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Magnante AT, Ord AS, Holland JA, Sautter SW. Neurocognitive functioning of patients with early-stage Parkinson's disease. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1041-1052. [PMID: 35931087 DOI: 10.1080/23279095.2022.2106865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Parkinson's disease (PD) is a neurological disorder commonly associated with motor deficits. However, cognitive impairment is also common in patients with PD. Cognitive concerns in PD may affect multiple domains of neurocognition and vary across different stages of the disease. Extant research has focused mainly on cognitive deficits in middle to late stages of PD, whereas few studies have examined the unique cognitive profiles of patients with early-stage PD. This study addressed this gap in the published literature and examined neurocognitive functioning and functional capacity of patients with de novo PD, focusing on the unique pattern of cognitive deficits specific to the early stage of the disease. Results indicated that the pattern of cognitive deficits in patients with PD (n = 55; mean age = 72.93) was significantly different from healthy controls (n = 59; mean age = 71.88). Specifically, tasks related to executive functioning, attention, and verbal memory demonstrated the most pronounced deficits in patients with early-stage PD. Clinical implications of these findings are discussed.
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Affiliation(s)
- Anna Theresa Magnante
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna Shirokova Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Jamie A Holland
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Scott W Sautter
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology Inc., Virginia Beach, VA, USA
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2
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Ratcliffe LN, Hale AC, Gradwohl BD, Spencer RJ. Preliminary findings from reevaluating the MMPI Response Bias Scale items in veterans undergoing neuropsychological evaluation. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1016-1023. [PMID: 35917583 DOI: 10.1080/23279095.2022.2106571] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Response Bias Scale (RBS) was developed to predict non-credible cognitive presentations among disability claimants without head injury. Developers used empirical keying, which is independent of apparent content, to select items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) item pool that distinguished between individuals passing or failing performance validity tests (PVTs). No study has examined which of these items would have psychometric value when used in clinical neuropsychological evaluations. This study reexamined items comprising RBS with reference to manifest item content, internal consistency, PVTs, and a symptom validity test (SVT) in a sample of 173 predominately White male veterans (MAGE = 50.70, MEDU = 13.73) in a VA outpatient neuropsychology clinic. Participants completed the MMPI-2 Restructured Form (MMPI-2-RF), PVTs, and an SVT. The 28-item RBS appears to contain three types of items: those that manifestly address cognitive functioning, those that are supported but do not appear to address cognitive functioning, and nine items that were unrelated to cognition and not statistically supported. The 19 empirically supported items, or RBS-19, predicted PVT and SVT failures marginally better than the RBS. Both the RBS and RBS-19 had stronger relationships with SVTs relative to PVTs. Although the removal of the nine problematic items improved the diagnostic accuracy of the scale, it still did not reach the level that is generally considered to be clinically optimal. The RBS-19 offers a measure with improved internal consistency and predictive validity compared to the RBS and warrants additional research.
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Affiliation(s)
- Lauren N Ratcliffe
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
- Department of Clinical Psychology, Mercer University College of Health Professions, Atlanta, GA, USA
| | - Andrew C Hale
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | - Brian D Gradwohl
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
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Liu BC, Iverson GL, Cook NE, Schatz P, Berkner P, Gaudet CE. The prevalence and correlates of scores falling below ImPACT embedded validity indicators among adolescent student athletes. Clin Neuropsychol 2024; 38:1175-1192. [PMID: 38233364 DOI: 10.1080/13854046.2023.2287777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/20/2023] [Indexed: 01/19/2024]
Abstract
Objective: Valid performance on preseason baseline neurocognitive testing is essential for accurate comparison between preseason and post-concussion test results. Immediate Post-Concussion and Cognitive Testing (ImPACT) is commonly used to measure baseline neurocognitive function in athletes. We examined the prevalence of invalid performance on ImPACT baseline testing and identified correlates of invalid performance. Method: The sample included 66,998 adolescents (ages 14-18, M = 15.51 years, SD = 1.22) who completed ImPACT baseline tests between 2009 and 2019. Invalid performance was determined by the embedded validity indicators (EVI). Associations between invalid performance, demographic characteristics, and health conditions were assessed using chi-square tests and odds ratios (ORs). Results: Overall, 7.2% of adolescents had baseline tests identified as invalid by one or more of the EVIs. Individual validity indicators classified between 0.5% and 3.7% tests as invalid. Higher frequencies of invalid scores were observed among youth with neurodevelopmental, academic, and medical conditions. Youth who reported having learning disabilities (n = 3126), receiving special education (n = 3563), or problems with attention-deficit/hyperactivity disorder (ADHD; n = 5104) obtained invalid baselines at frequencies of 16.4%, 16.0%, and 11.1%, respectively. Moreover, youth who reported receiving treatment for a substance use disorder (n = 311) or epilepsy (n = 718) obtained invalid baselines at frequencies of 17.0% and 11.1%, respectively. Conclusions: The base rate of invalid performance on ImPACT's EVIs was approximately 7%, consistent with prior research. Adolescents self-reporting neurodevelopmental conditions, academic difficulties, or a history of treatment for medical conditions obtained invalid baseline tests at higher frequencies. More research is needed to better understand invalid scores in youth with pre-existing conditions.
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Affiliation(s)
- Brian C Liu
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Grant L Iverson
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA
| | - Nathan E Cook
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Philip Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, PA, USA
| | - Paul Berkner
- College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Charles E Gaudet
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
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Stocks JK, Shields AN, DeBoer AB, Cerny BM, Ogram Buckley CM, Ovsiew GP, Jennette KJ, Resch ZJ, Basurto KS, Song W, Pliskin NH, Soble JR. The impact of visual memory impairment on Victoria Symptom Validity Test performance: A known-groups analysis. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:329-338. [PMID: 34985401 DOI: 10.1080/23279095.2021.2021911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE We assessed the effect of visual learning and recall impairment on Victoria Symptom Validity Test (VSVT) accuracy and response latency for Easy, Difficult, and Total Items. METHOD A sample of 163 adult patients administered the VSVT and Brief Visuospatial Memory Test-Revised were classified as valid (114/163) or invalid (49/163) groups via independent criterion performance validity tests (PVTs). Classification accuracies for all VSVT indices were examined for the overall sample, and separately for subgroups based on visual memory functioning. RESULTS In the overall sample, all indices produced acceptable classification accuracy (areas under the curve [AUCs] ≥ 0.79). When stratified by visual learning/recall impairment, accuracy indices yielded acceptable classification for both the unimpaired (AUCs ≥0.79) and impaired subsamples (AUCs ≥0.75). Latency indices had acceptable classification accuracy for the unimpaired subsample (AUCs ≥0.74), but accuracy and sensitivity dropped for the impaired sample (AUCs ≥0.67). CONCLUSIONS VSVT accuracy and response latency yielded acceptable classification accuracies in the overall sample, and this effect was maintained in those with and without visual learning/recall impairment for the accuracy indices. Findings indicate that the VSVT is a psychometrically robust PVT with largely invariant cut-scores, even in the presence of bona fide visual learning/recall impairment.
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Affiliation(s)
- Jane K Stocks
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Allison N Shields
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Adam B DeBoer
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Wheaton College, Wheaton, IL, USA
| | - Brian M Cerny
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | | | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Kyle J Jennette
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Karen S Basurto
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Woojin Song
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Neil H Pliskin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Lynch ST, Dornbush R, Shahar S, Mansour R, Klepacz L, Primavera LH, Ferrando SJ. Change in Neuropsychological Test Performance Seen in a Longitudinal Study of Patients With Post-acute Sequelae of COVID-19: A 6-Month Follow-up Study. J Acad Consult Liaison Psychiatry 2024; 65:231-247. [PMID: 38171454 DOI: 10.1016/j.jaclp.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Post-acute sequelae of COVID-19 may include physical, psychiatric, and neurocognitive symptoms. Few studies of cognitive symptoms have been longitudinal, with many following participants briefly after infection and relying on subjective complaints, screening instruments, or computerized testing. This group previously reported diminished neuropsychological (NP) test performance in over half of 60 individuals tested in-person 7 months post-COVID-19, particularly those seeking care for cognitive complaints. The current study describes the initial and 6-month follow-up results of an expanded cohort of 75 participants. OBJECTIVE To measure longitudinal changes in neuropsychological test performance, as well as medical and psychiatric changes, post-COVID-19. METHODS Participants underwent NP, psychiatric, and medical assessments approximately 7 months after acute COVID-19 infection. Sixty-three (84%) returned approximately 6 months later for repeat evaluation. RESULTS At the initial visit, 29 (38.7%) met criteria for low NP performance, and 16 (21.3%) met criteria for extremely low NP performance. At 6-month follow-up, several NP domains that were significantly below normative values at the initial visit were no longer abnormal, with the exception of language. Only measures of delayed memory and fatigue showed significant improvements between the 2 time points. CONCLUSIONS A substantial proportion of individuals recovered from acute COVID-19 infection have persistent neuropsychiatric symptoms over 1 year after infection. While the overall sample in this study showed some improvement in NP test performance relative to norms, only fatigue and delayed memory improved significantly between times 1 and 2. No individual declined in NP test performance, though relatively few individuals made significant clinical improvement, indicating the need for serial neuropsychiatric assessment and treatment supports. Longitudinal follow-up of this cohort is in progress.
