A-112 Examining the Utility of the New Dot Counting Test Cut-off Score in Latinx and Traumatic Brain Injury

2021 ◽  
Vol 36 (6) ◽  
pp. 1161-1161
Author(s):  
Sarah Saravia ◽  
Daniel W Lopez-Hernandez ◽  
Abril J Baez ◽  
Isabel Muñoz ◽  
Winter Olmos ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ethnic Groups ◽  
Group Differences ◽  
Failure Rates ◽  
Performance Validity ◽  
Validity Test ◽  
Chi Squared ◽  
Future Work ◽  
A Performance

Abstract Objective The Dot Counting Test (DCT) is a performance validity test. McCaul et al. (2018) recently revised the DCT cut-off score from ≥17 to 13.80; we evaluated the new cut-off in non-Latinx Caucasian and Caucasian Latinx traumatic brain injury (TBI) survivors and healthy comparison (HC) participants. Method The sample consisted of 37 acute TBI (ATBI; 11 Caucasian Latinx; 26 non-Latinx Caucasian), 27 chronic TBI (CTBI; 10 Caucasian Latinx; 17 non-Latinx Caucasian), and 55 HC (29 Caucasian Latinx; 26 non-Latinx Caucasian) participants. Results An ANCOVA, controlling for age, revealed no DCT E-scores differences between groups. Both the conventional and the new cut-off scores had different failure rates in ATBI (conventional cut-off: 0%; PNC: 16%), CTBI (conventional cut-off: 7%; PNC: 15%), and HC (conventional cut-off: 10%; PNC: 11%) participants. For the Caucasian Latinx group (conventional cut-off: 6%; PNC: 12%) and the non-Latinx Caucasian group (conventional cut-off: 6%; PNC: 14%), demonstrated different failure rates across cut-off scores. Group differences were found with the McCaul et al. (2018) cut-off and the conventional cut-off. Also, chi-squared analysis revealed non-Latinx Caucasian participants with ATBI had greater failure rates than Caucasian Latinx participants with ATBI. Conclusion The new DCT cut-off score resulted in greater failure rates in TBI survivors. Also, this effect appears to be most pronounced in non-Latinx Caucasian persons with ATBI. Future work should investigate possible reasons for these differences so that more stringent DCT can be utilized in a way that provides less biased results for brain injury survivors across racial and ethnic groups.

A-113 Evaluation of a Recognition Trial for the Symbol Digit Modalities Test as a Performance Validity Measure in Monolingual and Bilingual Traumatic Brain Injury Survivors

2021 ◽  
Vol 36 (6) ◽  
pp. 1162-1162
Author(s):  
Isabel Munoz ◽  
Daniel W Lopez-Hernandez ◽  
Rachel A Rugh-Fraser ◽  
Amy Bichlmeier ◽  
Abril J Baez ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Failure Rates ◽  
Performance Validity ◽  
Validity Assessment ◽  
Chi Squared ◽  
Bilingual Group ◽  
Performance Validity Assessment ◽  
Validity Measure ◽  
A Performance

Abstract Objective Research shows that traumatic brain injury (TBI) patients perform worse than healthy comparisons (HC) on the Symbol Digit Modalities Test (SDMT). We evaluated cut-off scores for a newly developed recognition trial of the SDMT as a performance validity assessment in monolingual and bilingual TBI survivors and HC adults. Method The sample consisted of 43 acute TBI (ATBI; 24 monolinguals; 19 bilinguals), 32 chronic TBI (CTBI; 13 monolinguals; 19 bilinguals), and 57 HC (24 monolinguals; 33 bilinguals) participants. All participants received standardized administration of the SDMT. None of the participants displayed motivation for feigning cognitive deficits. Results The HC group outperformed both TBI groups on the demographically adjusted SDMT scores, p = 0.000, ηp2 = 0.24. An interaction emerged in SDMT scores where monolingual ATBI outperformed bilingual ATBI and bilingual CTBI outperformed monolingual CTBI, p = 0.017, ηp2 = 0.06. No differences were found in the SDMT recognition trial. Both Bichlmeier and Boone’s suggested cut-off scores had different failure rates in ATBI (Bichlmeier: 77%; Boone: 37%), CTBI (Bichlmeier: 69%; Boone: 19%), and HC (Bichlmeier: 56%; Boone: 26%). For the monolingual group (Bichlmeier: 66%; Boone: 36%) and the bilingual group (Bichlmeier: 66%; Boone: 21%). Finally, chi-squared analysis revealed monolingual TBI had greater failure rates than the bilingual ATBI. Conclusion Bichlmeier’s proposed cut-off score resulted in greater failure rates in TBI survivors compared to Boone’s suggested cut-off score. Furthermore, monolingual ATBI were influenced more by Bichlmeier’s cut-off score than the bilingual ATBI group, although the reason for this finding is unclear and requires additional study with a larger sample size.

scholarly journals A-142 Examining the Impact of the Recent New Dot Counting Test Cut-Off Score in Bilingualism and Traumatic Brain Injury Survivors

