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Accuracy of NEO-PI-R ratings in the assessment of personality change following traumatic brain injury
146
Abstractsfrom the 17thAnnualMeeting
TappingTest,SpeechSoundsPerceptionTest(SS),SeashoreRhythmTest(SR),Trailmaking Parts A and B), LafayetteGroovedPegs, Beck DepressionInventory(BDI), SCL-90,and MMPI. Data to be reportedincludesubgroup(HI SeverityX Work Status,HI SeverityX WorkLevel)meansand standarddeviations,as wellasANOVAresultsfor each selectedtest. These data indicate that certain neuropsychologicaltests are statisticallyassociatedwith differencesin pre versuspost HI work levelktatus.Sincethe samplesize is largethe ability to generalizefrom the data would appearto be appropriate.The data are also organizedso that a cliniciancan utilizethe data and comparean individualpatientwith their normative patientreferencegroup. Peck, E., Mitchell,S., & Doudera,E. A Nonnative Study of the Memory Assessment Scale Following Head Injury.
The Memory AssessmentScales (MAS) has been shown to be an effective measure of learningand memory.The currentstudy developspreliminarynormsfor a sampleof head injury(HI) patients(95). Patients,aged 16 and above,met extensiveadmissioncriteriainto an ongoinghead injuryclinicaldatabaseand receiveda comprehensivebattery of neuropsychologicaland emotionalmeasures.Data on the MAS was collected for 70 mild, 18 moderate,and 7 severelyhead injuredpatients.Normativedata to be reportedincludemean and standarddeviationsfor each MAS SummaryScalescoreand each individualsubtest.In addition,ANOVA(HI SeverityX ClinicalScaleTestScore)resultswillbe given.The results of ANOVAscarried out indicatea statisticaldifferencefor level of severityof injury for several of the MAS SummaryScale scores and individualsubtest scores.This finding is presentdespitethe largedifferencein subgroupsamplesize.Basedon thesepreliminarydata, the MAS appearsto be sensitiveto differentdegreesof head injuryseverity.Thesedata will be organizedso that individualclinical cases can be comparedwith normativereference group scores. Campbell,D. A., Ranseen,J. D., Thacker,S. R., Schmitt,F. A., & Ywng, A. B. Accuracy of NEO-PI-R Ratings in the Assessment of Personality Change Following Traumatic Brain Injury.
Studiessupportthe use of the NEO-PI-Rin the quantificationof post-headinjurypersonality changebasedon the 5-factormodelof corepersonalitytraits.An analysisof selfandobserver ratings made availableby this instrumentmay be especiallyimportant,as head trauma patientsmay be unableto accuratelyrate themselvesseconday to cognitiveimpairmentand anosognosia.The presentstudyfurtherexaminedthe use of the NEO-PI-Ras a measureof personalitychange in this populationby comparingself with observerratings following traumaticbrain injury.Additionally,a surgicalcontrolgroupwas employedto examinethe effects of head trauma on personalityfunctioningindependentfrom the stress of general trauma.Methods:llventy-oneadultswho sustainedmoderateand severeclosedheadinjuries an average of 12 months earlier (GlasgowComa Scale upon admission,X = 7; age and educationlevel,X = 29 and 11years,respectively)were comparedto 21 age and educationmatched surgical back injury controls on NEO-PI-R self ratings of personality traits. Additionally,14of theheadtraumagroupselfratingswerealsocomparedto observerratings (FormR, NEO-PI-R)completedby a familymember.In comparisonwith controls,the head traumagroupexhibiteda significantlyhighermean scoreon the generaltrait of Neuroticism (t=–2.75; p c .01).Selfand observerratingswithinthe head injurygroupindicatedstrong correspondenceon the dimensionsof Neuroticism,Extraversion,Openness,and Agreeableness.However,observersviewedtheheadtraumagroupas demonstratingsignificantlylower levelsof Conscientiousnessas comparedto self ratings(t= –2.12, p < .04).These results suggestthat emotionaldistressfollowinghead injuryis persistent,cannotbe accountedfor
Abstractsfrom the 17thAnnualMeeting
147
solely on the basis of disability,and can be accuratelyrated by head trauma patients. However,thereis someindicationthatthe behavioraldisturbanceassociatedwith low levels of Conscientiousnessis probably not rated accuratelyby head trauma patients, possibly secondaryto the presenceof anosognosia. Ryan,L. M., Gmwier,W.D., & Schager,D. Predictors of Postconcussion Symptoms in Mild Head Injury.
