Classification Accuracy of the Portland Digit Recognition Test in Traumatic Brain Injury

Bianchini, Kevin J.; Mathias, Charles W.; Greve, Kevin W.; Houston, Rebecca J.; Crouch, John

doi:10.1076/clin.15.4.461.1890

Cited by 35 publications

(15 citation statements)

References 19 publications

(36 reference statements)

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“…Moreover, many specific measures frequently employed in neuropsychological practice were not administered. It is also acknowledged that some poorly motivated patients may have escaped detection by the PDRT, as no single measure of poor motivation is likely to detect all patients (Bianchini et al, 2001;Orey, Cragar, & Berry, 2000).…”

Section: Discussionmentioning

confidence: 98%

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Motivation and Neuropsychological Test Performance Following Mild Head Injury

Binder¹,

Kelly²,

Villanueva³

et al. 2003

Journal of Clinical and Experimental Neuropsychology

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Effect of motivation on neuropsychological test performance in mild head injury was assessed. Motivation was measured using the Portland Digit RecognitionTest. Three groups were compared: (a) mildhead injury, financial incentives, good motivation; (b) mild head injury, financial incentives, poor motivation; (c) moderate/severe head injury, good motivation. The neuropsychological battery included measures of sensory function, motor function, attention, intelligence, abstract reasoning, and memory. Mild head injury well motivated patients performed significantly better than the other two groups on some tests. Mild head injury poorly motivated individuals and moderate-severe head injury patients were indistinguishable on many tests. Consistent with previous reports, tactile sensory (finger recognition and Fingertip Number Writing Perception) and recognition memory (Rey Auditory Verbal Learning) tasks were identified as clinically useful measures of poor motivation. On these measures mild head injury well motivated examinees performed no better than moderate-severe patients, with both groups superior to mild head injury poorly motivated examinees. Sensitivity and specificity data are reported. Our measures of tactile sensation and verbal recognition memory were more affected by motivation than by the severity of head injury.

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Section: Discussionmentioning

confidence: 98%

“…Attorneys may coach clients (Youngjohn, 1995), behavior that encourages the use of multiple techniques to assess motivation. Forced choice tests in clinical settings have imperfect sensitivity; they will not identify all patients whose effort is poor (Bianchini, Mathias, Greve, Houston, & Crouch, 2001).…”

mentioning

confidence: 99%

Motivation and Neuropsychological Test Performance Following Mild Head Injury

Binder¹,

Kelly²,

Villanueva³

et al. 2003

Journal of Clinical and Experimental Neuropsychology

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“…Any score below 22 for the easy portion, 20 for the hard portion, or 44 total was considered an indication of poor effort. A number of studies confirm accurate classification of performance validity in patients with TBI at these cutoffs (Bianchini, Mathias, Greve, Houston, & Crouch, 2001;Binder, 1993a;Binder & Kelly, 1996;. Participants qualifying for the abbreviated administration were considered to be showing good effort based on administration procedures from Binder (1993b) and validation from Doane, Greve, and Bianchini (2005).…”

Section: Portland Digit Recognition Test (Pdrt; Binder 1993b)mentioning

confidence: 99%

Executive dysfunction in traumatic brain injury: The effects of injury severity and effort on the Wisconsin Card Sorting Test

Ord

Greve

Bianchini

et al. 2009

Journal of Clinical and Experimental Neuropsychology

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This study examined the persistent effects of traumatic brain injury (TBI) on Wisconsin Card Sorting Test (WCST) performance. Since poor effort can contaminate results in populations with incentive to perform poorly, performance validity was explicitly assessed and controlled for using multiple well-validated cognitive malingering indicators. Participants were 109 patients with mild TBI and 67 patients with moderate-to-severe TBI seen for neuropsychological evaluation at least one year post injury. Patients with diffuse neurological impairment and healthy controls were included for comparison. Results suggested a dose-response effect of TBI severity on WCST performance in patients providing good effort; the mild TBI group did not differ from controls while increased levels of impairment were observed in the moderate-to-severe TBI group. Effort during testing had a larger impact on WCST performance than mild or moderate-to-severe TBI. Clinical implications of these findings are discussed.

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“…Specifically, other tests designed to detect suspect effort have reported similar rates of detection: Test of Memory Malingering (less than 45 correct on Trial 2; 77% sensitivity; 100% specificity; Rees, Tombaugh, Gansler, & Moczynski, 1998);Hiscock & Hiscock, 1989 forced-choice procedure (74% sensitivity; 100 percent specificity; Guilmette, Hart, & Guiliano, 1993); nonverbal subtest of the Validity Indicator Profile (73.5% sensitivity; 85.7% specificity; Frederick, 1997); Portland Digit Recognition Test (77% sensitivity; 100% specificity; Bianchini, Mathias, Greve, Houston, & Crouch, 2001); Victoria Symptom Validity Test (90% difficult memory items correct criterion ¼ 64.2% sensitivity; 93.3% specificity; Grote et al, 2000), Dot Counting Test (68.2% sensitivity; 95.0% specificity; Boone, Lu, & Herzberg 2002a), Rey 15-item Memorization Test plus recognition trial (71% sensitivity; 92% specificity; Boone et al, 2002a), and the b Test (76.9% sensitivity; 90.0% specificity; Boone, Lu, & Herzberg, 2002b). However, the Rey Word Recognition Test has the advantage over the majority of these tests in that it is more economical to administer in terms of time and cost.…”

Section: Rey Word Recognition Test 883mentioning

confidence: 86%

The Utility of the Rey Word Recognition Test in the Detection of Suspect Effort

Nitch

Boone

Wen

et al. 2006

The Clinical Neuropsychologist

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The Rey Word Recognition Test potentially represents an underutilized tool for clinicians to use in the detection of suspect effort. The present study examined the predictive accuracy of the test by examining the performance of three groups of participants: (a) 92 noncredible patients (as determined by failed psychometric and behavioral criteria and external motive to feign), (b) 51 general clinical patients with no motive to feign, and (c) 31 learning disabled college students. Results demonstrated gender differences in performance that necessitated separate cutoff scores for men and women. Use of a cutoff score of < or = 7 words correctly recognized identified 80.5% of noncredible female patients while maintaining specificity of > 90%. However, to achieve this level of specificity in male noncredible patients, the cutoff score had to be lowered to < or = 5, with resultant sensitivity of only 62.7%. A combination variable (recognition correct minus false positive errors + number of words recognized from the first 8 words) showed enhanced sensitivity in identifying suspect effort in a subset of the noncredible sample who were claiming cognitive symptoms secondary to traumatic brain injury (i.e., cutoff score of < or = 9 = 81.6% sensitivity with 90% specificity). Results indicate that the Rey Word Recognition Test is an accurate and cost-effective method for the detection of noncredible cognitive performance.

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Classification Accuracy of the Portland Digit Recognition Test in Traumatic Brain Injury

Cited by 35 publications

References 19 publications

Motivation and Neuropsychological Test Performance Following Mild Head Injury

Motivation and Neuropsychological Test Performance Following Mild Head Injury

Executive dysfunction in traumatic brain injury: The effects of injury severity and effort on the Wisconsin Card Sorting Test

The Utility of the Rey Word Recognition Test in the Detection of Suspect Effort

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