Robert D Shura, Ryan W Schroeder, Anna S Ord, Rachel K Bieu, Victoria L O'Connor, Anna T Magnante, Makenna Snodgrass, Holly M Miskey, Sarah L Martindale, Jared A Rowland
{"title":"Symptom validity indices for the Beck Depression Inventory-II: Development and cross-validation in research and clinical samples.","authors":"Robert D Shura, Ryan W Schroeder, Anna S Ord, Rachel K Bieu, Victoria L O'Connor, Anna T Magnante, Makenna Snodgrass, Holly M Miskey, Sarah L Martindale, Jared A Rowland","doi":"10.1080/13854046.2024.2432058","DOIUrl":"10.1080/13854046.2024.2432058","url":null,"abstract":"<p><p><b>Objective:</b> The present study sought to cross validate the recently developed total score cut-off for the Beck Depression Inventory-II (BDI-II) and identify additional embedded symptom validity indices within this commonly used self-report depression measure. <b>Methods:</b> Study 1 included a research sample of 379 veterans with diagnostic subgroups of Current and Lifetime Depression and Current and Lifetime Posttraumatic Stress Disorder (PTSD). Study 2 included a clinical sample of 224 veterans with diagnostic subgroups of Current Depression, Lifetime Depression, and No Depression. Three embedded BDI-II symptom validity indices were examined in the total samples and subgroups: the BDI-II Symptom Severity Scale (total raw score), BDI-II Extreme Symptom Scale (summed frequency of extreme responses), and the BDI-II Rare Items Scale (summed frequency of rarely endorsed items). Validity indices from the Personality Assessment Inventory were utilized in both studies, with the Miller Forensic Assessment of Symptoms Test also used in Study 1. <b>Results:</b> In Study 1, BDI-II validity index cut-off scores had to be adjusted the highest for the Current Depression or Current PTSD subgroups. The cut-offs were associated with sensitivity rates ranging from 0.12 to 0.53 and specificity rates ranging from 0.90 to 0.96. In Study 2, cut-offs had to be adjusted, the highest for the Current Depression subgroup. Identified cut-offs had sensitivity rates ranging from 0.22 to 0.65 and specificity rates ranging from 0.89 to 0.95. <b>Conclusions:</b> This study supports the use of all three proposed BDI-II embedded symptom validity indices.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1960-1978"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Federica Rossetto, Sara Isernia, Giulia Smecca, Marco Rovaris, Francesca Baglio
{"title":"Time efficiency in mental state reasoning of people with multiple sclerosis: The double-sided affective and cognitive Theory of Mind disturbances.","authors":"Federica Rossetto, Sara Isernia, Giulia Smecca, Marco Rovaris, Francesca Baglio","doi":"10.1080/13854046.2024.2446026","DOIUrl":"10.1080/13854046.2024.2446026","url":null,"abstract":"<p><p><b>Objective:</b> Theory of Mind (ToM) disturbances are recognized as a hallmark of several neurological conditions including multiple sclerosis (MS). People with MS show lower ToM competencies compared to healthy controls (HC) from the earliest stages of the disease. However, the nature of this disturbance is still under investigation. The aims of this study were 1) to explore ToM competencies in people with MS using a single task (the Yoni-48) considering both accuracy and time efficiency according to a multi-level (first- and second-order) and multi-component (affective and cognitive) approach, and 2) to investigate the relationship between ToM and other neurocognitive functions in people with MS. <b>Method:</b> Seventy-seven participants underwent an individual evaluation session to investigate their ToM profile and associated neurocognitive domains (short-term and working memory, and executive functioning). <b>Results:</b> As expected, the comparison between the two groups (MS vs HC) on ToM performance showed a selective decline of accuracy for the second-order level (Cohen's d = 0.46) and the affective (Cohen's d = 0.57) components of ToM, and a pathological reduction in ToM time efficiency in people with MS (Cohen's d > 0.50). Moreover, a link between executive function, memory, and ToM was found. Our results highlight a double-sided selective decline of high levels and affective components of ToM in people with MS, and a broad involvement of time efficiency. <b>Conclusions:</b> These findings provide insights into the contribution of efficiency and automaticity of mental state reasoning in this pathology, suggesting the role of compensation strategies in maintaining adequate performance during social interactions.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1926-1943"},"PeriodicalIF":2.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bryson J Hewins, Rachael D C Jones, Megan E Glazer, Kimbra Kenney, Sara M Lippa
