Abstract

Objective: Research has suggested that traumatic brain injury (TBI) severity is one of the most robust predictors of outcome following a TBI, yet there have been few investigations within a compensation setting. The current study examined whether a similar dose-response relationship between severity and neuropsychological and psychological outcomes exists in a litigation sample with credible neuropsychological test scores. Method: Participants (n = 66) referred for compensation-related reasons following a TBI were retrospectively categorized as mild complicated-moderate (n = 39) or severe (n = 27) based on their Glasgow Coma Scale ratings and neuroimaging findings. Participants with a history of psychiatric and neurological conditions or failure on multiple standardized performance validity tests were excluded. Participants completed the Neuropsychological Assessment Battery – Screening Module (NAB-SM), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI). Age- and educated-adjusted norms were used. Results: Hierarchical regression analysis revealed that injury severity did not significantly predict overall NAB-SM scores (R2 = .01, F(1, 64) = .62, p = .43) or any of the domains. However, severity was a significant predictor of BDI-II (R2 = .13, F(1, 42) = 6.04, p = .02) and BAI scores (R2 = .20, F(1, 42) = 10.45, p < .01), with higher levels of depression and anxiety endorsed for mild complicated-moderate TBI than severe TBI groups. Conclusion(s): Individuals with less severe injuries examined in a compensation setting endorsed more emotional symptoms, but TBI severity was not predictive of neuropsychological performance in a litigation population.