Postconcussionsymptoms(PCS) are a clusterof physical,cognitive,and emotional/behavioral symptomsthat frequently occur following mild head injury. The most commonly reportedPCS are headache,dizziness,decreasedconcentration,memoryproblems,irritability, fatigue,visualdisturbance,noise sensitivity,judgmentproblems,and anxiety.PCS can persist from monthsto years followinginjury (Gouvier,Cubic,Jones, Brantley,& Cutlip, 1992)and both organicandpsychologicaletiologieshavebeen suggested(Bohnen& Jones, 1992).A number of neurocognitive,psychosocial,premorbid,and injury-relatedvariables have been implicatedin the maintenanceof PCS, however,the findingsamongthe various researchstudieshave been conflicting.Given this information,the presentstudy attempted to identifythe neurocognitive,psychosocial,premorbid,and injury-relatedvariablesassociated with persistentPCS amongmildly head injuredcollegestudents.It was hypothesized thatpsychologicaldistress(highProfileof MoodTatestotalscore),femalegender,decreased informationprocessing(SDMT,Ruff2 & 7 SelectiveAttentionTest),premorbidpsychological disturbance,externallocusof control(RevisedInternal-ExternalScale),and prior mild head injury would be predictiveof postconcussionsymptomatologyas measured by the PostconcussionSyndromeChecklist(PCSC).Participantswere 173 undergraduatestudent volunteers(102 females,71 males) who reportedhaving sustainedone or more mild head injuries.Forwardselectionstepwisemultipleregressionanalysisrevealedthat a combination of psychologicaldistress, female gender, powerful others external locus of control, and decreasedinformationprocessing(specificallydecreasedselectiveattention)accountedfor a significantproportionof variance(37%)in PCS scores.However,psychologicaldistressand female genderaccountedfor the largestproportionof variance(25% and 9%, respectively, for a total of 34%) and were thus the best predictorsof PCS. These results suggestthat emotionalstatusandgenderare moreimportantfactorsin persistentPCSthanneurocognitive status,locus of control,premorbidpsychologicaldisturbance,or historyof prior mild head injury. Schatz,P., Hillary,F., & Chute,D. L. Predicting Functional Outcome with Disability Rating Scale Scores Following Primary Rehabilitation: What You See Is What You Get.
Previous research identified Disability Rating Scale (DRS) scores at discharge from primary rehabilitationas a significantpredictor of functionaloutcome for moderate and severe traumatic brain injury patients (Schatz, 1995). A ten-point functional independence level (FIL) scale was introduced as a measure of rehabilitation outcome, which included need for assistancewith communication,self-care routines, basic living skills, and ability to live independent of supervision. Multiple regression analysis identified Disability Rating Scale (DRS) scores at 24 months post-injury as the most significant predictor of FIL scores up to 9 years post-injury,accountingfor 49% of the variance in FIL ratings (Schatz, 1995).In the current study,medical records were analyzed for 153 moderate and severe traumatic brain injury patients enrolled in the PennsylvaniaHead Injury Program (PHIP). Inclusion in the study was contingentupon having an outcome rating measured at 2 or more years post-injury,and having a DRS rating at discharge from primary rehabilitation. Subscores of the DRS were analyzed to determine the
Abstractsfrom the 17thAnnualMeeting
TappingTest,SpeechSoundsPerceptionTest(SS),SeashoreRhythmTest(SR),Trailmaking Parts A and B), LafayetteGroovedPegs, Beck DepressionInventory(BDI), SCL-90,and MMPI. Data to be reportedincludesubgroup(HI SeverityX Work Status,HI SeverityX WorkLevel)meansand standarddeviations,as wellasANOVAresultsfor each selectedtest. These data indicate that certain neuropsychologicaltests are statisticallyassociatedwith differencesin pre versuspost HI work levelktatus.Sincethe samplesize is largethe ability to generalizefrom the data would appearto be appropriate.The data are also organizedso that a cliniciancan utilizethe data and comparean individualpatientwith their normative patientreferencegroup. Peck, E., Mitchell,S., & Doudera,E. A Nonnative Study of the Memory Assessment Scale Following Head Injury.
The Memory AssessmentScales (MAS) has been shown to be an effective measure of learningand memory.The currentstudy developspreliminarynormsfor a sampleof head injury(HI) patients(95). Patients,aged 16 and above,met extensiveadmissioncriteriainto an ongoinghead injuryclinicaldatabaseand receiveda comprehensivebattery of neuropsychologicaland emotionalmeasures.Data on the MAS was collected for 70 mild, 18 moderate,and 7 severelyhead injuredpatients.Normativedata to be reportedincludemean and standarddeviationsfor each MAS SummaryScalescoreand each individualsubtest.In addition,ANOVA(HI SeverityX ClinicalScaleTestScore)resultswillbe given.The results of ANOVAscarried out indicatea statisticaldifferencefor level of severityof injury for several of the MAS SummaryScale scores and individualsubtest scores.This finding is presentdespitethe largedifferencein subgroupsamplesize.Basedon thesepreliminarydata, the MAS appearsto be sensitiveto differentdegreesof head injuryseverity.Thesedata will be organizedso that individualclinical cases can be comparedwith normativereference group scores. Campbell,D. A., Ranseen,J. D., Thacker,S. R., Schmitt,F. A., & Ywng, A. B. Accuracy of NEO-PI-R Ratings in the Assessment of Personality Change Following Traumatic Brain Injury.
Studiessupportthe use of the NEO-PI-Rin the quantificationof post-headinjurypersonality changebasedon the 5-factormodelof corepersonalitytraits.An analysisof selfandobserver ratings made availableby this instrumentmay be especiallyimportant,as head trauma patientsmay be unableto accuratelyrate themselvesseconday to cognitiveimpairmentand anosognosia.The presentstudyfurtherexaminedthe use of the NEO-PI-Ras a measureof personalitychange in this populationby comparingself with observerratings following traumaticbrain injury.Additionally,a surgicalcontrolgroupwas employedto examinethe effects of head trauma on personalityfunctioningindependentfrom the stress of general trauma.Methods:llventy-oneadultswho sustainedmoderateand severeclosedheadinjuries an average of 12 months earlier (GlasgowComa Scale upon admission,X = 7; age and educationlevel,X = 29 and 11years,respectively)were comparedto 21 age and educationmatched surgical back injury controls on NEO-PI-R self ratings of personality traits. Additionally,14of theheadtraumagroupselfratingswerealsocomparedto observerratings (FormR, NEO-PI-R)completedby a familymember.In comparisonwith controls,the head traumagroupexhibiteda significantlyhighermean scoreon the generaltrait of Neuroticism (t=–2.75; p c .01).Selfand observerratingswithinthe head injurygroupindicatedstrong correspondenceon the dimensionsof Neuroticism,Extraversion,Openness,and Agreeableness.However,observersviewedtheheadtraumagroupas demonstratingsignificantlylower levelsof Conscientiousnessas comparedto self ratings(t= –2.12, p < .04).These results suggestthat emotionaldistressfollowinghead injuryis persistent,cannotbe accountedfor
Abstractsfrom the 17thAnnualMeeting
147
solely on the basis of disability,and can be accuratelyrated by head trauma patients. However,thereis someindicationthatthe behavioraldisturbanceassociatedwith low levels of Conscientiousnessis probably not rated accuratelyby head trauma patients, possibly secondaryto the presenceof anosognosia. Ryan,L. M., Gmwier,W.D., & Schager,D. Predictors of Postconcussion Symptoms in Mild Head Injury.
Postconcussionsymptoms(PCS) are a clusterof physical,cognitive,and emotional/behavioral symptomsthat frequently occur following mild head injury. The most commonly reportedPCS are headache,dizziness,decreasedconcentration,memoryproblems,irritability, fatigue,visualdisturbance,noise sensitivity,judgmentproblems,and anxiety.PCS can persist from monthsto years followinginjury (Gouvier,Cubic,Jones, Brantley,& Cutlip, 1992)and both organicandpsychologicaletiologieshavebeen suggested(Bohnen& Jones, 1992).A number of neurocognitive,psychosocial,premorbid,and injury-relatedvariables have been implicatedin the maintenanceof PCS, however,the findingsamongthe various researchstudieshave been conflicting.Given this information,the presentstudy attempted to identifythe neurocognitive,psychosocial,premorbid,and injury-relatedvariablesassociated with persistentPCS amongmildly head injuredcollegestudents.It was hypothesized thatpsychologicaldistress(highProfileof MoodTatestotalscore),femalegender,decreased informationprocessing(SDMT,Ruff2 & 7 SelectiveAttentionTest),premorbidpsychological disturbance,externallocusof control(RevisedInternal-ExternalScale),and prior mild head injury would be predictiveof postconcussionsymptomatologyas measured by the PostconcussionSyndromeChecklist(PCSC).Participantswere 173 undergraduatestudent volunteers(102 females,71 males) who reportedhaving sustainedone or more mild head injuries.Forwardselectionstepwisemultipleregressionanalysisrevealedthat a combination of psychologicaldistress, female gender, powerful others external locus of control, and decreasedinformationprocessing(specificallydecreasedselectiveattention)accountedfor a significantproportionof variance(37%)in PCS scores.However,psychologicaldistressand female genderaccountedfor the largestproportionof variance(25% and 9%, respectively, for a total of 34%) and were thus the best predictorsof PCS. These results suggestthat emotionalstatusandgenderare moreimportantfactorsin persistentPCSthanneurocognitive status,locus of control,premorbidpsychologicaldisturbance,or historyof prior mild head injury. Schatz,P., Hillary,F., & Chute,D. L. Predicting Functional Outcome with Disability Rating Scale Scores Following Primary Rehabilitation: What You See Is What You Get.
Previous research identified Disability Rating Scale (DRS) scores at discharge from primary rehabilitationas a significantpredictor of functionaloutcome for moderate and severe traumatic brain injury patients (Schatz, 1995). A ten-point functional independence level (FIL) scale was introduced as a measure of rehabilitation outcome, which included need for assistancewith communication,self-care routines, basic living skills, and ability to live independent of supervision. Multiple regression analysis identified Disability Rating Scale (DRS) scores at 24 months post-injury as the most significant predictor of FIL scores up to 9 years post-injury,accountingfor 49% of the variance in FIL ratings (Schatz, 1995).In the current study,medical records were analyzed for 153 moderate and severe traumatic brain injury patients enrolled in the PennsylvaniaHead Injury Program (PHIP). Inclusion in the study was contingentupon having an outcome rating measured at 2 or more years post-injury,and having a DRS rating at discharge from primary rehabilitation. Subscores of the DRS were analyzed to determine the