Development of demographic norms for four new WAIS-III/WMS-III indexes

The BNT-15 provides an accurate measure of English proficiency in cognitively intact bilinguals - a study in cross-cultural assessment

This study was designed to replicate earlier reports of the utility of the Boston Naming Test - Short Form (BNT-15) as an index of limited English proficiency (LEP). Twenty-eight English-Arabic bilingual student volunteers were administered the BNT-15 as part of a brief battery of cognitive tests. The majority (23) were women, and half had LEP. Mean age was 21.1 years. The BNT-15 was an excellent psychometric marker of LEP status (area under the curve: .990-.995). Participants with LEP underperformed on several cognitive measures (verbal comprehension, visuomotor processing speed, single word reading, and performance validity tests). Although no participant with LEP failed the accuracy cutoff on the Word Choice Test, 35.7% of them failed the time cutoff. Overall, LEP was associated with an increased risk of failing performance validity tests. Previously published BNT-15 validity cutoffs had unacceptably low specificity (.33-.52) among participants with LEP. The BNT-15 has the potential to serve as a quick and effective objective measure of LEP. Students with LEP may need academic accommodations to compensate for slower test completion time. Likewise, LEP status should be considered for exemption from failing performance validity tests to protect against false positive errors.

Measuring Goal Setting in School-Aged Children: Studying the Effects of Demographic Variables in Regression-Based Norms

The aim of the study was to establish demographically representative norms for tasks measuring goal setting, and more specifically planning and reasoning in children. Three tasks were administered to n = 195 Ukrainian children aged 5.10 to 14.5 years old: the Spatial Working Memory (SWM), the Stockings of Cambridge (SOC) test, and the Naglieri Nonverbal Ability Test (NNAT). Main outcome per test was accuracy: i.e., the total number correct for the SOC and NNAT, and the total amount of incorrect responses for the SWM. Correlations among accuracy measures varied from − 0.51 to 0.60, indicating these tasks measure related but at the same time unique constructs. Higher age was associated with more accurate test performances on all outcome measures. On the NNAT, we found a curvilinear association between age and accuracy, indicating that younger children’s NNAT accuracy scores increased more with age compared with older children. We found a cubic age effect on accuracy for the SWM and SOC: i.e., test scores were relatively stable at younger and older ages, with a curvilinear increase in test scores in the other age groups. Demographically corrected norms were calculated and presented per test. These indicated that sex was not associated with accuracy scores on any of the tests. Last, a higher level of parental education (LPE) was associated with higher accuracy scores, but only on the NNAT. We conclude that demographic variables in norm analyses enhance insight in the scores and allow for application in clinical settings and research.

Examining Gender Differences in Neurocognitive Functioning Across Adulthood

OBJECTIVE

Previous research has shown that women have an advantage on verbal episodic memory and processing speed tasks, while men show an advantage on spatial ability measures. Previous work has also found differences in cognition across age. The current study examines gender differences in neurocognitive functioning across adulthood, whether age moderates this effect, and whether these differences remain consistent with practice across multiple testing sessions.

METHOD

Data from the Virginia Cognitive Aging Project were used, which included participants between the ages of 18 and 99 years (N = 5125). Participants completed measures assessing five cognitive domains: episodic memory, processing speed, reasoning, spatial visualization, and vocabulary.

RESULTS

Results showed that gender was significantly related to memory, speed, and spatial visualization, but not to vocabulary or reasoning. Results of invariance analyses across men and women provided evidence of configural and metric invariance, along with partial scalar invariance. Additionally, there was little evidence that age or practice influenced the gender effect on neurocognition.

CONCLUSIONS

Consistent with the previous research, these results suggest that there is a female advantage in episodic memory and processing speed, and a male advantage in spatial visualization. Gender was shown to influence cognition similarly across adulthood. Furthermore, the influence of gender remained the same across three sessions, which is consistent with the previous work that has shown that training does not differentially impact performance on spatial ability measures for females compared to males.

