Evaluating the ecological validity of neuropsychological tests has
become an increasingly important topic. Previous research suggests that
neuropsychological tests have a moderate level of ecological validity when
predicting everyday functioning. The presence of depressive symptoms,
however, may impact the relationship between neuropsychological tests and
real world performance. The current study empirically tests this
hypothesis in a sample of 216 participants with moderate to severe
traumatic brain injury (TBI) who completed neuropsychological testing,
self-report of mood symptoms, and report of everyday functioning six
months post-injury. Contrary to some previous research and clinical lore,
results indicated that depression was weakly related to neuropsychological
test performance, although it was more strongly related to everyday
functioning. Neuropsychological test performance was also significantly
related to everyday functioning. The ecological validity of the
neuropsychological tests together was not impacted by depressive symptoms,
when predicting significant other ratings of functional status. However,
patient self-report seems somewhat less related to neuropsychological
performance in those with significant depressive symptoms.
Neuropsychological test performance was equally related to self and other
report of everyday functioning in patients without significant depressive
symptoms. (JINS, 2007, 13, 377–385.)