The Behavior Rating Inventory of Executive Function®-Adult Version is Related to Emotional Distress, Not Executive Dysfunction, in a Veteran Sample

Abstract

Objective In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self-reported executive functioning (EF) and objective performance. Method Each study pulled from a sample of 123 veterans who were administered a BRIEF-A and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) during a neuropsychological evaluation. Participants were primarily middle-aged, and half carried a mood disorder diagnosis. Study 1 examined group differences in BRIEF-A ratings among valid, invalid, and indeterminate MMPI-2 responders. Analyses were conducted to determine the optimal cut-score for the BRIEF-A Negativity Validity scale. In Study 2, relationships were explored among MMPI-2-RF (restructured form) Restructured Clinical (RC) scales, somatic/cognitive scales, and the BRIEF-A Metacognition Index (MI); hierarchical analyses were performed to predict MI using MMPI-2-RF Demoralization (RCd) and specific RC scales. Study 3 correlated BRIEF-A clinical scales and indices with RCd and an EF composite score from neuropsychological testing. Hierarchical analyses were conducted to predict BRIEF-A clinical scales. Results Invalid performance on the MMPI-2 resulted in significantly elevated scores on the BRIEF-A compared to those with valid responding. A more stringent cut-score of ≥4 for the BRIEF-A Negativity scale is more effective at identifying invalid symptom reporting. The BRIEF-A MI is most strongly correlated with demoralization. BRIEF-A indices and scales are largely unrelated to objective EF performance. Conclusions In a veteran sample, responses on the BRIEF-A are most representative of generalized emotional distress and response bias, not actual EF abilities.

A randomized controlled trial of Goal Management Training for executive functioning in schizophrenia spectrum disorders or psychosis risk syndromes

“…As a consequence, the objective test setting provides too much structure to assess the complexity of interacting components of executive function required in real-life [87]. Subjective measures, on the other hand, are better at capturing complex everyday situations, but are more easily influenced by confounding emotional states [88]. Since the discrepancy between subjective and objective measures of cognition is often larger among persons with schizophrenia than in healthy samples, caution should be exercised in the interpretation of the mechanisms of change in subjective EF in the present study [89][90][91][92].…”

Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures

“…One explanation for this is that despite measuring the same underlying constructs, objective measures are thought to capture skills, while subjective measures capture the application of these skills in the real-world context ( Gioia et al, 2010 ; McAuley et al, 2010 ). Subjective measures on the other hand provide valuable information about everyday experience, but may be confounded by emotional states ( Shwartz et al, 2020 ).…”

Moderators of metacognitive strategy training for executive functioning in early schizophrenia and psychosis risk

“…A strength of the study is the extensive assessment battery tapping different aspects of executive function. A limitation of self-report measures of cognition is that they may be influenced by emotional states and challenges with self-awareness in serious mental illness ( Harvey, 2012 ; Shwartz et al, 2020 ; Toplak et al, 2013 ). Nonetheless, self-assessment may complement neuropsychological tests that are often too structured to capture the complexity of interacting components of executive function required in everyday life ( Friedman and Banich, 2019 ; Isquith et al, 2013 ; Sbordone, 2014 ).…”