{"title":"Growth hormone deficiency after moderate traumatic brain injury with normal (or high) IGF-1; a case report demonstrating benefit of replacement therapy and clinical pearls for diagnosis.","authors":"Bryson J Hewins, Rachael D C Jones, Megan E Glazer, Kimbra Kenney, Sara M Lippa","doi":"10.1080/13854046.2025.2562095","DOIUrl":"https://doi.org/10.1080/13854046.2025.2562095","url":null,"abstract":"<p><p><b>Objective:</b> Traumatic brain injury (TBI) is a common cause of acquired pituitary dysfunction in adults. The prevalence of anterior pituitary dysfunction after TBI varies widely, but growth hormone deficiency (GHD) is reported as the most common, ranging from 5-20% after mild to severe TBI. GHD can be difficult to diagnose: 1) its neuropsychological symptoms are nonspecific and overlap with many chronic TBI symptoms; 2) GHD frequently remits if present in the first year after TBI; 3) screening laboratories are not reliable; and 4) validated, easy to administer, confirmatory stimulation tests are not widely available. A diagnosis of GHD is often delayed until 5 years or more after injury. Nonetheless, replacement therapy is associated with improvement in GHD related symptoms, including cognition. This study aims to present a case of GHD after moderate TBI. <b>Methods:</b> We present a case of GHD after a moderate TBI and discuss the chronic effects of GH replacement therapy on his neuropsychological testing and symptoms, as well as clinical pearls for the diagnosis of GHD in persistently symptomatic patients with remote TBI. <b>Results:</b> This case demonstrates that clinical suspicion should supersede inconclusive screening results and prompt referral for definitive provocative testing. Even when diagnosed late, targeted GH replacement therapy can yield significant improvements in debilitating fatigue, metabolic health, and specific domains of neurocognition. <b>Conclusions:</b> Enhanced clinical awareness and a more proactive approach to endocrine surveillance by providers can prevent years of morbidity, reduce diagnostic delays, and offer patients a greater potential for functional recovery.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-15"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robert D Shura, Bradley N Axelrod, Katherine M Craig, Jennifer A Pender, Kyrstina H Mariouw
{"title":"The inventory of problems-29 (IOP-29) in a US clinical sample.","authors":"Robert D Shura, Bradley N Axelrod, Katherine M Craig, Jennifer A Pender, Kyrstina H Mariouw","doi":"10.1080/13854046.2025.2564157","DOIUrl":"https://doi.org/10.1080/13854046.2025.2564157","url":null,"abstract":"<p><p><b>Objective:</b> Research on the Inventory of Problems-29 (IOP-29) has primarily used simulation designs and non-US samples. This study evaluated the IOP-29 in US clinical samples relative to validity scales obtained from Minnesota Multiphasic Personality Inventory (MMPI). <b>Method:</b> Clinical patients (<i>N</i> = 217) were administered the IOP-29 and the second or third version of the Minnesota Multiphasic Personality Inventory (MMPI) as part of routine care. Correlations evaluated criterion validity of the IOP-29 False Disorder Probability Score (FDS). Diagnostic accuracy statistics were calculated, with the invalid group (<i>n</i> = 25) identified as those producing invalid scores on any two or more MMPI scales compared to those with no invalid scores. <b>Results:</b> The IOP-29 was positively correlated to overreport scales (<i>ρ</i> = .24 to .62), and not or negatively correlated to underreport scales. At FDS ≥ .50, sensitivity was .72 at specificity of .88. To reach a specificity of .90, the cutoff score needed raised to .58, but without any change in sensitivity. At the more conservative ≥ .64, specificity raised to .95 but sensitivity dropped to .56. <b>Conclusions:</b> The IOP-29 showed utility as a broad measure of negative response bias in mixed clinical sample in the US. The recommended cutoff of FDS ≥ .50 worked well in this mixed clinical sample, though a slight increase in cutoff was needed to achieve .90 specificity. The measure would benefit from additional criterion group studies in different clinical and forensic samples and using additional methods for identifying participants with invalid profiles.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-11"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neelima Marupudi, Jessica Morgan, Sarah Karabatsos, Neethi P Pinto
