Incremental Validity of Neuropsychological Evaluations to Computed Tomography in Predicting Long-Term Outcomes after Traumatic Brain Injury

• Published in: Clinical neuropsychologist Vol. 27; no. 3; pp. 356 - 375
• Main Authors: Williams, Michael W., Rapport, Lisa J., Hanks, Robin A., Millis, Scott R., Greene, Hillary A.
• Format: Journal Article
• Language: English
• Published: Hove Routledge 01.04.2013; Psychology Press
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Biological and medical sciences; Brain Injuries - complications; Brain Injuries - diagnostic imaging; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognitive functioning; Computed tomography; Disability; Disability Evaluation; Disabled Persons; Female; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Longitudinal Studies; Male; Medical sciences; Middle Aged; Neuropsychological testing; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Outcomes; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Regression Analysis; Rehabilitation; Reproducibility of Results; Severity of Illness Index; Time Factors; Tomography, X-Ray Computed; Traumas. Diseases due to physical agents; Traumatic brain injury; Young Adult; Handicap; Human; Nervous system diseases; Traumatic brain injury; Neuropsychological test; Psychometrics; Cognition; Long term; Outcomes; Disability; Test validation; Treatment; Reeducation; Incremental validity; Cognitive functioning; Computed tomography; Tomography; Evolution; Rehabilitation; Head trauma; Neuropsychological testing
• ISSN: 1385-4046; 1744-4144
• DOI: 10.1080/13854046.2013.765507

This study evaluated the incremental utility of neuropsychological tests to computed tomography (CT) in predicting long-term outcomes of adults with moderate to severe traumatic brain injury (TBI). Participants were 288 adults with mild complicated, moderate, and severe TBI. Longitudinal data were evaluated during inpatient status in an urban rehabilitation hospital with a TBI Model System, as well as 1 and 2 years post injury. Predictors including demographic characteristics, injury severity, CT characteristics, and neuropsychological evaluations were regressed to outcomes of disability, life satisfaction, and employment at 1 and 2 years post injury. Prediction of life satisfaction was not improved with the use of CT characteristics or neuropsychological tests, but prediction of return to work was improved by these variables at 2 years post injury. Neuropsychological evaluations uniquely contributed to outcome predictions of functional disability, even after considering demographic and injury severity characteristics, including information from CT. In contrast, CT characteristics were not predictive of long-term functional disability at 1 or 2 years post TBI. Taken together, the findings indicate that neuropsychological tests add unique predictive information for long-term functional outcomes after TBI.