Construct Validation of a Remote Brain Health Assessment Battery to Evaluate Vocational Aptitude and Factors Associated With Cognitive Resilience in the Military: Observational Trial.

内容摘要

Vocational aptitude and cognitive resilience predict military success, yet current assessments rely on resource-intensive, in-person testing that limits scalability. A brief, self-administered, remotely deployable computerized battery offers a practical solution for large-scale screening and monitoring. This study aims to deploy a set of computerized assessments among National Guard recruits and assess their preliminary construct validity against a standardized aptitude measure and a research-based proxy for cognitive resilience. In this observational study, 267 enlisted service members from the Minnesota Army National Guard participated in 2 complementary ethics-approved observational trials: Office of Naval Research Neuropsychometrics and Advancing Research on Mechanisms of Resilience (ARMOR). National Guard soldiers in ARMOR completed the Armed Forces Qualification Test (AFQT), Penn Computerized Neurocognitive Battery (Penn CNB), and a 20-minute computerized brain health assessment battery (BrainHQ) at separate time points over the course of their military careers. BrainHQ assessments consisted of adaptive psychophysical tasks measuring the speed and accuracy of visual and auditory information processing. The battery assessed decision-making speed, emotion-processing speed, selective attention under speeded conditions, working memory capacity for speeded visual elements, verbal memory and learning of speeded speech, and problem-solving speed. The Penn CNB included nonspeeded neuropsychological assessments of executive function, verbal memory, social cognition, and reasoning. Linear regression evaluated the association between BrainHQ performance and AFQT percentiles, and partial correlations assessed associations between conceptually related BrainHQ and Penn CNB subtests. Participants were predominantly young (mean age 19.1 years) and male (178/267, 66.7%). BrainHQ performance was significantly associated with enlistment eligibility and vocational aptitude, as measured by the AFQT (P<.001), after controlling for age and education. The overall model explained 24.4% of the variance in AFQT percentiles (adjusted R2=0.227). The BrainHQ assessment composite was the strongest predictor, uniquely accounting for 19.2% of the variance and supporting the construct validity of aptitude. These associations persisted despite the temporal separation between assessment time points. Quartile analyses showed graded relationships between BrainHQ performance and AFQT eligibility thresholds, with higher BrainHQ performance associated with progressively greater probabilities of meeting higher AFQT benchmarks. Preplanned partial correlations between BrainHQ subtests and standardized neurocognitive measures from the Penn CNB showed significant positive associations (r=0.17-0.25; all P<.001 to .02) with cognitive domains typically associated with cognitive resilience. A brief, self-administered, and scalable brain health battery demonstrates associations with military vocational aptitude and with neurocognitive domains associated with cognitive resilience. Future studies should evaluate whether integrating these assessments into current practices predicts success in Basic Combat Training, guides military progression, and supports long-term cognitive screening and monitoring across the Armed Forces.