{"title":"The need for PICU follow-up and evaluation of post-intensive care syndrome in pediatrics in a community children's hospital.","authors":"Neelima Marupudi, Jessica Morgan, Sarah Karabatsos, Neethi P Pinto","doi":"10.1080/13854046.2025.2566200","DOIUrl":"https://doi.org/10.1080/13854046.2025.2566200","url":null,"abstract":"<p><p><b>Objective</b>: Children admitted to the PICU are at risk for acquiring morbidities from their hospitalization known as post-intensive care syndrome in pediatrics (PICS-p). The objectives of this study were to examine the need for neurocognitive follow-up in evaluating for PICS-p, describe acquired PICS-p morbidities, and characterize recommended interventions. <b>Methods</b>: Children ages 1 day to 18 years admitted to the PICU between January 1, 2016 to December 31, 2023 who were evaluated in the pediatric neuropsychology outpatient clinic within 3-8 months of hospital discharge were included. <b>Results</b>: Among 453 referrals, 343 (76%) children were evaluated by the neuropsychology team. The most common post-discharge morbidities were sleep disturbances (63%), developmental/functional concerns (60%), and coping difficulties (56%). 289 children (84%) received interventions as a result of their neurocognitive evaluations. Medical interventions including referrals to physical, occupational, and speech therapy, psychiatry, psychotherapy, and neurology were recommended for 73.8% of children. Home interventions to address sleep and mood disturbances were recommended for 73.2% of children. Academic interventions including recommendations for educational services and provision of additional time to complete tasks were provided for 76.1% of children. <b>Conclusions</b>: The majority of children received recommendations for interventions as a result of their evaluations suggesting that neurocognitive follow-up has a role following pediatric critical illness. The high uptake of neuropsychology services among children referred for follow-up suggests that many PICU survivors experience significant functional and psychosocial morbidities after hospital discharge and are willing to seek support.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-15"},"PeriodicalIF":2.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amy M Letteri, Lynette Abrams-Silva, Monica Martinez
{"title":"Outreach neuropsychology: Innovations in community-based training.","authors":"Amy M Letteri, Lynette Abrams-Silva, Monica Martinez","doi":"10.1080/13854046.2025.2547013","DOIUrl":"https://doi.org/10.1080/13854046.2025.2547013","url":null,"abstract":"<p><p><b>Objectives:</b> Theoretical models of cross-cultural neuropsychology and practice have seen a rapid increase over the last several years. Yet while much progress has been made from a theoretical perspective, little has been said about the practicality of implementing such programs. Neuropsychology with vulnerable populations often demands more time for less reimbursement. <b>Method:</b> We propose to blend the need for robust and nuanced multicultural neuropsychology with innovative practical training. Community-oriented training programs led by trainees reduce the burden of billing and productivity, while increasing access and teaching complex concepts such as building partnerships, developing programs, and honing cross-cultural clinical skills. <b>Results:</b> The authors discuss two programs built on this model. First the graduate-level HopeWorks program to provides neuropsychology care to unhoused adults in New Mexico and second the Salud Para Niños neuropsychology program to provide care to Spanish-speaking children in Pennsylvania. They also discuss the need for supervision of bilingual trainees by monolingual supervisors and the use of tele-supervision. <b>Conclusions:</b> The authors propose that the success of these programs will encourage supervisors to establish new training rotations to serve their communities' most vulnerable members while providing valuable training experiences and robust supervision.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-26"},"PeriodicalIF":2.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leslie Guidotti Breting, Navya Kamath, Christopher Williams, Elizabeth Geary, Julia Thomas, Alexandra Kirsch
