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Abstract-The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure of anxiety and depression symptoms. This study examined the internal consistency and factor structure of the HADS among Veterans in a polytrauma/traumatic brain injury clinic. The sample consisted of 312 Veterans. A confirmatory factor analysis of the depression and anxiety subscales showed, not surprisingly, that the two factors were highly correlated (r = 0.70). Goodness of fit statistics for the two-factor model were acceptable (root mean square error of approximation = 0.06, comparative fit index = 0.94). The HADS demonstrated very good reliability overall (alpha = 0.89) and for the individual subscales (alpha = 0.84). This study supports the use of the HADS as a screen for depression and anxiety in the assessment of mild traumatic brain injury in a Veteran population.

This manuscript identifies some of the potential risks when work and life responsibilities are not well integrated. It is anticipated this will serve as a catalyst for future studies on work-life integration in the field of neuropsychology, specifically.

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Objective Deep brain stimulation (DBS) is a widely used treatment for essential tremor (ET). To assess for neurocognitive decline following DBS, most studies use statistical methods that directly compare changes in test scores between pre- and post-surgical evaluations. By contrast, reliable change scores are calculated using regression-based models that account for practice effect and systematic error that can occur between repeat test administrations. We sought to determine the utility of reliable change scores in monitoring neuropsychological function following DBS. Method Twenty-eight ET patients (M age = 70.2 ± 6.3, 57% female) completed neuropsychological evaluations at an outpatient clinic 6.4 ± 3.6 months before and 6.7 ± 1.9 months after DBS placement within the ventral intermediate nucleus of the thalamus (71% left-sided). Wilcoxon signed rank tests were used to identify differences in performance using absolute change versus reliable change scores. Results There were no significant absolute differences between pre- and post-surgery scores on tests of attention, processing speed, executive function, object naming, verbal fluency, or learning and memory. By contrast, significant differences in reliable change scores from zero were identified on tests of phonemic fluency (p < .001), semantic fluency (p = .05), and verbal learning (p = .005). Conclusions Analyses that used reliable change scores identified post-surgical declines that were not evident in traditional statistical comparisons. Results suggest that reliable change indices are useful tools for monitoring changes in neurocognitive functions that can occur following DBS and related neuromodulation treatments.

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