OBJECTIVE This study examined the relative contribution of performance and symptom validity in litigating adults with traumatic brain injury (TBI), as a function of TBI severity, and examined the relationship between self-reported emotional symptoms and cognitive tests scores while controlling for validity test performance. METHOD Participants underwent neuropsychological assessment between January 2012 and June 2021 in the context of compensation-seeking claims related to a TBI. All participants completed a cognitive test battery, the Personality Assessment Inventory (including symptom validity tests; SVTs), and multiple performance validity tests (PVTs). Data analyses included independent t-tests, one-way ANOVAs, correlation analyses, and hierarchical multiple regression. RESULTS A total of 370 participants were included. Atypical PVT and SVT performance were associated with poorer cognitive test performance and higher emotional symptom report, irrespective of TBI severity. PVTs and SVTs had an additive effect on cognitive test performance for uncomplicated mTBI, but less so for more severe TBI. The relationship between emotional symptoms and cognitive test performance diminished substantially when validity test performance was controlled, and validity test performance had a substantially larger impact than emotional symptoms on cognitive test performance. CONCLUSION Validity test performance has a significant impact on the neuropsychological profiles of people with TBI, irrespective of TBI severity, and plays a significant role in the relationship between emotional symptoms and cognitive test performance. Adequate validity testing should be incorporated into every neuropsychological assessment, and associations between emotional symptoms and cognitive outcomes that do not consider validity testing should be interpreted with extreme caution.

中文翻译：

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对患有创伤性脑损伤的成年人进行诉讼的客观认知结果和主观情绪后遗症：绩效和症状有效性测量的影响。

目的 本研究考察了作为 TBI 严重程度函数的成人创伤性脑损伤 (TBI) 诉讼中表现和症状有效性的相对贡献，并在控制有效性测试表现的同时检验了自我报告的情绪症状与认知测试分数之间的关系. 方法 参与者在 2012 年 1 月至 2021 年 6 月期间在与 TBI 相关的寻求赔偿索赔的背景下接受了神经心理学评估。所有参与者都完成了一系列认知测试、人格评估量表（包括症状有效性测试；SVT）和多项性能有效性测试（PVT）。数据分析包括独立 t 检验、单向方差分析、相关分析和分层多元回归。结果 共有 370 名参与者被纳入。不典型的 PVT 和 SVT 表现与较差的认知测试表现和较高的情绪症状报告相关，与 TBI 的严重程度无关。PVT 和 SVT 对简单的 mTBI 的认知测试表现有累加效应，但对更严重的 TBI 的影响较小。当有效性测试性能受到控制时，情绪症状与认知测试性能之间的关系显着减弱，并且有效性测试性能比情绪症状对认知测试性能的影响大得多。结论 无论 TBI 的严重程度如何，效度测试表现对 TBI 患者的神经心理特征都有显着影响，并且在情绪症状和认知测试表现之间的关系中起着重要作用。