This study was designed to determine whether the number and/or types of errors on the Trail Making Test differentiated head-injured and normal control subjects. Errors on Part B were categorized into two types of shifting errors (from number to letter and from letter to number) and two types of sequencing errors (number and letter). Subjects consisted of 133 head-injured patients and 145 normal controls. Analysis showed that the frequency of errors on Parts A and B did not differ significantly between the groups nor did the percentage of subjects making errors. Total shifting and sequencing errors also did not differentiate between the two groups. Although head-injured subjects were more likely than controls to err in shifting from letters to numbers, this finding was of no apparent clinical usefulness. The discriminative value of time scores was confirmed.

The Minnesota Multiphasic Personality Inventory (MMPI) is commonly used in neuropsychological assessment in hope of ferreting out the presence of psychiatric disorders and "emotional factors". This paper discusses whether or not the MMPI can in fact do this intended task. The conclusion is that the MMPI is a poor measure of emotional adjustment and a poor aide to differential psychiatric diagnosis because the question pool is contaminated by questions that can be endorsed by neurologic and other medical patients for reasons other than emotional maladjustment or psychiatric disorder. Several MMPI scales may be elevated in a neurologic patient's profile simply because his/her symptoms are consistent with a neurologic disorder and are not necessarily a reflection of pathological adaptation or poor emotional adjustment. The safe assumptions to make in interpreting the MMPIs of neurologic patients are presented. The need to use a comprehensive assessment process to understand personality, psychological reaction, and psychiatric disorder is emphasized.

A number of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) items have been hypothesized to reflect neurologic symptomatology, rather than psychopathology, among closed-head-injury (CHI) patients. Some investigators have proposed a correction factor interpretive approach, which involves the deletion of such items from the MMPI-2 profile, as a method of reducing the probability of artificial clinical scale elevations due to the symptoms of CHI. The present study employed receiver operating characteristic (ROC) analysis to evaluate the sensitivity and specificity of three correction factors. All three factors demonstrated strong sensitivity when discriminating CHI patients from normal individuals but demonstrated poor specificity when discriminating CHI patients from psychiatric patients. These findings suggest that caution should be applied in using MMPI-2 neurologic correction factors, particularly with patients who might have comorbid psychiatric conditions.

In this study the effectiveness of The Rey Auditory Verbal Learning Test (AVLT) at assessing patients with mixed brain impairment was compared with that of a number of other commonly used neuropsychological measures. Subjects were 50 patients with a mixture of medically confirmed neuropathologies, and 50 controls with no evidence of neurological history. Groups were equated for age, education, and sex. The AVLT was administered as pan of a full neuropsychological battery. Results indicated that all seven AVLT recall trials and the total of Trials I-V could significantly differentiate between the two groups (p <.001). The AVLT trial V score performed best (U = 457.5, p <.0001), correctly predicting group membership for 74% of the subjects. This hit-rate was better than any other single test on the Halstead-Reitan or Dodrill batteries, and was surpassed only by the Dodrill Discrimination Index. The potential usefulness of this test as part of a neuropsychological battery is discussed.

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