Factor Structure of the CVLT-II Short Form: Evidence From a Trauma-Exposed Sample

The current study sought to investigate the factor structure of the California Verbal Learning Test-Second Edition (CVLT-II) Short Form in a trauma-exposed sample. We used confirmatory factor analysis to test four competing models proposed by Donders in a study investigating the CVLT-II Standard Form. Consistent with Donders, a four-factor model consisting of Attention Span, Learning Efficiency, Delayed Memory, and Inaccurate Memory was supported. These results confirm the latent structure of the CVLT-II holds for the CVLT-II in its Short Form as well as in a trauma-exposed sample. Findings are particularly important, given previous research indicating attention span and learning efficiency may underpin memory complaints in trauma-exposed individuals.

Regression-Based Norms for a Bi-factor Model for Scoring the Brief Test of Adult Cognition by Telephone (BTACT)

The current study developed regression-based normative adjustments for a bi-factor model of the The Brief Test of Adult Cognition by Telephone (BTACT). Archival data from the Midlife Development in the United States-II Cognitive Project were used to develop eight separate linear regression models that predicted bi-factor BTACT scores, accounting for age, education, gender, and occupation-alone and in various combinations. All regression models provided statistically significant fit to the data. A three-predictor regression model fit best and accounted for 32.8% of the variance in the global bi-factor BTACT score. The fit of the regression models was not improved by gender. Eight different regression models are presented to allow the user flexibility in applying demographic corrections to the bi-factor BTACT scores. Occupation corrections, while not widely used, may provide useful demographic adjustments for adult populations or for those individuals who have attained an occupational status not commensurate with expected educational attainment.

Increasing culturally competent neuropsychological services for ethnic minority populations: a call to action

US demographic and sociopolitical shifts have resulted in a rapidly growing need for culturally competent neuropsychological services. However, clinical neuropsychology as a field has not kept pace with the needs of ethnic minority clients. In this discussion we review: historical precedents and the limits of universalism in neuropsychology; ethical/professional guidelines pertinent to neuropsychological practice with ethnic minority clients; critical cultural considerations in neuropsychology; current disparities germane to practice; and challenges to the provision of services to racial/ethnic minority clients. We provide a call to action for neuropsychologists and related organizations to advance multiculturalism and diversity within the field by increasing multicultural awareness and knowledge, multicultural education and training, multicultural neuropsychological research, and the provision of culturally competent neuropsychological services to racial/ethnic minority clients. Lastly, we discuss strategies for increasing the provision of culturally competent neuropsychological services, and offer several resources to meet these goals.

Detection of early amnestic mild cognitive impairment without significantly objective memory impairment: a case-controlled study

BACKGROUND

We encountered eight early amnestic mild cognitive impairment (aMCI) patients (early MCI group) who did not fulfill the diagnostic criteria for aMCI. We compared the scores of neuropsychological examinations as well as the cerebral metabolic rate for glucose consumption (CMRglc) decrease on (18)F-FDG PET examination between the early MCI group and 10 aMCI patients (MCI group) or six normal elderly subjects (normal group), to examine whether the current diagnostic criteria can detect early-stage aMCI.

METHODS

The three groups underwent Mini-Mental State Examination (MMSE), Wechsler Adult Intelligence Scale - Third Edition (WAIS-III), Wechsler Memory Scale Revised (WMS-R), magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) examinations.

RESULTS

The early MCI group did not show significant memory impairment of 1.0 SD or other cognitive dysfunctions on neuropsychological examinations, and did not fulfill the diagnostic criteria of aMCI. With one-way anova and Tukey's HSD post-hoc test, the early MCI group showed the highest scores for WAIS-III, whereas the MCI group showed the lowest scores for WMS-R, although there were no significant differences between the early MCI and normal groups. In order to show a discrepancy in scores between WAIS-III and WMS-R, we subtracted the scores of WMS-R from WAIS-III. Consequently, the normal group showed significantly smaller differences in scores than the other groups, although there were no significant differences between the early MCI and MCI groups. (18)F-FDG PET recognized a CMRglc decrease in the posterior cingulate gyrus and/or part of the parietotemporal area in both the MCI and early MCI groups, of which the extent and magnitude were weaker in the early MCI group. The normal group did not show a significant CMRglc.

CONCLUSIONS

The early MCI group should be included in aMCI not only based on the discrepancy between intelligence and memory scores, but also based on the (18)F-FDG PET findings. The combination of these examinations would make it possible to diagnose early-stage aMCI.

