Performance validity on the Stroop Color and Word Test in a mixed forensic and patient sample.

Objective: Assessment of performance validity is an essential component of neuropsychological evaluation. Performance validity indicators contained within cognitive ability measures are particularly advantageous, as they do not require additional test administration time or material, and allow for assessment of validity across multiple cognitive domains over the course of an evaluation. The present study examined the classification accuracy of the Stroop Color and Word Test (Stroop) Word, Color, and Color-Word trials in detecting invalid performance in a mixed forensic and patient sample. Method: Archival data from a mixed-diagnosis sample were analyzed, consisting of 558 (Mage=40.8; Meducation=15.3) individuals referred for neuropsychological evaluation in clinical or forensic contexts, who completed a test battery that included the Stroop and at least two performance validity tests (PVTs). Examinees were assigned to Valid or Invalid performance groups based on PVT outcomes. Results: Word and Color scores were found to have excellent classification accuracy, whereas Color-Word yielded acceptable classification accuracy. Sensitivity and specificity values are presented for a range of cutoff scores, as are positive and negative predictive values for setting-specific base rates of invalid performance. Conclusions: Performances on the Stroop Color and Word Test, particularly the Word and Color trials, can be useful in detecting invalid performance in a mixed patient and forensic sample. Clinical implications are discussed.

Cognitive functioning and postconcussive symptoms in trauma patients with and without mild TBI.

Although there is a large body of research on mild traumatic brain injury (MTBI), the portion that pertains to acute patients (those less than 1 month postinjury) is relatively small and yields inconsistent findings. The potential contribution of non-neurological factors, such as pain and emotional distress, to the clinical picture in this population is also lacking. To address these issues, the cognitive performance and symptom complaints of 37 hospitalized MTBI subjects were compared to those of 39 hospitalized trauma subjects, averaging 4.5 days postinjury. MTBI subjects performed significantly worse on all cognitive measures, but did not differ from trauma subjects in their report of postconcussive symptoms. Analyses also revealed that cognitive performance was unrelated to pain severity and emotional distress. Postconcussive symptoms were similarly unrelated to pain severity, but were consistently related to emotional distress. Results are discussed in terms of their etiological and treatment implications.