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The Behavior Rating Inventory of Executive Function®-Adult Version is Related to Emotional Distress, Not Executive Dysfunction, in a Veteran Sample.

Authors:
Susan K Shwartz Brad L Roper Timothy J Arentsen Ellen M Crouse Marcy C Adler

Arch Clin Neuropsychol 2020 Aug;35(6):701-716

Department of Veterans Affairs Medical Center, Memphis, TN, USA.

Objective: In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self-reported executive functioning (EF) and objective performance.

Method: Each study pulled from a sample of 123 veterans who were administered a BRIEF-A and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) during a neuropsychological evaluation. Participants were primarily middle-aged, and half carried a mood disorder diagnosis. Study 1 examined group differences in BRIEF-A ratings among valid, invalid, and indeterminate MMPI-2 responders. Analyses were conducted to determine the optimal cut-score for the BRIEF-A Negativity Validity scale. In Study 2, relationships were explored among MMPI-2-RF (restructured form) Restructured Clinical (RC) scales, somatic/cognitive scales, and the BRIEF-A Metacognition Index (MI); hierarchical analyses were performed to predict MI using MMPI-2-RF Demoralization (RCd) and specific RC scales. Study 3 correlated BRIEF-A clinical scales and indices with RCd and an EF composite score from neuropsychological testing. Hierarchical analyses were conducted to predict BRIEF-A clinical scales.

Results: Invalid performance on the MMPI-2 resulted in significantly elevated scores on the BRIEF-A compared to those with valid responding. A more stringent cut-score of ≥4 for the BRIEF-A Negativity scale is more effective at identifying invalid symptom reporting. The BRIEF-A MI is most strongly correlated with demoralization. BRIEF-A indices and scales are largely unrelated to objective EF performance.

Conclusions: In a veteran sample, responses on the BRIEF-A are most representative of generalized emotional distress and response bias, not actual EF abilities.

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http://dx.doi.org/10.1093/arclin/acaa024DOI Listing
August 2020

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Neuropsychology and Cognition Research Group, Department of Psychology, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma, Spain.

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