Journal of the International Neuropsychological Society



The ecological validity of neuropsychological assessment and the role of depressive symptoms in moderate to severe traumatic brain injury


NAOMI  CHAYTOR  a1 a2 c1 , NANCY  TEMKIN  a3 a4 a5 , JOAN  MACHAMER  a3 and SUREYYA  DIKMEN  a3 a4 a6
a1 Regional Epilepsy Center, Harborview Medical Center, Seattle, Washington
a2 Department of Neurology, University of Washington, Seattle, Washington
a3 Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
a4 Department of Neurological Surgery, University of Washington, Seattle, Washington
a5 Department of Biostatistics, University of Washington, Seattle, Washington
a6 Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Article author query
chaytor n   [PubMed][Google Scholar] 
temkin n   [PubMed][Google Scholar] 
machamer j   [PubMed][Google Scholar] 
dikmen s   [PubMed][Google Scholar] 

Abstract

Evaluating the ecological validity of neuropsychological tests has become an increasingly important topic. Previous research suggests that neuropsychological tests have a moderate level of ecological validity when predicting everyday functioning. The presence of depressive symptoms, however, may impact the relationship between neuropsychological tests and real world performance. The current study empirically tests this hypothesis in a sample of 216 participants with moderate to severe traumatic brain injury (TBI) who completed neuropsychological testing, self-report of mood symptoms, and report of everyday functioning six months post-injury. Contrary to some previous research and clinical lore, results indicated that depression was weakly related to neuropsychological test performance, although it was more strongly related to everyday functioning. Neuropsychological test performance was also significantly related to everyday functioning. The ecological validity of the neuropsychological tests together was not impacted by depressive symptoms, when predicting significant other ratings of functional status. However, patient self-report seems somewhat less related to neuropsychological performance in those with significant depressive symptoms. Neuropsychological test performance was equally related to self and other report of everyday functioning in patients without significant depressive symptoms. (JINS, 2007, 13, 377–385.)

(Received August 26 2006)
(Revised December 11 2006)
(Accepted December 12 2006)


Key Words: Activities of daily living; Everyday functioning; Cognition; Self-report; Depressed mood; Validation studies.

Correspondence:
c1 Correspondence and reprint requests to: Naomi S. Chaytor, Ph.D., Regional Epilepsy Center, Harborview Medical Center, P.O. Box 359745, 325 9th Avenue, Seattle, Washington 98104-2499. E-mail: chaytor@u.washington.edu


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