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Affiliation(s)
- Sean T Lynch
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY
| | - Rhea Dornbush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY
| | - Sivan Shahar
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY
| | - Rayah Mansour
- School of Public Health, New York Medical College, Valhalla, NY
| | - Lidia Klepacz
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY
| | - Louis H Primavera
- School of Health Sciences, Touro College and University System, Valhalla, NY
| | - Stephen J Ferrando
- Department of Psychiatry and Behavioral Sciences, School of Medicine, New York Medical College, Valhalla, NY; Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY.
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Li J, Fan H, Qu W, Jiang R, Tan S. Reliability and validity of a novel mobile-based automatic battery of cognitive tests in healthy young Chinese adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-10. [PMID: 38648268 DOI: 10.1080/23279095.2023.2290193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE To evaluate the reliability and validity of a newly developed computerized Automated Battery of Cognitive Tests in healthy individuals without cognitive impairments or psychiatric disorders. METHODS From April 20 to July 1, 2023, 142 healthy individuals in Beijing and Tangshan, China were assessed using the Automated Battery of Cognitive Tests. After a 3-week interval, 36 participants were randomly selected for retesting. The assessment also included administration of the Repeatable Battery for the Assessment of Neuropsychological Status and the Automated Battery of Cognitive Tests to 59 participants. RESULTS The Automated Battery of Cognitive Tests consists of 16 subtests. Internal consistency reliability was 0.75. The test-retest reliability for each factor ranged from 0.337 to 0.850 (p < 0.05). The criterion-related validity, as measured by correlation with the total Repeatable Battery for the Assessment of Neuropsychological Status score, was 0.748 (p < 0.001). The cumulative variance contribution rate is 70.109%. The results of the confirmatory factor analysis indicated a good model fit. CONCLUSIONS The computerized Automated Battery of Cognitive Tests is a cognitive self-assessment tool with good reliability and validity. It can evaluate multiple aspects of cognitive performance in healthy individuals and is suitable for self-administration through remote access via Internet.
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Affiliation(s)
- Jiajia Li
- Beijing Huilongguan Hospital, Beijing, China
- North China University of Science and Technology, Tangshan, China
| | | | - Wei Qu
- Beijing Huilongguan Hospital, Beijing, China
| | - Ronghuan Jiang
- The First Medical Center of Chinese People's Liberation, Army General Hospital, Beijing, China
| | - Shuping Tan
- Beijing Huilongguan Hospital, Beijing, China
- North China University of Science and Technology, Tangshan, China
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Ord AS, Eldridge AH, Netz DR, Kuschel SG, Holland J, Long T, Dumas C, Glover C, Schools M, Stephens R, Magnante AT, Sautter SW. Physical Activity and Neuropsychological Functioning in Older Adults. Gerontol Geriatr Med 2024; 10:23337214241262924. [PMID: 38911221 PMCID: PMC11191622 DOI: 10.1177/23337214241262924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/03/2024] [Accepted: 06/03/2024] [Indexed: 06/25/2024] Open
Abstract
Research has identified a positive relationship between physical activity and neuropsychological functioning across the lifespan. The present study further examined the relationship between physical activity, depression, anxiety, and cognitive functioning in community-dwelling older adults (ages 65-96) who completed an outpatient neuropsychological evaluation (N = 526). Psychometrically sound and validated measures were used to assess depression, anxiety, and cognitive functioning. Analyses of covariance (ANCOVA) were conducted to examine differences between individuals who reported regularly engaging in physical activity and those who did not, after adjusting for demographic variables (age, education, and gender). Results indicated that physical activity was associated with better scores on measures of depression, anxiety, and cognitive functioning. Effect sizes for total scores on all measures were large, but there was a sizeable range of effect sizes (from small to large) for various cognitive domains. Smallest effect sizes were observed for subtests measuring language skills and visuospatial abilities, whereas largest effect sizes were seen in processing speed and memory. Results suggest that engaging in physical activity may be a beneficial non-pharmacological intervention for older adults. These findings underscore the importance of integrating physical activity programs in community and healthcare settings to foster mental and cognitive health in older populations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Anna T. Magnante
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Scott W. Sautter
- Regent University, Virginia Beach, VA, USA
- Hampton Roads Neuropsychology, Virginia Beach, VA, USA
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Birberg Thornberg U, Andersson A, Lindh M, Hellgren L, Divanoglou A, Levi R. Neurocognitive deficits in COVID-19 patients five months after discharge from hospital. Neuropsychol Rehabil 2023; 33:1599-1623. [PMID: 36239662 DOI: 10.1080/09602011.2022.2125020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/11/2022] [Indexed: 10/17/2022]
Abstract
This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region Östergötland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life.
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Affiliation(s)
- Ulrika Birberg Thornberg
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Agnes Andersson
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Lindh
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Lovisa Hellgren
- Department of Rehabilitation Medicine, Region Jönköping County, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anestis Divanoglou
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Richard Levi
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Picon EL, Wardell V, Palombo DJ, Todd RM, Aziz B, Bedi S, Silverberg ND. Factors perpetuating functional cognitive symptoms after mild traumatic brain injury. J Clin Exp Neuropsychol 2023; 45:988-1002. [PMID: 37602857 DOI: 10.1080/13803395.2023.2247601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Self-reported memory difficulties (forgetting familiar names, misplacing objects) often persist long after a mild traumatic brain injury (mTBI), despite normal neuropsychological test performance. This clinical presentation may be a manifestation of a functional cognitive disorder (FCD). Several mechanisms underlying FCD have been proposed, including metacognitive impairment, memory perfectionism, and misdirected attention, as well as depression or anxiety-related explanations. This study aims to explore these candidate perpetuating factors in mTBI, to advance our understanding of why memory symptoms frequently persist following mTBI. METHODS A cross-sectional study of 67 adults (n = 39 with mTBI mean = 25 months ago and n = 28 healthy controls). Participants completed standardized questionnaires (including the Functional Memory Disorder Inventory), a metacognitive task (to quantify discrepancies between their trial-by-trial accuracy and confidence), and a brief neuropsychological test battery. We assessed candidate mechanisms in two ways: (1) between-groups, comparing participants with mTBI to healthy controls, and (2) within-group, examining their associations with functional memory symptom severity (FMDI) in the mTBI group. RESULTS Participants with mTBI performed similarly to controls on objective measures of memory ability but reported experiencing much more frequent memory lapses in daily life. Contrary to expectations, metacognitive efficiency did not differentiate the mTBI and control groups and was not associated with functional memory symptoms. Memory perfectionism was strongly associated with greater functional memory symptoms among participants with mTBI but did not differ between groups when accounting for age. Depression and checking behaviors produced consistent results across between-groups and within-group analyses: these factors were greater in the mTBI group compared to the control group and were associated with greater functional memory symptoms within the mTBI group. CONCLUSIONS This study highlights promising (e.g., depression, checking behaviors) and unlikely (e.g., metacognitive impairment) mechanisms underlying functional memory symptoms after mTBI, to guide future research and treatment.
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Affiliation(s)
- Edwina L Picon
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Victoria Wardell
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Daniela J Palombo
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rebecca M Todd
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bilal Aziz
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sanjana Bedi
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, Canada
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Aguilar C, Bailey C, Karyadi KA, Kinney DI, Nitch SR. The use of performance validity tests among inpatient forensic monolingual Spanish-speakers. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:671-679. [PMID: 34491851 DOI: 10.1080/23279095.2021.1970555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Performance validity tests (PVTs) are an integral part of neuropsychological assessments. Yet no studies have examined how Spanish-speaking forensic inpatients perform on PVTs, making it difficult to interpret these tests in this population. The present study examined archival data collected from monolingual Spanish-speaking forensic inpatients (n = 55; Mage = 49.6 years, SD = 12.0; 84.9% male; 93.5% diagnosed with a Psychotic Spectrum Disorder) to determine how this population performs on several PVTs. Most participants' scores on the Dot Counting Test (DCT; 82.2%; n = 45), Repeatable Battery for Assessment of Neuropsychological Status-Effort Index (RBANS EI; 84.4%; n = 33), and Test of Memory Malingering (TOMM; 79.1%; n = 43) were indicative of valid performance. Few participants, however, had Rey-15 Item Test (FIT) scores in the valid range (24.5% to 48.0%; Recall n = 50 and Combined n = 49, respectively); although FIT Recall specificity was improved when cutoff scores were lowered. Total years of education, but not other educational factors, were significantly associated with performance on PVTs (r = .33-.40, p = .01-.03). Study results suggest the DCT, TOMM, and RBANS EI may be more appropriate PVTs for Spanish-speaking forensic inpatients compared to the FIT.
