Effects of Brain Injury Severity and Effort on Neuropsychological Tests of Attention

Attention impairment is one of the most common complaints following Traumatic Brain Injury (TBI). Multiple studies have shown that performance on neuropsychological tests of attention is affected by many factors, including injury severity and effort. The aim of this study was to determine the effect of injury severity on neuropsychological tests across different domains of attention while controlling for effort. The domains of focused attention, selective attention, divided attention, sustained attention, and working memory were assessed by performance on the Digit Span Forward subtest, the Stroop Color Word Test, the Trail Making Test, the Conners' Continuous Performance Test - II, and Digit Span Backwards subtest, respectively. Effort was determined according to performance on the Portland Digit Recognition Test and the Test of Memory Malingering. Effort was found to have a greater effect on test performance (.79) than injury severity (.47). Clinical implications of the findings are discussed.