Detection of insufficient effort during neuropsychological examination using the RBANS in the elderly - Simulation study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F25%3A10504909" target="_blank" >RIV/00216208:11110/25:10504909 - isvavai.cz</a>

Result on the web

<a href="https://www.researchgate.net/publication/396524307_Detection_of_insufficient_effort_during_neuropsychological_examination_using_the_RBANS_in_the_elderly_-_Simulation_study" target="_blank" >https://www.researchgate.net/publication/396524307_Detection_of_insufficient_effort_during_neuropsychological_examination_using_the_RBANS_in_the_elderly_-_Simulation_study</a>

DOI - Digital Object Identifier

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Result language

angličtina

Original language name

Detection of insufficient effort during neuropsychological examination using the RBANS in the elderly - Simulation study

Original language description

Introduction: In neuropsychological examination it is essential to obtain the best possible validity of the test results. Thus, one of the current issues in neuropsychological diagnostics is the detection of insufficient effort during the examination. Objective: The aim of the study was to evaluate the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in detecting insufficient effort during neuropsychological examination in the elderly. We compared four validity indices for the RBANS - the Effort Index (EI) [1], the Effort Scale (ES) [2], the Performance Validity Index (PVI) [3] and the Charleston Revised Index of Effort for the RBANS (CRIER) [3]. Participants and Methods: From the total sample of 196 healthy elderly volunteers, 144 participants were included in the final analysis, ensuring that the research groups did not differ in terms of socio-demographic characteristics. Participants were examined using the RBANS under two different conditions: the simulation group consisted of 63 participants, while the group of participants indicating adequate effort consisted of 81 participants. The mean age of the participants was 67.4 years (SD = 8.61 years). The group of honest participants indicating adequate effort performed well in the RBANS, while the simulation group was asked to feign amnestic disorder according to a predetermined scenario [4]. The EI, ES, PVI and CRIER were calculated. Using the EI, scores above 3 are suspicious [1]. Using the ES, those scoring above 28 on the sum of the RBANS Digit Span and List Recognition subtests are excluded from further analysis and are considered to have shown adequate effort. Otherwise, the ES is calculated. Scores below 12 indicate invalid responses [2]. The PVI identifies invalid responses by values below 42 and the CRIER by values below 24 [3]. Results: A statistical analysis revealed that the research groups significantly differed in all four RBANS validity indices. The simulation group demonstrated significantly higher EI values (M = 9.10, SD = 2.31) compared to the group of honest participants (M = 0.14, SD = 0.59), U = 1.50, p = .001. For the ES, Fisher&apos;s exact test showed a statistically significant association between belonging to the research group and showing adequate effort (p = .001). In the honest group, 77 participants showed adequate effort and in the simulation group, 60 participants indicated inadequate effort based on the ES calculation. Furthermore, the simulation group demonstrated significantly lower PVI values (M = 27.1, SD = 10.1) in comparison to the group of honest participants (M = 63, SD = 5.72), U = 0.00, p = .001, and also significantly lower CRIER values (M = 15.5, SD = 10.6) in comparison to the group of honest participants (M = 61.9, SD = 6.02), U = 0.00, p = .001. Conclusions: The results of the study show that all four validity indices can be used to detect insufficient effort during neuropsychological examination using the RBANS in the elderly. Furthermore, all four validity indices reach the same conclusion. The results suggest that the cut-off scores proposed by the authors of these indices [1-3] can be used in the elderly. References: [1] Silverberg, N.D., Wertheimer, J.C., Fichtenberg, N.L., 2007. An Effort Index for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Clin. Neuropsychol. 21(5), 841-854. [2] Novitski, J., Steele, S., Karantzoulis, S., Randolph, C., 2012. The Repeatable Battery for the Assessment of Neuropsychological Status Effort Scale. Arch. Clin. Neuropsychol. 27(2), 190-195. [3] Paulson, D., Horner, M.D., Bachman, D., 2015. A comparison of four embedded validity indices for the RBANS in a memory disorders clinic. Arch. Clin. Neuropsychol. 30(3), 207-216. [4] Lace, J.W., Grant, A.F., Kosky, K.M., Sweet, J.J., 2020. Identifying Novel Embedded Performance Validity Test Formulas Within the Repeatable Battery for the Assessment of Neuropsychological Status: a Simulation Study. Psychol. Inj. Law 13(2), 303-315.

Czech name

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Czech description

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Type

O - Miscellaneous

CEP classification

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OECD FORD branch

30300 - Health sciences

Project

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Continuities

S - Specificky vyzkum na vysokych skolach

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů