Each year, 1.6 to 3.8 million sport-related concussions occur in the United States (Langlois et al., 2006), and rates continue to increase by about 7% annually (Hootman et al., 2007). The rapid biomechanical forces of a concussion cause numerous physical, cognitive, and emotional symptoms (Aubry et al., 2002). Athletes who return to play (RTP) too soon after a concussion are at risk for the devastating effects secondary injury, including death (Cantu, 2003). Currently, the most appropriate concussion assessment procedures involve balance and neurocognitive measures (McCrory et al., 2009). However, athletes have demonstrated the ability and propensity to deceive these assessments in order to influence RTP (McCrea e al., 2004) by minimizing post-injury symptoms, or by demonstrating suboptimal effort during baseline testing (Erdal, 2012; Hunt, Ferrara, Miller, & Macciocchi, 2009). The purpose of this study was to explore the utility of a stand-alone performance validity test (PVT) in detecting suboptimal effort using an analog simulation design. Simulators demonstrated significantly lower performance on measures of verbal memory, visual memory, visual motor speed, balance, symptom severity, reaction time, and performance validity than controls. Verbal memory, visual memory, visual motor speed, and reaction time scores were predicted by the PVT embedded within ImPACT, while impulse control, symptom severity, and SAC scores were predicted by the ASTM stand-alone PVT. The two PVTs did not combine to better predict any scores. Using cutoff scores recommended by the test publishers, both PVTs obtained 100% specificity. The sensitivity of the embedded PVT within ImPACT and the ASTM stand-alone PVT were 58% and 28%, respectively. The findings suggest these performance validity tests alone may not be adequate. Future examination of the recommended cutoff scores for this testing context is warranted.
","abstract_html":"<p>Each year, 1.6 to 3.8 million sport-related concussions occur in the United States (Langlois et al., 2006), and rates continue to increase by about 7% annually (Hootman et al., 2007). The rapid biomechanical forces of a concussion cause numerous physical, cognitive, and emotional symptoms (Aubry et al., 2002). Athletes who return to play (RTP) too soon after a concussion are at risk for the devastating effects secondary injury, including death (Cantu, 2003). Currently, the most appropriate concussion assessment procedures involve balance and neurocognitive measures (McCrory et al., 2009). However, athletes have demonstrated the ability and propensity to deceive these assessments in order to influence RTP (McCrea e al., 2004) by minimizing post-injury symptoms, or by demonstrating suboptimal effort during baseline testing (Erdal, 2012; Hunt, Ferrara, Miller, & Macciocchi, 2009). The purpose of this study was to explore the utility of a stand-alone performance validity test (PVT) in detecting suboptimal effort using an analog simulation design. Simulators demonstrated significantly lower performance on measures of verbal memory, visual memory, visual motor speed, balance, symptom severity, reaction time, and performance validity than controls. Verbal memory, visual memory, visual motor speed, and reaction time scores were predicted by the PVT embedded within ImPACT, while impulse control, symptom severity, and SAC scores were predicted by the ASTM stand-alone PVT. The two PVTs did not combine to better predict any scores. Using cutoff scores recommended by the test publishers, both PVTs obtained 100% specificity. The sensitivity of the embedded PVT within ImPACT and the ASTM stand-alone PVT were 58% and 28%, respectively. The findings suggest these performance validity tests alone may not be adequate. Future examination of the recommended cutoff scores for this testing context is warranted.</p>","abstract_has_math":false,"creators":["Staples, Joshua"],"institution":null,"degree_name":"Master of Science in Kinesiology (M.S.)","degree_level":"Thesis (restricted to Georgia Southern)","degree_discipline":"Department of Health and Kinesiology","degree_department":null,"school":null,"contributors":["Jody Langdon","Thomas Buckley","George Shaver"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2015,"date_issued":"2015-01-01T08:00:00Z","date_published":"2015-01-01T08:00:00Z","updated_at":"2026-07-24T02:28:22Z","subjects":["ETD","Concussion assessment","Baseline testing","Effort","Performance validity","Amsterdam Short Term Memory Test","ASTM","Sports Sciences"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digitalcommons.georgiasouthern.edu/etd/1255","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Jody Langdon","Thomas Buckley","George Shaver"]},{"key":"dc:creator","label":"Author","values":["Staples, Joshua"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2015-04-14T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Department of Health and Kinesiology"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Thesis (restricted to Georgia Southern)"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Science in Kinesiology (M.S.)