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Objective: Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms to accesses academic accommodations, making the assessment of symptom validity important in both populations., Method: Using a between-subjects design, 75 college students were randomly assigned to one of three groups: (1) coached feigning of ADHD, (2) coached feigning of depression and anxiety (DA), and (3) honest responding (HR). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Structured Inventory of Malingered Symptomatology (SIMS)., Results: The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified as feigning by the SIMS typically reported more severe symptoms than participants not identified on the DASS-21., Conclusions: The SIMS equally classified the feigned ADHD and DA participants for both cutoff scores utilized. Potential reasons for low sensitivity rates are discussed and future research recommendations are made.

Primary Objective: To examine associations between neuroimaging indicators of cerebral tract integrity and neurocognitive functioning in traumatic brain injury (TBI)., Research Design: Between-Groups design with two TBI groups and controls., Method and Procedures: Forty-four participants with TBI and 27 matched controls completed diffusion tensor imaging and neuropsychological measures of processing speed, attention, memory, and executive function. Multivariate analyses were conducted to examine group differences in white matter integrity (fractional anisotropy) for 11 regions of interest and cognitive performance among adult males with chronic phase, mild, moderate, or severe TBI. Correlational analyses investigated associations between white matter integrity, brain injury severity, and cognitive status., Main Outcomes and Results: Participants with moderate or severe TBI exhibited reduced white matter integrity in 8 of 11 ROIs and worse performance on most cognitive measures, relative to control participants. Persons with mild TBI did not differ from controls on white matter integrity values and differed on one measure of processing speed. Significant correlations were found between injury severity ratings and 10 ROIs, most notably between ROIs and measures of processing speed or memory., Conclusions: These findings provide nuanced information regarding white matter connectivity as it relates to neurocognitive abilities across the TBI severity spectrum.

Objective: While the Neuropsychological Assessment Battery, Screening Module (S-NAB) is a commonly used cognitive screening measure, no composite embedded performance validity test (PVT) formula has yet been described within it. This study sought to empirically derive PVT formulas within the S-NAB using an analog simulation paradigm., Method: Seventy-two university students ( M age = 18.92) were randomly assigned to either an Asymptomatic (AS) or simulated mild traumatic brain injury (S-mTBI) group and were administered a neuropsychological test battery that included the S-NAB and standalone and embedded PVTs. The AS group was instructed to perform optimally, and the S-mTBI group received symptom and test coaching to help simulate mTBI-related impairment. Both groups received warnings regarding the presence of PVTs throughout the test battery., Results: Groups showed significant differences (all p s < .001) on all S-NAB domain scores and PVTs. In the S-NAB, the Attention (S-ATT) and Executive Function (S-EXE) domains showed the largest effect sizes (Cohen's d s = 2.02 and 1.79, respectively). Seven raw scores from S-ATT and S-EXE subtests were entered as predictor variables in a direct logistic regression (LR). The model accurately classified 90.3% of cases. Two PVT formulas were described: (1) an exponentiated equation from LR results and (2) an arithmetic formula using four individually meaningful variables. Both formulas demonstrated outstanding discriminability between groups (AUCs = .96-.97) and yielded good classification statistics compared to other PVTs., Conclusions: This study is the first to describe composite, embedded PVT formulas within the S-NAB. Implications, limitations, and appropriate future directions of inquiry are discussed.

The Independent Living Scales Health and Safety (ILS HS) scale is commonly used by neuropsychologists when evaluating older adults' instrumental activities of daily living (IADLs). However, there is a minimal amount of research on its use in dementia populations and, specifically, its relationship to other neuropsychological measures. The present study investigated relationships between the ILS HS scale and measures of cognition and depression. The study utilized archival data from a sample ( N  = 142) of older adults (mean age = 77.85) diagnosed with dementia, who were evaluated at Saint Louis University Medical Center and administered the ILS HS scale as part of a larger clinical neuropsychological evaluation. Multiple regression analyses demonstrated that up to 37% of the variance in ILS HS performance was accounted for by demographic variables, premorbid intelligence, and cognitive functioning (e.g., global cognition, delayed verbal recall, and executive functioning), and regression models demonstrated medium to large effect sizes. Depression and self- or informant-reported IADLs were unrelated to the ILS HS scale. Results suggest that older adults' ability to function in health and safety-related situations requires a range of cognitive abilities. Performance on these measures may help guide clinical decision making regarding independent living and treatment planning.

