Abstract

Assessment of effort detection is an essential component of a neuropsychological evaluation to ensure results of testing are valid indicators of an individual’s true level of cognitive functioning. Effort detection in the initial screening process provides neuropsychologists information regarding patients’ test engagement prior to administering longer testing batteries. Two effort measures are embedded in the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), a neuropsychological screening assessment, but both have demonstrated elevated false positive rates for classifying individuals with memory impairment as those putting forth poor effort. These embedded measures rely on cut-off scores on digit span and memory subtests. In contrast, this RBANS Effort Supplement (RES) utilizes several forced-choice subtests, reflective of current research emphasizing the importance of multiple methods of effort detection; subtests in this measure included list learning forced-choice, figure copy forced-choice, picture naming forced-choice, a coding task, and a story recognition component utilized for face validity of memory assessment. Fiftynine participants were recruited from an outpatient neuropsychology facility in conjunction with 14 poor effort simulators; each participant was administered the RBANS, the RES, and the Dot Counting Test (DCT). Results supported the RES’ reliability at the individual decision-making level. Validity analyses demonstrated that the RES exhibited strong convergent validity with established effort detection measures and that individuals putting for poor effort scored significantly lower on the RES than individuals who put forth adequate effort, as delineated by the established DCT cutoff score of 17. In summary, the RES was shown to be a valid indicator of effort detection. Clinical implications of the RES include reduction of time and costs involved in neuropsychological assessment.

LLU Discipline

Psychology

Department

Psychology

School

[School of Behavioral Health]

First Advisor

Grace J. Lee

Second Advisor

Kyrstle D. Barrera

Third Advisor

Kendal C. Boyd

Fourth Advisor

Travis G. Fogel

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2019

Date (Title Page)

9-2019

Language

English

Library of Congress/MESH Subject Headings

Psychological Assessment Tools; Effort Measures; Validity Testing

Type

Dissertation

Page Count

xiii, 96 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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Psychology Commons

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