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Baseline neurocognitive testing is routinely conducted in athletes to obtain a point of comparison in the event of a concussion. Differential motivation exists, however, between baseline and post-injury testing, so clinicians must ensure the validity of baseline performance to make valid comparisons post-injury. There is increasing evidence that the validity indicators embedded within the ImPACT, the most widely used test in this context, are insensitive to invalid performance. The objective of the current study was to assess the convergent validity of ImPACT-based EVIs against a battery of well-established PVT/EVIs in an experimental malingering paradigm. Participants were undergraduate students at a Canadian university. Data was collected from 18 participants, 94.4% of whom were female, with a mean age of 21.61 years (SD=4.57). Malingerers had higher base rates of failure on free-standing PVTs, independent EVIs, and ImPACT-based EVIs. Malingerers also had lower neurocognitive performance on all measures, with effect sizes ranging from small-medium to large. All ImPACT Composite scores except for the Reaction Time Composite were significantly lower for experimental malingerers than controls. As expected, the Default EVI demonstrated substantially lower sensitivity than all other ImPACT-based EVIs, though specificity was consistently perfect. Overall, the ImPACT-5 had the best classification accuracy among the ImPACT-based EVIs. Results suggest that clinicians should stay abreast of the literature and use alternate ImPACT-based EVIs when assessing performance validity on ImPACT.
Messa-Hamidi, Isabelle, "The Effect of Motivation Status on Performance Validity in Concussion Baseline Testing" (2020). Electronic Theses and Dissertations. 8460.