Jacob Siedlik1, Spyros Siscos1, Philip Gallagher1, Jennifer Seeley2, Adam Rolf3, Karen Evans3, Phillip Vardiman1. 1Applied Physiology Laboratory, University of Kansas, Lawrence, KS; 2Department of Psychology and Research in Education, University of Kansas, Lawrence KS; 3Lawrence Memorial Hospital, Lawrence, KS.

In the United States it is estimated that 1.6 to 3.6 million concussions occur each year. Computerized neurocognitive assessment tools (NCAT) are commonly used by athletic trainers and physicians to measure cognitive abilities in healthy, non-concussed athletes. The systems are designed to measure post-concussion cognitive ability in order to thoroughly evaluate and monitor the athlete’s recovery to ensure proper return to play decisions. However, researchers are concerned that athletes would be capable of intentionally underperforming on baseline tests to expedite their return to the field following a concussion. PURPOSE: There were two specific aims of this study: 1. To investigate the test-taker’s ability to alter their NCAT baseline test scores, malingering baseline (MB) relative to a non-malingering baseline (NMB), 2. To assess the NCAT’s ability to detect MB compared to a physician trained in evaluation of results from this version of NCAT. METHODS: 20 male, collegiate rugby players completed this study (23±4yrs). Participants completed 2 NCAT assessments within a 7-day interval. Participants were initially deceived to believe this was a pre-test/post-test assessment. The NMB was measured following the NCAT’s normal sequence of instructions where they were asked to perform to the best of their abilities. Immediately prior to the second assessment (MB), each participant was debriefed about the prior deception and instructed to “underperform on the test” without specific direction on techniques to do so. NMB and MB clinical reports were generated by the NCAT system, blinded and sent to the physicians for secondary analysis. RESULTS: MB test scores were significantly lower (p < .05) than NMB scores for 12 of the 13 variables assessed as part of this study. The NCAT system detected 70% (n=14) of the MB tests, whereas the physician detected the same 14 MB tests and 2 additional (80%) from NCAT reports. CONCLUSIONS: There is a possibility that athletes would be able to malinger and alter their baseline scores using an NCAT system. This possibility is reduced with oversight by a properly trained physician familiar with the particular NCAT software. In-person clinical assessment coupled with NCAT provides the most reliable method to avoid malingering by athletes.

Supported by the University of Kansas Undergraduate Research Award.

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