The ensemble hypothesis proposes that uniquely human cognitive abilities depend on more than just language. Besides overt language, inner speech, and causal interpretations, executive attention, mental time travel, and theory of mind abilities are essential parts that combine additively and even multiplicatively. In this review, we consider the implications of the ensemble hypothesis for the psychopathologies of anxiety and depression. Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are two of the most common mental disorders worldwide. The mechanisms that differentiate them are difficult to identify, however. Mental time travel has been implicated in models of depressive and anxiety disorders, but here we argue that at least two other ensemble components, namely, interpreter biases and executive attention, must also be considered. Depressive and anxiety disorders have both been found to show impairments in all three of these components, but the precise relationships seem to distinguish the two kinds of disorders. In reviewing the literature, we develop models for depression and anxiety that take into account an ensemble of mental components that are unique for each disorder. We specify how the relations among mental time travel, interpreter biases, and executive attentional control differ in depression and anxiety. We conclude by considering the implications of these models for treating and conceptualizing anxiety and depression., (Copyright © 2020 Kellogg, Chirino and Gfeller.)

Objective: Neurocognitive deficits commonly are an accompanying feature of Multiple Sclerosis (MS). A brief, yet comprehensive neuropsychological battery is desirable for assessing the extent of these deficits. Therefore, the present study examined the validity of the Mercy Evaluation of Multiple Sclerosis (MEMS) for use with the MS population., Methods: Archival data from individuals diagnosed with MS (N = 378) by independent neurologists was examined. Cognitive domains assessed included processing speed and attention, learning, and memory, visuospatial, language, and executive functioning. A mean battery index was calculated to provide a general indicator of cognitive impairment within the current sample., Results: Overall performance across participants was found to be in the lower limits of the average range. Results of factor analytic statistical procedures yielded a four-factor solution, accounting for 67% of total variance within the MEMS. Four neurocognitive measures exhibited the highest sensitivity in detecting cognitive impairment, constituting a psychometrically established brief cognitive screening battery, which accounted for 83% of total variance within the mean battery index score., Conclusion: Overall, the results of the current study suggest appropriate construct validity of the MEMS for use with individuals with MS, as well as provide support for previously established cognitive batteries.

Objective: To assess whether increased incidence of post-traumatic stress disorder and depressive symptomatology in veterans with combat-related traumatic brain injury might help account for neurocognitive impairment relative to civilians with traumatic brain injury., Participants: Neuropsychological assessment data of 53 Operation Enduring Freedom/Operation Iraqi Freedom veterans and 48 civilians with positive history of traumatic brain injury were analyzed to assess differences with respect to cognitive performance., Design: Retrospective analysis of data including neurocognitive test performance and self-reported symptoms of post-traumatic stress disorder and depression., Results: Results showed worse neurocognitive performance (i.e. RBANS Total Index score) in the veteran sample relative to the civilian sample [F(1,99) = 3.92, p = .05, ƞ2 = .04], particularly on tasks measuring attentional capabilities [F(1,99) = 9.18, p = .003, ƞ2 = .09]. Additional analyses found that after controlling for post-traumatic stress disorder symptomatology, differences were no longer significant. Broad correlations between measures also showcased attenuated relationships after controlling for both post-traumatic stress disorder and depressive symptomatology using partial correlations Conclusion: Findings suggest that the presence of post-traumatic stress disorder and depressive symptomatology negatively impacts cognitive performance across neuropsychological assessment above and beyond deficits related to traumatic brain injury.

