Article

OBJECTIVE: To develop and cross-validate internal validity scales for the
Neurobehavioral Symptom Inventory (NSI). PARTICIPANTS: Four existing data sets
were used: (1) outpatient clinical traumatic brain injury
(TBI)/neurorehabilitation database from a military site (n = 403), (2) National
Department of Veterans Affairs TBI evaluation database (n = 48 175), (3) Florida
National Guard nonclinical TBI survey database (n = 3098), and (4) a
cross-validation outpatient clinical TBI/neurorehabilitation database combined
across 2 military medical centers (n = 206). RESEARCH DESIGN: Secondary analysis
of existing cohort data to develop (study 1) and cross-validate (study 2)
internal validity scales for the NSI. MAIN MEASURES: The NSI, Mild Brain Injury
Atypical Symptoms, and Personality Assessment Inventory scores. RESULTS: Study 1:
Three NSI validity scales were developed, composed of 5 unusual items (Negative
Impression Management [NIM5]), 6 low-frequency items (LOW6), and the combination
of 10 nonoverlapping items (Validity-10). Cut scores maximizing sensitivity and
specificity on these measures were determined, using a Mild Brain Injury Atypical
Symptoms score of 8 or more as the criterion for invalidity. Study 2: The same
validity scale cut scores again resulted in the highest classification accuracy
and optimal balance between sensitivity and specificity in the cross-validation
sample, using a Personality Assessment Inventory Negative Impression Management
scale with a T score of 75 or higher as the criterion for invalidity.
CONCLUSIONS: The NSI is widely used in the Department of Defense and Veterans
Affairs as a symptom-severity assessment following TBI, but is subject to symptom
overreporting or exaggeration. This study developed embedded NSI validity scales
to facilitate the detection of invalid response styles. The NSI Validity-10 scale
appears to hold considerable promise for validity assessment when the NSI is used
as a population-screening tool.

Langue : ANGLAIS