Discriminant construct validity of ImPACT™: a companion study.

In a previous analysis of ImPACT scores relative to traditional neuropsychological tests (NP) and experimental tasks (Maerlender et al., 2010 ) we demonstrated convergent construct validity for the primary ImPACT test-score composites. A complete analysis of discriminant validity was not undertaken at that time. Here, test scores from the 54 collegiate football and hockey players were re-analyzed to specifically address the discriminant validity of the ImPACT™ composite scores using a multiply operationalized correlation matrix of multi-trait multi-method data. In the method used here, discriminant validity is determined by obtaining non-significant correlations between a target score when correlated with the average of the other trait measurements (multiply-operationalized multi-trait-mono-method analysis). Results showed that the ImPACT™ Verbal Memory (p = .044), Visual Memory (p = .006), and Visual Motor Speed (p = .000) scores were highly correlated with composites of the other scores, while the Reaction Time composite demonstrated adequate discriminant validity (p = .145). In comparison all of the NP composites showed good discrimination (all p-values >.05, except for Reaction Time p = .05). Thus the apparent lack of discriminability between three of four composite scores in this sample raises questions about using ImPACT™ composite scores to support specific construct-oriented interpretations. Taken together, the discriminant and convergent construct validity properties of ImPACT™ indicate construct sensitivity, but limited construct specificity.

Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes.

OBJECTIVE: To determine whether exposure to repetitive head impacts over a single season negatively affects cognitive performance in collegiate contact sport athletes. METHODS: This is a prospective cohort study at 3 Division I National Collegiate Athletic Association athletic programs. Participants were 214 Division I college varsity football and ice hockey players who wore instrumented helmets that recorded the acceleration-time history of the head following impact, and 45 noncontact sport athletes. All athletes were assessed prior to and shortly after the season with a cognitive screening battery (ImPACT) and a subgroup of athletes also were assessed with 7 measures from a neuropsychological test battery. RESULTS: Few cognitive differences were found between the athlete groups at the preseason or postseason assessments. However, a higher percentage of the contact sport athletes performed more poorly than predicted postseason on a measure of new learning (California Verbal Learning Test) compared to the noncontact athletes (24% vs 3.6%; p < 0.006). On 2 postseason cognitive measures (ImPACT Reaction Time and Trails 4/B), poorer performance was significantly associated with higher scores on several head impact exposure metrics. CONCLUSION: Repetitive head impacts over the course of a single season may negatively impact learning in some collegiate athletes. Further work is needed to assess whether such effects are short term or persistent.

Examination of the construct validity of ImPACT™ computerized test, traditional, and experimental neuropsychological measures.

Although computerized neuropsychological screening is becoming a standard for sports concussion identification and management, convergent validity studies are limited. Such studies are important for several reasons: reference to established measures is needed to establish validity; examination of the computerized battery relative to a more traditional comprehensive battery will help understand the strengths and limitations of the computer battery; and such an examination will help inform the output of the computerized battery. We compared scores on the ImPACT™ battery to a comprehensive battery of traditional neuropsychological measures and several experimental measures used in the assessment of sports-related concussion in 54 healthy male athletes. Convergent validity was demonstrated for four of the five ImPACT™ domain scores. Two cognitive domains often compromised as a result of mild TBI were not directly identified by the ImPACT™ battery: sustained attention and auditory working memory. Affective symptoms correlated with performance on measures of attention and working memory. In this healthy sample the correlations between the domains covered by ImPACT™ and the neuropsychological battery supports ImPACT™ as a useful screening tool for assessing many of the cognitive factors related to mTBI. However, the data suggest other sources of data need to be considered when identifying and managing concussions.