Evaluation context impacts neuropsychological performance of OEF/OIF veterans with reported combat-related concussion

Nathaniel W. Nelson, James B. Hoelzle, Kathryn A. McGuire, Amanda G. Ferrier-Auerbach, Molly J. Charlesworth, Scott R. Sponheim

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73 Scopus citations


Although soldiers of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) encounter combat-related concussion at an unprecedented rate, relatively few studies have examined how evaluation context, insufficient effort, and concussion history impact neuropsychological performances in the years following injury. The current study explores these issues in a sample of 119 U.S. veterans (OEF/OIF forensic concussion, n = 24; non-OEF/OIF forensic concussion, n = 20; OEF/OIF research concussion, n = 38; OEF/OIF research without concussion, n = 37). The OEF/OIF forensic concussion group exhibited significantly higher rates of insufficient effort relative to the OEF/OIF research concussion group, but a comparable rate of insufficient effort relative to the non-OEF/OIF forensic concussion group. After controlling for effort, the research concussion and the research non-concussion groups demonstrated comparable neuropsychological performance. Results highlight the importance of effort assessment among OEF/OIF and other veterans with concussion history, particularly in forensic contexts.

Original languageEnglish (US)
Pages (from-to)713-723
Number of pages11
JournalArchives of Clinical Neuropsychology
Issue number8
StatePublished - Dec 2010

Bibliographical note

Funding Information:
This study was supported in part by Grants funded by the Congressionally Directed Medical Research Programs (number PT074550, contract W81XWH-08-2-0038) to SRS and the Minnesota Veterans Research Institute (MVRI) to NWN.


  • Forensic neuropsychology
  • Malingering/symptom validity testing


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