Abstract

Objective: The addition of Sequencing to WAIS-IV Digit Span (DS) brought about new Reliable Digit Span (RDS) indices and an Age-Corrected Scaled Score that includes Sequencing trials. Reports have indicated that these new performance validity tests (PVTs) are superior to the traditional RDS; however, comparisons in the context of known neurocognitive impairment are sparse. This study compared DS-derived PVT classification accuracies in a design that included adults with verified TBI. Methods: Participants included 64 adults with moderate-to-severe TBI (TBI), 51 healthy adults coached to simulate TBI (SIM), and 78 healthy comparisons (HC). Participants completed the WAIS-IV DS subtest in the context of a larger test battery. Results: Kruskal–Wallis tests indicated that all DS indices differed significantly across groups. Post hoc contrasts revealed that only RDS Forward and the traditional RDS differed significantly between SIM and TBI. ROC analyses indicated that RDS variables were comparable predictors of SIM vs. HC; however, the traditional RDS showed the highest sensitivity when approximating 90% specificity for SIM vs. TBI. A greater percentage of TBI scored RDS Sequencing < 1 compared to SIM and HC. Conclusion: In the context of moderate-to-severe TBI, the DS-derived PVTs showed comparable discriminability. However, the Greiffenstein et al. traditional RDS demonstrated the best classification accuracy with respect to specificity/sensitivity balance. This relative superiority may reflect that individuals with verified TBI are more likely to perseverate on prior instructions during DS Sequencing. Findings highlight the importance of including individuals with verified TBI when evaluating and developing PVTs.

摘要

目标：将测序添加到 WAIS-IV 数字跨度 (DS) 带来了新的可靠数字跨度 (RDS) 指数和年龄校正量表分数，其中包括测序试验。报告表明，这些新的性能有效性测试 (PVT) 优于传统的 RDS；然而，在已知神经认知障碍的背景下进行的比较很少。这项研究比较了 DS 衍生的 PVT 分类准确性，该设计包括经过验证的 TBI 成人。方法：参与者包括 64 名患有中度至重度 TBI (TBI) 的成年人、51 名接受过模拟 TBI 训练的健康成年人 (SIM) 和 78 名健康对照者 (HC)。参与者在更大的测试组中完成了 WAIS-IV DS 子测试。结果：Kruskal–Wallis 检验表明所有 DS 指数在各组之间存在显着差异。事后对比显示，只有 RDS Forward 和传统 RDS 在 SIM 和 TBI 之间存在显着差异。ROC 分析表明 RDS 变量是 SIM 与 HC 的可比预测因子；然而，当 SIM 与 TBI 的特异性接近 90% 时，传统的 RDS 显示出最高的灵敏度。与 SIM 和 HC 相比，更大比例的 TBI 得分为 RDS 测序 < 1。结论：在中度至重度 TBI 的情况下，DS 派生的 PVT 显示出可比的辨别力。然而，Greiffenstein 等人。传统的 RDS 在特异性/敏感性平衡方面表现出最佳的分类准确性。这种相对优势可能反映出经过验证的 TBI 个体在 DS 测序期间更有可能坚持先前的指示。研究结果强调了在评估和开发 PVT 时将患有 TBI 的个体包括在内的重要性。