The Neuropsychological Impairment Scale (NIS)

Self-Report Form
A WPS TEST REPORT by William E. O’Donnell, Ph.D., M.P.H.
Copyright ©1999 by Western Psychological Services
www.wpspublish.com
Version 1.110

ID Number: 000000001
Age: 29 Administration Date: 12/02/98
Gender: Female Processing Date: 12/05/98
Education: 15 Examiner ID Number: 123456789
Ethnicity: Native American Examiner Name: O'Donnell
Name: Sample -- Self-Report

Current Medications: None

This interpretive report for the NIS is designed for clinical evaluation purposes. The user should be familiar
with the material presented in the NIS Manual (WPS Product No. W-298C). No treatment or referral decision
should be made solely on the basis of this report without confirming information from independent sources.

Scale Raw T % T -Score

Validity Scores 30T 40T 50T 60T 70T 80T

Response Inconsistency (INC) 7 62 88 .
Defensiveness Scale (DEF) 8 46 33 .
Affective Disturbance (AFF) 19 66 94 .
Subjective Distortion Index (SDI) 3.3 >80 >99 .

Summary Scores
Global Measure Of Impairment (GMI) 160 73 99 .
Predicted GMI: 48 .
.
Total Items Circled (TIC) 56 64 92
.
Symptom Intensity Measure (SIM) 2.9 77 99
.
Impairment Subscales .
Critical Items (CRIT) 28 >80 >99 .
Cognitive Efficiency (COG) 21 71 98 .
Attention (A T T ) 21 70 97 .
Mem ory (MEM) 21 73 99 .
Frustration Tolerance (FRU) 21 73 99 .
Learning-Verbal (L-V) 12 71 98 .
Academic Skills (ACD) 19 68 96 .

2 5 10 25 50 75 90 95 98 99
<40T: Low 40-60T: Average 61-70T: High >70T: Very High
Percentile
For INC >70T: High
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Response Inconsistency Distortion of symptom reporting may be due to

The Response Inconsistency (INC) score is denial, affective distress, poor personal
used to evaluate the individual’s ability to judgment, poor awareness or misrepresentation
respond in a coherent, consistent manner. This for personal gain. It would be helpful to review
INC score of 62T does not reflect any unusual the test results with the patient to clarify her
lack of consistency in this individual’s NIS level of motivation and awareness.
responses. Summary Scores
Defensiveness The NIS provides three summary scores
The Defensiveness (DEF) score is related to that evaluate the pervasiveness and intensity of
test-taking attitude and the ability to make social an individual’s symptoms of cognitive
impairment--the Global Measure of Impairment
judgments. A DEF score of 46T indicates that
this individual was not unusually defensive when (GMI), Total Items Circled (TIC) and the
responding to NIS items, and appears to have no Symptom Intensity Measure (SIM). This client’s
unusual difficulty making social judgments. GMI score of 73T is markedly elevated and her
TIC and SIM scores are also high. The elevated
Affective Disturbance AFF score suggests that general psychological
distress may contribute to her cognitive
The Affective Disturbance (AFF) score difficulties. Her SDI score indicates that she
provides an indication of whether anxiety, overestimates the extent of her cognitive
depression or poor stress tolerance is present impairment.
that can result in the overreporting of
neuropsychological symptoms. The AFF score Impairment Subscales
of 66T for this patient is elevated. Her NIS
scores may be influenced by anxiety or The NIS Impairment Subscales evaluate the
depression. Further inquiry to determine the extent of an individual’s cognitive impairment in
nature and extent of any affective disturbance is specific symptoms areas. This client’s scores are
recommended. high on the Critical Items (CRIT), Cognitive
Efficiency (COG), Attention (ATT), Memory
Subjective Distortion Index (MEM), Frustration Tolerance (FRU),
Learning-Verbal (L-V) and Academic Skills
The Subjective Distortion Index (SDI) (ACD) scales. Emotional distress may have
provides a way to assess an individual’s contributed to the impairment subscale
tendency to exaggerate or to downplay elevations, since the AFF score is also high.
neurological symptoms and is based on a Because the AFF, FRU and CRIT scores are all
comparison of symptom reporting with the elevated a diagnosis of Organic Personality
actual performance of cognitive tasks. Before Disorder or Organic Mood Disorder should be
interpreting the SDI, the clinician should be considered.
reasonably sure that the tests used for prediction
provide an accurate reflection of the patient’s This individual obtained an elevated CRIT
abilities. score of more than 80T. The elevated CRIT
scores are usually associated with a history of
This client’s SDI score is based on her neurological trauma. The CRIT items that are
WAIS-R Digit Span score of 5 and Digit Symbol endorsed are listed at the end of this report. All
score of 12. Assuming that the tests used for such items are considered critical items.
prediction are accurate, an SDI of more than Therefore, follow-up inquiry should be
80T suggests severe overreporting of conducted for each CRIT symptom endorsed by
neuropsychological symptoms and the client’s the patient with regard to relevant medical
NIS scores should be reviewed with this in mind. history, current medications, and the onset and
WPS NIS TEST REPORT ID: 000000001 Page: 3

