Potential for interpretation disparities of Halstead–Reitan neuropsychological battery performances in a litigating sample☆☆☆

Abstract

The performances of 110 litigants on seven variables from the Halstead-Reitan neuropsychological battery (HRNB) were used to compare Heaton, Miller, Taylor, and Grant's (2004) Deficit Scale (DS) and Reitan and Wolfson's (1993) Neuropsychological Deficit Scale (NDS). Additional comparisons were made for people who passed or failed the Test of Memory Malingering (TOMM) to determine effects of effort on scores generated by either scoring system. Wilcoxon signed-rank tests revealed that all seven comparisons were significantly different for the full sample (p< or =0.001). The NDS indicated greater levels of impairment compared to DS across all variables. These findings were also obtained when considering effort, though TOMM failure was related to non-significant differences for two variables. These findings suggest that the two scoring systems are not equivalent, with Heaton et al.'s DS resulting in consistently higher identification rates of normal brain functioning compared to those generated from Reitan and Wolfson's NDS system.

Impairmentversusdeficiency in neuropsychological assessment: Implications for ecological validity

“…Some authors have argued that absolute scores are actually superior on the empirical grounds that demographically corrected scores underestimate cognitive impairment by over-adjusting for premorbid factors (e.g., Reitan & Wolfson, 2005 ;Yantz et al, 2006 ). Others have refuted this claim, concluding that demographically corrected scores "refl ect more accurately the neuropsychological status of patients" (Sherrill-Pattison et al, 2000 , pg.…”

Halstead-Reitan Deficit Scores in Assessment of Nonimpact Head Injury

“…RWS and R-HN deficit scores were made comparable by converting the two deficit scales to a 3-point impairment scale utilized by Yantz et al (2006). The 3-point scale allowed for conversion of the two sets of deficit scores in the following manner: 1 ¼ None to Mild Impairment -0 and 1 for both RWS and R-HN; 2 ¼ Mild to Moderate Impairment -2 for RWS and 2 and 3 for R-HN; and 3 ¼ Moderate to Severe Impairment À 3 for RWS and 4 and 5 for R-HN.…”

“…This finding is important because it shows that use of the revised computerized Heaton norms continue to demonstrate significantly less impairment than RWS norms as previously suggested by Fastenau (1998), Morgan and Caccappolo-van Vliet (2001), Reitan and Wolfson (2005), and Sweeney (1999), raising the possibility that these standard systems of interpretation could be misused in forensic settings. Yantz et al (2006) offered no hypothetical explanations in respect to how features of RWS and R-HN normative data may be contributing to deficit score discrepancies.…”

“…The main purpose of the current study was to affirm the differential findings of Yantz et al (2006) in the use of RWS and R-HN interpretive systems for neuropsychological assessment, in specific regard to evaluation of nonimpact litigants and insurance claimants meeting criteria for mild traumatic brain injury (MTBI; Congress of Rehabilitation Medicine, 1993), and to achieve a better understanding of the differential effects of RWS and R-HN normative data sets on the magnitude and frequency of deficit scores.…”

“…R-HN deficit scores can be compared with component deficit scores from the RWS to assess diagnostic comparability of these two commercially available systems of HRB interpretation. Yantz, Gavett, Lynch, and McCaffrey (2006) conducted a study comparing the RWS and R-HN deficit scores of 110 litigants with allegations of traumatic brain injury. There were no objective diagnostic criteria applied in this investigation to assess the legitimacy of claims of traumatic brain injury other than symptom validity data from the Test of Memory Malingering (TOMM; Tombaugh, 1996).…”