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Objective Intra-individual variability (IIV) has been associated with cognitive dysfunction and traumatic brain injury (TBI) severity. This study examined IIV in physical medicine and rehabilitation patients grouped by TBI severity and performance validity. Method Participants (N = 213) were 32% female and 90% white with average age and education of 42 (SD = 13) and 14 (SD = 2) years, respectively. Participants completed an outpatient evaluation using a flexible battery of up to 33 common neuropsychological measures. Participants were grouped by TBI severity and validity: mild (32%), moderate (14%), severe (32%), and questionable performance validity (QPV; 22%). QPV was determined on the basis of embedded and freestanding validity measures. Test battery scores were converted to T scores. Cases with four or more scores below 36 T were identified as impaired. Measures of IIV were calculated including overall test battery mean (OTBM), test battery standard deviation (SD), kurtosis, skew, range, and unbiased coefficient of variation (UCV). IIV measures were compared across groups. Results Groups were significantly different in OTBM (p < .001), kurtosis (p < .03), and UCV (p < .001). In valid cases, TBI severity was associated with OTBM (rho = −.31), SD (.19), kurtosis (−.16), and UCV (.33). Impaired and unimpaired cases were significantly different in OTBM (p < .001), SD (p < .001), range (p < .01), and UCV (p < .001). QPV cases were similar to impaired cases on measures of IIV. Conclusions IIV measures have potential clinical utility in characterizing cognitive deficits in TBI and warrant further study.

Background: Approximately 25% of U.S. veterans have diabetes and suffer from psychosocial complications. The Diabetes Empowerment Group (DEG), developed by Loma Linda VA Hospital’s Behavioral Medicine Service, is a 12-week interdisciplinary group to help veterans manage their diabetes. Curriculum included values assessment, SMART goal setting, stress management, problem solving, mindful eating and nutritional education. Methods: Veterans attended their respective 12-week DEG group. Hemoglobin A1c levels were measured and participants completed QI measures at the beginning and end of their group cycles. Scores on QI measures were used to determine if group content impacted veterans’ HbA1c levels, diabetes-related psychosocial self-efficacy, knowledge, emotional distress, confidence to perform management behaviors and depressive symptoms. Paired sample t-tests compared pre- and post-group values. Results: Eighty veterans completed lab work and QI measures. Significant mean differences were found between scores on pre- and post-treatment measures for A1c levels, depressive symptoms, diabetes knowledge, distress, psychosocial self-efficacy and confidence to manage their diabetes. Post-treatment scores were significantly lower than pre-treatment scores for A1C levels, depressive symptoms, and diabetes distress. Post-treatment scores were significantly higher than pre-treatment scores for diabetes knowledge, psychosocial self-efficacy, and confidence. Conclusion: Findings expand on a previous QI study and demonstrate the efficacy of the DEG group at helping manage diabetes, reducing biopsychosocial complications and increasing knowledge. Future options for QI include evaluation of future programs (e.g., Diabetes Support Grp and DEG mobile app) to support current and alumni group members with maintenance of diabetes management skills learned. Disclosure N. Farrell: None. J. S. Shaheed: None. J. Davis: None. G. Valencia: None. R. Clark: None. D. J. Colella: None.