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Affiliation(s)
- Cynthia Aguilar
- Department of Psychology, Patton State Hospital, Patton, CA, USA
| | - Cassandra Bailey
- Department of Psychology, Patton State Hospital, Patton, CA, USA
| | - Kenny A Karyadi
- Department of Psychology, Patton State Hospital, Patton, CA, USA
| | | | - Stephen R Nitch
- Department of Psychology, Patton State Hospital, Patton, CA, USA
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Himsl KM, Reynolds BW, Nitch SR, Kinney DI, Lee N, Britt WG. Let's lower the floor: Clinical utility of the D-KEFS TMT with a forensic psychiatric inpatient population. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:740-748. [PMID: 34547210 DOI: 10.1080/23279095.2021.1974863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Trail-making tests are widely used as part of neuropsychological assessments, although the prevalence of processing speed deficits in schizophrenia spectrum disorders may limit their utility when administered to this population. In response, our study sought to explore D-KEFS TMT performance among a forensic-oriented schizophrenia spectrum sample, with the goal of generating normative data to enhance the utility of the TMT with this population. Archival data was collected from a sample of patients admitted to a forensic maximum-security psychiatric facility. Analyses revealed a large percentage of individuals achieved an "impaired" result across D-KEFS TMT trials, ranging from 20% to more than 60%. The most noteworthy finding was for Number-Letter Switching, in which approximately 48% of participants performed at the floor level. Following reclassification of performance, 36% of our sample were identified as "below average," while greater than 60% of individuals were captured as average to above average. The current analyses revealed a problematic skew in TMT performance among schizophrenia spectrum patients, in turn complicating interpretation of cognitive status as well as the ability to compare performance between patients and over time. The present adjustments account for this skew and yield more variability in standardized scoring.
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Affiliation(s)
- Kiera M Himsl
- Department of Psychology, Department of State Hospitals-Metropolitan, Norwalk, CA, USA
| | - Bradley W Reynolds
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Health System, Los Angeles, CA, USA
| | - Stephen R Nitch
- Psychology, Department of State Hospitals-Patton, Patton, CA, USA
| | | | - Narae Lee
- Department of Psychology, Department of State Hospitals-Metropolitan, Norwalk, CA, USA
| | - William G Britt
- Department of Psychiatry, School of Medicine, Loma Linda University, Loma Linda, CA, USA
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Vehar JV, Rahimpour S, Moretti P, Kassavetis P, Alshaikh J, Rolston J, Duff K. Recognition subtests of the Repeatable Battery for the Assessment of Neuropsychological Status: evidence for a cortical vs. subcortical distinction. J Clin Exp Neuropsychol 2023; 45:786-797. [PMID: 37728425 PMCID: PMC10922284 DOI: 10.1080/13803395.2023.2259044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/10/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Within clinical neuropsychology, a classic diagnostic distinction is made between cortical and subcortical disorders, especially based on their memory profiles. Typically, this is based on the comparison of recall and recognition trials, where individuals with cortical conditions do not tend to benefit (i.e., score well) on recognition trials and individuals with subcortical conditions do. Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief cognitive battery, there is a lack of evidence to support this measure's utility in distinguishing between the memory profiles of these conditions. METHOD Thirty-six mild Alzheimer's disease (AD), 55 Parkinson's disease (PD), and 105 essential tremor (ET) participants (N = 196) were administered the RBANS with additional Story and Figure Recognition subtests. Group differences on recall and recognition scores (Total Correct, Hits or True Positives, False Positive Errors, and discriminability index) were examined across the three groups, while controlling for the influence of age and gender. RESULTS As expected, individuals with AD had poorer recognition scores compared to the other clinical groups across tasks (all p-values < .05), while the ET sample largely performed comparably to the PD sample. With the exception of comparable Figure Recognition and Recall in the PD sample, all groups exhibited significantly greater recognition Hit performance compared to Recall (all p-values < .05). CONCLUSIONS The group differences in performance across RBANS recognition subtests suggest support for traditional "cortical" and "subcortical" profiles. However, all groups, including the mild AD sample, demonstrated a benefit from recognition cues compared to free recall. Overall, these findings support the inclusion of the newly developed Story and Figure Recognition subtests in future clinical practice and research endeavors.
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Affiliation(s)
- Julia V Vehar
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Shervin Rahimpour
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA
| | - Paolo Moretti
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
- Department of Neurology George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | | | - Jumana Alshaikh
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - John Rolston
- Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, Utah, USA
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
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Monjazeb S, Crowell TA. Performance validity of the Dot Counting Test in a dementia clinic setting. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-11. [PMID: 37119265 DOI: 10.1080/23279095.2023.2207125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE This study examined the utility of a performance validity test (PVT), the Dot Counting Test (DCT), in individuals undergoing neuropsychological evaluations for dementia. We investigated specificity rates of the DCT Effort Index score (E-Score) and various individual DCT scores (based on completion time/errors) to further establish appropriate cutoff scores. METHOD This cross-sectional study included 56 non-litigating, validly performing older adults with no/minimal, mild, or major cognitive impairment. Cutoffs associated with ≥90% specificity were established for 7 DCT scoring methods across impairment severity subgroups. RESULTS Performance on 5 of 7 DCT scoring methods significantly differed based on impairment severity. Overall, more severely impaired participants had significantly higher E-Scores and longer completion times but demonstrated comparable errors to their less impaired counterparts. Contrary to the previously established E-Score cutoff of ≥17, a cutoff of ≥22 was required to maintain adequate specificity in our total sample, with significantly higher adjustments required in the Mild and Major Neurocognitive Disorder subgroups (≥27 and ≥40, respectively). A cutoff of >3 errors achieved adequate specificity in our sample, suggesting that error scores may produce lower false positive rates than E-Scores and completion time scores, both of which overemphasize speed and could inadvertently penalize more severely impaired individuals. CONCLUSIONS In a dementia clinic setting, error scores on the DCT may have greater utility in detecting non-credible performance than E-Scores and completion time scores, particularly among more severely impaired individuals. Future research should establish and cross-validate the sensitivity and specificity of the DCT for assessing performance validity.
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Affiliation(s)
- Sanam Monjazeb
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Timothy A Crowell
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Sumpter R, Camsey E, Meldrum S, Alford M, Campbell I, Bois C, O'Connell S, Flood J. Remote neuropsychological assessment: Acceptability and feasibility of direct-to-home teleneuropsychology methodology during the COVID-19 pandemic. Clin Neuropsychol 2023; 37:432-447. [PMID: 35505636 DOI: 10.1080/13854046.2022.2056922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the acceptability and feasibility of telephone and video-conference calls to complete cognitive assessments during the COVID-19 pandemic. METHOD In rapid response to the pandemic, evidence-based adaptations were made to routine face-to-face (FTF) practice, delivering teleneuropsychology (TNP) within a National Health Service (NHS) Scotland neuropsychology service. Caldicott guardian approval was obtained to complete a six month study (April to October 2020) from the early stages of the first United Kingdom (UK) lockdown. Assessments were completed with patients in their own homes (direct-to-home) via remote connections. Neuropsychology clinicians, service-users and referring agents were approached for structured feedback and qualitative comment. RESULTS Data was captured for 212 referrals assessed by seven clinical psychologists; with responses from 70 (33%) service-users and 14 (58%) referring agents. 94% of referrals were assessed remotely and discharged. TNP reduced defaulted appointment discharge rates. Gender, socioeconomic deprivation and age did not affect access to information technology (IT) equipment.Clinicians agreed that remote assessment allowed them to complete initial interview (96%) and formulate (77%) cases appropriately. Service-users agreed they were comfortable with equipment (84%), the process was straightforward (74%), and would recommend TNP to others (68%). Referring agents were satisfied with the service provided (100%). Limitations included evidence-based remote test availability, technical issues and home distractions. CONCLUSIONS Study findings evidence the acceptability and efficiency of TNP; increasing service accessibility, while reducing infection risk, defaulted appointments and travel. The results advocate for a post-pandemic mixed model of service delivery encompassing both FTF and TNP approaches.
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Affiliation(s)
| | | | | | - Max Alford
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | | | | | | | - John Flood
- NHS Greater Glasgow & Clyde, Glasgow, UK
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Chipi E, Fruttini D, Salvadori N, Montanucci C, Siena E, Menculini G, Mazzeschi C, Parnetti L. Repeatable Battery for the Assessment of Neuropsychological Status: Italian Normative Data for Older Adults. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2023; 38:72-79. [PMID: 35909085 DOI: 10.1093/arclin/acac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), widely used for detecting cognitive impairment in different neuropsychiatric conditions, is increasingly applied for measuring cognitive functioning in older individuals. Available normative data for RBANS Italian version suffer from under-representation of the older ages (>60 years) and are not corrected for education. Moreover, normative data are provided only for Indexes and Total scores. We thus administered RBANS Italian version in a larger sample of older adults, taking into account the effect of age, education and gender on all scores. METHOD We used a regression-based model to assess the effect of age, education, and gender on RBANS Subtests, Indexes and Total scores in a consecutive series of healthy cognitively normal volunteers aged 60-79 years (N = 158). The obtained norms were compared with the Italian original normative data by means of Wilcoxon rank-sum test. RESULTS Multiple linear regression analyses showed that age and educational level significantly influence performances on most RBANS scores. A free-to-use Excel to calculate subject's percentiles for any single score was developed. When compared with original normative values, our percentiles distribution of Indexes and Total scores did not reveal significant differences (p > .05). CONCLUSION The obtained normative data show good concordance with previous norms. The instrument seems not significantly affected by educational level. The possibility to correct for any single score could make RBANS a more precise measure for capturing subtle cognitive deficits in prevention studies.
