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Industry: Email Alert RSS FeedWechsler Adult Intelligence Scale-Third Edition Characteristics of a Military Traumatic Brain Injury Sample
Military Medicine, Dec 2003 by Clement, Pamelia F, Kennedy, Jan E
The WAIS-III verbal subtests can be looked at in terms of the VCI and the WMI as opposed to a monolithic VIQ. Similarly, the performance subtests can be broken down into the POI and PSI. In the current sample, the VCI had the highest mean score, followed by the POI, the WMI, and the PSI. These findings are consistent with the formulation that stable verbal skills are most resistant to brain injury, followed closely by nonverbal reasoning and visuospatial ability, and then working memory with speed of information processing being the most vulnerable to the effects of brain injury. In terms of subtest scores, digit symbol appears to be most sensitive to the effects of TBI.
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Prior research suggests that the WAIS-III PSI score is a sensitive indicator of cognitive function. Lower PSI scores characterized all clinical groups in the standardization samples of the WAIS-III.7 In a study using profile analysis with WAIS-III index scores, subgroups were formed based on both overall level of WAIS-III performance and on a pattern of scores represented primarily by low or high score on the PSI.8 Another recent study found a large effect size of PSI score when comparing mild TBI, moderate-severe TBI, and control groups.9 TBI patients in another study showed slowing on the WAIS-III digit symbol subtest (one of the two major subtests loading on the PSI) at 1-week after injury compared with patients with mild non-neurological injuries.10 Taken together, all of these results support the idea that processing speed is a sensitive indicator of global brain function and efficiency after TBI.
Not only is processing speed often poorer than other cognitive functions after TBI, but there is also evidence suggesting that its recovery is prolonged. In a study developing a mathematical model for recovery from TBI based on duration of coma and WAIS-R scores, PIQ, a major component of which is processing speed, was over four times slower to recover than VIQ.11 Present results reinforce this concept in that our sample was tested an average of almost 3 years after injury, yet PSI scores were significantly lower than scores on the other WAIS-III indexes. In summary, present results indicate that global intelligence is relatively unaffected after TBI. They reinforce prevailing research showing that speed of information processing is particularly vulnerable to brain injury across a range of severity and time after injury.
References
1. Goldstein M: Traumatic brain injury: a silent epidemic. Ann Neural 1990, 27: 327.
2. Brain Injury Association. Available at http://www.biausa.org/Pages/ For%20Military%20%26%20Veterans.html; accessed January 2002.
3. Wechsler D: Wechsler Adult Intelligence Scale. Ed 3. San Antonio. TX, The Psychological Corporation, 1997.
4. WAIS-III WMS-III Technical Manual. San Antonio, TX, The Psychological Corporation, 1997.
5. Farr SP, Greene RL, Fisher-White SP: Disease process, onset, and course and their relationship to neuropsychological performance. In: Handbook of Clinical Neuropsychology, pp 213-53. Edited by Filskov SB, Boll TJ. New York, Wiley, 1986.
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