Objective: The Conners' Continuous Performance Test Second Edition (CPT-II) is a measure commonly used in persons with suspected attentional deficits. Our study examined the utility of the CPT-II as a measure of attention in adults with traumatic brain injury (TBI) of varying severity., Method: As part of a larger investigation, several measures of cognitive functioning, including the CPT-II, were administered to 30 healthy control participants (HCP), 30 mild TBI participants (M-TBI), and 30 moderate to severe TBI participants (MS-TBI). Multivariate and correlational analyses compared group performances and examined convergent and divergent relationships between the CPT-II and various measures, including other tests of attention and neuropsychological function., Results: Group differences were found for four of six CPT-II variables, with the MS-TBI group exhibiting greater impairment, relative to M-TBI and HCP. In addition, the CPT-II commission and detectability variables were found to correlate significantly with TBI severity. The CPT-II variables also demonstrated correlations of varying magnitude between commonly used neuropsychological measures., Conclusions: These findings support the utility of the CPT-II for assessing attentional abilities in persons with TBI of varying severity, particularly those with moderate to severe status. Moreover, the current study also demonstrates relationships that are consistent with convergent validity but inconsistent findings with regard to divergent validity. As a result, the CPT-II measures components of attention that is unique to other commonly used neuropsychological measures of attentive functioning. Further research examining CPT-II performance in TBI populations is recommended., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Neuropsychological evaluation of persons with chronic traumatic brain injury (TBI) symptoms is complicated by multiple factors. The authors explored the impact of mechanism of injury, effort testing performance, and neuropsychiatric status in a sample of military veterans (V-TBI) and civilians (C-TBI) with chronic TBI. V-TBI (n = 74), C-TBI (n = 67), and healthy civilian control (C-HC) participants (n = 66), completed a battery of neuropsychological, effort, and self-report neuropsychiatric measures. Results indicated that C-HC and C-TBI participants exhibited comparably low failure rates on effort tests (6% and 3%, respectively). V-TBI participants exhibited significantly higher rates of failure (18%). Subgroups (n = 20) of effort-screened participants matched for demographics and disability level were compared regarding neuropsychological performance and neuropsychiatric self-report. Both TBI groups exhibited limited neuropsychological impairment, relative to the C-HC participants. The V-TBI group exhibited pronounced neuropsychiatric symptomology compared with the other participant groups. The implications of these findings are discussed for evaluation in the context of disability and litigation., (Copyright © 2013 John Wiley & Sons, Ltd.)

The present study examined the relationships among measures that purportedly assess emotional intelligence (EI), social cognition, and emotional decision making within a sample of nonclinical undergraduate participants. Forty participants, both male and female, who scored in either the highest or the lowest quartiles of an EI measure (the Trait Meta-Mood Scale) completed the Reading the Mind in the Eyes Test and the Iowa Gambling Task. As expected, main effects for gender and EI level occurred, as women outperformed men on the Eyes Test, and participants in the higher EI group outperformed those in the lower EI group on the Eyes Test. Additionally, men classified in the higher EI group performed significantly better on the Eyes Test than men in the lower EI group. However, no group or gender differences were found on the Iowa Gambling Task.

Primary Objective: This study examined the construct and concurrent validity of ImPACT, a computerized neuropsychological test battery used for evaluating sports-related concussion., Research Design: Approximately 100 neurologically intact undergraduates completed ImPACT and a battery of traditional neuropsychological tests utilized by the National Football League (NFL)., Methods and Procedures: Participants completed the two batteries in a counterbalanced order. Factor analyses examined the component structure of ImPACT and the NFL battery's factor structure. Correlational analyses assessed relationships among variables within and across the two batteries., Main Results: A four-factor solution explaining 70% of variance was found with the NFL battery, including general memory, mental processing speed, verbal memory and processing speed and auditory and verbal working memory. A five-factor solution explaining 69% of variance was found with the ImPACT battery, with components assessing forced choice efficiency, verbal and visual memory, inhibitory cognitive abilities, visual processing abilities with a memory component and a factor with a single loading from Colour Match Total Commissions. Correlations revealed a range of significant and non-significant correlations between the two batteries., Conclusions: While both batteries overlap regarding their assessed constructs (e.g. memory, inhibitory cognitive abilities) notable differences in their factor structures were present as well.

