The Use of the Rey 15-Item Test and Recognition Trial to Evaluate Suboptimal Effort in Neuropsychological Assessment with a Pediatric Mild TBI Sample

The utilization of symptom validity tests (SVTs) in pediatric assessment is receiving increasing empirical support. The Rey 15-Item Test (FIT) is an SVT commonly used in adult assessment, with limited research in pediatric populations. Given that FIT classification statistics across studies to date have been quite variable, Boone, Salazar, Lu, Warner-Chacon, and Razani (2002) developed a recognition trial to use with the original measure to enhance accuracy. The current study aims to assess the utility of the FIT and recognition trial in a pediatric mild traumatic brain injury (TBI) sample (N = 112; M = 14.6 years), in which a suboptimal effort base rate of 17% has been previously established (Kirkwood & Kirk, 2010). All participants were administered the FIT as part of an abbreviated neuropsychological evaluation; failure on the Medical Symptom Validity Test (MSVT) was used as the criterion for suspect effort. The traditional adult cut-off score of(99%), but poor sensitivity (6%). When the recognition trial was also utilized, a combination score of(sensitivity = 64%, specificity = 93%). Results indicate that the FIT with recognition trial may be useful in the assessment of pediatric suboptimal effort, at least among relatively high functioning children following mild TBI.

Narrative Therapy and Stigma Management: Restorying the Patient Experience of Being Told, “You have MS

The purpose of this investigation was to determine if the way patients are informed of the diagnosis of multiple sclerosis (MS) affects their feelings about themselves as people with MS. Building on illness narrative, I hoped to examine how patients “storied” their experience of being informed of the diagnosis of MS and whether this “storying” had a lasting impact on their self-concept. The alternative would be that no connection exists between how a neurologist informs a patient of the diagnosis and how a person makes sense of their diagnosis and life with MS. Due to study limitations (e.g., small sample size, threat of response bias), the results are unclear about whether the way in which the news is broken has a lasting effect on patients' perceptions. However, review of the literature and patient responses indicate that there is a need for psychological intervention when patients are diagnosed with MS.