2020 ◽  
Vol 35 (6) ◽  
pp. 935-935
Author(s):  
Graub N ◽  
Lopez-Hernandez D ◽  
Litvin P ◽  
Rugh-Fraser R ◽  
Rad H ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Language ◽  
The Other ◽  
Group Differences ◽  
Failure Rates ◽  
Language Groups ◽  
English Second Language ◽  
Chi Squared ◽  
The Impact

Abstract Objective McCaul et al. (2018) recently revised the Dot Counting Test (DCT) cut-off score from ≥17 to 13.80; we evaluated the new cut-off in monolingual and bilingual traumatic brain injury survivors (TBIS) and healthy comparison participants (HCP). Method The sample consisted of 43 acute TBI [ATBI; 23 English monolinguals (EM); 11 English first language bilinguals (EFLB); and 9 English second language bilinguals (ESLB)]; 30 chronic TBI (CTBI; 13 EM; 9 EFLB; 8 ESLB), and 56 HCP (23 EM; 11 EFLB; 22 ESLB). Results An ANCOVA, controlling for age and education, revealed an interaction where ATBI-EFLB had higher E-scores than the other groups and the CTBI-EFLB had lower E-scores than the other groups. Both the conventional and proposed new cut-off (PNC) scores had different failure rates in ATBI (conventional cut-off: 9%; PNC: 28%), CTBI (conventional cut-off: 10%; PNC: 20%), and HCP (conventional cut-off: 11%; PNC: 13%). For language groups, EM (conventional cut-off: 14%; PNC: 22%), EFLB (conventional cut-off: 10%; PNC: 26%), and ESLB (conventional cut-off: 5%; PNC: 10%) demonstrated different failure rates across cut-off scores. Group differences were found with McCaul et al. (2018) cut-off, but not the conventional cut-off score. Also, chi-squared analysis revealed ATBI EFLB and EM had greater failure rates than ATBI ESLB. Conclusion Unfortunately, the new DCT cut-off score resulted in greater failure rates in TBIS. Furthermore, ATBI EM and EFLB were impacted more by the new cut offs than ATBI ESLB who learned English later in life, although the reason for this finding is unclear and requires additional study.

Patterns of Performance and Symptom Validity Test Findings After Mild Traumatic Brain Injury

2019 ◽  
Author(s):  
Jacobus Donders ◽  
Nathan Lefebre ◽  
Rachael Goldsworthy
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Symptom Validity ◽  
Performance Validity ◽  
Financial Compensation ◽  
Validity Test ◽  
Compensation Seeking ◽  
Group A ◽  
Symptom Validity Test

Abstract Objective The purpose of this study was to evaluate the presence of demographic, injury and neuropsychological correlates of distinct patterns of performance validity test and symptom validity test results in persons with mild traumatic brain injury (mTBI). Method One hundred and seventy-eight persons with mTBI completed the Test of Memory Malingering (TOMM; performance validity) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; symptom validity) within 1–12 months postinjury. Four groups were compared: (a) pass both TOMM and MMPI-2-RF validity criteria, (b) pass TOMM and fail MMPI-2-RF, (c) fail TOMM and pass MMPI-2-RF, and (d) fail both TOMM and MMPI-2-RF. Results Compared to Group a, participants in combined Groups b–d were more than twice as likely to be engaged in financial compensation-seeking and about four times less likely to have neuroimaging evidence of an intracranial lesion. The average performance of Group d on an independent test of verbal learning was more than 1.5 standard deviations below that of Group a. Participants in Group b were more likely to have intracranial lesions on neuroimaging than participants in Group c. Conclusion Performance and symptom validity tests provide complementary and non-redundant information in persons with mTBI. Whereas financial compensation-seeking is associated with increased risk of failure of either PVT or SVT, or both, the presence of intracranial findings on neuroimaging is associated with decreased risk of such.

Severity of Ongoing Post-Concussive Symptoms as a Predictor of Cognitive Performance Following a Pediatric Mild Traumatic Brain Injury

2020 ◽  
pp. 1-11
Author(s):  
Veronik Sicard ◽  
Danielle C. Hergert ◽  
Sharvani Pabbathi Reddy ◽  
Cidney R. Robertson-Benta ◽  
Andrew B. Dodd ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Performance ◽  
Mild Traumatic Brain Injury ◽  
Parental Education ◽  
Visual Learning ◽  
Learning Task ◽  
Risk Scores ◽  
Group Differences ◽  
Post Injury

Abstract Objective: This study aimed to examine the predictors of cognitive performance in patients with pediatric mild traumatic brain injury (pmTBI) and to determine whether group differences in cognitive performance on a computerized test battery could be observed between pmTBI patients and healthy controls (HC) in the sub-acute (SA) and the early chronic (EC) phases of injury. Method: 203 pmTBI patients recruited from emergency settings and 159 age- and sex-matched HC aged 8–18 rated their ongoing post-concussive symptoms (PCS) on the Post-Concussion Symptom Inventory and completed the Cogstate brief battery in the SA (1–11 days) phase of injury. A subset (156 pmTBI patients; 144 HC) completed testing in the EC (∼4 months) phase. Results: Within the SA phase, a group difference was only observed for the visual learning task (One-Card Learning), with pmTBI patients being less accurate relative to HC. Follow-up analyses indicated higher ongoing PCS and higher 5P clinical risk scores were significant predictors of lower One-Card Learning accuracy within SA phase, while premorbid variables (estimates of intellectual functioning, parental education, and presence of learning disabilities or attention-deficit/hyperactivity disorder) were not. Conclusions: The absence of group differences at EC phase is supportive of cognitive recovery by 4 months post-injury. While the severity of ongoing PCS and the 5P score were better overall predictors of cognitive performance on the Cogstate at SA relative to premorbid variables, the full regression model explained only 4.1% of the variance, highlighting the need for future work on predictors of cognitive outcomes.

