The Behavior Rating Inventory of Executive Function®-Adult Version is Related to Emotional Distress, Not Executive Dysfunction, in a Veteran Sample.

OBJECTIVE: In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self-reported executive functioning (EF) and objective performance. METHOD: Each study pulled from a sample of 123 veterans who were administered a BRIEF-A and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) during a neuropsychological evaluation. Participants were primarily middle-aged, and half carried a mood disorder diagnosis. Study 1 examined group differences in BRIEF-A ratings among valid, invalid, and indeterminate MMPI-2 responders. Analyses were conducted to determine the optimal cut-score for the BRIEF-A Negativity Validity scale. In Study 2, relationships were explored among MMPI-2-RF (restructured form) Restructured Clinical (RC) scales, somatic/cognitive scales, and the BRIEF-A Metacognition Index (MI); hierarchical analyses were performed to predict MI using MMPI-2-RF Demoralization (RCd) and specific RC scales. Study 3 correlated BRIEF-A clinical scales and indices with RCd and an EF composite score from neuropsychological testing. Hierarchical analyses were conducted to predict BRIEF-A clinical scales. RESULTS: Invalid performance on the MMPI-2 resulted in significantly elevated scores on the BRIEF-A compared to those with valid responding. A more stringent cut-score of ≥4 for the BRIEF-A Negativity scale is more effective at identifying invalid symptom reporting. The BRIEF-A MI is most strongly correlated with demoralization. BRIEF-A indices and scales are largely unrelated to objective EF performance. CONCLUSIONS: In a veteran sample, responses on the BRIEF-A are most representative of generalized emotional distress and response bias, not actual EF abilities.

Psychometric properties of the Saint Louis University Mental Status Examination.

The Saint Louis University Mental Status (SLUMS) Examination is a brief screening measure for mild neurocognitive disorder developed for use with veterans. To date, there has been a paucity of research on its psychometric properties. The purpose of this study is to evaluate the psychometric properties of the SLUMS in a referred sample to a specialty clinic. Using a sample of 148 male veterans referred to a Mild Cognitive Impairment (MCI) Clinic for evaluation, the ability of the SLUMS to discriminate between MCI versus Major Depressive Disorder (MDD) or no diagnosis was compared to results from a more comprehensive neuropsychological battery. The SLUMS was significantly correlated with every neuropsychological measure (r = .25 to .46), except for Trails B (r = .14). Diagnostic discriminability was comparable to a typical, longer, neuropsychological battery for discriminating between MCI and no diagnosis, and between MCI and MDD. The study provides additional psychometric support for the SLUMS as a viable brief cognitive screening measure in veteran populations, particularly when discriminating between MCI and MDD.