A differential diagnosis between head injury and depression is critical to ensure proper treatment and appropriate interventions. Knowledge about this can only aid counseling psychologists' work with this population and, identifying a measure that can assist in this process is essential. The purpose of this study is to measure the utility of the Dean — Woodcock Neuropsychological Assessment System (D-WNAS) in distinguishing individuals with head injury from those who have a primary diagnosis of depression, and general neurological impairment. Participants included 433 adults (222 males, 211 females) between the ages 20-55 years of age (mean = 35.3 years, SD = 10.97 years) from the Midwestern United States. During the individual's treatment in the neuropsychological laboratory, each person was administered the following: the Dean-Woodcock Structured Interview (Dean & Woodcock, 1999), mental status exam, the Woodcock Johnson — Revised Tests of Cognitive Ability (WJ-R COG; Woodcock & Johnson, 1989b), the Woodcock Johnson — Revised Tests of Achievement (WJ-R ACH; Woodcock & Johnson, 1989a), and the Dean-Woodcock Sensory Motor Battery (DWSMB; Dean & Woodcock, 1999). This study indicates that responses to D-WNAS can be used to reliably classify adults into groups of depression, head injury, and general neuropsychological impairment. In particular, responses to the D-WSMB portion of the D-WNAS can be used to reliably classify adults into groups of depression, head injury, and general neuropsychological impairment. Classification results revealed that the original grouped cases were classified with 62.6 % (p < .001) accuracy and with 73.2% overall accuracy when the head injury and general neurological impairment groups were combined and compared to depression and normative groups. The WJ-R COG and WJ-R ACH were not as reliable as the D-WSMB at predicting group membership. / Department of Counseling Psychology and Guidance Services

Clinical neuropsychologists who assess patients following mild closed head injury (CHI) are often asked to offer an opinion whether there is evidence of malingering. Factors that impact the ability of a person to intentionally portray impairment are quite important since mis-diagnosis of malingering can result in delayed treatment. In this study knowledge of the sequelae of mild CHI was provided to normal college students in an effort to change reporting of symptoms and influence the type of malingering strategy used when completing the Neuropsychological Symptom Inventory (NSI). Subjects were randomly assigned to either a prior knowledge malingering group (PK;N=57), no prior knowledge malingering group (NPK;N=58), or control group (CON;N=61). The results showed that PK subjects endorsed more general and attention/concentration symptoms than NPK or CON subjects. The results also showed PK subjects were as likely to be detected by the NSI lie scale as NPK subjects. Thus, the NSI lie scale demonstrated sensitivity to malingering despite subjects having brief instruction about mild CHI. Also, having prior knowledge did not result in significantly different strategies when completing the NSI. Instead, both malingering groups reportedly used exaggeration and attempted to be consistent as frequent strategies. / Department of Educational Psychology

published_or_final_version / Electrical and Electronic Engineering / Master / Master of Philosophy

published_or_final_version / abstract / Medicine / Master / Doctor of Medicine

published_or_final_version / Diagnostic Radiology / Doctoral / Doctor of Philosophy

The purpose of this study was to examine the utility of the Dean-Woodcock Sensory Motor Battery (DWSMB) as a diagnostic tool for identifying individuals with and without closed-head injury, comparing the predictive power of a two- and three-factor representation (DWSMB; Dean & Woodcock, 2003). The current study's major research questions focused on the predictive utility of the structure of the DWSMB. The simplified two-factor model (Total Sensory and Total Motor), based on the DWSMB manual (Dean & Woodcock), was compared to a three-factor theoretical model (Basic Sensory, Higher Sensory and Motor Functions) (R.S.Dean, personal communication, March 29, 2006) for this study. Logistic Regression was used to analyze the data. Results from this study demonstrate that when using the two-factor solution, the overall correct prediction of group membership was 73.8 % (59.4% for CHI and 85.2% for normals). The Total Motor Impairment variable was the only meaningful predictor. The results from the three-factor solution show an 84.2 % overall correct prediction rate (71.4 % for CHI and 95.1 % for normals). The significant contributors for identifying CHI when using the three-factor model included Basic Sensory and Motor Functions. Everything favors the three-factor model as being more precise. All indicators of prediction accuracy and goodness of fit favored the three-factor model. Based on these results, the DWSMB was determined to be a good screening instrument for identifying children in school contexts who should be referred for a neuropsychological examination to confirm pre-existing CHI that interfere with school functioning. / Department of Educational Psychology