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Affiliation(s)
- Elena Chipi
- Center for Memory Disturbances, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Daniela Fruttini
- Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Nicola Salvadori
- Center for Memory Disturbances, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Chiara Montanucci
- Center for Memory Disturbances, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elisa Siena
- Center for Memory Disturbances, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Claudia Mazzeschi
- Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, Italy
| | - Lucilla Parnetti
- Center for Memory Disturbances, Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Raudeberg R, Karr JE, Iverson GL, Hammar Å. Examining the repeatable battery for the assessment of neuropsychological status validity indices in people with schizophrenia spectrum disorders. Clin Neuropsychol 2023; 37:101-118. [PMID: 33522847 DOI: 10.1080/13854046.2021.1876169] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: We examined the frequency of possible invalid test scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in patients with schizophrenia spectrum disorders, and whether there was an association between scores on the embedded RBANS performance validity tests (PVTs) and self-reported symptoms of apathy as measured by the Initiate Scale of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). Methods: Participants included 250 patients (M = 24.4 years-old, SD = 5.7) with schizophrenia spectrum disorders. Base rates of RBANS Effort Index (EI), Effort Scale (ES), and Performance Validity Index (PVI) test scores were computed. Spearman correlations were used to examine the associations between the RBANS PVTs, the RBANS Index scores, and the BRIEF-A Initiate Scale. Regression analyses were used to investigate how well the RBANS PVTs predicted scores on the BRIEF-A Initiate Scale. Results: The frequency of invalid scores on the EI (>3) and the PVI (<42) in participants with schizophrenia spectrum disorders was 6%. The frequency of invalid ES scores (<12) was 28% in the patients compared to 15% in the U.S. standardization sample. There was a small significant correlation between the EI and the BRIEF-A Initiate Scale (rho=.158, p<.05). Conclusions: The rates of invalid scores were similar to previously published studies. Invalid scores on the BRIEF-A were uncommon. Apathy measured with the BRIEF-A Initiate Scale was not associated with performance on the RBANS validity measures or with measures of cognition.
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Affiliation(s)
- Rune Raudeberg
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Justin E Karr
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School; Spaulding Rehabilitation Hospital and Spaulding Research Institute; & Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, Massachusetts, USA
| | - Åsa Hammar
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Martin BJ, Sober JD, Millis SR, Hanks RA, Reslan S, Waldron-Perrine B. CVLT-3 response bias as an indicator of performance validity in a litigating population. Clin Neuropsychol 2023; 37:81-90. [PMID: 34689724 DOI: 10.1080/13854046.2021.1993347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study examined the efficacy of CVLT-3 response bias (i.e., parametric and nonparametric response bias) indices in differentiating between a clinical sample with traumatic brain injury and a litigating sample with poor performance validity. Participants included 106 individuals, divided into two groups: clinical group with TBI (n = 56) and a litigating group who demonstrated inadequate performance validity (n = 50), as measured by failure on at least two performance validity tests. Archival CVLT-II data was rescored utilizing the CVLT-3 scoring and normative data. Receiver operator characteristic (ROC) curve analysis was used to evaluate the diagnostic discriminability of the two response bias indices. Both parametric and nonparametric bias indices showed acceptable levels of diagnostic discrimination: AUC = .791 for parametric response bias and AUC = .753 for nonparametric response bias. Parametric response bias' discrimination was statistically superior to the nonparametric responses bias' discrimination. The CVLT-3 response bias score demonstrated good sensitivity and specificity when differentiating between individuals in a clinical sample with TBI and individuals in litigation who demonstrated inadequate performance validity.
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Affiliation(s)
- Bess J Martin
- Neuropsychology, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
| | - Jonathan D Sober
- Neuropsychology, Rehabilitation Institute of Michigan, Detroit, Michigan, USA
| | - Scott R Millis
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Robin A Hanks
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Summar Reslan
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Brigid Waldron-Perrine
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA
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Obolsky MA, Resch ZJ, Fellin TJ, Cerny BM, Khan H, Bing-Canar H, McCollum K, Lee RC, Fink JW, Pliskin NH, Soble JR. Concordance of Performance and Symptom Validity Tests Within an Electrical Injury Sample. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09469-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Reinhard MJ, Allen N, Crock LE, McCarron KK, Veltkamp GM, Brewster RC. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Clinical Normative Data for Gulf War Veterans. J Occup Environ Med 2022; 64:e799-e804. [PMID: 36190917 PMCID: PMC9729373 DOI: 10.1097/jom.0000000000002706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Heterogenous test batteries and methods applied in neurocognitive research on Gulf War Veterans (GWVs) limit the translation of findings to clinical practice. A clinical data set is necessary. METHODS Neurocognitive screening data from treatment-seeking GWVs were collected from multiple sites and compiled, informed by consideration of performance validity. RESULTS Repeatable Battery for the Assessment of Neuropsychological Status scores revealed the cognitive profile for GWVs (n = 189) as poorer across multiple domains when compared with similarly educated, nonveteran peers. However, mean scores generally remained within normal clinical limits. Data tables are presented to establish a comparison group for use in clinical care. CONCLUSIONS When assessing cognitive symptoms in GWVs, attention to education level and interpretation of subtle deficits is warranted. Current results highlight the importance of nuanced translation of neurocognitive research findings into clinical practice with GWVs.
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Affiliation(s)
- Mathew J. Reinhard
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Nathaniel Allen
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Lucas E. Crock
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
| | - Kelly K. McCarron
- War Related Illness and Injury Study Center at the VA New
Jersey Healthcare System (WRIISC-NJ), East Orange, NJ, United States of America. The
work for this article was conducted during my work as an employee of the Department
of Veterans Affairs
| | - Gladys M. Veltkamp
- War Related Illness and Injury Study Center at the VA Palo
Alto Health Care System (WRIISC-CA), Palo Alto, CA, United States of America
| | - Ryan C. Brewster
- War Related Illness and Injury Study Center at the
Washington DC VA Medical Center (WRIISC-DC), Washington, DC, United States of
America
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Rioux M, Wardell V, Palombo DJ, Picon EL, Le ML, Silverberg ND. Memory for forgetting in adults with persistent symptoms following concussion. J Clin Exp Neuropsychol 2022; 44:19-30. [PMID: 35536243 DOI: 10.1080/13803395.2022.2067326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Persistent memory complaints following concussion often do not coincide with evidence of objective memory impairment. To the extent this clinical presentation represents Functional Cognitive Disorder (FCD), we would expect preservation or even enhancement of memory for instances of forgetting, based on two lines of prior evidence. First, emotional arousal enhances autobiographical memory. People who experience memory lapses as worrisome may better remember them. Second, individuals with FCD can paradoxically provide detailed accounts of memory lapses compared to patients with neurodegenerative disease, who tend to provide vague examples. The current study aimed to better characterize the recall of forgetting events in people with subjective memory problems following concussion. METHODS The study sample consisted of adults with chronic post-concussion symptoms (N = 37, M = 42.7 years old; 70.27% women; M = 24.9 months post-injury) and normal-range performance on conventional neuropsychological tests. Participants completed a measure of memory complaint severity and the Autobiographical Interview (AI). The AI was used to quantify the richness of narrative recollections of recent instances when they forgot something and (control) personal events that did not involve forgetting. Linear regression modeling assessed the relationship between memory complaint severity and AI variables, including narrative details, valence, arousal, and rehearsal of memories. RESULTS There was no association between memory complaint severity and memory for forgetting vs. control events. We further found no association between memory complaint severity and AI performance overall (collapsing across forgetting and control events). Participants with greater memory complaints experienced past memory lapses as more negative than control memories, but did not consistently differ on other AI phenomenological variables. CONCLUSION Autobiographical recall of memory lapses appears preserved but not selectively heightened in people who report experiencing severe memory problems long after concussion. This inconsistency supports conceptualization of persistent memory complaints after concussion as FCD.
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Affiliation(s)
- Mathilde Rioux
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Victoria Wardell
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Daniela J Palombo
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Edwina L Picon
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - M Lindy Le
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Neuropsychological performance and effort in patients diagnosed with psychogenic nonepileptic seizures - Descriptive study of a Czech sample. Epilepsy Behav 2022; 128:108584. [PMID: 35131734 DOI: 10.1016/j.yebeh.2022.108584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to examine the neuropsychological performance and effort in patients with a confirmed PNES diagnosis. The second aim of the study was to investigate the relationship between validity indicators from the cognitive battery with validity and clinical scales from a personality scale. METHOD Patients with PNES (N = 250; F:M 186:64; mean age 38.32 (13.23)) were assessed utilizing the RBANS (Czech Research version) to evaluate cognitive performance and to obtain the Effort Index. The MMPI-2 was used to evaluate personality and psychopathology. RESULTS Global cognitive performance was 0.92 SD below average (according to the Gaussian distribution) in patients with PNES. The lowest scores in the sample were in the Attention domain (-1.7SD). Insufficient effort was detected in 10% of patients. Education correlated negatively with the Effort index (rs = -0.25, p = 0.01). A mild significant correlation in Scale 7 (rs = 0.21, p = 0.01) and Scale 8 (rs = 0.24, p = 0.01), and a significant correlation between Effort Index and Back F Scale (rs = 0.23, p = 0.01) were noted. CONCLUSIONS Assessment of cognitive performance and effort is an essential part of the comprehensive evaluation of patients with PNES during their hospitalization at Epilepsy centers. Many aspects of the neuropsychological assessment can offer useful indications for reaching a differential diagnosis, including clinical history, behavioral observations, cognitive and symptom validity testing, and structured psychological inventories.
