Screening for Postdeployment Conditions

Vanderploeg, Rodney D.; Cooper, Douglas B.; Belanger, Heather G.; Donnell, Alison; Kennedy, Jan E.; Hopewell, Clifford A.; Scott, Steven

doi:10.1097/htr.0b013e318281966e

Cited by 161 publications

(85 citation statements)

References 12 publications

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“…Thus, the development and validation of SVTs and PVTs for mTBI populations is warranted. Vanderploeg and colleagues [23] developed an embedded SVT in the Neurobehavioral Symptom Inventory (NSI) [24] to identify likely overreporting of postconcussive symptoms. The NSI is a part of the Comprehensive TBI Evaluation that is administered to every Veteran in Department of Veterans Affairs (VA) clinical settings who screen positive for TBI and opt for further evaluation of their symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…The NSI is a part of the Comprehensive TBI Evaluation that is administered to every Veteran in Department of Veterans Affairs (VA) clinical settings who screen positive for TBI and opt for further evaluation of their symptoms. Vanderploeg et al [23] identified items on the NSI that were most highly correlated with the mild Brain Injury Atypical Symptoms scale (mBIAS) [25] and the Negative Impression Management scale on the Personality Assessment Inventory (PAI) [26] to create the Negative Impression Management Atypical Scale (NIM5), which contained highly unlikely or bizarre symptoms. They then identified the least frequently endorsed NSI items across various mild to severe TBI clinical and nonclinical samples to create the NSI Infrequent Scale (LOW6).…”

Section: Introductionmentioning

confidence: 99%

“…The combination of the NIM5 and LOW6 (with one overlapping item) comprises the 10 items of the Validity-10. Logistic regression using a clinical cross-validation sample and a cutoff score of 8 or more on the mBIAS [25] revealed that a cutoff score of greater than 22 on the Validity-10 was most effective at identifying symptom overreporting [23]. Since its publication, two studies have identified different cutoff scores for the Validity-10 in military servicemembers with mild [27] and all severities of TBI [28].…”

Section: Introductionmentioning

confidence: 99%

“…The Validity- 10 has not yet been used, nor have the initial results been replicated outside of the initial development and validation sample in a homogenous sample of Veterans with mTBI [23]. One study replicated the initial development and validation study in servicemembers with mTBI but identified a much lower cutoff score [27].…”

Section: Introductionmentioning

confidence: 99%

“…This study examined the items and cutoff score used in the initial development and validation study [5] in a homogenous sample of Veterans with a history of mTBI. Specifically, we aimed to compare the lowfrequency items (LOW6) and the percentage of Veterans scoring above (SVT-fail group) versus below (SVT-pass group) the cutoff score of 22 on the Validity-10 to the findings of Vanderploeg et al [23]. We also extended those findings by comparing the SVT-fail and SVT-pass groups on variables of interest such as demographics, injury characteristics (LOC, PTA, number of lifetime TBIs), psychiatric variables, VA service connection, and PVT performance.…”

Section: Introductionmentioning

confidence: 99%

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Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

et al. 2016

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Abstract-A comprehensive evaluation, including the assessment of neurobehavioral symptoms, has been instituted at the Department of Veterans Affairs (VA) healthcare system to address the large number of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans returning with mild traumatic brain injuries (mTBIs). The Validity-10 is a measure of symptom overreporting embedded within the Neurobehavioral Symptom Inventory, a component of the comprehensive evaluation that assesses postconcussive symptom severity. The Validity-10 is composed of 10 unlikely/low-frequency items and a validated cutoff score to identify postconcussive symptom overreporting. We examined the items and cutoff used in the initial development and validation study of the Validity-10 through retrospective chart reviews of 331 treatment-seeking Veterans who sustained an mTBI. The Validity-10 exhibited significant relationships with psychiatric variables, VA service connection, and neuropsychological performance validity (all p < 0.01), but nonsignificant relationships with demographic and injury variables (all p > 0.05). Furthermore, the Validity-10 modestly predicted neuropsychological performance validity test failure over and above psychiatric comorbidities and VA service connection. The present study supports the use of the Validity-10 to assess symptom validity in treatment-seeking OIF/OEF Veterans with a history of mTBI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

et al. 2016

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A Comparison of Insufficient Effort Rates, Neuropsychological Functioning, and Neuropsychiatric Symptom Reporting in Military Veterans and Civilians with Chronic Traumatic Brain Injury

Gfeller

Roskos

2013

Behavioral Sci & The Law

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Neuropsychological evaluation of persons with chronic traumatic brain injury (TBI) symptoms is complicated by multiple factors. The authors explored the impact of mechanism of injury, effort testing performance, and neuropsychiatric status in a sample of military veterans (V-TBI) and civilians (C-TBI) with chronic TBI. V-TBI (n = 74), C-TBI (n = 67), and healthy civilian control (C-HC) participants (n = 66), completed a battery of neuropsychological, effort, and self-report neuropsychiatric measures. Results indicated that C-HC and C-TBI participants exhibited comparably low failure rates on effort tests (6% and 3%, respectively). V-TBI participants exhibited significantly higher rates of failure (18%). Subgroups (n = 20) of effort-screened participants matched for demographics and disability level were compared regarding neuropsychological performance and neuropsychiatric self-report. Both TBI groups exhibited limited neuropsychological impairment, relative to the C-HC participants. The V-TBI group exhibited pronounced neuropsychiatric symptomology compared with the other participant groups. The implications of these findings are discussed for evaluation in the context of disability and litigation.

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Concussive Brain Injury in the Military: September 2001 to the Present

Logan¹,

Goldman²,

Zola³

et al. 2013

Behavioral Sci & The Law

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Since the terrorist attacks of September 11, 2001, 1,348,405 citizens have been deployed to combat in Operation Iraqi Freedom (OIF), Operation New Dawn in Iraq, and Operation Enduring Freedom in Afghanistan (OEF). During this same period 266,810 (20%) of these individuals have been diagnosed with a traumatic brain injury (TBI). The majority of these were Army soldiers, with 155,282 (58%) receiving the diagnosis. Mild TBI comprised 82% of the total, with the remainder being moderate to severe. Over this same period the Department of Defense (DoD) has invested $374.9 million to enhance access and quality of care services, including 57 TBI treatment centers in the combat theater and throughout the U.S. The Army's medical research division, the Medical Research and Material Command (MRMC), has invested an additional $700 million to TBI research during this time. The effort has faced a number of challenges, including limited human subject basic and translational research, limited epidemiological data on combat-related injuries, limited capacity and standards for data acquisition, and a lack of standardized evidenced-based protocols for treatment. All these areas have undergone significant growth and development, leading to the comprehensive system of care present today. A further challenge in this patient population has been the clinical co-morbidity of TBI, post-traumatic stress disorder, and chronic pain syndrome. The Army and the DoD have created treatment programs that are interdisciplinary in clinical approach, targeting particular neuropsychological domains of dysfunction rather than diagnostic category or etiology of injury. This article presents the history of this effort, the challenges to accurate and adequate diagnosis and care that remain, and the future of brain injury clinical and research efforts in the military.

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Screening for Postdeployment Conditions

Cited by 161 publications

References 12 publications

Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury

A Comparison of Insufficient Effort Rates, Neuropsychological Functioning, and Neuropsychiatric Symptom Reporting in Military Veterans and Civilians with Chronic Traumatic Brain Injury

Concussive Brain Injury in the Military: September 2001 to the Present

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