Forced choice test score of ≤ .20 and failures on ≥ six performance validity tests results in similar Overall Test Battery Means.

To determine if similar levels of performance on the Overall Test Battery Mean (OTBM) occur at different forced choice test (FCT) value score failures. Second, to determine the OTBM levels that are associated with failures at above chance on various performance validity (PVT) tests. OTBMs were computed from archival data obtained from four practices.

RBANS Validity Measures and the TOMM in Veterans Undergoing Seizure Monitoring.

Objective: To assess the validity of embedded measures of performance validity, the effort index (EI) and effort scale (ES) of the repeatable battery for the assessment of neuropsychological status (RBANS), in Veterans with seizures; to compare the frequency of failure on the test of memory malingering (TOMM) in patients with epileptic versus psychogenic nonepileptic seizures (PNES).

Methods: Seizure diagnosis was established for 309 participants in epilepsy monitoring units using conventional diagnostic criteria who completed both the TOMM and RBANS. The criterion for performance invalidity was failure on any trial of the TOMM.

Validity testing in veterans with epileptic seizures and psychogenic nonepileptic seizures.

Objective: Identification of clinically meaningful subgroups among patients with psychogenic nonepileptic seizures (PNES) or epileptic seizures (ES) is of potential value for assessing prognosis and predicting therapeutic response. Invalid performance on validity tests has been associated with noncredible complaints and worse cognitive test scores, and may be one such classification criteria. We studied invalid performance in Veterans with PNES or ES, and the association of invalid performance with cognitive test scores and subjective complaints.

Health-related quality of life in Veterans with epileptic and psychogenic nonepileptic seizures.

Rationale: Health-related quality of life (HRQoL) is compromised in civilians with epileptic seizures (ES) or psychogenic nonepileptic seizures (PNES). U.S.

The patient-psychologist relationship and informed consent in neuropsychological evaluations.

To discuss specific issues regarding consent for neuropsychological evaluation and the patient-psychologist relationship within the context of the Ethics Code of the American Psychological Association and relevant literature. The author makes recommendations based on the Ethics Code and published sources. This article is advisory and does not prescribe ethical practice.

Psychiatric comorbidity and traumatic brain injury attribution in patients with psychogenic nonepileptic or epileptic seizures: A multicenter study of US veterans.

Objective: To determine the frequency and severity of psychiatric disorders and attribution of seizures to traumatic brain injury (TBI) in veterans with verified psychogenic nonepileptic seizures (PNES) versus epileptic seizures (ES).

Methods: We studied 333 consecutive admissions to the monitoring units of three Veterans Administration epilepsy centers. All patients underwent continuous video-electroencephalographic recording to define definite PNES or ES.

[Formula: see text]Determination of the smoking gun of intent: significance testing of forced choice results in social security claimants.

Objective: Significantly below-chance findings on forced choice tests have been described as revealing "the smoking gun of intent" that proved malingering. The issues of probability levels, one-tailed vs. two-tailed tests, and the combining of PVT scores on significantly below-chance findings were addressed in a previous study, with a recommendation of a probability level of .

Sensory sensitivity in operation enduring freedom/operation Iraqi freedom veterans with and without blast exposure and mild traumatic brain injury.

To examine factors associated with noise and light sensitivity among returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with a self-reported history of mild traumatic brain injury (mTBI) due to blast exposure, we compared the self-report of noise and light sensitivity of 42 OEF/OIF Veterans diagnosed with mTBI resulting from combat blast-exposure to that of 36 blast-exposed OEF/OIF Veterans without a history of mTBI. Results suggest a statistically significant difference between Veterans with and without a history of mTBI in the experience of noise and light sensitivity, with sensory symptoms reported most frequently in the mTBI group. The difference remains significant even after controlling for symptoms of PTSD, depression, and somatization.

Comparing the Neuropsychological Test Performance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with and without Blast Exposure, Mild Traumatic Brain Injury, and Posttraumatic Stress Symptoms.

To compare neuropsychological test performance of Veterans with and without mild traumatic brain injury (MTBI), blast exposure, and posttraumatic stress disorder (PTSD) symptoms. We compared the neuropsychological test performance of 49 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans diagnosed with MTBI resulting from combat blast-exposure to that of 20 blast-exposed OEF/OIF Veterans without history of MTBI, 23 OEF/OIF Veterans with no blast exposure or MTBI history, and 40 matched civilian controls. Comparison of neuropsychological test performance across all four participant groups showed a complex pattern of mixed significant and mostly nonsignificant results, with omnibus tests significant for measures of attention, spatial abilities, and executive function.

Intent to fail: significance testing of forced choice test results.

A score that is significantly below the level of chance on a forced choice (FC) performance validity test results from the deliberate production of wrong answers. In order to increase the power of significance testing of a below chance result on standardized FC tests with empirically derived cutoff scores, we recommend using one-tailed tests of significance and selecting probability levels greater than .05 (.

Meta-analytic methods and the importance of non-TBI factors related to outcome in mild traumatic brain injury: response to Bigler et al. (2013).

Bigler et al. (2013, The Clinical Neuropsychologist) contend that weak methodology and poor quality of the studies comprising our recent meta-analysis led us to miss detecting a subgroup of mild traumatic brain injury (mTBI) characterized by persisting symptomatic complaint and positive biomarkers for neurological damage. Our computation of non-significant Q, tau(2), and I(2) statistics contradicts the existence of a subgroup of mTBI with poor outcome, or variation in effect size as a function of quality of research design.

Psychogenic stuttering and other acquired nonorganic speech and language abnormalities.

Three cases are presented of peculiar speech and language abnormalities that were evaluated in the context of personal injury lawsuit or workers compensation claims of brain dysfunction after mild traumatic brain injuries. Neuropsychological measures of effort and motivation showed evidence of suboptimal motivation or outright malingering. The speech and language abnormalities of these cases probably were not consistent with neurogenic features of dysfluent speech including stuttering or aphasia.

Computerized neuropsychological assessment devices: joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology.

This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting.

Computerized neuropsychological assessment devices: joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology.

This joint position paper of the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology sets forth our position on appropriate standards and conventions for computerized neuropsychological assessment devices (CNADs). In this paper, we first define CNADs and distinguish them from examiner-administered neuropsychological instruments. We then set forth position statements on eight key issues relevant to the development and use of CNADs in the healthcare setting.

A meta-analysis of neuropsychological outcome after mild traumatic brain injury: re-analyses and reconsiderations of Binder et al. (1997), Frencham et al. (2005), and Pertab et al. (2009).

The meta-analytic findings of Binder et al. (1997) and Frencham et al. (2005) showed that the neuropsychological effect of mild traumatic brain injury (mTBI) was negligible in adults by 3 months post injury.

Relative subtest scatter in the WAIS-IV standardization sample.

The frequencies of differences between highest and lowest subtest scores as a function of highest subtest score (relative scatter), are reported for the standardization sample of the Wechsler Adult Intelligence Scale-IV (WAIS-IV). Large differences between highest and lowest subtest scores were common. The degree of relative scatter was related to the height of the highest subtest score.

Comparison of oral and computerized versions of the word memory test.

A computer-administered version of the Word Memory Test (WMT) was compared with the orally administered version in two clinical samples to assess equivalency of the two versions. The two samples included inpatients at an epilepsy center (n = 67) and forensic and clinical referrals to a private practice (n = 58). A randomized procedure was used to assign participants to either version of the WMT.

MMPI-2 profiles: fibromyalgia patients compared to epileptic and non-epileptic seizure patients.

We compared MMPI-2 profiles of Gulf War veterans with fibromyalgia (FM) to epileptic seizure (ES) patients, psychogenic non-epileptic seizure (PNES) patients, and Gulf War veteran healthy controls. Both PNES and FM are medically unexplained conditions. In previous MMPI-2 research PNES patients were shown to have significantly higher Hs and Hy clinical scales than ES patients.

To err is human: "abnormal" neuropsychological scores and variability are common in healthy adults.

Normative studies of variability in performance by healthy adults on neuropsychological batteries are reviewed. Regarding test score scatter, normative participants often have large discrepancies between best and worst scores. When "abnormality" was defined as a score more than one standard deviation below the mean, in test batteries with at least 20 measures, the great majority of normative participants had one or more abnormalities.

Rates of below-chance performance in forced-choice symptom validity tests.

The rates of significantly below-chance results on three neuropsychological symptom validity tests (SVTs) including the Portland Digit Recognition Test (PDRT), Test of Memory Malingering (TOMM), and Word Memory Test (WMT) were compared in a private practice forensic sample of 1032 examinees with alleged mild traumatic brain injury, moderate to severe traumatic brain injury, alleged toxic exposure, and reported chronic pain. The PDRT and WMT were equivalent to one another in the rates of below-chance results, with both yielding more frequent below-chance results than the TOMM. Seemingly more difficult sections of the PDRT and WMT had higher yields than seemingly easier sections.

Psychogenic nonepileptic seizures.

Neurological, neurodiagnostic, and neuropsychological aspects of psychogenic nonepileptic seizures (PNES) are reviewed, including psychosocial, psychiatric, cognitive, and MMPI-2 findings.