The current study sought to examine the classification accuracy of the Wisconsin Card Sorting Test (WCST) as an embedded performance symptom validity test (PVT) among three different samples. The sample of interest included 110 participants with mild traumatic brain injury (mTBI). For comparison, the study included 69 participants with moderate to severe traumatic brain injury (TBI) (STBI) and 155 non-neurological patients with mixed depression/anxiety psychiatric diagnoses (PSYCH). Furthermore, a logistically derived combination of Number Correct, Perseverative Responses, and Trials to First Category was created as an additional predictor variable named WCSTCOMB. Results indicated significant group differences between the credible performance (PASS) and non-credible performance (FAIL) groups for the PSYCH sample in the following variables: Number of Trials, Total Errors, Perseverative Errors, Perseverative Responses, Number of Categories Completed, and WCSTCOMB. Significant group differences in the STBI sample were found in the following variables: Number of Trials, Total Errors, Perseverative Errors, Perseverative Responses, Number of Categories Completed, and WCSTCOMB. The study found no significant differences in the WCST variables between the PASS and FAIL groups in the mTBI sample. Receiver operating characteristic (ROC) analysis found that Perseverative Responses and WCSTCOMB had acceptable classification accuracy of at least .70 in the PSYCH group. In the STBI group, ROC analysis found that the following WCST variables had at least acceptable classification accuracy of at least .70 for the following: Number of Trials, Total Errors, Perseverative Errors, Perseverative Responses, Number of Categories Completed, and WCSTCOMB. Sensitivity, specificity, positive predictive power, negative predictive power, and recommended raw cutoff scores were provided for WCST variables with acceptable classification accuracy. Acceptable classification accuracy was not found among any WCST variables in the mTBI sample. Results do not provide support for the WCST as an embedded PVT among those with mTBI. However, results did provide support for the WCST as embedded PVTs with populations with moderate to severe TBI and depressed/anxious outpatients.
|School:||Adler School of Professional Psychology|
|School Location:||United States -- Illinois|
|Source:||DAI-B 77/01(E), Dissertation Abstracts International|
|Keywords:||Executive functioning, Neuropsychological assessment, Noncredible performance, Test validity, Traumatic brain injury (TBI), Wisconsin Card Sorting Test (WCST)|
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