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Logistic regression function for detection of suspicious performance during baseline evaluations using concussion
Benjamin David Hill1, Melissa N Womble, Martin L Rohling
1a Psychology Department , University of South Alabama , Mobile , Alabama.
Applied Neuropsychology. Adult
|November 6, 2014
Summary
Concussion Vital Signs (CVS) effectively distinguishes genuine from feigned cognitive performance. This tool aids in accurate concussion assessments and return-to-play decisions by identifying potential malingering.
Area of Science:
- Neuropsychology
- Cognitive Psychology
- Forensic Psychology
Background:
- Concussion assessment relies on objective measures.
- Differentiating genuine from feigned cognitive deficits is crucial for accurate diagnosis and management.
- Computerized test batteries are increasingly used for baseline and post-injury evaluations.
Purpose of the Study:
- To determine if Concussion Vital Signs (CVS) performance patterns can differentiate individuals with genuine versus feigned cognitive performance.
- To develop and validate a logistic regression model using CVS measures to detect feigned impairment.
- To assess the utility of CVS in identifying potential malingering in clinical and simulated samples.
Main Methods:
- Logistic regression analysis was applied to data from a known-groups design.
- Predictor variables included performance on CVS, Shipley-2, and California Verbal Learning Test-Second Edition.
- A validation sample of undergraduate students and a clinical sample were used to test the model's accuracy.
Main Results:
- Individuals feigning performance scored significantly lower on the CVS, Shipley-2, and CVLT-II subtests.
- A three-variable model (Verbal Memory immediate hits, Verbal Memory immediate correct passes, Stroop Test complex reaction time correct) achieved 83% accuracy in classifying known groups.
- The model demonstrated high specificity (.97) and moderate sensitivity (.65) for detecting feigned performance.
- Application to a separate sample identified 5% of individuals as possibly feigning, indicating a low false-positive rate.
Conclusions:
- Concussion Vital Signs (CVS) can effectively differentiate genuine from feigned cognitive performance.
- The developed logistic regression model shows promise for identifying malingering in concussion assessments.
- These findings support the use of CVS in baseline cognitive testing and return-to-play decisions, enhancing the validity of concussion evaluations.