A confirmatory factor analysis of the California Verbal Learning Test--Second Edition (CVLT-II) in a traumatic brain injury sample

The latent structure of the California Verbal Learning Test-Second Edition (CVLT-II) was examined in a clinical sample of 223 persons with traumatic brain injury that had been screened to remove individuals with complicating premorbid (e.g., psychiatric) or comorbid (e.g., financial compensation seeking) histories. Analyses incorporated the z scores from 12 CVLT-II variables. Maximum-likelihood confirmatory analyses were performed to test the fit and parsimony of four hypothetical models. A four-factor model, consisting of Attention Span, Learning Efficiency, Delayed Memory, and Inaccurate Memory, met all the a priori specified criteria for model fit and parsimony. This model was consistent with that identified previously in a confirmatory factor analysis of the CVLT-II standardization sample. The results support the construct validity of the CVLT-II in individuals with traumatic brain injury and indicate that a multifactorial interpretation is appropriate for clinical practice.

Neuropsychological, cognitive, and theoretical considerations for evaluation of bilingual individuals

As the number of bilinguals in the USA grows rapidly, it is increasingly important for neuropsychologists to be equipped and trained to address the unique challenges inherent in conducting ethical and competent neuropsychological evaluations with this population. Research on bilingualism has focused on two key cognitive mechanisms that introduce differences between bilinguals and monolinguals: (a) reduced frequency of language-specific use (weaker links), and (b) competition for selection within the language system in bilinguals (interference). Both mechanisms are needed to explain how bilingualism affects neuropsychological test performance, including the robust bilingual disadvantages found on verbal tasks, and more subtle bilingual advantages on some measures of cognitive control. These empirical results and theoretical claims can be used to derive a theoretically informed method for assessing cognitive status in bilinguals. We present specific considerations for measuring degree of bilingualism for both clients and examiners to aid in determinations of approaches to testing bilinguals, with practical guidelines for incorporating models of bilingualism and recent experimental data into neuropsychological evaluations. This integrated approach promises to provide improved clinical services for bilingual clients, and will also contribute to a program of research that will ultimately reveal the mechanisms underlying language processing and executive functioning in bilinguals and monolinguals alike.

Voxel-based diffusion tensor magnetic resonance imaging evaluation of low-grade hepatic encephalopathy

PURPOSE

To quantify the changes in brain water diffusivity in hepatic encephalopathy (HE) associated with cirrhosis using diffusion tensor imaging (DTI) and to correlate with neuropsychological (NP) scores.

MATERIALS AND METHODS

DTI was performed in 14 patients with low-grade HE and age/gender-comparable 16 healthy controls. Whole brain mean diffusivity (MD) and fractional anisotropy (FA) maps were calculated, normalized to common space, smoothed, and compared voxel-by-voxel between groups using analysis of covariance with age included as a covariate. The average MD and FA values were also calculated from individual subjects for selected brain regions and correlated with the neuropsychological scores.

RESULTS

Patients with HE showed increased MD in the cortical gray and white matter and the internal capsule. Less extensive brain regions with decreased FA were observed in the bilateral frontal and occipital white matter. MD values from the corpus callosum correlated inversely with several NP scores among HE patients and controls. Positive correlations were observed with FA values and cognitive scores.

CONCLUSION

Voxel-based DTI analysis showed widespread brain regions with increased MD values, indicating enhanced water content and decreased FA in cirrhotic patients with HE. The MD and FA values from selected regions correlated with the NP scores.

A confirmatory factor analysis of the California Verbal Learning Test--Second Edition (CVLT-II) in the standardization sample

The purpose of this study is to determine the latent structure of the California Verbal Learning Test-Second Edition (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000) at three different age levels, using the standardization sample. Maximum likelihood confirmatory factor analyses are performed to test four competing hypothetical models for fit and parsimony. A four-factor model consisting of Attention Span, Learning Efficiency, Delayed Memory, and Inaccurate Memory provides the best fit to the data at two age levels (16-30 years and 31-60 years, respectively) but the factor structure is somewhat less robust in the oldest age group (>60 years). The results clarify the latent structure of the CVLT-II and suggest that a multifactorial interpretation of quantitative and qualitative indexes from this instrument is appropriate for clinical practice with most adults, although findings may need to be interpreted more cautiously among older persons.