The predictive validity of the Repeatable Battery for the Assessment of Neuropsychological Status for long -term functional, social, vocational, and psychiatric outcome in traumatic and nontraumatic brain -injured patients

Lauren Greiner, Fordham University

Abstract

Traumatic and nontraumatic brain injuries frequently have a long-term devastating effect on all major domains of functioning. This outcome has been found to be similar, regardless of mechanism of injury. Previous research has focused on identifying patients early, who are at higher risk for poor outcome, this can assist treatment planning, allowing for intervention before major problems develop. Much of the research has targeted initial severity of injury. Those with worse injuries typically have poorer outcome. Length and depth of coma and posttraumatic amnesia are often used to measure injury severity; measurement of these variables, though, can be methodologically problematic. There has therefore been interest in identifying alternate measures of injury severity. Neuropsychological assessment conducted shortly after injury has been shown to correlate with later outcome. Financial constraints associated with managed health care dictate a need for brief, comprehensive neuropsychological measures. ^ The present study investigated the predictive validity of a short, comprehensive neuropsychological test, the RBANS, for functional and psychosocial long-term outcome in a sample of TBI and CVA patients. Another objective of the study was to examine the relationships among outcome variables. Twenty-nine participants who had been hospitalized for a moderate or severe brain injury at an acute rehabilitation facility and administered an RBANS, were interviewed three to six years post-discharge. Participants completed measures of functioning, depression, anxiety, and suicidal ideation. Results indicated no evidence of clinically significant symptoms in the sample, which was not consistent with previous research. There was no relationship between the RBANS and outcome measures. All outcome measures, however, were strongly correlated with each other. The lack of findings for the RBANS hypothesis may have been due to participants' awareness deficits, posttraumatic amnesia lowering RBANS scores, small sample size, or participants' current cognitive impairments. ^ The strong association between outcome variables, found at long-term follow-up underscores the importance of continued, periodic screening for functional and psychiatric problems in brain-injured individuals. Given long term awareness deficits, family members and treatment providers should be interviewed as part of any assessment. For future research, a longitudinal study that controls for limitations of the current study should be considered. ^

Subject Area

Psychology, Clinical|Psychology, Psychometrics

Recommended Citation

Lauren Greiner, "The predictive validity of the Repeatable Battery for the Assessment of Neuropsychological Status for long -term functional, social, vocational, and psychiatric outcome in traumatic and nontraumatic brain -injured patients" (January 1, 2006). ETD Collection for Fordham University. Paper AAI3216911.
http://fordham.bepress.com/dissertations/AAI3216911

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