ptsd Got back my NEUROPSYCHOLOGY REPORT.... what does it mean?

[ozboi]

Short history on me.... 50% SC PTSD, 10% Tinutis.... 3x OIF Veteran, IED blast exposure on 3rd tour......

 

I took an a test that lasted about all damn day last month..... finally checked myhealthevet and got the results back from the Blue Button from the VA PHD NEUROPSYCHOLOGIST.... can someone please tell me what all this crap means? It sounds BAD to me!!!!!

 

 

VALIDITY:

Test results were below cutoff scores on measures of effort and motivation.  He 
had 1 score less than 5% for validity battery, and the TBI group had 9% with 
this pattern. An additional measure of validity was below 15% cut off again 
consistent with 9% of the TBI group.  Embedded scores of validity on 2 cognitive 

functioning tests indicated likely invalid scores.  The pattern of scores on 
memory and attention tests were not associated with mild TBI or PTSD. 
Therefore, the scores from the battery of tests was considered to have below 
standard validity and reliability, and they will not be reported.

EMOTIONAL FUNCTIONING:

Patient was administered two tests of psychological functioning with results of 
clinical symptoms of depression and anxiety.  These can be followed up by his 
menta
l health providers.

FUNCTIONAL MEASURES:

Regarding behaviors associated with executive functioning, the patient reported 
problems with organization and problem-solving and self-regulation of emotions. 
Time management, self-restraint, and motivation scales were within the normal 
range.  Regarding functional skills, the patient reported impairment within the 
clinical range regarding functioning at home with family, work, interactions 
with strangers and friends, driving, daily responsibilities, and health 
maintenance.  He reported normal functioning with regard to completing chores at 

home, his marital relationship, money management, sexual relations, self-care 
routines, and childrearing.

DIAGNOSTIC IMPRESSIONS:

No diagnosis: results inconclusive
PTSD symptoms by history and reported psychological distress

SUMMARY & CONCLUSIONS:

Performance was notable for evidence of psychological distress in context of 
complaints of severe cognitive problems and psychological problems, and 
inconsistent report of daily living functional skills.

Given medical record and current complaints, it is likely the patient continues 
to experience symptoms of depression and anxiety that may interfere with 
cognitive functioning, especially attention and concentration processes which 
then reduce functional memory skills.  Self-report of depression and anxiety 
symptoms were associated with clinical mood disorders.  Due to the below 
standard validity of test performances and the concern about inconsistencies in 
observed and reported functioning on the mental status exam versus the patient's 

complaints, no diagnosis can be confirmed in these results.

RECOMMENDATIONS:

1.      Continue mental health treatment with regular follow-up concerning 
multiple reported symptoms of depression, anxiety, and PTSD and behavior 
evidencing poor coping skills.  It is recommended the patient enroll in the 
evidence based treatment program for PTSD.
2.      Medication management should consider limited response to current 
regimen for all symptoms including PTSD, depression, and headache pain.
3.      Sleep disorder exam to determine if additional treatment is needed for 
insomnia and reported restless sleep with nightmares.
4.      TBI team follow-up to monitor treatment progress and coordinate care. 
5.      Speech therapy treatment to address the patient's cognitive complaints 
directly and provide techniques to improve his attention and short-term memory 
functioning.

 

What is the NEUROPSYCHOLOGIST saying here?

Is the PHD NEUROPSYCHOLOGIST trying to blaime all on my PTSD???!!!!! 

 

[Berta]

There is some stuff here you might sure want to read:

 

http://www.disabledveterans.org/2014/05/16/va-screwing-tbi-vets-quick-facts-tbi-evaluation/

http://www.disabledveterans.org/2016/05/05/veterans-affairs-tbi-scandal-affected-25000-veterans/

 

"To ensure that TBI is properly evaluated for disability compensation purposes, VA developed a policy in 2007 requiring that one of four specialists – a psychiatrist, physiatrist, neurosurgeon or neurologist – complete TBI exams when VA does not have a prior diagnosis."

(from above links) The doctor was obviously well qualified to do the exam but I think he used the Glascow Coma criteria and not the tests mentioned in the links above.

http://www.disabledveterans.org/2016/06/02/secretary-bob-mcdonald-announces-tbi-scandal-fix

Do you know the name of the testing he gave you?

[ozboi]

Hey thank you for your response....

I haven't file a claim for TBI..... not sure that I will now from what The neuropsychologist is saying I do not have it.....

