Discrepancy Between Predicted and Obtained WAIS-R IQ Scores Discriminates Between Traumatic Brain Injury and Insufficient Effort

This study examines how well the discrepancy between predicted and obtained Wechsler Adult Intelligence Scale-Revised (WAIS-R) scores discriminate between insufficient effort (IE) and traumatic brain injury (TBI). The 27 IE patients performed significantly more poorly on the WAIS-R than the 48 moderate-severe TBI patients. Premorbid IQs were calculated with formulae that use demographics (Barona Index) or demographics and WAIS-R performance (Best-3 and the Oklahoma Premorbid Intelligence Estimation). Predictions were similar on the Barona, but IE patients' predicted IQs were lower than TBIs for measures with a performance component. IE patients demonstrated a greater discrepancy score (i.e., predicted IQ − obtained IQ) than TBIs; variable levels of sensitivity and specificity were obtained when discriminate functions were developed on these scores. The potential advantage of using discrepancy scores versus performance-based measures to detect insufficient effort is discussed.