{"title":"Competency-based curriculum in neuropsychology fellowship training.","authors":"Leslie Guidotti Breting, Navya Kamath, Christopher Williams, Elizabeth Geary, Julia Thomas, Alexandra Kirsch","doi":"10.1080/13854046.2025.2559021","DOIUrl":"https://doi.org/10.1080/13854046.2025.2559021","url":null,"abstract":"<p><p><b>Objective:</b> The purpose of this paper is to review existing neuropsychological training guidelines for fellowship training and to propose a competency-based training curriculum that can be implemented in a two-year neuropsychological fellowship. Competency-based approaches to training are commonly used in psychology, some competencies specific to neuropsychology include the Houston Conference Guidelines and the Clinical Neuropsychology Taxonomy. Despite training guidelines, curriculum based on these guidelines for fellowship training programs is not readily available and may vary across programs. <b>Method:</b> Various published training approaches/models were reviewed. A sample curriculum, with specifications for neuropsychological foundational and functional training competencies, was developed based on previously published training guidelines, clinical experience, and supervisory experiences that are common in neuropsychological practice. Narrative examples were included to illustrate this curriculum. <b>Conclusion:</b> The proposed curriculum can be implemented flexibly at a variety of training sites while still helping trainees achieve key competencies, which can help trainees move successfully through future board certification. A future task force is recommended to gather additional data from training programs, expertise from training directors and supervisors, and trainee feedback as it relates to curriculum development.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-17"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sidonia E Compton, Troy A Webber, Steven Paul Woods, Andrew M Kiselica
{"title":"Reliability and stability of cognitive intraindividual variability indices among cognitively unimpaired older adults.","authors":"Sidonia E Compton, Troy A Webber, Steven Paul Woods, Andrew M Kiselica","doi":"10.1080/13854046.2025.2552279","DOIUrl":"https://doi.org/10.1080/13854046.2025.2552279","url":null,"abstract":"<p><p><b>Objective:</b> Cognitive intraindividual variability (IIV) dispersion measures within-person variability in performance across a neuropsychological test battery and is prognostic of structural and functional decline. Although evidence for the construct validity of cognitive dispersion has grown considerably, its utility in applied settings relies on its stability and reliability. Thus, we examined mean-level stability, test-retest reliability, and reliable change of several cognitive dispersion indices among cognitively unimpaired older adults. <b>Method:</b> Participants were 2224 robustly cognitively unimpaired older adults from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set 3.0. Intraindividual standard deviation (<i>ISD</i>) and coefficient of variation (<i>CoV</i>) dispersion indices were calculated for raw, scaled, and demographically-adjusted normed scores for the neuropsychological test battery at baseline and initial follow-up visit (<i>M</i><sub>days</sub> = 424.99). Analyses included paired samples <i>t</i>-tests and generation of effect sizes for mean-level stability, correlations for test-retest reliability, and practice-adjusted reliable change indices (RCIs) for classifying individuals. <b>Results:</b> The mean-level change effect sizes for <i>ISD</i> and <i>CoV</i> scores were very small (<i>ds</i> < .06); only <i>CoV</i> showed significant improvements. Test-retest reliability was poor (<i>M<sub>r</sub> =</i> .41) for cognitive dispersion indices compared to global composite scores (<i>r</i> = .82). RCIs suggested that normed score changes greater than 1.75 standard deviations were significant. <b>Conclusions:</b> Findings showed stable mean-level cognitive dispersion across 424.99 days; however, consistent with process-based neuropsychological test scores literature, test-retest reliability was poor, perhaps reflecting random measurement error among cognitively unimpaired individuals. Change in cognitive dispersion may inform clinical prognosis and serve as supplementary information within broader neuropsychological evaluations given reliability limitations.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-19"},"PeriodicalIF":2.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katie Stephenson, Nathan E Cook, Charles E Gaudet, Paul D Berkner, Grant L Iverson
