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Ecological validity of neuropsychological assessment in severe traumatic brain injury
Abstract
The measures currently used in neuropsychological assessment were validated for diagnostic purposes (i.e., locus-of-lesion location); however, neuropsychologists are increasingly being asked to answer questions about everyday vocational functioning (e.g., return to work) and functional competence (e.g., ability to live alone/handle own finances). While an increasing number of studies have recently attempted to investigate questions about the ecological validity of neuropsychological tests, numerous methodological problems, such as poor choice of predictor and outcome variables, have prevented a clear understanding of the relationships between neuropsychological performance and everyday functioning. The present study was designed to assess the utility of a battery of commonly used neuropsychological measures which tap a broad range of cognitive skills in predicting functional competence and vocational functioning in a sample of 25 individuals with severe traumatic brain injury (TBI). A secondary goal of this study was to investigate the relative utility of neuropsychological measures when compared with other well-described predictors of outcome, including demographic, biomedical, and emotional variables. Results indicated that participants were severely impaired, performing at approximately one to two standard deviations below the mean on most measures of neuropsychological, vocational, and functional performance. Analyses revealed that neuropsychological measures were generally poor predictors of vocational functioning, and that they did not provide significantly greater predictive utility than demographic variables such as prior occupational level. In contrast, neuropsychological measures of arithmetic and attention/speed of information processing accounted for approximately 46% of the variance in measures of overall functional competence, and provided a greater degree of predictive utility than demographic, emotional, or biomedical variables. Limitations of the study include small sample size and homogeneity of injury severity and suggest that these findings may be applicable to only a severe TBI sample. The findings highlight the need for future research investigating the relationship between neuropsychological performance and clinically useful outcome variables in different patient populations.
Subject Area
Psychotherapy|Neurology
Recommended Citation
Griffin, Stefanie Lynn, "Ecological validity of neuropsychological assessment in severe traumatic brain injury" (2001). ETD collection for University of Nebraska-Lincoln. AAI3022630.
https://digitalcommons.unl.edu/dissertations/AAI3022630