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The study examined the effect of preparation time and financial incentives on healthy adults' ability to simulate traumatic brain injury (TBI) during neuropsychological evaluation. A retrospective comparison of two TBI simulator group designs: a traditional design employing a single-session of standard coaching immediately before participation (SIM-SC; n = 46) and a novel design that provided financial incentive and preparation time (SIM-IP; n = 49). Both groups completed an ecologically valid neuropsychological test battery that included widely-used cognitive tests and five common performance validity tests (PVTs). Compared to SIM-SC, SIM-IP performed significantly worse and had higher rates of impairment on tests of processing speed and executive functioning (Trails A and B). SIM-IP were more likely than SIM-SC to avoid detection on one of the PVTs and performed somewhat better on three of the PVTs, but the effects were small and non-significant. SIM-IP did not demonstrate significantly higher rates of successful simulation (i.e., performing impaired on cognitive tests with <2 PVT failures). Overall, the rate of the successful simulation was ∼40% with a liberal criterion, requiring cognitive impairment defined as performance >1 SD below the normative mean. At a more rigorous criterion defining impairment (>1.5 SD below the normative mean), successful simulation approached 35%. Incentive and preparation time appear to add limited incremental effect over traditional, single-session coaching analog studies of TBI simulation. Moreover, these design modifications did not translate to meaningfully higher rates of successful simulation and avoidance of detection by PVTs. [ABSTRACT FROM AUTHOR]

Pupillometry provides information about physiological and psychological processes related to cognitive load, familiarity, and deception, and it is outside of conscious control. This study examined pupillary dilation patterns during a performance validity test (PVT) among adults with true and feigned impairment of traumatic brain injury (TBI). Participants were 214 adults in three groups: adults with bona fide moderate to severe TBI (TBI; n = 51), healthy comparisons instructed to perform their best (HC; n = 72), and healthy adults instructed and incentivized to simulate cognitive impairment due to TBI (SIM; n = 91). The Recognition Memory Test (RMT) was administered in the context of a comprehensive neuropsychological battery. Three pupillary indices were evaluated. Two pure pupil dilation (PD) indices assessed a simple measure of baseline arousal (PD-Baseline) and a nuanced measure of dynamic engagement (PD-Range). A pupillary-behavioral index was also evaluated. Dilation-response inconsistency (DRI) captured the frequency with which examinees displayed a pupillary familiarity response to the correct answer but selected the unfamiliar stimulus (incorrect answer). All three indices differed significantly among the groups, with medium-to-large effect sizes. PD-Baseline appeared sensitive to oculomotor dysfunction due to TBI; adults with TBI displayed significantly lower chronic arousal as compared to the two groups of healthy adults (SIM, HC). Dynamic engagement (PD-Range) yielded a hierarchical structure such that SIM were more dynamically engaged than TBI followed by HC. As predicted, simulators engaged in DRI significantly more frequently than other groups. Moreover, subgroup analyses indicated that DRI differed significantly for simulators who scored in the invalid range on the RMT (n = 45) versus adults with genuine TBI who scored invalidly (n = 15). The findings support continued research on the application of pupillometry to performance validity assessment: Overall, the findings highlight the promise of biometric indices in multimethod assessments of performance validity. [ABSTRACT FROM AUTHOR]

With greater survival rates after catastrophic injury, more women with traumatic brain injury (TBI) are living longer than ever. However, knowledge about this transition in these women is largely unexamined and there are no scales that have been developed to assess the experience of symptoms. To address this gap, we developed and tested a new scale of menopause symptoms in midlife women with TBI. We selected candidate items from two existing measures based on feedback from focus group discussions with seven women with TBI. Twenty candidate items were tested in cognitive interviews with six women with TBI/1 non-TBI. Then, these were field tested with 221 participants (TBI, n = 68; non-TBI, n = 153) recruited from registries. Rasch analysis and convergent validity testing were used to evaluate the new scale. Results of the Rasch analysis indicate that overall, the scale fits well the Rasch model with evidence for unidimensionality. Differential item functioning indicated that the scale performed equally well for women with and without TBI and distinguished pre- and post-menopausal states. Convergent validity was found in the expected directions. These findings support further development of the new scale to understand the experience of menopause symptoms among women with TBI. [ABSTRACT FROM AUTHOR]

Strong associations between civilian posttraumatic stress disorder (PTSD) scales and measures of general psychological distress suggest that the scales are nonspecific to PTSD. Three common PTSD scales were administered to 122 undergraduates who had experienced an emotionally salient, nontraumatic event: a college examination. Results indicated that normal levels of anxiety associated with the examination were positively correlated with scores on the Impact of Event Scale-Revised, Revised Civilian Mississippi Scale, and PTSD Checklist-Civilian Version. Multiple regression analyses indicated that substantial variance in the PTSD scales was accounted for by trait characteristics such as negative and positive affectivity and affect intensity (R2 .29 to .53). Negative affectivity correlated as highly with PTSD measures (r = .46 to .71) as those measures correlated with each other (r = .48 to .65). A high proportion of participants exceeded clinical cutoffs on these measures. The findings suggest that these PTSD scales may be overly sensitive to nontraumatic stressors such as everyday distress and trait characteristics.