{"title":"Acute effects of sport-related concussion among adolescents with a self-reported history of treatment for anxiety or depression.","authors":"Katie Stephenson, Nathan E Cook, Charles E Gaudet, Paul D Berkner, Grant L Iverson","doi":"10.1080/13854046.2025.2554745","DOIUrl":"https://doi.org/10.1080/13854046.2025.2554745","url":null,"abstract":"<p><p><b>Objective:</b> This study compared symptom reporting and cognitive test performance within 72 h of a suspected concussion between high school student-athletes with and without pre-injury self-reported mental health treatment. <b>Methods:</b> Eight hundred seventy-nine high school athletes with (<i>n</i> = 75) and without (<i>n</i> = 804) a self-reported history of treatment for anxiety or depression underwent preseason baseline testing, and post-injury testing within 72 h of suspected concussion. <b>Results:</b> At baseline, adolescents with a self-reported history of treatment for anxiety or depression (<i>n</i> = 75, 8.5%) endorsed significantly greater affective (Cohen's <i>d</i> = 0.70), cognitive (<i>d</i> = 0.52), physical (<i>d</i> = 0.53), and sleep-arousal (<i>d</i> = 0.50) symptoms compared to those with no mental health treatment history (<i>n</i> = 804). There was not a statistically significant group-by-time interaction for the total symptom severity score (<i>F</i>(4, 874)=2.27; <i>p=</i>.06), indicating that the magnitude of acute symptom worsening following concussion did not appear to differ in association with pre-injury mental health status. There were no significant group differences in neurocognitive composite scores at baseline or following concussion. Similarly, adolescents with self-reported history of treatment for anxiety or depression not more likely to exceed the reliable change cutoffs for worsening symptoms or cognitive functioning as compared to those without a self-reported history of treatment for anxiety or depression. <b>Conclusions:</b> Although there was no difference in the magnitude of change from baseline to post-injury symptom scores between the two groups, adolescents with pre-injury mental health difficulties reported more symptoms at baseline and acutely following a concussion. Adolescents with a self-reported history of treatment for anxiety or depression did not differ from those without on cognitive scores at baseline or following concussion.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-16"},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Derivation of embedded symptom validity indicators for the Brief Symptom Inventory-18.","authors":"Jeremy J Davis, Scott R Millis","doi":"10.1080/13854046.2025.2555587","DOIUrl":"10.1080/13854046.2025.2555587","url":null,"abstract":"<p><strong>Objective: </strong>Symptom validity assessment is an important component of the evaluation of psychological sequelae of traumatic brain injury (TBI). Many personality inventories have embedded symptom validity scales (SVTs). A growing body of research reports derivation of embedded SVTs in brief symptom and self-report measures. We sought to develop embedded SVT indicators based on the Brief Symptom Inventory-18 (BSI-18).</p><p><strong>Method: </strong>This project involved secondary analysis of TRACK-TBI data obtained from the Federal Interagency Traumatic Brain Injury Research Informatics System repository. Participants (<i>N</i> = 1,694) sustained TBI (<i>n</i> = 1,515) and or non-head orthopedic injury (<i>n</i> = 179). Independent SVTs were used to identify TBI cases with questionable validity (QV). Two novel SVTs were examined: BSI-V, which was developed using Bayesian model averaging (BMA) to determine a subset of BSI-18 items that predict QV, and BSI GSI, which is a total score cutoff based on the BSI-18 Global Severity Index. Receiver operating characteristic (ROC) analysis was used to compare classification accuracy of BSI-V and BSI GSI.</p><p><strong>Results: </strong>Four BSI-18 items were determined to be optimal predictors of QV. The BSI-V and BSI GSI both showed outstanding discrimination with area under the ROC curve (AUC) of .95. BSI-V (≥5) and BSI GSI (≥64 T) cutoffs showed 83% sensitivity and 90% specificity.</p><p><strong>Conclusions: </strong>Findings provide preliminary evidence of novel embedded SVTs in the BSI-18 with comparable support for BSI-V and BSI GSI. These findings warrant independent cross-validation to provide additional evidence of classification accuracy and refine cutoffs prior to implementation in practice.</p>","PeriodicalId":55250,"journal":{"name":"Clinical Neuropsychologist","volume":" ","pages":"1-20"},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}