Symptom Validity Test Performance in American War Veterans with Traumatic Brain Injury and Post-traumatic Stress Disorder Kerry Donnelly, Ph.D., ABPP;

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Symptom Validity Test Performance in American War Veterans with Traumatic Brain Injury and Post-traumatic Stress Disorder Kerry Donnelly, Ph.D., ABPP; James P. Donnelly, Ph.D.; Mina Dunnam, Ph.D.; Gary C. Warner, Ph.D.; Jim Kittleson, Psy.D., ABPP; Charles Bradshaw, Ph.D. & Michelle Alt, M.A. This project was funded by the US Department of Veterans Affairs Health Services Research & Development: SDR 06-162 Cognitive Assessment of Veterans after Traumatic Brain Injury

Method Participants Measures *13 missing cases 500 OEF/OIF veterans living in upstate NY, USA 90.4% Male (n=452); Mean age=32.2 (SD=8.89) Education: < 12 yrs 26.8% (n=134), 13-16 yrs 67.5% (n=338), 17+ 5.6% (n=28) Ethnicity: White/Caucasian 85.6% (n=428) Employment: Full time (job or school) 64.8% (n=324), Part time 10.4% (n=52), None 24.8% (n=124) VA Service-connected disability: 55.4% (n=277) Clinician-confirmed TBI: 219 (43.8%) PCL-M >50: 230 (47.2%)* *13 missing cases Reliable Digit Span (RDS) Test of Memory Malingering (TOMM) Trials 1, 2, and Retention Medical Symptom Validity Test (MSVT) Immediate Recall, Delayed Recall, Consistency, Paired Associates California Verbal Learning Test-II Forced-Choice Test (CVLT-II) Structured Clinical Interview to Confirm TBI PTSD Checklist- Military Version (PCL-M)

Mean Differences in Symptom Validity Test Scores by Diagnostic Subgroup TBI- PTSD- n M (SD) TBI+ n M (SD) p PTSD+ TBI+ PTSD+ RDS 184 9.99 (2.18) 212 9.29 (1.99)* 230 9.13 (1.97)** 136 8.98 (2.00)** CVLT 185 99.21 (2.65) 210 97.01 (7.05)** 230 97.57 (6.35)* 136 96.51 (7.42)* TOMM 1 185 47.85 (2.66) 207 45.68(5.26)** 227 45.68 (4.86)** 133 44.89 (5.62)** TOMM 2 185 49.85 (.82) 207 48.86(3.56)* 227 48.98 (3.19)* 133 48.52 (3.86)* TOMM R 170 49.82 (.80) 186 48.46 (4.04)** 211 48.67 (3.55)** 125 48.08 (4.19)** MSVT IR 185 99.11 (3.11) 210 95.55 (10.07)** 229 95.92(9.32)** 136 93.97 (10.79)** MSVT DR 185 98.78 (3.09) 209 94.67 (10.45)** 228 94.87(9.89)** 135 92.96(11.59)** MSVT C 185 98.11 (4.29) 209 93.29 (11.97)** 228 93.65(11.54)** 135 91.09(13.39)** MSVT PA 185 97.73 (7.17) 209 93.35 (14.45)** 22893.16 (13.72)** 135 91.26(15.99)** As compared with combat veterans without TBI or probable PTSD, as shown in the first column, those with clinician-confirmed TBI, probable PTSD, and both conditions together scored significantly worse on every SVT. Note: p values represent contrast between TBI-PTSD- group vs. others. *p <.001, **p <.0001

Percentage of Symptom Validity Test Failures by Diagnostic Subgroup TOMM trial 1 and RDS showed the highest failure rates for all groups, including combat controls. Veterans both TBI and probable PTSD had the highest SVT failure rates overall.

For More information: Kerry.donnelly@va.gov Mina.dunnam@va.gov Thank you!