White Matter Disruption in Pediatric Traumatic Brain Injury: Results from ENIGMA Pediatric Moderate to Severe Traumatic Brain Injury

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012222
Author(s):  
Emily L Dennis ◽  
Karen Caeyenberghs ◽  
Kristen R Hoskinson ◽  
Tricia L Merkley ◽  
Stacy J Suskauer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Behavioral Problems ◽  
Child Behavior Checklist ◽  
Injury Severity ◽  
Meta Analysis ◽  
Post Injury ◽  
Severe Tbi ◽  
Future Work

Objective:Our study addressed aims: (1) test the hypothesis that moderate-severe TBI in pediatric patients is associated with widespread white matter (WM) disruption; (2) test the hypothesis that age and sex impact WM organization after injury; and (3) examine associations between WM organization and neurobehavioral outcomes.Methods:Data from ten previously enrolled, existing cohorts recruited from local hospitals and clinics were shared with the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric msTBI working group. We conducted a coordinated analysis of diffusion MRI (dMRI) data using the ENIGMA dMRI processing pipeline.Results:Five hundred and seven children and adolescents (244 with complicated mild to severe TBI [msTBI] and 263 controls) were included. Patients were clustered into three post-injury intervals: acute/subacute - <2 months, post-acute - 2-6 months, chronic - 6+ months. Outcomes were dMRI metrics and post-injury behavioral problems as indexed by the Child Behavior Checklist (CBCL). Our analyses revealed altered WM diffusion metrics across multiple tracts and all post-injury intervals (effect sizes ranging between d=-0.5 to -1.3). Injury severity is a significant contributor to the extent of WM alterations but explained less variance in dMRI measures with increasing time post-injury. We observed a sex-by-group interaction: females with TBI had significantly lower fractional anisotropy in the uncinate fasciculus than controls (𝞫=0.043), which coincided with more parent-reported behavioral problems (𝞫=-0.0027).Conclusions:WM disruption after msTBI is widespread, persistent, and influenced by demographic and clinical variables. Future work will test techniques for harmonizing neurocognitive data, enabling more advanced analyses to identify symptom clusters and clinically-meaningful patient subtypes.

A-102 Performance Validity Testing in Telehealth Research: A VA Traumatic Brain Injury Model Systems Study

2021 ◽  
Vol 36 (6) ◽  
pp. 1151-1151
Author(s):  
Justin O'Rourke ◽  
Robert J Kanser ◽  
Marc A Silva
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Digit Span ◽  
Secondary Analysis ◽  
Primary Objective ◽  
Model Systems ◽  
Performance Validity ◽  
Cut Scores ◽  
Chi Square ◽  
Severe Tbi

Abstract Objective Studies on Performance Validity Tests (PVTs) for tele-neuropsychology (TeleNP) are sparse. Verbal PVTs appear to better translate to TeleNP, so the primary objective of this study was to provide initial data on two well-established, verbal PVTs administered via TeleNP for research participants with traumatic brain injury (TBI). Methods This secondary analysis of the Veterans Affairs TBI Model Systems data included 53 participants enrolled in a PVT module study (3/01/2020–09/20/2020) with documented moderate-to-severe TBI per Glasgow Coma Score (M = 6.5, SD = 4.4), posttraumatic amnesia duration (M = 42.7 days, SD = 47.1), and/or time to follow commands (M = 10.5 days, SD = 16.3). Participants completed two PVTs—Reliable Digit Span (RDS) and the 21-Item Test (21-IT)—alongside telephone-based cognitive assessment 1–7 years after TBI. Descriptive analyses were performed to compare PVT performances to previously established cut scores. Chi square analyses were employed to examine 21-IT and RDS as dichotomous outcomes (pass/fail) at selected cutoffs. Results RDS ranged from 5 to 16 (M = 10.5, SD = 2.4). 21-IT ranged from 7 to 21 (M = 16.4, SD = 3.1). For RDS, 9.8% were invalid with a cutscore of ≤7 and 19.6% using a cutscore of ≤8. For the 21-IT, 7.8% were in invalid using a cutscore of ≤11, and 13.7% using a cutscore of ≤12. Conclusion(s) Using previously established cut scores, telephone-administered RDS and 21-IT resulted in relatively low rates of invalid performance among individuals with moderate-to-severe TBI. These findings provide preliminary support for the RDS and 21-IT in TeleNP.

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