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Dissertation

Interpreting the repeatable battery for the assessment of neuropsychological status with a forensis inpatient psychiatric population

9 December 2005

Abstract

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a brief neurocognitive screening instrument with normative data available for individuals ages 20-89. The RBANS has excellent psychometric characteristics and is easily administered and scored. Although the RBANS has been evaluated for use with psychiatric populations, no studies have examined RBANS performance in a forensic inpatient psychiatric setting. This study examined RBANS performance of forensic psychiatric inpatients at a large state hospital, and provided local normative data. Additionally, three hypotheses were examined. First, it was hypothesized that confounding factors, such as psychiatric comorbidity, history of alcohol/substance abuse or dependence, and external disincentives to perform optimally on testing would produce lower mean RBANS scores in this forensic population than those produced by psychiatric samples in extant RBANS studies. Second, it was predicted that patients diagnosed with schizophrenia or schizoaffective disorder would produce RBANS scores indicating significantly greater impairment than patients diagnosed with bipolar disorder or other mood disorder. Third, it was hypothesized that education level would have a significant impact on RBANS performance. Results of this study were inconclusive regarding the first two hypotheses, indicating no significant relationships between history of substance use/dependence and impaired performance. Although the bipolar sample performed better overall on the RBANS than the schizophrenic sample, the difference was not significant. Results clearly indicate education had a significant impact on RBANS performance. Age was also found to have a significant impact on two RBANS indices in this sample. Due to limitations in the research design of this study, additional research is needed to elucidate the relationships between confounding factors present in a forensic psychiatric setting and neurocognitive test performance. Although this study had several limitations, the results were generally consistent with other studies evaluating the RBANS with psychiatric populations. This study adds to the literature supporting the use of the RBANS in inpatient psychiatric" settings, and provides clinicians with a normative base for RBANS interpretation specifically for use in forensic inpatient settings.


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