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White DJ, Ovsiew GP, Rhoads T, Resch ZJ, Lee M, Oh AJ, Soble JR. The Divergent Roles of Symptom and Performance Validity in the Assessment of ADHD. J Atten Disord 2022; 26:101-108. [PMID: 33084457 DOI: 10.1177/1087054720964575] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined concordance between symptom and performance validity among clinically-referred patients undergoing neuropsychological evaluation for Attention-Deficit/Hyperactivity Disorder (ADHD). METHOD Data from 203 patients who completed the WAIS-IV Working Memory Index, the Clinical Assessment of Attention Deficit-Adult (CAT-A), and ≥4 criterion performance validity tests (PVTs) were analyzed. RESULTS Symptom and performance validity were concordant in 76% of cases, with the majority being valid performance. Of the remaining 24% of cases with divergent validity findings, patients were more likely to exhibit symptom invalidity (15%) than performance invalidity (9%). Patients demonstrating symptom invalidity endorsed significantly more ADHD symptoms than those with credible symptom reporting (ηp2 = .06-.15), but comparable working memory test performance, whereas patients with performance invalidity had significantly worse working memory performance than those with valid PVT performance (ηp2 = .18). CONCLUSION Symptom and performance invalidity represent dissociable constructs in patients undergoing neuropsychological evaluation of ADHD and should be evaluated independently.
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Affiliation(s)
- Daniel J White
- University of Illinois College of Medicine, Chicago, IL USA.,Roosevelt University, Chicago, IL, USA
| | | | - Tasha Rhoads
- University of Illinois College of Medicine, Chicago, IL USA
| | - Zachary J Resch
- University of Illinois College of Medicine, Chicago, IL USA.,Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Mary Lee
- University of Illinois College of Medicine, Chicago, IL USA
| | - Alison J Oh
- University of Illinois College of Medicine, Chicago, IL USA
| | - Jason R Soble
- University of Illinois College of Medicine, Chicago, IL USA
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OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:1214-1220. [DOI: 10.1093/arclin/acac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 11/13/2022] Open
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Senczyszyn A, Wallner R, Szczesniak DM, Łuc M, Rymaszewska J. The Effectiveness of Computerized Cognitive Training Combined With Whole Body Cryotherapy in Improving Cognitive Functions in Older Adults. A Case Control Study. Front Psychiatry 2021; 12:649066. [PMID: 34248698 PMCID: PMC8267365 DOI: 10.3389/fpsyt.2021.649066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) are common in elderly population, and constitute a high-risk group for progression to dementia. Innovative, complex, and engaging non-pharmacological methods of cognitive stimulation, implementable at this stage, are needed. The aim of the study was to determine the effect of Computerized Cognitive Training (CCT) combined with Whole Body Stimulation (WBC) on cognitive functions of older adults with SCD and MCI. Methods: A 9-week single-blind pre/post case control trial was conducted. The study enrolled 84 adults aged 60 or older, allocated to one of two intervention groups: EG; CCT with psychoeducation, EG2; CCT with psychoeducation and 10 WBC sessions, or the control group (CG), which comprised patients receiving usual care. The primary outcome measures were cognitive functions evaluated with MoCA scale and several other neuropsychological tools. Depressive symptoms assessed with the GDS scale constituted the secondary outcome measures. Results: The results show evidence for increased performance in the assessment of general cognitive functioning in both EGs (p ≤ 0.05). Significant improvement was also visible in several cognitive domains, such as verbal fluency (EG1 & EG2), learning ability and immediate memory (EG1 & EG2), delayed memory (EG2), attentional control (EG1), and information processing (EG2) (p ≤ 0.05). However, only in the group with combined interventions (CCT + WBC) the participants presented significantly less depressive symptoms (p ≤ 0.05). Conclusions: The results of the study suggest that CCT, especially in combination with WBC, might be a practical and effective method of improving cognitive performance. Moreover, this combination leads to a reduction of depressive symptoms.
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Harris M, Merz ZC. High elevation rates of the Structured Inventory of Malingered Symptomatology (SIMS) in neuropsychological patients. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1344-1351. [PMID: 33662216 DOI: 10.1080/23279095.2021.1875227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified based on clinician-completed questions. SIMS elevation rates were examined at different cutoffs and between these groups and were correlated with other indicators of validity. High rates of SIMS elevations were found at the standard cutoff (>14) for the total sample (45.5%), low suspicion cases (24.4%), and high suspicion cases (95.7%). Other indicators of invalidity were low (secondary gain = 8.5%, clinical suspicion of exaggeration in interview M = 2.37/5, medical records concerning for invalidity = 2.4%, mixed/poor performance validity = 6.1%). Elevations correlated with clinician concern for over-reporting in interview, subject-reported cognitive concern (r = -.610) and psychological measures (BDI-II r = -.602, PROMIS r = -.409) but not with neuropsychological memory tests or performance validity measures (all p > .23). The SIMS should be interpreted with caution, as elevations appeared largely related to cognitive concern and psychiatric distress rather than true malingering. A cutoff of > 16 could be used in neuropsychological populations, although this is still of modest specificity.
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Affiliation(s)
- Matthew Harris
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA
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Paxton JL, Resch ZJ, Cation B, Lapitan F, Obolsky MA, Calderone V, Fink JW, Lee RC, Soble JR, Pliskin NH. The relationship between neuropsychological dispersion, processing speed and memory after electrical injury. J Clin Exp Neuropsychol 2021; 43:144-155. [PMID: 33648409 DOI: 10.1080/13803395.2021.1889989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Previous studies of neuropsychological performance in electrical injury (EI) patients have produced evidence of deficits in various cognitive domains, but studies have yet to investigate relationships among performance in cognitive domains post-EI. This study examined whether dispersion among neuropsychological test scores was associated with injury parameters and neuropsychological performance in EI patients. Additionally, we examined whether dispersion, processing speed and/or executive abilities explain variance in episodic verbal and visual memory performance among EI patients.Method: Data from 52 post-acute EI patients undergoing outpatient evaluation with objectively-verified valid neuropsychological test performance were examined. Tests included measures of verbal and visual memory, processing speed, and executive functioning. Dispersion was calculated from executive functioning and processing speed scores.Results: Dispersion was not related to mean performance or injury characteristics, but was significantly negatively correlated with performance on a test of processing speed, suggesting that increased dispersion is associated with reduced cognitive efficiency post-EI. Delayed visual memory was related to both dispersion scores and processing speed. Stepwise regression equations predicting delayed memory determined that processing speed most significantly predicted delayed visual memory, even after controlling for immediate visual memory. No significant relationships emerged between verbal memory and non-memory neuropsychological scores.Conclusions: This is the first study to examine neuropsychological dispersion and relationships among domains of cognitive functioning in EI. Current results suggested that neuropsychological dispersion is not a marker of general functioning or severity of injury in EI patients, but may represent more specific processing speed abilities. Processing speed predicts delayed visual memory performance in EI patients, which should be considered in interpreting test scores during evaluations.
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Affiliation(s)
- Jessica L Paxton
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Bailey Cation
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Franchezka Lapitan
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Maximillian A Obolsky
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Veroly Calderone
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA
| | - Joseph W Fink
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Raphael C Lee
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Departments of Surgery, Medicine and Organismal Biology, University of Chicago, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Neil H Pliskin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA.,The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Murray AL, Vollmer M, Deary IJ, Muniz-Terrera G, Booth T. Assessing individual-level change in dementia research: a review of methodologies. ALZHEIMERS RESEARCH & THERAPY 2021; 13:26. [PMID: 33451358 PMCID: PMC7811223 DOI: 10.1186/s13195-021-00768-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 01/01/2021] [Indexed: 01/12/2023]
Abstract
Background Whether in the context of monitoring disease progression or in assessing the effects of interventions, a major challenge in dementia research is determining when an individual has undergone meaningful change in symptoms and other relevant outcomes such as cognitive test performance. The challenge lies in differentiating genuine improvement or deterioration from change in scores due to random and systematic error. Body In this review, we discuss the advantages and limitations of available methods for assessing individual-level change in the context of key challenges, including imperfect and differential reliability of scores, and practice effects. We discuss indices of reliable change and the use of composite and item response theory (IRT) scores. Conclusion We conclude that IRT-based approaches hold particular promise because they have the flexibility to accommodate solutions to a wide range of issues that influence the accuracy of judgements of meaningful change. We close by discussing the practical implications of adopting IRT-based approaches.
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Affiliation(s)
- Aja Louise Murray
- Department of Psychology, University of Edinburgh, F17, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Marlena Vollmer
- Department of Psychology, University of Edinburgh, F17, 7 George Square, Edinburgh, EH8 9JZ, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, F17, 7 George Square, Edinburgh, EH8 9JZ, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Graciela Muniz-Terrera
- Centre for Clinical Brain Sciences, Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Tom Booth
- Department of Psychology, University of Edinburgh, F17, 7 George Square, Edinburgh, EH8 9JZ, UK.
