The present study aimed to develop an internal validity indicator for a brief general purpose screening battery, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Two subtests of the RBANS were predicted to be relatively resilient to cognitive dysfunction on the basis of previous research. An Effort Index (EI) was created by combining them via a scaling system. The frequency of EI scores was first examined in a heterogenous clinical sample. A subsequent validation study showed good discriminability. In conclusion, the EI appears to be useful for detecting insufficient effort on a screening battery.

Sleep disturbance among patients with TBI may be associated with a particular constellation of neuropsychological abilities. These issues are discussed in relation to prior findings that indicate the involvement of additional neuropsychiatric factors associated with sleep disturbance in mild TBI.

Poor sleep quality and insomnia were definitely problems for the TBI group, although the magnitude of these problems was much greater for the rehabilitation comparison group. Degraded and disordered sleep may represent widespread challenges within the rehabilitation population in general.

The current study evaluated the utility of the Digit Span subtest in discriminating patients with mild head trauma from individuals referred for independent neuropsychological evaluation with objective evidence of poor effort. Various indices from the Digit Span subtest were evaluated to determine the best discriminator of brain injury from poor motivation patient groups: Digit Span Forward, Digit Span Backwards, Reliable Digit Span, Digit Span Age-Corrected Scaled Score, and the difference score between the Vocabulary and Digit Span scaled scores. The Digit Span scaled score was found to be the best discriminating index. A cutoff score of less than or equal to 7 accurately classified 75% of persons in the incomplete effort group and 69% of persons in the TBI group. Application of this cutoff score to a non-litigating mild brain injury group yielded a 77% correct classification rate. However, Digit Span scaled score accounted for a modest amount of variation and it is not recommended as a stand-alone validity measure.

The RBANS has become increasingly utilized in various populations since it reliably assesses individual neurocognitive domains in a rapid, efficient manner. The present study examined the convergent validity of the RBANS to frequently administered instruments in a moderate-severe traumatic brain injured (M-S TBI) sample. Fifty-seven individuals who sustained a M-S TBI were included in this study. The RBANS subtests showed moderate to strong internal reliability within the sample. Most of the subtests displayed moderate to strong correlations with the other neuropsychological tests, including the CVLT-II, COWAT, and WAIS-III subtests. The strongest correlations were within the RBANS Attention Index, with both the Digit Span and Coding subtests showing strong correlations with their WAIS-III counterparts. The RBANS measures distinct abilities that supplement other neuropsychological instruments that assess similar functions within a TBI sample. In addition to its administration advantages, the results of this study provide support for the use of the RBANS as a clinical valid and reliable tool in the brief screening of individuals with M-S TBI.

This study determined whether performance patterns on the California Verbal Learning Test-II (CVLT-II) could differentiate participants with traumatic brain injury (TBI) showing adequate effort from those with mild TBI exhibiting poor effort using a case-control design. The TBI group consisted of 124 persons with moderate to severe traumatic brain injury (TBI). The poor effort group consisted of 77 persons with mild head injury who were involved in litigation (LG) and failed at least one stand-alone symptom validity measure (SVT) and also either a second SVT or an effort indicator embedded within a standard clinical test. A total of 18 CVLT-II variables were investigated using Bayesian model averaging (BMA) for logistic regression to determine which variables best differentiated the groups. The CVLT-II variables having the most support were Long-Delay Free Recall, Total Recognition Discriminability (d'), and Total Recall Discriminability.

The PSQI was demonstrated to be a valid and useful screening tool for assessing insomnia among postacute patients with traumatic brain injury.

The Postconcussive Symptom Questionnaire (PCSQ) was developed to assess the symptoms associated with the controversial diagnosis of postconcussion syndrome. We examined item endorsement on the PCSQ in two groups. The first group was made up of individuals diagnosed with moderate to severe traumatic brain injury. The second group was made up of individuals meeting criteria for mild traumatic brain injury who exhibited no evidence of neurological injury. In addition, they demonstrated poor effort during neuropsychological examination. Significant differences in item endorsement were found the majority of individual items as well as on the PCSQ indices. The poor effort mild traumatic brain injury group consistently reported more symptoms with greater severity. The results raise further questions about the validity of postconcussion symptoms.