Test-retest reliability of the Halstead Impairment Index in hospitalized alcholic and nonalcoholic males with mild to moderate neuropsychological impairment

Reliability and Item Analysis of the Seashore Rhythm Test

The internal reliability of the Seashore Rhythm Test was examined for a sample of 376 patients. Two different combinations of items yielded reliability coefficients of approximately .75. Repeated-measures analysis of variance indicated significant differences in the mean numbers of errors occurring on the three subtests. Item analysis showed considerable variability in the rate at which the items were passed. Items with low pass rates were identified among all three subtests which suggests that factors other than length of the patterns to be discriminated contribute to difficulty of items.

Use of objective psychomotor tests in health professionals

Evaluation of psychomotor skills is undertaken in a number of broad contexts. This includes testing of health professional populations as a measure of innate ability, to evaluate skill acquisition, or to compare professions. However, the use of psychomotor tests is frequently confounded by a lack of understanding of a particular tool's psychometric properties, strengths, and weaknesses. To identify and appraise the most commonly used tests on health professional populations, 86 articles were reviewed and the top nine tests identified. Few tests have had sufficient validity or reliability testing on health professionals. Based on the evidence available, use of the Grooved Pegboard Test, the Purdue Pegboard Test, or the Finger Tapping Test is recommended for the evaluation of dexterity in a health professional population; however, this choice may be dependent on the task(s) to which findings are generalised. More rigorous evaluation of validity and other psychometric properties is required.

The robust reliability of neuropsychological measures: meta-analyses of test-retest correlations

Test-retest reliability is an important psychometric property relevant to assessment instruments typically used in neuropsychological assessment. This review presents a quantitative summary of test-retest reliability coefficients for a variety of widely used neuropsychological measures. In general, the meta-analytic test-retest reliabilities of the test scores ranged from adequate to high (i.e., r=.7 and higher). Furthermore, the reliability values were largely robust across factors such as age, clinical diagnosis, and the use of alternate forms. The values for some of the memory and executive functioning scores were lower (i.e., less than r=.7). Some of the possible reasons for these lower values include ceiling effects, practice effects, and across time variability in cognitive abilities measured by those tests. In general, neuropsychologists who use these measures in their assessments can be encouraged by the magnitude of the majority of the meta-analytic test-retest correlations obtained.

IS THERE COGNITIVE IMPAIRMENT IN CLINICALLY ‘HEALTHY’ ABSTINENT ALCOHOL DEPENDENCE?

AIMS

The aim of this study was to determine neuropsychological performance in apparently cognitively, mentally, and physically healthy abstinent alcohol-dependent subjects compared with control subjects who were recruited for a number of different neuroimaging studies.

METHODS

All subjects completed a battery of neuropsychological tests as part of the neuroimaging protocol.

RESULTS

The group dependent on alcohol performed as well as controls on a non-verbal memory test and verbal fluency but performed worse in the verbal memory task, Trail A + B, and total IQ derived from Silverstein's short-form of the WAIS-R. However, the IQ performance of both groups was above average. In both groups, age was associated with slower performance on the Trail A + B task. In the alcohol-dependent group, severity of dependence and length of abstinence was not associated with performance of any task.

CONCLUSIONS

In this apparently clinically healthy population of abstinent alcohol-dependent subjects, frontal lobe dysfunction was detectable using the Trail A + B and digit symbol tasks. This was despite above-average WAIS-R IQ scores. Consideration needs to be given to routine incorporation of cognitive testing in alcohol dependence since subtle deficits may not be easily apparent and may impact on treatment outcome.

Neuropsychologists diagnose traumatic brain injury

The case of John versus Im (2002) stands for the proposition that clinical neuropsychologists are not qualified to diagnose traumatic brain injury. This ruling by the Supreme Court of Virginia prohibits neuropsychologists from testifying about these professional conclusions in the courtroom. However, in clinical practice neuropsychologists are often asked to disentangle the relative contribution of brain dysfunction and psychological factors to presenting symptomology. In the proposed submission, the authors provide an analysis of the neuropsychological testimony at issue in John versus Im using the admissibility standards for expert testimony that were established and refined by a trilogy of cases from the Supreme Court of the United States. The paper provides support for the notion that neuropsychological method has an established scientific base of knowledge, standards for clinical competence, and evidence of peer-reviewed acceptance by medical related disciplines. No other scientific discipline has employed a more rigorous methodology for assessing cognitive function and disentangling the relative contributions of brain dysfunction and psychological factors to presenting symptomology. By limiting the testimony of neuropsychologists as to cause of an individual's cognitive impairment, courts will exclude opinions based on scientific research and specialized knowledge that would assist in the trier of fact.

Measures of short-term test-retest reliability of computerized neurobehavioral tests

Neurobehavioral test batteries are often administered repeatedly to evaluate changes over time or effects of clinical interventions or neurotoxic exposures. Time intervals between test sessions range from very short (hours) to very long (decades). The aim of this study was to compare the impact of two brief time intervals on the test-retest reliability of frequently used neurobehavioral tests. Fifty healthy adults were recruited through newspaper advertisements in Portland, Oregon. Participants were divided into either a 6h (same-day) or 1-week retest group. All participants completed a battery of tests from the computerized Behavioral Assessment and Research System (BARS). Reliability was assessed by Pearson product-moment correlation and by intraclass correlation coefficient (ICC). The test battery generally showed adequate reliability in the short-term (week) and very short-term (day) and stability in performance over repeated administration when examined by multiple measures. Intraclass correlation coefficient ranged from 0.35 to 0.85. The magnitude of variation of performance in the administered tests was equally distributed around zero (i.e. no difference). The findings suggest that neurobehavioral tests such as BARS may be a useful tool for the assessment of acute exposures and clinical status where short-term evaluation is required (e.g. in the same-day or within 1 week).

