B - 31 Factor Analysis of Neuropsychological Attention Measures with Mild Traumatic Brain Injury Patients

Abstract Objective Mild traumatic brain injury (mTBI) often leads to attentional deficits, yet the neuropsychological tests traditionally used may not adequately reflect the cognitive impairments these patients experience. This study aimed to critically evaluate the construct validity and factor structure of attention-related neuropsychological tests in mTBI patients to better understand and diagnose attentional deficits. Method The research utilized a battery of neuropsychological tests used to assess attention among a sample of 269 adults with mTBI including the NAB Numbers & Letters Test, PASAT, Trail Making Test, and WAIS Digit Span, Coding, and Arithmetic subtests. Exploratory factor analysis was employed to investigate the factor structure of the test battery and to test the hypothesis concerning the dimensionality of attention constructs. Results The analysis revealed that attentional measures did not converge on a single latent factor but instead reflected four distinct factors. These factors were identified as 1) Visual Attention/Psychomotor Speed, 2) Auditory Working Memory, 3) Visuospatial Scanning/Search, and 4) Disruption. Conclusions This exploratory factor analysis unveiled a distinction between auditory and visual attention mechanisms within this population. This separation suggests that attentional processes are not monolithic but rather encompass distinct auditory and visual domains and corroborates the existing literature, including Mirsky’s (1991) model of attention, which posits multiple components of attention, albeit with a focus on differentiating processes rather than sensory modalities. The study highlights the complexity of attentional impairments in mTBI and underscores the need for a nuanced approach to the neuropsychological assessment of attention among mTBI patients.