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A-10 Self-Reported Post-Concussive Symptom Levels as Predictors of Performance Validity in a Sample of Active Duty Service Members with a History of Mild Traumatic Brain Injury

Objective The study investigated the relationship between levels of symptom reporting and performance validity testing (PVT) in Active Duty Service Members (ADSM) with mild traumatic brain injury (mTBI). Method A total of 70 ADSM with a history of mTBI completed the Neurobehavioral Symptom Inventory (NSI); the PTSD Check List for DSM-5 (PCL-5), Headache Impact Test (HIT-6), Patient Health Questionnaire (PHQ8), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorders Identification Test (AUDIT-C); and a comprehensive neuropsychological evaluation including the Test of Memory Malingering (TOMM). A multiple regression was conducted with all self-reported symptom questionnaires as predictors of PVT performance. To further explore this relationship, the four NSI subscales (affective, cognitive, vestibular, somatosensory) plus the mild Brain Injury Atypical Symptoms (mBIAS) subscore were entered into a separate regression analysis. Results The NSI was the only significant predictor of TOMM Trial 1 performance (TOMMT1; R2 = .272, F(6,58) = 3.606, p .01). When the four NSI subscales (affective, cognitive, vestibular, somatosensory) plus the mild Brain Injury Atypical Symptoms (mBIAS) subscore were entered into a separate regression analysis, only the somatosensory subscore emerged as a significant predictor of TOMMT1 (R2 = .208, F(5,63) = 3.317, p .05). Conclusions Results suggest that performance validity measures in ADSM with mTBI may at times be more strongly influenced by patients’ health concerns than by overt dissimulation.