Measuring premorbid IQ in traumatic brain injury: An examination of the validity of the Wechsler Test of Adult Reading (WTAR)
Measuring premorbid IQ in traumatic brain injury: An examination of the validity of the Wechsler Test of Adult Reading (WTAR)
复制标题
DOI：
10.1080/13803390701300524
复制
发表时间：
2008-02-01
影响因子：
2.2
通讯作者：
Bradbury, Cheryl
中科院分区：
文献类型：
--
作者：
Green, Robin E. A.;Melo, Brenda;Bradbury, Cheryl
创伤性脑损伤 (TBI) 病前智商的估计具有临床和科学价值，因为它可以量化损伤对认知的影响。这是通过将当前能力测试的表现与病前智商估计进行比较来实现的，从而能够根据受伤前的能力来解释当前的能力。然而，常用于 TBI 的病前智商测试的有效性受到质疑。在本研究中，我们检查了最近开发的测试的心理测量特性，即韦克斯勒成人阅读测试（WTAR），该测试尚未针对 TBI 进行检查。在受伤后 2 个月和 5 个月时，对 24 名从 TBI 中恢复的患者（平均格拉斯哥昏迷量表评分在严重受损范围内）的认知表现进行了测量。在这两种情况下，患者都接受了三项用于测量病前智商的测试（韦克斯勒成人智力量表第三版的 WTAR 和词汇和矩阵推理子测试，WAIS-III）和三项当前能力测试（WAIS-III 的符号数字模态测试-口语和相似性以及块设计子测试）。我们发现，在当前认知能力测试中，表现显着提高，证实了康复。相反，从评估 1 (M = 34.25/50) 到评估 2 (M = 34.21/50；r = .970，p < .001)，在 WTAR 上观察到稳定的性能。评估的平均改善可以忽略不计（t = -0.086，p = .47；Cohen's d = -0.005），并且观察到个体参与者的变化最小（模态标度分数变化 = 0）。 WTAR 分数也与病前 IQ 的人口统计估计分数高度相似。因此，综合证据——TBI 恢复期间的高稳定性以及与人口统计学方程相似的 IQ 估计——表明 WTAR 是 TBI 病前 IQ 的有效衡量标准。在需要进行单词发音测试的情况下（即，在能够流利地说和阅读英语的患者中），这些结果支持对 TBI 患者使用 WTAR。
Estimation of premorbid IQ in traumatic brain injury (TBI) is clinically and scientifically valuable because it permits the quantification of the cognitive impact of injury. This is achieved by comparing performances on tests of current ability to estimates of premorbid IQ, thereby enabling current capacity to be interpreted in light of preinjury ability. However, the validity of premorbid IQ tests that are commonly used for TBI has been questioned. In the present study, we examined the psychometric properties of a recently developed test, the Wechsler Test of Adult Reading (WTAR), which has yet to be examined for TBI. The cognitive performance of a group of 24 patients recovering from TBI (with a mean Glasgow Coma Scale score in the severely impaired range) was measured at 2 and 5 months postinjury. On both occasions, patients were administered three tests that have been used to measure premorbid IQ (the WTAR and the Vocabulary and Matrix Reasoning subtests of the Wechsler Adult Intelligence Scale 3rd Edition, WAIS-III) and three tests of current ability (Symbol Digit Modalities Test-Oral and Similarities and Block Design subtests of the WAIS-III). We found that performance significantly improved on tests of current cognitive ability, confirming recovery. In contrast, stable performance was observed on the WTAR from Assessment 1 (M = 34.25/50) to Assessment 2 (M = 34.21/50; r = .970, p < .001). Mean improvement across assessments was negligible (t = -0.086, p = .47; Cohen's d = -0.005), and minimal individual participant change was observed (modal scaled score change = 0). WTAR scores were also highly similar to scores on a demographic estimate of premorbid IQ. Thus, converging evidence-high stability during recovery from TBI and similar IQ estimates to those of a demographic equation-suggests that the WTAR is a valid measure of premorbid IQ for TBI. Where word pronunciation tests are indicated (i.e., in patients for whom English is spoken and read fluently), these results endorse the use of the WTAR for patients with TBI.