Offenders in justice system settings have high rates of traumatic brain injury (TBI) in comparison with the general population. Consequently, justice systems are using screening tools to identify and manage these individuals. Currently, that includes screening for TBI history and gross cognitive impairment. The present study attempted to determine whether the modified Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) was predictive of ongoing cognitive impairment as measured by the Automated Neuropsychological Assessment Metrics (ANAM) Core Battery. If so, the OSU TBI-ID could be used as a stand-alone measure of TBI history and impairment. This study had 223 participants (male = 160, female = 62). Sensitivity and specificity results revealed poor (.65) to very poor (.36) estimates for all OSU TBI-ID indices across all ANAM subtests. This study suggests that screening for lifetime history of TBI does not identify cognitive impairment. Implications for screening policy and future research are discussed.
Objective
In this study we examined the temporal stability of the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) within NCAA Division I athletes across various timepoints using an exhaustive series of statistical models.
Methods
Within a cohort design, 48 athletes completed repeated baseline ImPACT assessments at various timepoints. Intraclass correlation coefficients (ICC) were calculated using a two-way mixed effects model with absolute agreement.
Results
Four ImPACT composite scores (Verbal Memory, Visual Memory, Visual Motor Speed, and Reaction Time) demonstrated moderate reliability (ICC = 0.51–0.66) across the span of a typical Division I athlete’s career, which is below previous reliability recommendations (0.90) for measures used in individual decision-making. No evidence of fixed bias was detected within Verbal Memory, Visual Motor Speed, or Reaction Time composite scores, and minimal detectable change values exceeded the limits of agreement.
Conclusions
The demonstrated temporal stability of the ImPACT falls below the published recommendations, and as such, fails to provide robust support for the NCAA’s recommendation to obtain a single preparticipation cognitive baseline for use in sports-related concussion management throughout an athlete’s career. Clinical interpretation guidelines are provided for clinicians who utilize baseline ImPACT scores for later performance comparisons.
Objective
Traumatic brain injury (TBI) is a serious public health concern. Furthermore, inmates and probationers are at a higher risk for TBI, as well as mental health issues and sleepiness. Both sleep and mood disturbance have been linked to poor cognitive performance. These state-dependent cognitive changes can undermine the evaluation of true cognitive ability and contaminate validity. This study examined the effects of sleep and mood on neurocognitive functioning and its impact on the validity of assessment results.
Methods
This study looked at retrospective Automated Neuropsychological Assessment Metrics (ANAM) core battery data. The sample included inmates and probationers (n = 419) with a history of TBI. A multiple linear regression was used to examine the relationship between self-reported sleepiness, mood state, and cognitive performance.
Results
All regression models were statistically significant, with negative mood being the most significant predictor of ANAM throughput scores (p = 0.000). Higher endorsement of negative mood states was related to lower cognitive performance overall (p = 0.003). Sleepiness predicted worse performance on at the end of the battery (p < 0.05), whereas positive mood predicted better performance at the beginning of the battery (p < 0.01).
Conslusion
The present study confirms that negative mood adversely affects global neurocognitive test performance in a forensic population. Examiners should be aware that sleepiness and mood states have an effect on test performance during even brief cognitive batteries. The current findings suggest that it is imperative to screen and identify sleepiness and negative mood symptoms as they may depress test results and threaten the validity or test interpretations and recommendations.
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