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Victoria Symptom Validity Test: A Systematic Review and Cross-Validation Study. Neuropsychol Rev 2021; 31:331-348. [PMID: 33433828 DOI: 10.1007/s11065-021-09477-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 01/03/2021] [Indexed: 12/12/2022]
Abstract
The Victoria Symptom Validity Test (VSVT) is a performance validity test (PVT) with over two decades of empirical backing, although methodological limitations within the extant literature restrict its clinical and research generalizability. Chief among these constraints includes limited consensus on the most accurate index within the VSVT and the most appropriate cut-scores within each VSVT validity index. The current systematic review synthesizes existing VSVT validation studies and provides additional cross-validation in an independent sample using a known-groups design. We completed a systematic search of the literature, identifying 17 peer-reviewed studies for synthesis (7 simulation designs, 7 differential prevalence designs, and 3 known-groups designs). The independent cross-validation sample consisted of 200 mixed clinical neuropsychiatric patients referred for outpatient neuropsychological evaluation. Across all indices, Total item accuracy produced the strongest psychometric properties at an optimal cut-score of ≤ 40 (62% sensitivity/88% specificity). However, ROC curve analyses for all VSVT indices yielded statistically significant areas under the curve (AUCs; .73-81), suggestive of moderate classification accuracy. Cut-scores derived using the independent cross-validation sample converged with some previous findings supporting cut-scores of ≤ 22 for Easy item accuracy and ≤ 40 for Total item accuracy, although divergent findings were noted for Difficult item accuracy. Overall, VSVT validity indicators have adequate diagnostic accuracy across populations, with the current study providing additional support for its use as a psychometrically sound PVT in clinical settings. However, caution is recommended among patients with certain verified clinical conditions (e.g., dementia) and those with pronounced working memory deficits due to concerns for increased risk of false positives.
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30
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O'Sullivan M, Fitzsimons S, Ramos SDS, Oddy M, Sterr A. Characteristics and neuropsychological impact of traumatic brain injury in female prisoners. Brain Inj 2020; 35:72-81. [PMID: 33307834 DOI: 10.1080/02699052.2020.1858344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To investigate the characteristics of head injury (HI) and its association with offending behaviour, psychological and neurobehavioral functioning, and cognitive performance in female prisoners.Methods: Using a cross-sectional design, female prisoners in the UK reporting a HI with a loss of consciousness (LOC) over ten minutes (n = 10) were compared with a group without a HI with LOC over ten minutes (n = 41) across a range of measures; including scores on standardized clinical questionnaires and performance-based cognitive assessments. Semi-structured clinical interviews assessed HI and forensic history, with forensic history triangulated against the prison database.Results: Domestic abuse was the most frequently reported cause of HI. The HI with LOC group had been to prison a greater number of times and had committed a greater number violent offences. No significant difference was found on self-reported psychological and neurobehavioral measures, or between the groups' cognitive functioning on neuropsychological tests.Conclusions: Psychosocial factors such as trauma may contribute to higher rates of violent offending and imprisonment in those with a HI with LOC. Domestic abuse is an important factor in HI amongst female prisoners. Forensic screening and interventions need to be designed, adapted and evaluated with consideration of trauma and HI.
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Affiliation(s)
- Michelle O'Sullivan
- School of Psychology, University of Surrey, Guildford, Surrey, UK.,Rail Safety & Standards Board, The Helicon, London, UK
| | | | - Sara da Silva Ramos
- The Disabilities Trust Foundation, Brain Injury Rehabilitation Trust, Kerwin Court, Horsham, West Sussex, UK
| | - Michael Oddy
- The Disabilities Trust Foundation, Brain Injury Rehabilitation Trust, Kerwin Court, Horsham, West Sussex, UK
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, Surrey, UK
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Zhang J, Ren Y, Jiang W, Luo J, Yan F, Tang Y, Ma X. Shorter recovery times and better cognitive function-A comparative pilot study of magnetic seizure therapy and electroconvulsive therapy in patients with depressive episodes. Brain Behav 2020; 10:e01900. [PMID: 33070479 PMCID: PMC7749607 DOI: 10.1002/brb3.1900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Magnetic seizure therapy (MST) is a new convulsive therapy that is as effective as traditional electroconvulsive therapy (ECT) in treating depression but with fewer cognitive side effects. The aim of this study was to compare the efficacy and cognitive effects between MST (100 Hz applied over the vertex) and bifrontal ECT for treating patients with depressive episodes. METHODS Forty-five patients with depressive episodes were enrolled, with 18 receiving MST and 27 receiving ECT. MST was administered over the vertex with 100 Hz frequency. Treatment consisted of six sessions. The 17-item Hamilton Rating Scale for Depression (HAMD-17) was used to assess the severity of depression. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognition. Assessments were performed at baseline and after the third and sixth treatment sessions. RESULTS Both MST and ECT improved the patients' depressive symptoms significantly, yet no significant difference was found between the two groups (p > .05). The response rates and remission rates of MST and ECT were 72.2% versus 81.5% and 61.1% versus 63.0%, respectively. The MST group showed significant improvements in immediate memory (p < .001), delayed memory (p = .002), and attention (p < .001) than ECT. The recovery times for consciousness (p < .001), spontaneous breathing (p < .001), and orientation (p < .001) were shorter in MST group than ECT group. RBANS improvements were negatively correlated with the recovery time for orientation (r = .561, p < .001). CONCLUSION Magnetic seizure therapy showed similar efficacy to bifrontal ECT for treating depressive episodes. While MST may be an effective alternative to ECT, larger randomized trials are needed.
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Affiliation(s)
- Junyan Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Yanping Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Wei Jiang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Jiong Luo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Fang Yan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
| | - Yilang Tang
- Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaGAUSA
- Mental Health Service LineAtlanta VA Medical CenterDecaturGAUSA
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental DisordersBeijing Anding HospitalCapital Medical UniversityBeijingChina
- Advanced Innovation Center for Human Brain ProtectionCapital Medical UniversityBeijingChina
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32
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Lacritz LH, Carlew AR, Livingstone J, Bailey KC, Parker A, Diaz A. Patient Satisfaction with Telephone Neuropsychological Assessment. Arch Clin Neuropsychol 2020; 35:1240-1248. [PMID: 33124648 PMCID: PMC7665292 DOI: 10.1093/arclin/acaa097] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Telephone-based neuropsychological assessment (TeleNP) has been shown to be a valid alternative to in-person or video-based assessment. However, there is limited information regarding patients' satisfaction with TeleNP. This report presents satisfaction survey data from a diverse, clinical sample who received TeleNP during the coronavirus disease pandemic. METHOD A total of 43 adult patients (30.2% Hispanic/Latinx, 32.6% Black), aged 24-75, who received TeleNP as part of routine clinical care participated in a postassessment satisfaction survey. Responses were analyzed qualitatively and via nonparametric comparisons based on demographic factors. RESULTS Given options of "Not Satisfied," "Somewhat Satisfied," "Satisfied," or "Very Satisfied," 97.7% of patients reported satisfaction with their visit as well as the visit length, and 80% felt the visit met their needs ("Good" + "Very Good"). There were no significant differences in responses based on age, race/ethnicity, sex, or education. Endorsed advantages of TeleNP included "Avoid potential exposure to illness" and "Flexibility/Convenience," and 20% reported difficulty communicating, concentrating, and/or connecting with their provider as potential disadvantages. Although 67.7% reported a preference for in-person visits, 83.7% expressed interest in another "virtual visit" (telephone or video conference) with their provider. CONCLUSIONS TeleNP was well received by the sample and demonstrated good patient satisfaction. These results in conjunction with other research supporting the validity of TeleNP support consideration of this assessment modality for patients who might not otherwise have access to in-person or video conference-based neuropsychological services. Based on these findings, a greater focus on rapport building may be warranted when utilizing TeleNP to enhance patients' sense of connection to their provider.
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Affiliation(s)
- Laura H Lacritz
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Anne R Carlew
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Julia Livingstone
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - K Chase Bailey
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Allison Parker
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aislinn Diaz
- Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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33
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Spencer RJ, Gradwohl BD, Kordovski VM. Initial Validation of Short Forms of the SIMS for Neuropsychological Evaluations. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09394-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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34
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Armistead-Jehle P, Ingram PB, Morris CS. Personality Assessment Inventory Cognitive Bias Scale: Validation in a Military Sample. Arch Clin Neuropsychol 2020; 35:1154–1161. [PMID: 32738043 DOI: 10.1093/arclin/acaa049] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/13/2020] [Accepted: 06/23/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Recently, in a mixed neuropsychological outpatient sample, a measure of cognitive response bias has been developed for the Personality Assessment Inventory (PAI) called the Cognitive Bias Scale (CBS). This study sought to cross-validate this measure in a military sample. METHOD Retrospective review of 197 active duty soldiers referred to an Army outpatient clinic for neuropsychological evaluation. Groups were created based on the number of failed performance validity tests (0, 1, or 2-3 performance validity testing [PVT] failures). RESULTS The magnitude of effect for the 10-item CBS scale was medium-to-large when comparing those with one PVT failure to those with two to three (d = .98) and those with no failures (d = 1.21); however, effects between the 1 and 2-3 PVT failure groups were less pronounced. In 1 and 2-3 PVT failure groups, a score of $\ge$16 had high specificity (.92 and .95, respectively) and low to moderate sensitivity (.20 and .55, respectively). CONCLUSIONS In a military sample, the CBS demonstrated high specificity with relatively low sensitivity. The measure operated similarly to the original study and the current data supports the CBS to rule in, but not rule out, over-reported cognitive symptoms on the PAI.