 

Here are the tests I was given

 

PROCEDURES ADMINISTERED:

Barkley Functional Impairment Scale
Barkley Deficits in Executive Functioning Scale
Beck Anxiety Inventory
Beck Depression Inventory (BDI-II)
Boston Naming Test (BNT)
California Verbal Learning Test ? II
Clinical Interview 
Conners Continuous Performance Test 3rd Edition
Delis-Kaplan Executive Functioning System Trail Making
Delis-Kaplan Executive Functioning System Verbal Fluency
Delis-Kaplan Executive Functioning System Color Word Interference 
Grooved Pegboard Test
Mental Status Exam
Records review
Rey Osterreith Complex Figure Copy and Recall Trials
Symptom Validity Tests
Test of Premorbid Functioning
Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Subtests
Wechsler Memory Test ? IV Subtests
Wisconsin Card Sorting Test (WCST) Computer Version 4

[Berta]

I am confused...how did you get a TBI C & P if you have not formally claimed it yet?

Maybe this was some sort of pre screening???

The residuals of TBI are rating as found in this recent BVA decision:

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp16/Files2/1617317.txt

The exam says" Therefore, the scores from the battery of tests was considered to have below 
standard validity and reliability, and they will not be reported."

That is an odd remark. My husband had to take 6 tests that took 2 days at the VA to assess a stroke and then separate it from his 30% PTSD. Wechsler and put the pin in the box test were two of them.

VA denied having any record of the testing and results  but the shrink who gave him those tests assured me they did have them and, he sent them to the RO himself again.

He also gave me a write up assessment of the results which awarded 100% SC for PTSD P & T in 1997 ( as soon as he sent the records in again to the RO) and then 100% P & T as if SC (1151) for the stroke in 2012. There was more evidence I had for these claims,still pending when he died but I am surprised at the remark from the doc suggesting those tests had no value to the assessment.

" IED blast exposure on 3rd tour...... " is that confirmed in your SMRs?

 

 

[ozboi]

Thank you very much for your response....

I am confused...how did you get a TBI C & P if you have not formally claimed it yet?

That is correct, I have not file a claim for TBI yet.

I was being seen at the VAMC by a Spinal Cord and Brain Injury Medicine (Specialist/Doctor?) 

I was  referred by the  Spinal Cord and Brain Injury Medicine (Specialist/Doctor?) for neuropsychological assessment regarding TBI with brief loss of consciousness, and screening results were impaired 
attention, short-term memory, long-term memory, directionality, arithmetic 
skills, and insight.

 

Maybe this was some sort of pre screening???

This is what is listed on myhealthevet:

"
 LOCAL TITLE: NEUROPSYCHOLOGICAL EVALUATION REPORT               
STANDARD TITLE: NEUROPSYCHOLOGY REPORT     "

 

The exam says" Therefore, the scores from the battery of tests was considered to have below 
standard validity and reliability, and they will not be reported."

This is the part that I do not understand..... 

That is an odd remark. My husband had to take 6 tests that took 2 days at the VA to assess a stroke and then separate it from his 30% PTSD. Wechsler and put the pin in the box test were two of them.

" IED blast exposure on 3rd tour...... " is that confirmed in your SMRs?

Yes I have documentation in my SMRs, I am rated 50% PTSD because of it.

 

Anyone care to chime in?

Should I file a claim for TBI or not after this (what seems like a negative) NEUROPSYCHOLOGICAL EVALUATION REPORT?

Edited July 7, 2016 by ozboi
Forgot to answer a question that was asked

[Andyman73]

I know nothing of which you speak, in relation to TBI and PTSD.  However, I too, recently enjoyed neuropsych testing.  Some of my results came back as inconclusive, because the scores were not inline with the overall picture...and were not reported.  Some were below average, some were average. One came back at 4%, which was deemed borderline(borderline to what??!!??)

The report says short and long term memory losses possibly due to my MDD, and chronic sleep issues, both which are aggrevated by my chronic pain issues.(that are SCd). 

I'd say file that TBI claim.

[armorer]

The VA is not going to do any tests with false positives and/or representative values. You can bet the only tests performed, and especially suggested without prompting from the vet, will tend to be false negative tests. A psychiatrist is the worst example of a physician possible and I would stay clear of them at all costs. They are a pure waste of oxygen, imo, and their bogus tests don't mean squat in reality. For mental, a psychologist is far superior in tangible results, and a neurologist is better from a M.D.'s perspective (it's hard to find a stupid VA M.D. with neurology education, unless they are a starving student just graduated.) And a N.P. wouldn't be qualified to fill in as neurologist, like they do for (bad) psychiatrists. ymmv