Self-concept and quality of life following acquired brain injury: a pilot investigation.

OBJECTIVE: To investigate through pilot exploration the relationships between depression, self-concept and perceived quality of life (QoL) in post-acute patients with acquired brain injury (ABI). METHODS: Nineteen patients with ABI were administered the Beck Depression Inventory-II and the Quality of Life Inventory, along with the Tennessee Self-Concept Scale-2 and the Head Injury Semantic Differential Scale, measures of self-concept. The relationships between these measures were explored using correlational analyses. RESULTS: Ratings of self-concept were correlated with perceived QoL, suggesting that poorer view of self was associated with lower subjective QoL. Additionally, depressive symptoms were associated with lower QoL ratings, consistent with previous research. CONCLUSIONS: These results suggest that intra-personal variables, such as self-concept and depression, impact the perceived QoL of the ABI survivor. Future research exploring the mediating effects of these variables on QoL may clarify this relationship and may aid in developing more effective interventions for these individuals.

Detection of inadequate effort on neuropsychological testing: a meta-analytic review of selected procedures.

Thirty-two studies of commonly researched neuropsychological malingering tests were meta-analytically reviewed to evaluate their effectiveness in discriminating between honest responders and dissimulators. Overall, studies using the Digit Memory Test (DMT), Portland Digit Recognition Test (PDRT), 15-Item Test, 21-Item Test, and the Dot Counting Test had average effect sizes indicating that dissimulators obtain scores that are approximately 1.1 standard deviations below those of honest responders. The DMT separated the means of groups of honest and dissimulating responders by approximately 2 standard deviations, whereas the 21-Item Test and the PDRT separated the groups by nearly 1.5 and 1.25 standard deviations, respectively. The 15-Item Test and the Dot Counting Test were less effective, separating group means by approximately 3/4 of a standard deviation. Although the DMT, PDRT, 15-, and 21-Item Tests all demonstrated very high specificity rates, at the level of individual classification, the DMT had the highest sensitivity and overall hit-rate parameters. The PDRT and 15-Item Test demonstrated moderate sensitivity, whereas the 21-Item Test demonstrated poor sensitivity. The less than perfect sensitivities of all the measures included in this review argue against their use in isolation as malingering screening devices.