Relations Among Performance and Symptom Validity, Mild Traumatic Brain Injury, and Posttraumatic Stress Disorder Symptom Burden in Postdeployment Veterans

The purpose of this study was to evaluate relationships among the Word Memory Test (WMT), symptom validity test (SVT) indices of the Personality Assessment Inventory (PAI), history of mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) symptom burden. Participants were postdeployment, predominantly male (88.5%) veterans (N = 417) who completed a neurocognition study that included the WMT and PAI. Correlations, chi-square analyses, and ANOVAs were used for analyses. Results of aim 1 examining relations among the two tests found that 20.4% produced invalid scores on the WMT (regardless of PAI scores), 13.8% produced an invalid PAI (regardless of WMT scores), and 4.6% were invalid on both tests. Of the 4 original PAI validity scales, only Negative Impression Management was related to WMT failure; the supplementary Malingering Index was also significant at a smaller effect size. The second aim evaluated mTBI and PTSD symptoms in relation to validity scores. History of mTBI was associated with invalid WMT scores but not PAI scores; follow-up analyses indicated that injuries sustained during deployment were significantly more likely to produce invalid WMT scores than non-deployment injuries. Contrary to hypotheses, PTSD symptom burden was related to WMT failure but not overreporting on the PAI. After dividing the sample into four groups based on valid versus invalid WMT and PAI scores, the invalid PVT valid SVT group had the highest proportion of mTBI, whereas PTSD symptom burden was highest in the groups that invalidated both measures or only the WMT. Service-connected disability status was unrelated to either type of validity. Given invalidating both types of validity measures is uncommon, the importance of sampling both types of validity is highlighted.

Duke Scholars

Author Larry A. Tupler Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...