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Wechsler Adult Intelligence Scale-Third Edition Characteristics of a Military Traumatic Brain Injury Sample

Military Medicine, Dec 2003 by Clement, Pamelia F, Kennedy, Jan E

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Procedure

Demographic and injury information were collected at the time of the neuropsychological evaluation from medical records and interviews with the participant and, when possible, a family member. Classification of severity of TBI as mild, moderate, or severe was determined using available medical record information. Mild TBI cases had loss of consciousness less than 60 minutes and no neurological findings. Cases with loss of consciousness between 1 and 24 hours or significant neurological findings, even if the loss of consciousness was somewhat less than 60 minutes, were classified as moderate. Severe cases were those hospitalized for several days or longer with documented neurological damage and prolonged recovery.

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The WAIS-III was administered and scored according to standard procedures by either a psychologist in postdoctoral fellowship training or a trained neuropsychological technician. WAIS-III scores analyzed in this study included age-corrected scaled scores on 13 subscales (omitting the Optional Object Assembly Subtest), four index scores (Verbal Comprehension Index [VCI], Perceptual Organization Index [POI], Working Memory Index [WMI], and Processing Speed Index [PSI]), and three IQ scores (full-scale, verbal [VIQ], and performance [PIQ]). Statistical comparison between VIQ and PIQ scores was done using a within-subjects Student's t test. Comparisons among the four index scores were made using an overall one-way within-subjects analysis of variance followed by individual pairwise comparisons using within-subjects Student's t test.

Results

Table III presents summary statistics for WAIS-III scores. No evidence of global impairment of IQ scores was seen for the sample as a whole. Average VIQ score of 103.6 was significantly higher than the average PIQ score of 99.6 (t = 2.72; df = 60; p = 0.008). The four mean WAIS-III index scores differed significantly (F = 18.86; df = 3; p

Table IV presents WAIS-III IQ and index scores separately for mild, moderate, and severe TBI groups. Age-corrected scaled scores on WAIS-III subscales for mild, moderate, and severe TBI groups are shown in Table V. WAIS-III scores for the three seventy groups are quite similar. Because of small sample sizes within the severity subgroups, statistical comparisons of WAIS-III scores across groups were not possible.

Discussion

The findings of this study suggest that the revisions seen in the WAIS-III can enhance its value as a neuropsychological instrument in a TBI population. In particular, the four WAIS-III indexes provide a finer-grained analysis of cognitive functioning than do the VIQ and PIQ scores in themselves. In this study, there was a statistically significant difference between VIQ and PIQ scores, although the actual means differed by only approximately 4 points. Traditionally, the VIQ has been considered a measure of stable verbal skills, whereas the PIQ as an indicator of fluid reasoning skills has been thought to be more vulnerable to brain injury.5 This assumption has recently been questioned in a review of 10 studies that found VIQ to be only slightly higher than PIQ in TBI populations.6 Although present findings reveal a statistically significant difference between VIQ and PIQ scores, the difference was clinically modest. These findings support the view that PIQ is more vulnerable to brain injury than VIQ but with variability across patients and clinically small overall group differences.

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Wechsler Adult Intelligence Scale-Third Edition Characteristics of a Military Traumatic Brain Injury Sample

Military Medicine, Dec 2003 by Clement, Pamelia F, Kennedy, Jan E

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