duration of symptoms. Memory problems are indicated by the

In the absence of affective disturbance, this relatively high MEM scale score of 73T, and
individual’s high COG score of 71T would further inquiry and testing should be conducted
suggest significant cognitive impairment. It is to clarify the nature and extent of these
important to determine whether these symptoms symptoms.
are long-standing or a result of recent illness, The FRU scale measures the degree to
and whether the symptoms have improved or which irritability and volatility are a problem for
worsened over time. Patients with high COG the patient. Considering this relatively high FRU
scores often have difficulty with reasoning and score of 73T, it will be especially helpful to
problem solving. They may exhibit psychomotor identify specific situations in which FRU
slowness and cognitive rigidity, and have symptoms occur and any strategies the patient
difficulty coping with fast-paced environments. has developed for coping with such symptoms.
Additional testing should include a more detailed Whenever elevated FRU and AFF scores are
examination of the patient’s reasoning and observed together, the possibility of Organic
problem-solving abilities. Personality Disorder should be considered.
Difficulty with attention or concentration is The L-V scale score of 71T obtained by this
indicated by this ATT score of 70T. High ATT individual is high and typical of patients with
scores are sometimes associated with agitation aphasic difficulties or reasoning problems.
or restlessness. Further testing is recommended
This individual’s relatively high ACD score
to identify the specific situations where this
of 68T may be related to recent neurological
symptom is noticed, the coping strategies that
trauma or to a long-term learning disability.
have been used and any other details regarding
Clarification on the basis of the patient’s clinical
the symptom that may clarify its nature and
history should be pursued.
facilitate treatment.

Critical Items
The following critical items were endorsed. Further inquiry about the onset and duration of these
symptoms in the context of the patient’s medical history and current medications is recommended.

Item Response
45. I have been knocked unconscious. 4 = Extremely
48. I have had a head injury. 4 = Extremely
79. I have had epileptic seizures. 4 = Extremely
86. I have trouble with the right side of my body. 4 = Extremely
92. I have severe headaches. 4 = Extremely
94. I suffer from severe pain. 3 = Quite A Bit
46. Part of my body feels numb. 2 = Moderately
63. My muscles are weak. 2 = Moderately
38. My health is getting worse. 1 = A Little Bit
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Inconsistent Item Pairs

Item Response
7. I often feel sad and blue. 3 = Quite A Bit
57. I feel depressed most of the time. 2 = Moderately

8. My words get mixed up. 3 = Quite A Bit

81. I have trouble talking. 1 = A Little Bit

15. I have serious memory problems. 4 = Extremely

52. I have trouble remembering important things. 3 = Quite A Bit

23. My thinking becomes blocked. 4 = Extremely

33. I get confused easily. 2 = Moderately

70. Doing simple math problems in my head is difficult. 3 = Quite A Bit

85. My arithmetic is poor. 4 = Extremely
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Item Responses

1. 4 11. 3 21. 3 31. 0 41. 1 51. 3 61. 2 71. 0 81. 1 91. 3

2. 3 12. 0 22. 0 32. 3 42. 4 52. 3 62. 3 72. 3 82. 0 92. 4
3. 3 13. 0 23. 4 33. 2 43. 0 53. 3 63. 2 73. 3 83. 4 93. 3
4. 3 14. 3 24. 0 34. 0 44. 3 54. 3 64. 0 74. 4 84. 3 94. 3
5. 0 15. 4 25. 0 35. 4 45. 4 55. 0 65. 4 75. 3 85. 4 95. 3
6. 0 16. 0 26. 2 36. 4 46. 2 56. 0 66. 1 76. 1 86. 4
7. 3 17. 2 27. 3 37. 2 47. 0 57. 2 67. 1 77. 2 87. 1
8. 3 18. 0 28. 0 38. 1 48. 4 58. 0 68. 1 78. 3 88. 4
9. 0 19. 0 29. 0 39. 1 49. 0 59. 0 69. 2 79. 4 89. 1
10. 3 20. 0 30. 0 40. 1 50. 4 60. 2 70. 3 80. 2 90. 3

Response Key
0 Not At All
1 A Little Bit
2 Moderately
3 Quite A Bit
4 Extremely
- Missing Response

Number of Missing Responses: 0

This report was generated based on WPS TEST REPORT Microcomputer Data Entry.

END OF REPORT