Abstract

Abstract Objective In the context of sports-related concussion (SRC) evaluations, athletes have been shown to “sandbag” their baseline testing in order to improve their chances of return-to-play post-concussion. To circumvent this problem, performance validity tests are often administered. The ImPACT, a widely used computerized program in SRC evaluations, has five embedded validity indices (VIs); however, indications of their use as measures of effort have not been well established. With this in mind, we aimed to compare performance on the ImPACT VIs between athletes and non-athlete controls at baseline. Given the incentive to “sandbag” by at least some players, it was hypothesized that athletes would demonstrate poorer performance on all VIs than controls. Method Participants included 1,254 college students (70% male; 77.3% Caucasian) divided into two groups: athletes (n = 929) and non-athlete controls (n = 325). All participants completed the ImPACT individually. Primary outcomes of interest included the five ImPACT VIs: Impulse Control Composite, X’s and O’s Total Incorrect, Word Memory Learning Percent Correct, Design Memory Learning Percent Correct, and Three Letters Total Letters Correct. Results Independent samples t-tests revealed that athletes performed worse than controls on 4 of the 5 VIs (p = < .001 to .028; d = 0.13 to 0.23). The only VI that was not significantly different between groups was Three Letters (p>.05, d = 0.11). Conclusion Consistent with our hypotheses, findings generally showed that athletes demonstrated worse performance on the ImPACT VIs compared to non-athlete controls. Although future research is needed to validate the utility of the VIs, our results suggest that these scores may be useful in detecting suboptimal baseline performance.

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