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["ETD","Concussion assessment","Baseline testing","Effort","Performance validity","Amsterdam Short Term Memory Test","ASTM","Sports Sciences"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digitalcommons.georgiasouthern.edu/etd/1255"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Each year, 1.6 to 3.8 million sport-related concussions occur in the United States (Langlois et al., 2006), and rates continue to increase by about 7% annually (Hootman et al., 2007). The rapid biomechanical forces of a concussion cause numerous physical, cognitive, and emotional symptoms (Aubry et al., 2002). Athletes who return to play (RTP) too soon after a concussion are at risk for the devastating effects secondary injury, including death (Cantu, 2003). Currently, the most appropriate concussion assessment procedures involve balance and neurocognitive measures (McCrory et al., 2009). However, athletes have demonstrated the ability and propensity to deceive these assessments in order to influence RTP (McCrea e al., 2004) by minimizing post-injury symptoms, or by demonstrating suboptimal effort during baseline testing (Erdal, 2012; Hunt, Ferrara, Miller, & Macciocchi, 2009). The purpose of this study was to explore the utility of a stand-alone performance validity test (PVT) in detecting suboptimal effort using an analog simulation design. Simulators demonstrated significantly lower performance on measures of verbal memory, visual memory, visual motor speed, balance, symptom severity, reaction time, and performance validity than controls. Verbal memory, visual memory, visual motor speed, and reaction time scores were predicted by the PVT embedded within ImPACT, while impulse control, symptom severity, and SAC scores were predicted by the ASTM stand-alone PVT. The two PVTs did not combine to better predict any scores. Using cutoff scores recommended by the test publishers, both PVTs obtained 100% specificity. The sensitivity of the embedded PVT within ImPACT and the ASTM stand-alone PVT were 58% and 28%, respectively. The findings suggest these performance validity tests alone may not be adequate. Future examination of the recommended cutoff scores for this testing context is warranted.
"]},{"key":"dc:source","label":"Dc Source","values":["Staples, J. R. (2015) Performance validity testing in baseline concussion assessment (Unpublished master's thesis). Georgia Southern University, Statesboro, Georgia."]},{"key":"dc:title","label":"Title","values":["Performance Validity Testing in Baseline Concussion Assessment"]}]}],"canonical_facts":{"dc:contributor":["Jody Langdon","Thomas Buckley","George Shaver"],"dc:creator":["Staples, Joshua"],"dc:date.available":["2015-04-14T07:00:00Z"],"dc:description.abstract":["Each year, 1.6 to 3.8 million sport-related concussions occur in the United States (Langlois et al., 2006), and rates continue to increase by about 7% annually (Hootman et al., 2007). The rapid biomechanical forces of a concussion cause numerous physical, cognitive, and emotional symptoms (Aubry et al., 2002). Athletes who return to play (RTP) too soon after a concussion are at risk for the devastating effects secondary injury, including death (Cantu, 2003). Currently, the most appropriate concussion assessment procedures involve balance and neurocognitive measures (McCrory et al., 2009). However, athletes have demonstrated the ability and propensity to deceive these assessments in order to influence RTP (McCrea e al., 2004) by minimizing post-injury symptoms, or by demonstrating suboptimal effort during baseline testing (Erdal, 2012; Hunt, Ferrara, Miller, & Macciocchi, 2009). The purpose of this study was to explore the utility of a stand-alone performance validity test (PVT) in detecting suboptimal effort using an analog simulation design. Simulators demonstrated significantly lower performance on measures of verbal memory, visual memory, visual motor speed, balance, symptom severity, reaction time, and performance validity than controls. Verbal memory, visual memory, visual motor speed, and reaction time scores were predicted by the PVT embedded within ImPACT, while impulse control, symptom severity, and SAC scores were predicted by the ASTM stand-alone PVT. The two PVTs did not combine to better predict any scores. Using cutoff scores recommended by the test publishers, both PVTs obtained 100% specificity. The sensitivity of the embedded PVT within ImPACT and the ASTM stand-alone PVT were 58% and 28%, respectively. The findings suggest these performance validity tests alone may not be adequate. Future examination of the recommended cutoff scores for this testing context is warranted.
"],"dc:identifier":["https://digitalcommons.georgiasouthern.edu/etd/1255"],"dc:source":["Staples, J. R. (2015) Performance validity testing in baseline concussion assessment (Unpublished master's thesis). Georgia Southern University, Statesboro, Georgia."],"dc:subject":["ETD","Concussion assessment","Baseline testing","Effort","Performance validity","Amsterdam Short Term Memory Test","ASTM","Sports Sciences"],"dc:title":["Performance Validity Testing in Baseline Concussion Assessment"],"thesis:degree_discipline":["Department of Health and Kinesiology"],"thesis:degree_level":["Thesis (restricted to Georgia Southern)"],"thesis:degree_name":["Master of Science in Kinesiology (M.S.)"]},"updated_at":"2026-07-24T02:28:22Z"}