Performance and Symptom Validity Testing as a Function of Medical Board Evaluation in U.S. Military Service Members with a History of Mild Traumatic Brain Injury

Armistead-Jehle, Patrick; Cole, Wesley R.; Stegman, Robert L

doi:10.1093/arclin/acx031

Cited by 15 publications

(3 citation statements)

References 7 publications

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“…symptom exaggeration) is an issue in mild TBI. [54][55][56] Future work to validate the BAST, among those with mild TBI in particular, should include validity test items addressing these issues.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Development and content validity of the behavioral assessment screening tool (BAST_β)

Juengst

Terhorst

Dicianno

et al. 2018

Disability and Rehabilitation

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The BAST is a theoretically grounded, multidimensional self-reported assessment of behavioral dysregulation after traumatic brain injury, with good content validity. Future translation into mobile health modalities could improve effectiveness and efficiency of long-term symptom monitoring post-traumatic brain injury. Future work will establish and validate the factor structure, internal consistency reliabilities and other validities of the BAST. Implications for Rehabilitation Behavioral problems after traumatic brain injury is one of the strongest contributing factors to poor mood and community integration outcomes after injury. Behavior is complex and multidimensional, making it a challenge to measure and to monitor long term. The Behavioral Assessment Screening Tool (BAST) is a patient-oriented outcome assessment developed in collaboration with individuals with traumatic brain injury, their care partners, and experts in the field of traumatic brain injury rehabilitation to be relevant and accessible for adults with traumatic brain injuries. The BAST is a long-term monitoring and screening tool for community-dwelling adults with traumatic brain injuries, to improve identification and management of behavioral and emotional sequelae.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Development and content validity of the behavioral assessment screening tool (BAST_β)

Juengst

Terhorst

Dicianno

et al. 2018

Disability and Rehabilitation

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“…14,15 Individuals with mTBI have performed worse on these memory assessments than peers without injury. 16,17 However, the relationship between fMRI findings and clinical tests has not been well established though this is essential in interpreting the relationships between imaging measures and clinical outcomes. Therefore, the purpose of this CAT was to determine if sport-related mTBI was associated with structural (e.g., cortical thinning) or functional (e.g., decreased tissue perfusion) changes visible with fMRI that were associated with memory impairments (i.e., worse performance during memory assessment).…”

Section: Clinical Scenariomentioning

confidence: 99%

Memory Impairments Associated With Mild Traumatic Brain Injury: A Critically Appraised Topic

Burns

Sanford

Tierney

et al. 2022

International Journal of Athletic Therapy and Training

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Clinical Question: Do sports-related mild traumatic brain injury in adolescents and young adults produce changes that can be identified with functional magnetic resonance imaging that are associated with memory impairment? Clinical Bottom Line: After sport-related mild traumatic brain injury, functional magnetic resonance imaging identified inconsistent structural changes (e.g., cortical thickness changes, brain activation patterns), and negative performance changes in memory function (e.g., lower neuropsychological scores) in adolescents and young adults 9 days to more than a year following injury.

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“…Therefore, a comprehensive gait assessment model has been proposed for those with mTBI. 9 Response bias is a critical issue that can impact apparent long-lasting difficulties following TBI in both civilian 10 and military 11 contexts. Response bias can be broken into 2 components: (1) symptom validity, which is the accuracy of a person's self-reported symptoms, and (2) performance validity, which is the validity of performance on objective measures of ability.…”

mentioning

confidence: 99%

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Rosen

Delpy

Pape

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: Physical therapy following traumatic brain injury (TBI) can be negatively impacted by psychological symptoms, atypical symptom reporting, and response bias. We examined rates of Symptom Validity Test (SVT) failure in active duty military service members with a history of mild-moderate TBI and its impact on gait speed. Setting: Intensive Outpatient Program at the National Intrepid Center of Excellence at Walter Reed National Military Medical Center. Participants: Participants were 84 active duty service members with a history of mild-moderate TBI classified as SVT pass (n = 49) or SVT fail (n = 35). Design: Retrospective study. Main Measures: Overground preferred and fast walking speed as well as Computer Assisted Rehabilitation Environment (CAREN) gait speed were recorded. Participants completed the Neurobehavioral Symptom Inventory and the Validity-10 was used to assign patients into the SVT pass and SVT fail groups. Gait speed metrics were compared across these groups and test operating characteristics were calculated. Results: Approximately 42% of the sample was classified into the SVT fail group. All 3 gait speed measures were significantly slower in the SVT fail group than in the SVT pass group (Ps < .001, ds = 0.60-0.80). Gait speed cutoffs for screeners or indicators of atypical reporting were identified. Conclusions: The potential for response bias is a critical area for the clinician to consider when conducting physical therapy evaluations. Participants in the SVT fail group had slower walking speed on all 3 measures assessed. Several useful cutoffs were identified to serve as screeners or indicators of SVT failure, though these preliminary findings have limitations and need to be replicated.

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Performance and Symptom Validity Testing as a Function of Medical Board Evaluation in U.S. Military Service Members with a History of Mild Traumatic Brain Injury

Cited by 15 publications

References 7 publications

Development and content validity of the behavioral assessment screening tool (BAST_β)

Development and content validity of the behavioral assessment screening tool (BAST_β)

Memory Impairments Associated With Mild Traumatic Brain Injury: A Critically Appraised Topic

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

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Performance and Symptom Validity Testing as a Function of Medical Board Evaluation in U.S. Military Service Members with a History of Mild Traumatic Brain Injury

Cited by 15 publications

References 7 publications

Development and content validity of the behavioral assessment screening tool (BASTβ)

Development and content validity of the behavioral assessment screening tool (BASTβ)

Memory Impairments Associated With Mild Traumatic Brain Injury: A Critically Appraised Topic

Overground and Virtual Reality Gait Speed Are Associated With Atypical Symptom Reporting in Active Duty Service Members With a History of Mild to Moderate Traumatic Brain Injury

Contact Info

Product

Resources

About

Development and content validity of the behavioral assessment screening tool (BAST_β)

Development and content validity of the behavioral assessment screening tool (BAST_β)