Performance Of The Immediate Post Concussion Assessment And Cognitive Testing Protocol Validity Indices
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| Author | : Lisa M. Manderino |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2017 |
| Genre | : |
| ISBN | : |
Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a widely used, computerized neuropsychological test battery for the diagnosis and management of sport-related concussions (SRC). As SRC is known to affect neurocognitive performance, athletes provide pre-injury, baseline ImPACT scores, to which post-injury scores can be compared in the event of SRC. However, if an athlete's baseline scores are not fully representative of his abilities, the utility of post-injury score comparison is diminished. Return-to-play release may be granted prematurely, putting the athlete at risk for second injury or long-term consequences. For this reason, the ImPACT includes low score thresholds on five validity indices to identify insufficient effort, though evidence of these indices' performance is limited. The present study compares existing ImPACT validity indices, as well as three proposed indices not currently being used to inform protocol validity, to external validity measures. The ImPACT, Word Memory Test (WMT) and Minnesota Multiphasic Personality Inventory - 2- Restructured Form (MMPI-2-RF) were administered to 242 undergraduate students. Participants were instructed to either give full effort on testing or to simulate SRC. The ImPACT demonstrated significantly higher specificity (0.94) and lower sensitivity (0.42) as compared to the WMT and MMPI-2-RF. Alternative score thresholds for the existing ImPACT validity indices may maintain high specificity while improving sensitivity. The three proposed indices showed higher sensitivities than the existing ImPACT indices, though lower specificities. The existing ImPACT indices' high specificity at the expense of lower sensitivity compared to external validity measures raises concern, as unidentified poor-effort may result in premature return-to-play decisions for athletes with SRC. Improvements or additions to the existing indices may raise sensitivity while maintaining acceptable specificity, aiding in the protection of athletes and safe athletic participation.
| Author | : Brittany J. Allen |
| Publisher | : |
| Total Pages | : 186 |
| Release | : 2008 |
| Genre | : Brain |
| ISBN | : |
| Author | : National Research Council |
| Publisher | : National Academies Press |
| Total Pages | : 215 |
| Release | : 2014-02-04 |
| Genre | : Medical |
| ISBN | : 0309288037 |
In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.
| Author | : Phillip D. Ruppert |
| Publisher | : |
| Total Pages | : 116 |
| Release | : 2009 |
| Genre | : Brain |
| ISBN | : |
| Author | : Kyle Brauer Boone |
| Publisher | : Guilford Publications |
| Total Pages | : 731 |
| Release | : 2021-04-13 |
| Genre | : Psychology |
| ISBN | : 1462545572 |
The go-to resource for clinical and forensic practice has now been significantly revised with 85% new material, reflecting the tremendous growth of the field. Leading authorities synthesize the state of the science on symptom feigning in cognitive testing and present evidence-based recommendations for distinguishing between credible and noncredible performance. A wide range of performance validity tests (PVTs) and symptom validity tests (SVTs) are critically reviewed and guidelines provided for applying them across differing cognitive domains and medical, neurological, and psychiatric conditions. The book also covers validity testing in forensic settings and with particular populations, such as ethnic and linguistic minority group members. New to This Edition *Numerous new authors, a greatly expanded range of topics, and the latest data throughout. *"Clinical primer" chapter on how to select and interpret appropriate PVTs. *Chapters on methods for validity testing in visual–spatial, processing speed, and language domains and with cognitive screening instruments and personality inventories. *Chapter on methods for interpreting multiple PVTs in combination. *Chapters on additional populations (military personnel, children and adolescents) and clinical problems (dementia, somatoform/conversion disorder). *Chapters on research methods for validating PVTs, base rates of feigned mild traumatic brain injury, and more.
| Author | : Ryan W. Schroeder |
| Publisher | : Guilford Publications |
| Total Pages | : 593 |
| Release | : 2021-09-20 |
| Genre | : Psychology |
| ISBN | : 1462547788 |
Practical and comprehensive, this is the first book to focus on noncredible performance in clinical contexts. Experts in the field discuss the varied causes of invalidity, describe how to efficiently incorporate validity tests into clinical evaluations, and provide direction on how to proceed when noncredible responding is detected. Thoughtful, ethical guidance is given for offering patient feedback and writing effective reports. Population-specific chapters cover validity assessment with military personnel; children; and individuals with dementia, psychiatric disorders, mild traumatic brain injury, academic disability, and other concerns. The concluding chapter describes how to appropriately engage in legal proceedings if a clinical case becomes forensic. Case examples and sample reports enhance the book's utility.
