Utility of the Neurobehavioral Symptom Inventory As an Outcome Measure: A VA TBI Model Systems Study.

Objective: To examine the utility of the Neurobehavioral Symptom Inventory (NSI)-a measure of postconcussion symptoms used within the Veterans Health Administration-as an index of rehabilitation outcome.

Setting: Veterans Administration Polytrauma Rehabilitation Centers Traumatic Brain Injury (TBI) Model Systems program.

Participants: A total of 159 Veterans (14% with mild TBI; 86% with moderate-severe TBI).

Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks.

Objective: To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment-related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems.

Participants: Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI.

Normative Data for the Neurobehavioral Symptom Inventory (NSI) and post-concussion symptom profiles among TBI, PTSD, and nonclinical samples.

The Neurobehavioral Symptom Inventory (NSI) is a self-report measure of symptoms commonly associated with Post-Concussion Syndrome (PCS) that may emerge after mild traumatic brain injury (mTBI). Despite frequent clinical use, no NSI norms have been developed. Thus, the main objective of this study was to establish NSI normative data using the four NSI factors (i.

Consolidation deficits in traumatic brain injury: the core and residual verbal memory defect.

While memory deficits are consistently found to be a salient problem in individuals with moderate to severe traumatic brain injury (TBI), the specific memory processes (i.e., encoding, consolidation, and retrieval) underlying the verbal memory deficit are disputed in the literature.

The structure of postconcussion symptoms on the Neurobehavioral Symptom Inventory: a comparison of alternative models.

Objective: To evaluate and compare the existing Neurobehavioral Symptom Inventory factor structure models to determine which model provides the best overall fit for postconcussion symptoms and determine which model is useful across different samples (eg, with and without mild traumatic brain injury [TBI] history).

Setting: N/A.

Participants: A Florida National Guard sample (N = 3098) and a national Department of Veterans Affairs sample (N = 48,175).

TBI and Nonverbal Executive Functioning: Examination of a Modified Design Fluency Test's Psychometric Properties and Sensitivity to Focal Frontal Injury.

The purpose of this study was to investigate a modified version of the Design Fluency Test (DFT; Jones-Gotman & Milner, 1977 ) to establish its psychometric properties and clinical sensitivity to frontal traumatic brain injury (TBI). Twenty-five participants with moderate-to-severe TBI and focal frontal injury confirmed on magnetic resonance imaging or computed tomography, and 25 participants with TBI and nonfrontal focal injury were administered a modified fixed version of the DFT (Russell & Starkey, 1993 ). Analyses revealed that this modified DFT demonstrated excellent interrater agreement and consistency.

Screening for postdeployment conditions: development and cross-validation of an embedded validity scale in the neurobehavioral symptom inventory.

Objective: To develop and cross-validate internal validity scales for the Neurobehavioral Symptom Inventory (NSI).

Participants: Four existing data sets were used: (1) outpatient clinical traumatic brain injury (TBI)/neurorehabilitation database from a military site (n = 403), (2) National Department of Veterans Affairs TBI evaluation database (n = 48 175), (3) Florida National Guard nonclinical TBI survey database (n = 3098), and (4) a cross-validation outpatient clinical TBI/neurorehabilitation database combined across 2 military medical centers (n = 206).

Research Design: Secondary analysis of existing cohort data to develop (study 1) and cross-validate (study 2) internal validity scales for the NSI.

Abnormal neurological exam findings in individuals with mild traumatic brain injury (mTBI) versus psychiatric and healthy controls.

In those with a history of mild traumatic brain injury (mTBI), cognitive and emotional disturbances are often misattributed to that preexisting injury. However, causal determinations of current symptoms cannot be conclusively determined because symptoms are often nonspecific to etiology and offer virtually no differential diagnostic value in postacute or chronic phases. This population-based study examined whether the presence of abnormalities during neurological examination would distinguish between mTBI (in the chronic phase), healthy controls, and selected psychiatric conditions.

Incidence of postconcussion symptoms in psychiatric diagnostic groups, mild traumatic brain injury, and comorbid conditions.

The constellation of physical, cognitive, and emotional symptoms, collectively known as postconcussion syndrome (PCS), is not uniquely associated with concussion, making the etiology of chronic postconcussion symptoms controversial. The current study compared percentages of individuals meeting symptom-based criteria for PCS in a population-based sample of veterans composed of subgroups with various psychiatric diagnoses, a history of mild traumatic brain injury (MTBI), and healthy controls. Participants were identified from 4462 randomly sampled male U.

Implications of psychometric measurement for neuropsychological interpretation.

The purpose of this study is to examine the implications of various less-examined psychometric issues in the interpretation of neuropsychological data. Using a dataset of 4371 independent functioning and community-dwelling individuals who underwent neuropsychological evaluations, it was demonstrated that many common measures are not normally distributed. Non-normalized data can lead to erroneously pathological conclusions, particularly on the lower end of negatively skewed distributions.

Oculomotor function in chronic traumatic brain injury.

Objective: To characterize oculomotor function using visually guided saccade and antisaccade (AS) tasks in chronic traumatic brain injury (TBI) and assess the relationship to neuropsychologic testing.

Background: TBI causes dysfunction of prefrontal cortex, in part by disrupting cortical and subcortical pathways, resulting in specific cognitive impairments. Oculomotor function tests provide a method of assessing the integrity of these pathways.

Rapidly-administered short forms of the Wechsler Adult Intelligence Scale-3rd edition.

Although the Wechsler Full Scale IQ (FSIQ) is a common component of most neuropsychological evaluations, there are many clinical situations where the complete administration of this battery is precluded by various constraints, including limitations of time and patient compliance. These constraints are particularly true for dementia evaluations involving elderly patients. The present study reports data on two short forms particularly suited to dementia evaluations, each requiring less than 20min of administration time.

Factor structure and differential validity of the expanded Brief Psychiatric Rating Scale.

The Brief Psychiatric Rating Scale (BPRS) is one of the most widely used measures in psychiatric outcome and clinical psychopharmacology research. To date, however; research on the psychometric properties of the expanded version of the BPRS (BPRS-E) has been limited. An exploratory factor analysis (n = 360) using maximum likelihood extraction with oblimin rotation found a four-factor solution (Thought Disturbance, Animation, Mood Disturbance, Apathy) to underlie the BPRS-E.

A systematic program to enhance clinician group skills in an inpatient psychiatric hospital.

This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness.