Ability of the Wisconsin Card-Sorting Test-64 as an embedded measure to identify noncredible neurocognitive performance in mild traumatic brain injury litigants.

Objective: To investigate the ability of selective measures on the Wisconsin Card Sorting Test-64 (WCST-64) to predict noncredible neurocognitive dysfunction in a large sample of mild traumatic brain injury (mTBI) litigants.

Method: Participants included 114 adults who underwent a comprehensive neuropsychological examination. Criterion groups were formed based upon their performance on stand-alone measures of cognitive performance validity (PVT).

Results: Participants failing PVTs performed worse across all WCST-64 dependent variables of interest compared to participants who passed PVTs. Receiver operating curve analysis revealed that only categories completed was a significant predictors of PVT status. Multivariate logistic regression did not add to classification accuracy.

Conclusion: Consideration of noncredible executive functioning may be warranted in mild traumatic brain injury (mTBI) litigants who complete ≤ 1 category on the WCST-64.