| Author | : Jesse F. Peterson |
| Publisher | : |
| Total Pages | : 91 |
| Release | : 2017 |
| Genre | : Brain |
| ISBN | : |
Concussions make up a large portion of sports-related injuries. Research has identified a distinct pathophysiology and quantified mild, transient cognitive deficits associated with concussion. One method of monitoring concussion symptoms and informing return- to-play decisions in sports is preseason baseline neurocognitive testing that can be compared with postconcussion testing results. However, individuals are at greater risk of producing uninterpretable results when there is potential for external gain. Performance validity tests were developed to identify invalid testing data and are strongly supported in the neuropsychological community. The current study evaluated the embedded performance validity indicators of the ImPACT, the most widely used computerized baseline and post-concussion assessment tool, using a three-group simulation design. The Victoria Symptom Validity Test (VSVT) was also administered for comparison with the ImPACT's indicators. The ImPACT's five standard validity indicators were only moderately sensitive to intentionally poor performance. A combination of 9 indicators provided better sensitivity and perfect specificity, while the classification characteristics of the Word Memory Correct Distractors score was comparable to the VSVT. Thus, the ImPACT's standard validity indicators are insufficient for detecting intentionally poor performance. Further research must be conducted before other embedded alternatives are employed, and a stand-alone performance validity test should be administered during baseline testing until that time. Suggestions for improving performance validity research with the ImPACT are provided. Keywords: ImPACT, performance validity, concussion, Victoria Symptom Validity Test, malingering
| Author | : Kenneth Lee |
| Publisher | : Springer Nature |
| Total Pages | : 238 |
| Release | : 2021-11-18 |
| Genre | : Medical |
| ISBN | : 3030830047 |
This book arises from the challenges and difficulties involved in the evaluation and management of concussions in wheelchair athletes. Concussions are most readily identified in the ambulatory population via identifying gross motor instability or when athletes lose their balance and stumble after a blow to the head or neck region. Because wheelchair athletes participate in sport while sitting down and using a wheelchair, clinicians must be extra attentive to identify a potential concussion. Once a potential concussion is identified, there are many challenges in evaluation of the wheelchair athlete population due to their comorbidities. At baseline, they may have signs and symptoms that mimic a concussion, and their impairments can also alter their cognitive and balance assessments. Therefore, it is critical to make a distinction between these athletes’ baseline comorbid impairments and potential new exam findings in a concussion. Filling in a critical gap in the literature, this is a concise pocket guide for any clinician, trainer, or rehabilitation specialist who is involved in wheelchair sports. It focuses on the unique challenges in evaluating a concussion in the wheelchair athlete, including baseline testing, the process of evaluating the signs and symptoms of a concussion, cognitive and vestibular examination, new clinical techniques specific to wheelchair athletes, and the return to play process. A Concussion Management Program (CMP) for use on the sideline as well as in the office is included. Practical and timely, Concussion Management for Wheelchair Athletes is a valuable resource to increase awareness, provide guidance on the unique challenges within this population, and generate interest in future research and investigation.
| Author | : Ashley N. Figaro |
| Publisher | : |
| Total Pages | : 0 |
| Release | : 2016 |
| Genre | : |
| ISBN | : |
| Author | : Joshua Staples |
| Publisher | : |
| Total Pages | : 56 |
| Release | : 2015 |
| Genre | : Electronic dissertations |
| ISBN | : |
Author's abstract: Each year, 1.6 to 3.8 million sport-related concussions occur in the United States (Langlois et al., 2006), and rates continue to increase by about 7% annually (Hootman et al., 2007). The rapid biomechanical forces of a concussion cause numerous physical, cognitive, and emotional symptoms (Aubry et al., 2002). Athletes who return to play (RTP) too soon after a concussion are at risk for the devastating effects secondary injury, including death (Cantu, 2003). Currently, the most appropriate concussion assessment procedures involve balance and neurocognitive measures (McCrory et al., 2009). However, athletes have demonstrated the ability and propensity to deceive these assessments in order to influence RTP (McCrea e al., 2004) by minimizing post-injury symptoms, or by demonstrating suboptimal effort during baseline testing (Erdal, 2012; Hunt, Ferrara, Miller, & Macciocchi, 2009). The purpose of this study was to explore the utility of a stand-alone performance validity test (PVT) in detecting suboptimal effort using an analog simulation design. Simulators demonstrated significantly lower performance on measures of verbal memory, visual memory, visual motor speed, balance, symptom severity, reaction time, and performance validity than controls. Verbal memory, visual memory, visual motor speed, and reaction time scores were predicted by the PVT embedded within ImPACT, while impulse control, symptom severity, and SAC scores were predicted by the ASTM stand-alone PVT. The two PVTs did not combine to better predict any scores. Using cutoff scores recommended by the test publishers, both PVTs obtained 100% specificity. The sensitivity of the embedded PVT within ImPACT and the ASTM stand-alone PVT were 58% and 28%, respectively. The findings suggest these performance validity tests alone may not be adequate. Future examination of the recommended cutoff scores for this testing context is warranted.
