A-107 Quantifying the Effect of Sleepiness and Mood on Gross Neuropsychological Functioning in a Forensic Population with a History of Traumatic Brain Injury

Abstract

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.