A Two-Factor Theory for Concussion Assessment Using ImPACT: Memory and Speed

Authors

Philip Schatz, Saint Joseph’s University, PhiladelphiaFollow
Arthur C. Maerlender, University of Nebraska-LincolnFollow

Date of this Version

2013

Citation

Published in Archives of Clinical Neuropsychology 28:8 (2013), pp. 791-797; doi: 10.1093/arclin/act077

Comments

Copyright © 2013 Philip Schatz and Arthur Maerlender. Published by Oxford University Press. Used by permission.

Abstract

We present the initial validation of a two-factor structure of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) using ImPACT composite scores and document the reliability and validity of this factor structure. Factor analyses were conducted for baseline (N = 21,537) and post-concussion (N = 560) data, yielding “Memory” (Verbal and Visual) and “Speed” (Visual Motor Speed and Reaction Time) Factors; inclusion of Total Symptom Scores resulted in a third discrete factor. Speed and Memory z-scores were calculated, and test–retest reliability (using intra-class correlation coefficients) at 1 month (0.88/0.81), 1 year (0.85/0.75), and 2 years (0.76/0.74) were higher than published data using Composite scores. Speed and Memory scores yielded 89% sensitivity and 70% specificity, which was higher than composites (80%/ 62%) and comparable with subscales (91%/69%). This emergent two-factor structure has improved test–retest reliability with no loss of sensitivity/specificity and may improve understanding and interpretability of ImPACT test results.