Clinical utility of WAIS-IV 'excessive decline from premorbid functioning' scores to detect invalid test performance following traumatic brain injury. Issue 3 (2nd April 2020)

• Record Type: Journal Article
• Authors: Moore, Rich A.; Lippa, Sara M.; Brickell, Tracey A.; French, Louis M.; Lange, Rael T.
• Is Part Of: Clinical neuropsychologist. Volume 34:Issue 3(2020)
• Page Start: 512
• Page End: 528
• Publication Date: 2020-04-02
• Subjects: Wechsler Adult Intelligence Scale -- test of premorbid functioning -- performance validity -- effort -- excessive decline; Neuropsychology -- Periodicals; Neuropsychology -- Periodicals; Mental Disorders -- Periodicals; 612.805
• DOI: 10.1080/13854046.2019.1668059
• Languages: English
• ISSNs: 1385-4046

Abstract

Abstract: Objective: Excessive Decline from Premorbid Functioning (EDPF), an atypical discrepancy between demographically predicted and obtained Wechsler Adult Intelligence Scale-4th Edition (WAIS-IV) scores, has been recently proposed as a potential embedded performance validity test (PVT). This study examined the clinical utility of EDPF scores to detect invalid test performance following traumatic brain injury (TBI). Methods: Participants were 194 U.S. military service members who completed neuropsychological testing on average 2.4 years (SD = 4.0) following uncomplicated mild, complicated mild, moderate, severe, or penetrating TBI (Age: M = 34.0, SD = 9.9). Using TBI severity and PVT performance (i.e., PVT Pass/Fail), participants were classified into three groups: Uncomplicated Mild TBI-PVT Fail (MTBI-Fail; n = 21), Uncomplicated Mild TBI-PVT Pass (MTBI-Pass; n = 94), and Complicated Mild to Severe/Penetrating TBI-PVT Pass (CM/STBI-Pass; n = 79). Seven EDPF measures were calculated by subtracting WAIS-IV obtained index scores from the demographically predicted scores from the Test of Premorbid Functioning (TOPF). Cutoff scores to detect invalid test performance were examined for each EDPF measure separately. Results: The MTBI-Fail group had higher scores than the MTBI-Pass and CM/STBI-Pass groups on five of the seven EDPF measures ( p <.05). Overall, the EDPF measure using the Processing Speed Index (EDPF-PSI) was the most useful score to detect invalid test performance. However, sensitivity was only low to moderate depending on the cutoff score used. Conclusions: These findings provide support for the use of EDPF as an embedded PVT to be considered along with other performance validity data when administering the WAIS-IV.