Estimating the diagnostic value of the trail making test for suboptimal effort in acquired brain injury rehabilitation patients

Matthew R. Powell, Dona E.C. Locke, Jeffrey S. Smigielski, Michael McCrea

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

This investigation explored the classification accuracy of Trail Making Test (TMT; Reitan Wolfson, 1992) indices for suboptimal effort in a sample of non-litigious acquired brain injury patients seeking outpatient rehabilitation. Patients who exhibited optimal effort completed TMT A and B faster than suboptimal effort patients. Although TMT A time to completion demonstrated adequate sensitivity to suboptimal effort, positive predictive value was fair to poor unless the base rate of suboptimal effort was inflated to 40%. TMT B time to completion yielded poor sensitivity and positive predictive value for suboptimal effort. While TMT A time to completion appears to have some value as a validity indicator, no TMT validity indicator should replace more precise symptom validity tests during neuropsychological assessment.

Original languageEnglish (US)
Pages (from-to)108-118
Number of pages11
JournalClinical Neuropsychologist
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2011

Keywords

  • Suboptimal effort
  • Symptom validity testing
  • Trail Making Test

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Arts and Humanities (miscellaneous)
  • Psychiatry and Mental health

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