1. 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
Cognitive Assessment of Veterans after Traumatic Brain Injury

2. 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), yrs 67.5% (n=338), % (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)

3. Mean Differences in Symptom Validity Test Scores by Diagnostic Subgroup
TBI- PTSD-
n M (SD)
TBI+
n M (SD) p
PTSD+
TBI+ PTSD+
RDS
(2.18)
(1.99)*
(1.97)**
(2.00)**
CVLT
(2.65)
(7.05)**
(6.35)*
(7.42)*
TOMM 1
(2.66)
(5.26)**
(4.86)**
(5.62)**
TOMM 2
(.82)
(3.56)*
(3.19)*
(3.86)*
TOMM R
(.80)
(4.04)**
(3.55)**
(4.19)**
MSVT IR
(3.11)
(10.07)**
(9.32)**
(10.79)**
MSVT DR
(3.09)
(10.45)**
(9.89)**
(11.59)**
MSVT C
(4.29)
(11.97)**
(11.54)**
(13.39)**
MSVT PA
(7.17)
(14.45)**
(13.72)**
(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

4. 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.

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