Abstract

Introduction

Computerized neuropsychological testing is a cornerstone of sport-related concussion assessment. Female soccer players are at an increased risk for concussion as well as exposures to repetitive head impacts from heading a soccer ball. Our primary aim was to examine factorial validity of the Automated Neuropsychological Assessment Metrics (ANAM) neuropsychological test battery in computing the multiple neurocognitive constructs it purports to measure in a large cohort of interscholastic female soccer players.

Methods

Study participants included 218 interscholastic female soccer players (age = 17.0±0.7 year; mass = 55.5±6.8 kg; height = 164.7±6.6 cm) drawn from a large (850+) prospective database examining purposeful heading from four area high schools over a 10-year period. The ANAM-2001 measured neurocognitive performance. Three methods were used to identify integral constructs underlying the ANAM: (a) exploratory factor analysis (EFA), (b) first-order confirmatory factor analysis (CFA), and (c) hierarchical CFA.

Results

Neuropsychological phenomena measured by the ANAM-2001 were best reproduced by a hierarchical CFA organization, composed of two lower level factors (Simple Reaction Time, Mental Efficiency) and a single, general composite. Although the ANAM was multidimensional, only the composite was found to possess sufficient construct dimensionality and reliability for clinical score interpretation. Findings failed to uphold suppositions that the ANAM measures seven distinct constructs, or that any of its seven tests provide unique information independent of other constructs, or the composite, to support individual interpretation.

Conclusions

Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners.

中文翻译：

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使用一组女子高中足球运动员的 ANAM 的内部（因子）有效性

摘要

介绍

计算机化神经心理测试是运动相关脑震荡评估的基石。女足球运动员患脑震荡的风险增加，并且由于头球击球而重复头部撞击的风险增加。我们的主要目的是检查自动神经心理学评估指标 (ANAM) 神经心理学测试组在计算它声称要在一大群校际女足球运动员中测量的多种神经认知结构时的因子有效性。

方法

研究参与者包括 218 名校际女足球运动员（年龄 = 17.0±0.7 岁；体重 = 55.5±6.8 公斤；身高 = 164.7±6.6 厘米）来自大型 (850+) 前瞻性数据库，检查来自四所地区高中的有目的的头球运动。 10 年期限。ANAM-2001 测量神经认知表现。三种方法用于识别 ANAM 的整体结构：(a) 探索性因素分析 (EFA)，(b) 一阶验证性因素分析 (CFA)，和 (c) 分层 CFA。

结果

由 ANAM-2001 测量的神经心理学现象最好由分层 CFA 组织再现，该组织由两个较低级别的因素（简单反应时间、心理效率）和一个单一的、一般的综合因素组成。尽管 ANAM 是多维的，但只有复合材料被发现具有足够的结构维数和可靠性以用于临床评分解释。结果未能支持 ANAM 测量七个不同的结构，或者其七个测试中的任何一个提供独立于其他结构或组合的独特信息以支持个人解释的假设。

结论

结果推断 ANAM 拥有因子有效性证据，但只有综合评分似乎在内部充分有效和可靠，以支持从业者的应用。