The Repeatable Battery for the Assessment of Neuropsychological Status Effort Scale

The measurement of effort is now considered to be an important component of neuropsychological assessment. In addition to stand-alone measures, built-in, or embedded measures of effort have been derived for a limited number of standard neurocognitive tests. The Repeatable Battery for the Assessment...

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Bibliographic Details
Published in:Archives of clinical neuropsychology 2012-03, Vol.27 (2), p.190-195
Main Authors: Novitski, Julia, Steele, Shelly, Karantzoulis, Stella, Randolph, Christopher
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alzheimer Disease - complications
Amnesia - complications
Area Under Curve
Biological and medical sciences
Brain Injuries - complications
Cognition Disorders - diagnosis
Cognition Disorders - etiology
Cognition Disorders - psychology
Female
Humans
Male
Medical sciences
Middle Aged
Neuropsychological Tests
Psychology. Psychoanalysis. Psychiatry
Psychometrics. Diagnostic aid systems
Psychomotor Performance
Psychopathology. Psychiatry
Recognition (Psychology)
ROC Curve
Techniques and methods
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Summary:The measurement of effort is now considered to be an important component of neuropsychological assessment. In addition to stand-alone measures, built-in, or embedded measures of effort have been derived for a limited number of standard neurocognitive tests. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief battery, employed as a core diagnostic tool in dementia and as a neurocognitive screening battery or tracking/outcome measure in a variety of other disorders. An effort index (EI) for the RBANS has been published previously (Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. 2007. An EI for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clinical Neuropsychology, 21 (5), 841-854), but it has been reported to result in high false positive rates when applied to patients with "true" amnesia (e.g., Alzheimer's disease). We created a new effort scale (ES) for the RBANS based on the observation of patterns of free recall and recognition performance in amnesia versus inadequate effort. The RBANS ES was validated on a sample of patients with amnestic disorders and a sample of mild traumatic brain injury participants who failed a separate measure of effort. The sensitivity and specificity of the new ES was compared with the previously published EI. Receiver-operating characteristic analyses demonstrated much better sensitivity and specificity of the ES, with a marked reduction in false positive errors. Application and limitations of the RBANS ES, including indications for its use, are discussed.
ISSN:0887-6177
1873-5843
DOI:10.1093/arclin/acr119