Internal consistency of three tests from the Halstead-Reitan neuropsychological battery for older children

The internal consistency of three neuropsychological tests was examined in a sample of 334 referred children (9-14 years of age). Coefficient alpha was calculated to estimate reliability on the Seashore Rhythm Test (SRT), two forms of the Speech Sounds Perception Test (SSPT), and the Aphasia Screening Test (AST). The standard SSPT appears to have relatively good internal consistency with an average coefficient of.81. The average coefficient for the abbreviated form of the SSPT was considerably lower (i.e.,.73), highlighting the superiority of the standard form in clinical practice. Internal consistency of the SRT was relatively low (i.e.,. 67). This level of reliability may be acceptable in group research and for component tests, but is marginal for independent clinical use. Coefficient alpha for the AST was moderate (i.e.,.77), suggesting adequate reliability for a screening test. These reliability estimates are compared to those obtained in previous studies using these tests in adult samples and with other tests commonly used with children.

Severity of alcohol dependence and its relationship to neurological soft signs, neuropsychological impairment and family history

We examined the relationship between severity of alcohol dependence, subtle neurological impairment, neuropsychological deficits and genetic vulnerability among 36 day hospital attenders who satisfied the DSM-III-R criteria for alcohol dependence. Severity of alcohol dependence was unrelated to the presence of a family history, but was correlated with neurological soft signs and neuropsychological impairment. Neurological soft signs were correlated with neuropsychological impairment on both Trail A and Trail B. Patients with an affected first-degree relative exhibited more neurological soft signs. These data indicate that severity of alcohol dependence is related not only to neuropsychological impairment, but also to subtle neurological deficits which may not be apparent on conventional neurological examination. Patients with a positive family history of alcohol dependence may be particularly susceptible to the neurological sequelae of alcohol dependence, or may have neurological deficits which antedate their alcohol dependence.

The influence of age, education, IQ, gender, and alcohol abuse on Halstead-Reitan Neuropsychological Test Battery performance

This article highlights trends that show the influence of age, education, IQ, gender, and alcohol abuse on Halstead-Reitan Neuropsychological Test Battery (HRB) performance. These factors must be considered as possible competing hypotheses that might account for a patient's HRB performance. HRB scores among normal, community-living persons can resemble scores of individuals with known neuropsychological impairment due only to the effects of these variables. Accordingly, when clinical neuropsychologists use "levels of current performance" or research based "cut-off score" methods to make inferences about the adequacy of brain function, appropriate comparison norms must be used to minimize the likelihood of false-positive errors. This paper summarizes and provides references to some of these comparison norms. Additionally, robust estimates of premorbid ability are essential when one is making neuropsychological inferences. Such estimates can be obtained from nationally standardized measures of intellectual ability found on most grade and high school transcripts, as well as Scholastic Aptitude Test, military, and related aptitude test scores, plus the individual's social and occupational history.

Reliability and construct validity of the six-block Tactual Performance Test in and adult sample

The ten-block Tactual Performance Test (TPT-10) has been criticized as a clinical instrument due to the long administration time and accompanying psychological distress. The shorter children's six-block version (TPT-6) has been proposed as a potential substitute. The current study examined the internal consistency, the test/retest reliability and the construct validity of the TPT-6. The results indicate that the TPT-6 is a very reliable instrument and is similar to the TPT-10 in terms of construct validity. Most importantly, the actual administration time is approximately one third that of the TPT-10.

Neuropsychological performance and treatment outcome in male alcoholics

Commonly used neuropsychological tests were administered to 91 detoxified alcoholics at the beginning of treatment. Statistically significant relationships were observed between test scores and post-treatment consumption determined 8 months after completing treatment for 72 patients. The results varied depending upon the particular measure of posttreatment consumption evaluated and the type of statistical analysis used. The most consistent relationships were often counter to the notion that increased neuropsychological performance is correlated with a more favorable treatment outcome. Neuropsychological evaluation is of limited clinical utility in predicting posttreatment alcohol consumption.

Reliability of the Speech Sounds Perception Test

Several studies have examined the test-retest reliability of the Halstead-Reitan battery of which the Speech Sounds Perception Test is one component. However, there are no data on internal reliability. Clinical experience with the test suggests that the subtests are not equally difficult. The present study examined the internal reliability in two independent samples (ns = 106 and 81). In both samples, a significantly greater number of errors was found on the first half of the test. Also in both samples, the largest number of errors occurred on Subtests B and A, while the fewest errors were found on Subtests E and D. The split-half reliability coefficients for the two samples were .74 and .87. There was also some tentative support for the use of an abbreviated version. A formula was generated (Series A + Series B + Series C + 2) which correctly classified a high percentage of patients in both samples (96% and 90%) using performance above and below the conventional cutoff score of eight errors.