Estimating the diagnostic value of the trail making test for suboptimal effort in acquired brain injury rehabilitation patients

Clin Neuropsychol. 2011 Jan;25(1):108-18. doi: 10.1080/13854046.2010.532912. Epub 2010 Nov 23.

Abstract

This investigation explored the classification accuracy of Trail Making Test (TMT; Reitan & Wolfson, 1992) indices for suboptimal effort in a sample of non-litigious acquired brain injury patients seeking outpatient rehabilitation. Patients who exhibited optimal effort completed TMT A and B faster than suboptimal effort patients. Although TMT A time to completion demonstrated adequate sensitivity to suboptimal effort, positive predictive value was fair to poor unless the base rate of suboptimal effort was inflated to 40%. TMT B time to completion yielded poor sensitivity and positive predictive value for suboptimal effort. While TMT A time to completion appears to have some value as a validity indicator, no TMT validity indicator should replace more precise symptom validity tests during neuropsychological assessment.

MeSH terms

  • Adult
  • Brain Injuries / diagnosis*
  • Brain Injuries / psychology*
  • Brain Injuries / rehabilitation
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outpatients
  • Severity of Illness Index
  • Trail Making Test*