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Affiliation(s)
| | - Paul B Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Cole S Morris
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
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Identifying Novel Embedded Performance Validity Test Formulas Within the Repeatable Battery for the Assessment of Neuropsychological Status: a Simulation Study. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09382-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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36
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Martin PK, Schroeder RW, Olsen DH. Performance validity in the dementia clinic: Specificity of validity tests when used individually and in aggregate across levels of cognitive impairment severity. Clin Neuropsychol 2020; 36:165-188. [DOI: 10.1080/13854046.2020.1778790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Phillip K. Martin
- Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine – Wichita, Wichita, KS, USA
| | - Ryan W. Schroeder
- Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine – Wichita, Wichita, KS, USA
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Shwartz SK, Roper BL, Arentsen TJ, Crouse EM, Adler MC. The Behavior Rating Inventory of Executive Function®-Adult Version is Related to Emotional Distress, Not Executive Dysfunction, in a Veteran Sample. Arch Clin Neuropsychol 2020; 35:701-716. [DOI: 10.1093/arclin/acaa024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Abstract
Objective
In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self-reported executive functioning (EF) and objective performance.
Method
Each study pulled from a sample of 123 veterans who were administered a BRIEF-A and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) during a neuropsychological evaluation. Participants were primarily middle-aged, and half carried a mood disorder diagnosis. Study 1 examined group differences in BRIEF-A ratings among valid, invalid, and indeterminate MMPI-2 responders. Analyses were conducted to determine the optimal cut-score for the BRIEF-A Negativity Validity scale. In Study 2, relationships were explored among MMPI-2-RF (restructured form) Restructured Clinical (RC) scales, somatic/cognitive scales, and the BRIEF-A Metacognition Index (MI); hierarchical analyses were performed to predict MI using MMPI-2-RF Demoralization (RCd) and specific RC scales. Study 3 correlated BRIEF-A clinical scales and indices with RCd and an EF composite score from neuropsychological testing. Hierarchical analyses were conducted to predict BRIEF-A clinical scales.
Results
Invalid performance on the MMPI-2 resulted in significantly elevated scores on the BRIEF-A compared to those with valid responding. A more stringent cut-score of ≥4 for the BRIEF-A Negativity scale is more effective at identifying invalid symptom reporting. The BRIEF-A MI is most strongly correlated with demoralization. BRIEF-A indices and scales are largely unrelated to objective EF performance.
Conclusions
In a veteran sample, responses on the BRIEF-A are most representative of generalized emotional distress and response bias, not actual EF abilities.
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Affiliation(s)
- Susan K Shwartz
- Department of Veterans Affairs Medical Center, Memphis, TN, USA
| | - Brad L Roper
- Department of Veterans Affairs Medical Center, Memphis, TN, USA
- Departments of Psychiatry and Neurology, University of Tennessee College of Medicine, Memphis, TN, USA
| | | | - Ellen M Crouse
- Department of Veterans Affairs Medical Center, Memphis, TN, USA
| | - Marcy C Adler
- Department of Veterans Affairs Medical Center, Memphis, TN, USA
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Schulz-Heik RJ, Fahimi A, Durazzo TC, Friedman M, Bayley PJ. Evaluation of adding the CANTAB computerized neuropsychological assessment battery to a traditional battery in a tertiary care center for veterans. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 27:256-266. [PMID: 30633552 DOI: 10.1080/23279095.2018.1534735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Numerous advantages of and concerns about computerized neuropsychological assessment systems have been noted. Here we report a program evaluation of incorporating a computerized system, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in our tertiary assessment center for Veterans. Patients were 23 consecutive referrals to the Western War Related Illness and Injury Study Center, an interdisciplinary assessment center within the Veterans Affairs Healthcare System for Veterans with complex medical presentations. Patients were administered both the CANTAB and a brief traditional neuropsychological battery. The correlation between global composite scores from each method was .71 (p < .05), indicating "good" concordance. Concordance was "fair" to "good" for scores on specific cognitive domains. However, concordance was lower when classifying patients' cognition as "impaired" or "not-impaired" based on a cutoff score. Despite the CANTAB's primarily visuospatial interface, discrepancy between the two methods' scores was not associated with patients' visuospatial abilities. The two methods were similarly sensitive to deficits associated with posttraumatic stress disorder, which is prevalent among the Center's patients. The CANTAB was judged to be a valid and useful complement to, but not an acceptable alternative to a traditional neuropsychologist-administered cognitive assessment battery for the Center's specific patients and needs.
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Affiliation(s)
- R Jay Schulz-Heik
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA
| | - Atoossa Fahimi
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Timothy C Durazzo
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Marcelle Friedman
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, California, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, San Jose, California, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA
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Resch ZJ, Pham AT, Abramson DA, White DJ, DeDios-Stern S, Ovsiew GP, Castillo LR, Soble JR. Examining independent and combined accuracy of embedded performance validity tests in the California Verbal Learning Test-II and Brief Visuospatial Memory Test-Revised for detecting invalid performance. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:252-261. [DOI: 10.1080/23279095.2020.1742718] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Zachary J. Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Amber T. Pham
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Dayna A. Abramson
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Daniel J. White
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Samantha DeDios-Stern
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Gabriel P. Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Liliam R. Castillo
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R. Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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Soble JR, Alverson WA, Phillips JI, Critchfield EA, Fullen C, O’Rourke JJF, Messerly J, Highsmith JM, Bailey KC, Webber TA, Marceaux JC. Strength in Numbers or Quality over Quantity? Examining the Importance of Criterion Measure Selection to Define Validity Groups in Performance Validity Test (PVT) Research. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-019-09370-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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41
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Ingram PB, Golden BL, Armistead-Jehle PJ. Evaluating the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) over-reporting scales in a military neuropsychology clinic. J Clin Exp Neuropsychol 2020; 42:263-273. [PMID: 31900041 DOI: 10.1080/13803395.2019.1708271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: This study examines the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity scales to detect invalid responding within a sample of active duty United States Army soldiers referred for neuropsychological evaluations.Method: This study examines the relationship between performance validity testing and performance on the MMPI-2-RF over-reporting scales. Specifically, mean differences between those who passed (n = 152; 75.6%) or failed (n = 49; 24.4%) performance validity testing were compared. Receiver operator characteristic analyzes were also conducted to expand available information on the MMPI-2-RF over-reporting sensitivity and specificity in an Army sample.Results: This study has two distinct findings. First, effect size differences between those passing and failing performance validity testing are classified as small to medium in magnitude (ranging from d = . 30/g = .32 on F-r to d = .66/g = .73 on RBS). Second, over-reporting scales have higher specificity and poorer sensitivity. Likewise, performance of the over-reporting scales suggests that those who exceeding recommended cut scores are likely to have failed extra-test performance validity measures.Conclusion: These findings suggest that many who fail external performance measures may be undetected on the MMPI-2-RF over-reporting scales and that those exceeding recommended cut scores are likely to have failed extra-test performance validity testing. Implications for research on, and practice with, the MMPI-2-RF in military populations are discussed.
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Affiliation(s)
- Paul B Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA.,Dwight D. Eisenhower VAMC, Eastern Kansas Veteran Healthcare System, Leavenworth, KS, USA
| | - Brittney L Golden
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
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42
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Lace JW, Grant AF, Ruppert P, Kaufman DAS, Teague CL, Lowell K, Gfeller JD. Detecting noncredible performance with the neuropsychological assessment battery, screening module: A simulation study. Clin Neuropsychol 2019; 35:572-596. [DOI: 10.1080/13854046.2019.1694703] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- John W. Lace
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Alex F. Grant
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Phillip Ruppert
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO, USA
| | | | - Carson L. Teague
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Kimberly Lowell
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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43
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O'Sullivan M, Fitzsimons S, Ramos SDS, Oddy M, Glorney E, Sterr A. Utility of the Brain Injury Screening Index in Identifying Female Prisoners With a Traumatic Brain Injury and Associated Cognitive Impairment. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:313-327. [PMID: 31742464 DOI: 10.1177/1078345819879898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is a high prevalence of traumatic brain injury (TBI) in prisoners, but screening tools for identifying TBI in female prisoners are not readily available. Using a cross-sectional design, the psychometric properties of the Brain Injury Screening Index (BISI) were investigated in a closed United Kingdom female prison. Purposive sampling comprised 56 females. Assessment included clinical interview, the BISI, self-report measures of mood, and a battery of measures of cognitive functioning. Seven of the 10 clinical indicators on the BISI met test-retest reliability criteria. Two of the three BISI summary variables demonstrated correlations with questionnaires in the hypothesized directions; however, only two BISI variables were associated with cognitive functioning. Findings support further investigation into the validity and reliability of the BISI with a larger sample.
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Affiliation(s)
- Michelle O'Sullivan
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom.,Rail Safety and Standards Board, London, United Kingdom
| | - Steven Fitzsimons
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Sara da Silva Ramos
- Brain Injury Rehabilitation Trust, The Disabilities Trust Foundation, Horsham, West Sussex, United Kingdom
| | - Michael Oddy
- Brain Injury Rehabilitation Trust, The Disabilities Trust Foundation, Horsham, West Sussex, United Kingdom
| | - Emily Glorney
- School of Law, Royal Holloway, University of London, Egham, Surrey, United Kingdom
| | - Annette Sterr
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
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44
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McGuire C, Crawford S, Evans JJ. Effort Testing in Dementia Assessment: A Systematic Review. Arch Clin Neuropsychol 2019; 34:114-131. [PMID: 29579143 DOI: 10.1093/arclin/acy012] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 01/30/2018] [Indexed: 11/14/2022] Open
Abstract
Objective Interpretation of neuropsychological test data is only valid when appropriate effort has been exerted. Research, however, suggests that neuropsychologists do not always formally test for effort and that this may especially be the case in the context of dementia assessment. This review systematically examined the literature that has investigated the use of both purpose-built and embedded effort-sensitive indices in dementia, mild cognitive impairment (MCI), and healthy control samples. The aim was to determine which tests of effort are most sensitive to suboptimal effort and least sensitive to the type of cognitive impairment seen in dementia. Methods A systematic search of databases was conducted to October 2017. There was no start date. Results Twenty-five studies were included for review. The studies were divided into two categories according to methodology. One category of studies (n = 5) was reviewed using a tailored methodological quality rating checklist whilst the remaining studies (n = 20) were reviewed using the Crowe Critical Appraisal Tool (CCAT). Conclusions The results of this review suggest that PVTs which take a hierarchical approach to effort testing such as the WMT, MSVT, and NV-MSVT are preferable for use with older adults who are under investigation for possible dementia. These tests go above and beyond the traditional pass/fail approach of more traditional tests of effort because they allow the examiner to analyze the examinee's profile of scores. The methodological limitations and challenges involved in this field of research are discussed.
