Quantifying the Effect of Sleepiness and Mood on Gross Neuropsychological Functioning in a Forensic Population with a History of Traumatic Brain Injury

Date of Award


Document Type

Doctoral Research Paper

Degree Name



Graduate School of Professional Psychology

First Advisor

Kimberly Gorgens, Ph.D., ABPP

Second Committee Member

Marybeth Lehto, Ph.D.

Third Committee Member

Laura Meyer, Ph.D.

Fourth Committee Member

Gina Signoracci, Ph.D.


Traumatic brain injury, Assessment, Depression, Sleep, Forensic

Publication Statement

Copyright held by the author. Permanently suppressed.


Traumatic brain injury (TBI) is a serious public health concern and in justice-involved populations the prevalence is significantly higher. Furthermore, inmates and probationers are also at a higher risk for mental health issues and are more likely to experience sleepiness. Both sleep and mood disturbance have been linked to poor cognitive performance. These state-dependent cognitive changes can undermine the evaluation of true cognitive ability and contaminate the validity of assessment results. This study looked at the effects of sleep and mood on neurocognitive functioning and its impact on the validity of assessment results in this particularly vulnerable population. A multiple linear regression was used to examine the relationship between self-reported sleepiness, mood state, and cognitive performance. Higher endorsement of negative mood states was related to lower cognitive performance overall. Sleepiness predicted worse performance on an attention and processing speed task at the end of the battery, whereas positive mood predicted better performance on a different trial of the same task at the beginning of the battery. The present study confirms that negative mood adversely affects global neurocognitive test performance in a population of justice-involved persons. It also suggests that sleepiness predicts impaired attention and processing speed, but only toward the end of a testing sequence. Conversely, positive mood was related to better scores on the same task at the beginning of a testing sequence. Overall, examiners should be aware that sleepiness and mood states have an effect on test performance during even brief cognitive batteries. The current findings suggest that it is imperative to screen and identify sleepiness and negative mood symptoms as they may depress test results and threaten the validity or test interpretations and recommendations.


36 pgs

Paper Method

Empirical - Quantitative

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