Objective: To examine motor vehicle crash frequency and risk factors following moderate-to-severe traumatic brain injury (TBI). Setting: Eight TBI Model Systems sites. Participants: Adults (N = 438) with TBI who required inpatient acute rehabilitation. Design: Cross-sectional, observational design. Main Measures: Driving survey completed at phone follow-up 1 to 30 years after injury. Results: TBI participants reported 1.5 to 2.5 times the frequency of crashes noted in the general population depending on the time frame queried, even when accounting for unreported crashes. Most reported having no crashes; for those who experienced a crash, half of them reported a single incident. Based on logistic regression, age at survey, years since injury, and perception of driving skills were significantly associated with crashes. Conclusion: Compared with national statistics, crash risk is higher following TBI based on self-report. Older age and less time since resuming driving were associated with lower crash risk. When driving was resumed was not associated with crash risk. These results do not justify restricting people from driving after TBI, given that the most who resumed driving did not report experiencing any crashes. However, there is a need to identify and address factors that increase crash risk after TBI. [ABSTRACT FROM AUTHOR]

Describes a comprehensive, day treatment program conducted in public school classrooms for children with serious emotional disorders (SED) and presents data evaluating program efficacy. At the 9-month follow-up, 50.7% of the sample showed overall symptom reduction, and 27.5% scored below clinical cutoff levels, indicating remission of symptoms to within normal limits. (Contains 80 references and 3 tables.) (GCP)

The nature and magnitude of practice effects on the Wechsler Memory Scale-Revised (D. Wechsler, 1987) were studied with 64 adult college students. The clinically meaningful increase observed across the four test sessions highlights the importance of controlling for practice effects on repeated administration of neuropsychological measures. (SLD)

Objective: The COVID-19 pandemic exacerbated gender disparities in some academic disciplines. This study examined the association of the pandemic with gender authorship disparities in clinical neuropsychology (CN) journals. Method: Author bylines of 1,018 initial manuscript submissions to four major CN journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender. Additionally, authorship of 40 articles published on pandemic-related topics (COVID-19, teleneuropsychology) across nine CN journals were coded for binary gender. Results: Initial submissions to these four CN journals increased during the pandemic (+27.2%), with comparable increases in total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field. Conclusions: Findings suggest that representation of women as authors of peer-reviewed manuscript submissions to some CN journals did not change during the initial months of the COVID-19 pandemic. Future studies might examine how risk and protective factors may have influenced individual differences in scientific productivity during the pandemic. [ABSTRACT FROM AUTHOR]

This study investigated the best estimate of true Wechsler Adult Intelligence Scale-Revised (WAIS-R) Full Scale IQ for people who recently had been administered the WAIS-R using 65 college students. Results indicate the Verbal IQ, Verbal Comprehension factor score, and subtracting six points from the current full scale IQ yield the best estimates. (SLD)

Objective: The addition of Sequencing to WAIS-IV Digit Span (DS) brought about new Reliable Digit Span (RDS) indices and an Age-Corrected Scaled Score that includes Sequencing trials. Reports have indicated that these new performance validity tests (PVTs) are superior to the traditional RDS; however, comparisons in the context of known neurocognitive impairment are sparse. This study compared DS-derived PVT classification accuracies in a design that included adults with verified TBI. Methods: Participants included 64 adults with moderate-to-severe TBI (TBI), 51 healthy adults coached to simulate TBI (SIM), and 78 healthy comparisons (HC). Participants completed the WAIS-IV DS subtest in the context of a larger test battery. Results: Kruskal–Wallis tests indicated that all DS indices differed significantly across groups. Post hoc contrasts revealed that only RDS Forward and the traditional RDS differed significantly between SIM and TBI. ROC analyses indicated that RDS variables were comparable predictors of SIM vs. HC; however, the traditional RDS showed the highest sensitivity when approximating 90% specificity for SIM vs. TBI. A greater percentage of TBI scored RDS Sequencing < 1 compared to SIM and HC. Conclusion: In the context of moderate-to-severe TBI, the DS-derived PVTs showed comparable discriminability. However, the Greiffenstein et al. traditional RDS demonstrated the best classification accuracy with respect to specificity/sensitivity balance. This relative superiority may reflect that individuals with verified TBI are more likely to perseverate on prior instructions during DS Sequencing. Findings highlight the importance of including individuals with verified TBI when evaluating and developing PVTs. [ABSTRACT FROM AUTHOR]

Background and Purpose: Driving a motor vehicle is an essential activity of daily living for adults; however, few studies have examined the effects of driving cessation on community integration among stroke survivors. The present study investigated this relationship as well as social support and gender as potential moderators of outcome. Method: Ninety pairs of stroke survivors and informants participated. Objective community integration (mobility, occupation, social integration) was assessed via informant ratings, whereas subjective community integration and social support were assessed via selfreport. These poststroke outcomes were compared for survivors who did and did not resume driving post stroke. Results: Multivariate analysis of covariance (MANCOVA) indicated that drivers were more mobile and made more productive use of their time than did non-drivers, even after accounting for stroke severity and use of alternative transportation. Two interaction effects were observed: Drivers with high social support showed better community integration than did nondrivers and drivers with low social support. Additionally, among men, non-drivers fared substantially worse than drivers, whereas among women, drivers and non-drivers showed equivalent community integration. Conclusion: Driving status has unique and substantial influence on community integration following stroke. Social support facilitated community integration but did not substantially buffer the effects of driving cessation. Although men and women resumed driving at equal rates, driving cessation showed differential effects for men and women in regard to their community integration. Research is needed to design interventions that promote full engagement in community living among persons who cease driving after stroke. Key words: community integration, driving, gender differences, social support, stroke, Driving a motor vehicle is essential to functional independence and community integration, as it enables access to work, shopping, health care, and social activities, (1-5) Most adults are understandably resistant [...]