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The Response Bias Scale (RBS) was developed to predict non-credible cognitive presentations among disability claimants without head injury. Developers used empirical keying, which is independent of apparent content, to select items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) item pool that distinguished between individuals passing or failing performance validity tests (PVTs). No study has examined which of these items would have psychometric value when used in clinical neuropsychological evaluations. This study reexamined items comprising RBS with reference to manifest item content, internal consistency, PVTs, and a symptom validity test (SVT) in a sample of 173 predominately White male veterans ( M AGE = 50.70, M EDU = 13.73) in a VA outpatient neuropsychology clinic. Participants completed the MMPI-2 Restructured Form (MMPI-2-RF), PVTs, and an SVT. The 28-item RBS appears to contain three types of items: those that manifestly address cognitive functioning, those that are supported but do not appear to address cognitive functioning, and nine items that were unrelated to cognition and not statistically supported. The 19 empirically supported items, or RBS-19, predicted PVT and SVT failures marginally better than the RBS. Both the RBS and RBS-19 had stronger relationships with SVTs relative to PVTs. Although the removal of the nine problematic items improved the diagnostic accuracy of the scale, it still did not reach the level that is generally considered to be clinically optimal. The RBS-19 offers a measure with improved internal consistency and predictive validity compared to the RBS and warrants additional research.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used as a cognitive screening measure or as part of a comprehensive neuropsychological battery. Augmenting the current memory subtests of the RBANS to reflect clinically meaningful distinctions in memory performance may improve its clinical utility, allowing users to generate additional hypotheses and refine clinical interpretations. We pilot four supplementary memory measures to use with the RBANS, adapted from paradigms commonly used by other neuropsychological tests. We also provide several new theoretically derived memory indices to supplement the standard Delayed Memory Index. The new subtests correlated significantly with the standard memory measures, and the new indices demonstrated good reliability and diagnostic accuracy. This study provides preliminary support for supplementing the RBANS to allow for more nuanced interpretations of memory performance.

Initial learning and learning slope are often acknowledged as important qualitative aspects of learning, but the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) contains discrete indices for neither. The traditional method of calculating learning slope involves a difference score between the last trial and first trial, which is referred to as raw learning score (RLS). However, this method does not account for initial Trial One performance and produces a ceiling effect that penalizes efficient first learners. We propose an alternative method of calculating learning score that accounts for initial learning performance, called learning ratio (LR), and we compared the psychometric and predictive properties of these methods. Performances from the List Learning and Story Memory subtests were used to create the indices, and composite learning scores were calculated by combining List Learning and Story Memory. The sample included 289 military veterans (mean age = 65.9 [12.6], education = 13.3 [2.4]), most of whom were male, undergoing neuropsychological assessments that included the RBANS. Results indicated that LR demonstrated superior correlations with criterion measures of memory when compared with RLS, and the LR composite score better discriminated between those with and without a neurocognitive diagnosis, AUC = 0.81 (0.76-0.87), than the RLS composite, AUC = 0.70 (0.64-0.76). We concluded that scores from the RBANS can be computed for initial learning and learning slope and that the LR method of calculating learning is superior to RLS in this older veteran sample.

The third trial of Golden's Stroop Color and Word Test (SCWT), which involves identifying the color of words printed in a color that contrasts with its spelling, is usually limited to 45 seconds. Some authors have opined on the benefits of extending this portion of the test beyond 45 seconds to increase sensitivity to cognitive deficits and preliminary data among healthy individuals support this notion. This project examined possible benefits of extending the test beyond the standard 45 second time limit. Fifty-four veteran patients completed the SCWT as part of outpatient neuropsychological assessment. Speed of completing items within 45 seconds was compared to the speed of completing items beyond the first 45 seconds. A composite measure made of neuropsychological tests requiring speed and complex attention served as the criterion measure. Results indicated that extending the interference trial of the SCWT did not improve prediction on criterion measures beyond the standard 45 second SCWT. In conclusion, among individuals undergoing clinical evaluations, extending the SCWT beyond 45 seconds is unlikely to yield sufficient meaningful clinical data to offset the additional administration time and potential frustration to examinees.