Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 5, 2016
   Pages 571 — 584

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

Sarah M. Jurick, MS;1–2 Elizabeth W. Twamley, PhD;3–4 Laura D. Crocker, PhD;5 Chelsea C. Hays, MS;1–2 Henry J. Orff, PhD;3–4 Shahrokh Golshan, PhD;2,4 Amy J. Jak, PhD3,5*

1San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA; 2Veterans Medical Research Foundation, San Diego, CA; 3Center of Excellence for Stress and Mental Health, Department of Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA; 4Department of Psychiatry, University of California San Diego, San Diego, CA; 5Psychology Service, VA San Diego Healthcare System, San Diego, CA

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.

Key Words: concussion, depression, mild traumatic brain injury, neurobehavioral symptoms, neuropsychology, Operation Enduring Freedom/Operation Iraqi Freedom, performance validity test, postconcussive symptoms, posttraumatic stress disorder, symptom validity test.


View HTML ¦ View PDF ¦ Contents Vol. 53, No.5

This article and any supplementary material should be cited as follows:
Jurick SM, Twamley EW, Crocker LD, Hays CC, Orff HJ, Golshan S, Jak AJ. Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury. J Rehabil Res Dev. 2016;53(5):571–84.
http://dx.doi.org/10.1682/JRRD.2015.05.0094
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