Relationships Between the BRIEF/BRIEF-SR and Performance-Based Neuropsychological Tests in Adolescents with Mild Traumatic Brain Injury

Clinical neuropsychologists typically use both performance-based tests and behavioral rating scales as part of comprehensive assessment. However, literature has suggested that performance-based tests account for limited variance in behavioral rating scales in healthy and clinical populations. Importantly, little work has investigated the relationships between performance-based tests and behavioral rating scales in adolescent mild traumatic brain injury (mTBI). The present study was retrospective in nature and included 136 adolescents (M age = 14.97; 56% female) in the post-acute phase of recovery from mTBI (M days since injury = 33.4) referred for neuropsychological evaluation. Participants were administered a multi-domain neuropsychological test battery with measures of reaction time, processing speed, sustained attention, impulsivity, working memory, and verbal and visual memory, and the Behavior Rating Inventory of Executive Function (BRIEF) and BRIEF-Self Report (BRIEF-SR). Results revealed mean neuropsychological test performance and parent- and self-reported executive dysfunction within the average range. Hierarchical multiple regressions revealed that performance-based test scores accounted for between 13 and 18% variance in BRIEF scores and between 8 and 14% variance in BRIEF-SR scores after controlling for demographic factors (which accounted for 3% variance in BRIEF scores and 7–10% variance in BRIEF-SR scores). Processing speed emerged as the most consistent significant individual predictor of BRIEF/BRIEF-SR scores across regression analyses. These findings build on previous literature by suggesting relatively limited psychometric overlap between performance-based tests and behavioral rating scales, such that these approaches likely assess distinct and unique psychological constructs. Relationships to previous work, limitations of the current study, and directions for future research are discussed.