Affiliations: Epic Rehab, 188 Woodlands Place Court, St. Charles, MO
63303, USA. Tel.: +1 636 346 8869; Fax: +1 636 898 0954; E-mail:
len@epicrehab.com
Abstract: Objective: To study whether severity of traumatic brain injury and
the intelligence quotient are related to executive dysfunction. Participants: Sixty-two adults with brain injury who were referred for a work
capacity evaluation. Methods: Retrospective review of severity of
traumatic brain injury, intelligence quotient from a previously-conducted
neuropsychological evaluation, determination of executive function status from
the neuropsychological evaluation, and both self-report and informant-report
executive dysfunction scores from the Behavior Rating Inventory of Executive
Function. Results: Executive dysfunction and the intelligence quotient
are related to severity of traumatic brain injury, but executive dysfunction
and the intelligence quotient are not related to each other. Executive
dysfunction as determined by a neuropsychological evaluation was not consistent
with clients' self-reports but was consistent with informant-reported executive
dysfunction. Five types of executive dysfunction were reported by knowledgeable
informants, with significant elevations on the Shift, Plan/Organize, Task
Monitor, Organization of Materials, and Working Memory BRIEF clinical scales. Conclusions: The intelligence quotient is not a useful indicator of
executive dysfunction. Informant-report executive dysfunction is a reliable and
potentially useful adjunct to a neuropsychological evaluation. Working memory
is the most severe type of executive dysfunction and may not be adequately
measured by current neuropsychological evaluation methods.