In this psychometric study, we compared the recently developed Validity Scales from the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992b) with the MMPI-2 (Butcher, Dahstrom, Graham, Tellegen, & Kaemmer, 1989) Validity Scales. We collected data from clients (n = 74) who completed comprehensive psychological evaluations at a university-based outpatient mental health clinic. Correlations between the Validity Scales of the NEO-PI-R and MMPI-2 were significant and in the expected directions. The relationships provide support for convergent and discriminant validity of the NEO-PI-R Validity Scales. The percent agreement of invalid responding on the two measures was high, although the diagnostic agreement was modest (kappa = .22-.33). Finally, clients who responded in an invalid manner on the NEO-PI-R Validity Scales produced significantly different clinical profiles on the NEO-PI-R and MMPI-2 than clients with valid protocols. These results provide additional support for the clinical utility of the NEO-PI-R Validity Scales as indicators of response bias.

The current study investigated neuropsychologists' beliefs and practices with respect to assessing effort and malingering by surveying a sample of NAN professional members and fellows (n=712). The results from 188 (26.4%) returned surveys indicated that 57% of respondents frequently included measures of effort when conducting a neuropsychological evaluation. While a majority of respondents (52%) rarely or never provide a warning that effort indicators will be administered, 27% of respondents often or always provide such a warning. The five most frequently used measures of effort or response bias were the Test of Memory Malingering (TOMM), MMPI-2 F-K ratio, MMPI-2 FBS, Rey 15-item test, and the California Verbal Learning Test. However, the TOMM, Validity Indicator Profile, Word Memory Test, Victoria Symptom Validity Test, and the Computerized Assessment of Response Bias were rated as most accurate for detecting suboptimal effort. These results and other findings are presented and discussed.

The WAIS-III Digit Span and Vocabulary subtests were investigated as indicators of feigned cognitive impairment. Participants included 64 undergraduates randomly assigned to control, symptom-coached, or test-coached groups. Six previously researched validity indicators were examined. We hypothesized that symptom-coached participants would perform worse relative to test-coached simulators. Analyses determined both simulator groups performed lower than controls on all indicators except Vocabulary. Symptom-coached participants, however, did not differ from test-coached participants on any indicator. Classification accuracies for these six indicators ranged from 42 to 78%. While the WAIS-III validity indicators hold some promise, they should not be employed as independent measures.

This study assessed the relationship between symptoms of psychopathology and cognitive functioning in clients completing comprehensive psychoeducational assessments at a university-based outpatient mental health clinic. Seventy clients (36 women, 34 men, mean age=28.8) completed the Wechsler Memory Scale-Third Edition (WMS-III), Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), and Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2). Partial correlations between the MMPI-2 clinical scales, WMS-III Index scores, WAIS-III Index scores, and WAIS-III IQ scores were not significant. Memory and Intelligence scores for clients with comorbid symptoms of depression and anxiety were comparable to scores for clients without comorbid symptomatology. Psychopathology factors accounted for 22% of the variance in the WAIS-III Full Scale IQ and 6.5% of the variance in the WMS-III General Memory Index. The results suggest that psychopathology as measured by the MMPI-2 may be minimally associated with intelligence and memory test performance in adults seen for psychoeducational assessment.

Objective: To examine and compare the prevalence and functional impact of depressive symptoms for older adult stroke and nonstroke rehabilitation inpatients., Design: Case-control study examining functional outcome using a 2 (stroke, nonstroke) by 2 (depression, no depression) design., Setting: Urban hospital rehabilitation unit., Participants: A total of 509 rehabilitation inpatients (age, > or = 60 y) were included and grouped by diagnosis of stroke (n=207) and nonstroke (n=302)., Interventions: Not applicable., Main Outcome Measures: Geriatric Depression Scale and FIM instrument. Analysis of covariance procedures examined the impact of depressive symptoms on discharge functional ability controlling for age, sex, admission functional ability, and hospital length of stay., Results: Prevalence of depressive symptoms was similar for stroke (31.8%) and nonstroke (31.5%) and negatively associated with functional ability at discharge for both groups. Overall, the stroke and nonstroke groups did not differ significantly with respect to functional recovery., Conclusions: Depression, and its impact on acute rehabilitation, is significantly related to functional recovery but does not differ in its frequency or impact for stroke patients. Because depressive symptoms do not appear to discriminate across diagnostic groups, routine screening for depression is recommended for all rehabilitation inpatients.

