Objective: To examine the association between performance validity, ICD-10 diagnostic criteria for postconcussional syndrome, and DSM-IV criteria for major and mild neurocognitive disorder in military service members. Method: Service members [n = 254; 94.1% men; Age: M = 27.7 (SD = 7.1)] with MTBIs assessed on average 3.9 months (SD = 4.4) post-injury at Walter Reed Army Medical Center were divided into three mutually exclusive groups: (a) Revised PVT-Pass, n = 163 [i.e., Test of Memory Malingering (TOMM) Trial 1 > 40, TOMM Trial 2 > 48, and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) = 0]; (b) Revised PVT-Fail, n = 58 (i.e., TOMM Trial 1 < 41, TOMM Trial 2 < 49 but >44, or RBANS EI = 1–3); and (c) Original PVT-Fail, n = 33 (i.e., TOMM Trial 2 < 45 or RBANS EI>3). They also completed the Neurobehavioral Symptom Inventory (NSI). Results: The PVT failure rate was 13% for the original cutoffs and 35.8% for the revised cutoffs. Participants who passed revised PVT cutoffs performed better on neuropsychological testing and reported fewer symptoms than the two PVT-Fail groups, and the original PVT-Fail group performed more poorly on cognitive testing and reported more symptoms than the revised PVT-Fail group [RBANS Total Index: PVT-Pass M = 89.5 (SD = 10.7); Revised PVT-Fail M = 75.2 (SD = 12.6); Original PVT-Fail M = 62.3 (SD = 12.0); NSI Total: PVT-Pass M = 22.9 (SD = 16.7); Revised PVT-Fail M = 31.2 (SD = 15.3); Original PVT-Fail M = 41.7 (SD = 16.5)]. Participants who failed PVTs were more likely to meet DSM-5 criteria for major and mild neurocognitive disorder and ICD-10 criteria for postconcussional syndrome. Conclusion: There is a statistically significant and clinically meaningful relationship between PVT performance and the overall outcome from a neuropsychological evaluation with service members.
Examining the Association between Performance Validity, Postconcussional Syndrome, and Mild Cognitive Impairment in Service Members
S Lippa, R Lange, L French, G Iverson; A-61
Examining the Association between Performance Validity, Postconcussional Syndrome, and Mild Cognitive Impairment in Service Members. Arch Clin Neuropsychol 2015; 30 (6): 507-508. doi: 10.1093/arclin/acv047.61
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