomotor Disorders/diagnosis , Adult , Brain Concussion/psychology , Brain Damage, Chronic/psychology , Brain Injuries/psychology , Diagnosis, Differential , Female , Humans , Male , Malingering/diagnosis , Malingering/psychology , Middle Aged , Motor Neuron Disease/diagnosis , Motor Neuron Disease/psychology , Neurologic Examination , Psychomotor Disorders/psychologyABSTRACT
The predictive accuracy of Andre Rey's malingered amnesia measures (Memory for Fifteen Items and Word Recognition List) was examined. Discriminant function and crosstabulation analytic strategies were applied to predict membership in either a traumatically brain injured group (n = 60) or in a litigated minor head injury group claiming permanent severe disability (n = 90). Satisfactory hit rates were achieved with Rey's original scoring methods, but improved hit rates were obtained with scoring modifications. Removal of dense amnesiacs from the sample resulted in even better hit rates. Rey's measures appear to be valid for the assessment of cognitive malingering in settings where litigated disability claims are out of proportion to injury characteristics. Rey's measures are not appropriate for globally and severely impaired patients in clinical settings.
