Departments of Mental Health and Behavioral Sciences (Drs Vanderploeg, Belanger, and Donnell), and Physical Medicine and Rehabilitation (Dr Scott) and Health Services Research and Development (HSR&D)/Rehabilitation Research and Development (RR&D) Center of Excellence: Maximizing Rehabilitation Outcomes (Drs Vanderploeg, Belanger, and Scott), James A. Haley Veterans' Hospital, Defense and Veterans Brain Injury Center (Drs Vanderploeg, Belanger, Donnell, and Scott), and Department of Psychology (Drs Vanderploeg and Belanger) and Psychiatry and Neurosciences (Dr Vanderploeg), University of South Florida, Tampa, Florida; Defense and Veterans Brain Injury Center (Drs Cooper and Kennedy) and Neurology Service, Department of Medicine (Drs Cooper and Kennedy), San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas; and Traumatic Brain Injury Clinic, Darnall Army Medical Center, Fort Hood, Killeen, Texas (Dr Hopewell).
J Head Trauma Rehabil. 2014 Jan-Feb;29(1):1-10. doi: 10.1097/HTR.0b013e318281966e.
To develop and cross-validate internal validity scales for the Neurobehavioral Symptom Inventory (NSI).
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).
Secondary analysis of existing cohort data to develop (study 1) and cross-validate (study 2) internal validity scales for the NSI.
The NSI, Mild Brain Injury Atypical Symptoms, and Personality Assessment Inventory scores.
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.
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.
开发并交叉验证神经行为症状量表（NSI）的内部有效性量表。
使用了四个现有数据集：（1）来自军事地点的门诊临床创伤性脑损伤（TBI）/神经康复数据库（n=403）；（2）美国退伍军人事务部 TBI 评估数据库（n=48175）；（3）佛罗里达国民警卫队非临床 TBI 调查数据库（n=3098）；以及（4）跨验证的门诊临床 TBI/神经康复数据库，来自两个军事医疗中心（n=206）。
对现有队列数据进行二次分析，以开发（研究 1）和交叉验证（研究 2）NSI 的内部有效性量表。
NSI、轻度脑损伤非典型症状和人格评估量表的评分。
研究 1：开发了三个 NSI 有效性量表，由 5 个不寻常项目（负面印象管理[NIM5]）、6 个低频率项目（LOW6）和 10 个不重叠项目（Validity-10）组成。使用轻度脑损伤非典型症状评分 8 分或更高作为无效性的标准，确定了这些措施中最大化敏感性和特异性的临界值。研究 2：在交叉验证样本中，再次使用相同的有效性量表临界值，使用人格评估量表的负面印象管理量表 T 分数为 75 或更高作为无效性的标准，获得了最高的分类准确性和最佳的敏感性与特异性之间的平衡。
NSI 在国防部和退伍军人事务部中广泛用于 TBI 后的症状严重程度评估，但存在症状夸大或夸大的情况。本研究开发了嵌入式 NSI 有效性量表，以帮助检测无效的反应模式。当 NSI 用作人群筛查工具时，NSI Validity-10 量表似乎具有相当大的有效性评估潜力。
