Detection of Sub-Optimal Performance Using a Floor Effect Strategy in Patients with Traumatic Brain Injury
| Autor: | Norman L. Fichtenberg, Samantha L. Backhaus, Robin A. Hanks |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Malingering medicine.medical_specialty Percentile Adolescent Traumatic brain injury Neuropsychological Tests Sensitivity and Specificity Severity of Illness Index Physical medicine and rehabilitation Arts and Humanities (miscellaneous) Floor effect Developmental and Educational Psychology medicine Humans In patient Aged Probability Motivation Neuropsychology Reproducibility of Results Middle Aged medicine.disease Psychiatry and Mental health Clinical Psychology Neuropsychology and Physiological Psychology Brain Injuries Predictive power Female Cognition Disorders Psychology |
| Zdroj: | The Clinical Neuropsychologist. 18:591-603 |
| ISSN: | 1744-4144 1385-4046 |
| DOI: | 10.1080/13854040490888558 |
| Popis: | This archival study examined the effectiveness of using a normative floor effect method to detect suboptimal performance in a clinical sample of 120 cases consecutively referred for a neuropsychological evaluation. These cases were divided into moderate-severe TBI, mild TBI, and poor effort litigants (demonstrating suboptimal effort). Percentiles, sensitivity, specificity, positive and negative predictive power, and overall correct classification rates were calculated using the moderate-severe TBI sample as the clinical reference group. Several levels of stringency for the floor effect using different base rates were also examined. Setting the floor at the 50th percentile consistently appeared to provide for the best overall hit rate when comparing cases with mild brain injury versus poor effort. At this level, a strong trend (greater than one third of total scores) toward the generation of positive scores offers compelling evidence that, in general, the neuropsychological data have been invalidated by poor motivation. Clinical implications are discussed. |
| Databáze: | OpenAIRE |
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