Research Reports - Neuropsychological assessment of distractibility in mild traumatic brain injury and depression

Clin Neuropsychol. 2012 Jul;26(5):769-89

Schnabel R, Kydd R

Traditional neuropsychological assessments are conducted exclusively in a quiet,
distraction-free environment; clients' abilities to operate under busy and
distracting conditions remain untested. Environmental distractions, however, are
typical for a multitude of real-life situations and present a challenge to
clients with frontal-temporal brain injury. In an effort to improve ecological
validity, an extension of the traditional neuropsychological assessment was
developed, comprising a standardized distraction condition. This allowed
cognitive functions to be tested both in the traditional setting and with
exposure to a specified audio-visual distraction. The present study (n = 240)
investigated how clients with mild Traumatic Brain Injury (mTBI) (n = 80), Major
Depression (MDE) (n = 80), and a healthy control sample (n = 80) performed on
sub-tests of the Wechsler Adult Intelligence Scale-IV and the Wechsler Memory
Scale-IV both in the standard and the distraction conditions. Test effort was
controlled. Significant deterioration of performance in the distraction setting
was observed among clients with mTBI. In contrast the performance of a healthy
control sample remained unchanged. Significant improvement of performance in the
distraction setting was documented for clients with MDE. Contrary to their
improved performance, depressed clients experienced the distraction setting as
more distressing than the control and mTBI group.

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