Depression among the head-injured and non-head-injured: a discriminant analysis

Neuropsychologists often use traditional psychological tests to assess depression following a head injury; but the assumption that depression with a head injury resembles that in an uninjured person is suspect. The current study attempts to examine the cognitive manifestations of depression with and without a coexisting head-injury. Advanced statistical methods are used to assess whether or not the two depressions 'look alike' with respect to the neuropsychological sequelae of the disorders. A total of 1182 people were entered into one of two discriminant function analyses (DFA) for depression. Each person was a member of one of the following groups: (a) depressed, (b) non-depressed, (c) head-injured, or (d) head-injured and depressed. Two functions were performed for depression, one on the population of head-injured people and one on the population of uninjured people. Cross-validations were performed for each population and across populations in order to assess the utility of each population's function for the opposite group. This comparison allows the researcher to indirectly compare depression in the two populations. Both functions were successfully applied to either population when MMPI variables were included in the analyses. However, when only cognitive variables were included the function performed on the non-head-injured population did not correctly classify head-injured people as depressed or non-depressed. One explanation for this is that the range of cognitive scores in head-injured people is so great that it allows for a less accurate but more generalizable function. Suggestions for future research are discussed.