The current study examined the effects of performance enhancement techniques (PET's) on motor skill performance. Specifically, one hundred fifty college student volunteers (Men = 41; 27.3% and Women = 109; 72.6%) were randomly assigned to one of the nine conditions (Cond): Cond 1 and 2, simultaneous, externally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery out loud while putting); Cond 3 and 4, delayed externally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery out loud before putting); Cond 5 and 6, simultaneous, internally verbalized self-talk or imagery (e.g., participants were instructed to say "aim, back, birdie "or engaged in imagery silently to oneself while putting); Cond 7 and 8, delayed internally verbalized (e.g., participant were instructed to say "aim, back, birdie "or engaged in imagery silently to oneself before putting); and Cond 9, no instruction control group. All participants were asked to perform a golf-putting task. Results indicated that participants who implemented several (PET's) increased their putting accuracy across overall difference score evaluations F (8, 141) = 4.01, p < 0.05 when compared to a no instruction control condition. Follow-up analyses indicated that participants who reportedly engaged in ten hours or less of athletic activities per week preferred self-talk strategies F (2, 119) = 4.38, p < 0.05 whereas participants who endorsed ten hours or more of athletic activity per week preferred imagery strategies F (2, 25) = 5.27, p < 0.05. Key PointsMental imagery and self-talk strategies are implemented by athletes in order to regulate arousal, reduce maladaptive behaviors, reconstruct negative thoughts, and to increase one's concentration and focus.Results of the current study suggest that participants who engaged in several performance enhancement techniques exhibited enhanced performance on a golf putting task when compared to participants in a control condition.Participants who endorsed limited athletic familiarity and activity (e.g., ten hours or less) preferred self-talk practice whereas participants who endorsed higher ratings scores of athletic familiarity and activity (e.g., ten hours or more) preferred imagery strategies.The results of this study demonstrate the flexibility of Performance Enhancement Techniques (e.g., imagery v. self-talk, internal v. external, simultaneous v. delayed) and how they can be implemented to help an athlete reach his or her full potential.

This investigation explored the usefulness of serial position patterns during word recall on the Rey Auditory Verbal Learning Test (RAVLT; Rey, 1964) as an indicator of poor effort. Significantly better recall for early (primacy) and recent (recency) material defines the serial position effect (SPE; Rundus, 1971). The SPE on the RAVLT was examined in four groups: normal controls (NC), symptom-coached simulators (SC), test-coached simulators (TC), and a group of moderate to severe subacute traumatic brain injury (TBI) patients. Normal control participants and TBI patients demonstrated the expected SPE. Only the SC simulators clearly suppressed the primacy effect. The SPE appears neither sensitive nor specific enough to be used independently of more sensitive symptom validity tests in the detection of suboptimal effort. It may be especially problematic when used with clients presenting with sophisticated styles of exaggeration and in settings with lower base rates of compromised effort.

The ability of the Test of Memory Malingering (TOMM; Tombaugh, 1996) to detect feigned-memory impairment was explored. The TOMM was administered to three groups: (a) a control group instructed to perform optimally, (b) a symptom-coached group instructed to feign memory problems after being educated about traumatic brain injury symptomatology, and (c) a test-coached group instructed to feign memory problems after being educated about test-taking strategies to avoid detection. The recommended cutoff scores (Tombaugh, 1996) on Trial 2 and the Retention Trial produced overall classification accuracy rates of 96%, with high levels of sensitivity and specificity. Although the symptom-coached group performed more poorly on the TOMM relative to the test-coached group, the test was equally sensitive in detecting suboptimal effort across the different coaching paradigms.