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Affiliation(s)
- Claire McGuire
- NHS Greater Glasgow & Clyde, Older People's Psychology Service, Eastwood Health and Care Centre, Drumby Crescent, Clarkston, UK
| | - Stephanie Crawford
- NHS Greater Glasgow & Clyde, Older People's Psychology Service, Crown House, 30 King Street, Greenock, UK
| | - Jonathan J Evans
- Mental Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, UK
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45
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Lippa SM, Lange RT, French LM, Iverson GL. Performance Validity, Neurocognitive Disorder, and Post-concussion Symptom Reporting in Service Members with a History of Mild Traumatic Brain Injury. Arch Clin Neuropsychol 2019; 33:606-618. [PMID: 29069278 DOI: 10.1093/arclin/acx098] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 09/26/2017] [Indexed: 11/13/2022] Open
Abstract
Objective To examine the influence of different performance validity test (PVT) cutoffs on neuropsychological performance, post-concussion symptoms, and rates of neurocognitive disorder and postconcussional syndrome following mild traumatic brain injury (MTBI) in active duty service members. Method Participants were 164 service members (Age: M = 28.1 years [SD = 7.3]) evaluated on average 4.1 months (SD = 5.0) following injury. Participants were divided into three mutually exclusive groups using original and alternative cutoff scores on the Test of Memory Malingering (TOMM) and the Effort Index (EI) from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): (a) PVT-Pass, n = 85; (b) Alternative PVT-Fail, n = 53; and (c) Original PVT-Fail, n = 26. Participants also completed the Neurobehavioral Symptom Inventory. Results The PVT-Pass group performed better on cognitive testing and reported fewer symptoms than the two PVT-Fail groups. The Original PVT-Fail group performed more poorly on cognitive testing and reported more symptoms than the Alternative PVT-Fail group. Both PVT-Fail groups were more likely to meet DSM-5 Category A criteria for mild and major neurocognitive disorder and symptom reporting criteria for postconcussional syndrome than the PVT-Pass group. When alternative PVT cutoffs were used instead of original PVT cutoffs, the number of participants with valid data meeting cognitive testing criteria for neurocognitive disorder or postconcussional syndrome decreased dramatically. Conclusion PVT performance is significantly and meaningfully related to overall neuropsychological outcome. By using only original cutoffs, clinicians and researchers may miss people with invalid performances.
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Affiliation(s)
- Sara M Lippa
- Defense and Veterans Brain Injury Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Rael T Lange
- Defense and Veterans Brain Injury Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Louis M French
- Defense and Veterans Brain Injury Center, Bethesda, MD, USA.,National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.,Center for Neuroscience and Regenerative Medicine, Bethesda, MD, USA.,Department of Physical Medicine and Rehabilitation, Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Grant L Iverson
- Defense and Veterans Brain Injury Center, Bethesda, MD, USA.,Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.,Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA.,Home Base, A Red Sox Foundation and Massachusetts General Hospital Program, Boston, MA, USA
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46
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Soble JR, Resch ZJ, Schulze ET, Paxton JL, Cation B, Friedhoff C, Costin C, Fink JW, Lee RC, Pliskin NH. Examination of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) validity and substantive scales in patients with electrical injury. Clin Neuropsychol 2019; 33:1501-1515. [DOI: 10.1080/13854046.2019.1616114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jason R. Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J. Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Evan T. Schulze
- Department of Neurology, Saint Louis University, St. Louis, MO, USA
| | | | - Bailey Cation
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Claire Friedhoff
- Department of Psychology, Roosevelt University, Chicago, IL, USA
| | - Colleen Costin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Illinois School of Professional Psychology, Schaumburg, IL, USA
| | - Joseph W. Fink
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA
| | - Raphael C. Lee
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA
- Departments of Surgery, Medicine and Organismal Biology, University of Chicago, Chicago, IL, USA
| | - Neil H. Pliskin
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
- The Chicago Electrical Trauma Rehabilitation Institute (CETRI), Chicago, IL, USA
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47
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Roye S, Calamia M, Bernstein JPK, De Vito AN, Hill BD. A multi-study examination of performance validity in undergraduate research participants. Clin Neuropsychol 2019; 33:1138-1155. [DOI: 10.1080/13854046.2018.1520303] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Scott Roye
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - John P. K. Bernstein
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Alyssa N. De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Benjamin D. Hill
- Department of Psychology, University of Southern Alabama, Mobile, AL, United States
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Williams KD, Hancock E, Wozniak N, Oehler S, Manguso R. Psychometric limitations of the RBANS effort index in forensic inpatient populations. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 27:181-187. [PMID: 30724593 DOI: 10.1080/23279095.2018.1517768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely studied and utilized screening measure with an Effort Index (EI), there is a minimal amount of data available regarding the utility of the EI for forensic inpatients. Specific concerns include the possibility that the published cutoffs would result in high false positive rates. The present study investigated this issue by comparing the validity of the RBANS EI with that of the Dot Counting Test (DCT) and Test of Memory Malingering (TOMM) in a forensic psychiatric setting (N = 117). Analyses indicated a positive association between RBANS EI categorizations (invalid or genuine responding) and the classifications made by the DCT and the TOMM. However, the false positive rate for the RBANS EI was found to be excessively high (17.95%), while the positive predictive value was below chance (44.74%). Additional psychometric properties for the RBANS EI in this population are reported in the article, including findings from a Receiver Operating Characteristic (ROC) analysis. Overall, the results suggest that caution is warranted, when utilizing the RBANS EI as a validity measure within a forensic inpatient psychiatric setting and more appropriate cutoffs are needed for this population.
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Affiliation(s)
| | - Emily Hancock
- Colorado Mental Health Institute at Pueblo, Pueblo, Colorado, USA
| | - Nicole Wozniak
- Colorado Mental Health Institute at Pueblo, Pueblo, Colorado, USA
| | - Susan Oehler
- Colorado Mental Health Institute at Pueblo, Pueblo, Colorado, USA
| | - Rose Manguso
- Colorado Mental Health Institute at Pueblo, Pueblo, Colorado, USA
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49
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Goette WF, Goette HE. A meta-analysis of the accuracy of embedded performance validity indicators from the repeatable battery for the assessment of neuropsychological status. Clin Neuropsychol 2018; 33:1044-1068. [PMID: 30472924 DOI: 10.1080/13854046.2018.1538429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Meta-analyze the embedded performance validity tests of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), emphasizing two topics: diagnostic accuracy and relationships with demographics. Method: Literature was identified through a review of PsycINFO, PubMed, and Google Scholar. Bivariate linear mixed models were used for diagnostic accuracy analyses. Random-effects analysis of correlations with demographic variables was also used for the Effort Index. Results: Diagnostic accuracy analyses utilized 12 studies of the Effort Index (EI; N = 1469) and 6 studies of the Effort Scale (ES; N = 854). The EI was found to have a sensitivity of .44 (95% CI: .28 - .62), specificity of .87 (95% CI: .78 - .93), and diagnostic odds ratio (DOR) of 5.41 (95% CI: 3.74 - 7.58). The ES produced a sensitivity of .67 (95% CI: .50 - .81), specificity of .72 (95% CI: .53 - .85), and DOR of 5.97 (95% CI: 1.70 - 15.30). Meta-analysis of correlations utilized 14 samples of the EI (N = 3781), but insufficient data were available for the ES. Correlations between the EI and age (r = .10, 95% CI: .05 - .16), education (r = -.11, 95% CI: -.18 to -.04), and the RBANS Total Scale (r = -.45, 95% CI: -.62 to -.24) were significant. These results appeared to be robust to publication bias. Conclusion: Results support use of the EI over the ES; however, the latter is comparatively less studied and did not have similar variability in reported cut-off scores. ES accuracy statistics were significantly predicted by sample variables, which may be related to its relatively fewer studies. Both measures should be used cautiously in the context of genuine cognitive impairment.
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Affiliation(s)
- William F Goette
- a Department of Psychology and Counseling , The University of Texas at Tyler , Tyler , Texas , USA
| | - Haley E Goette
- b Department of History , The University of Texas at Tyler , Tyler , Texas , USA
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50
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Riordan P, Lahr G. Classification accuracy of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Effort Index (EI) and Effort Scale (ES) relative to the Test Of Memory Malingering (TOMM) in a mixed clinical sample. APPLIED NEUROPSYCHOLOGY-ADULT 2018; 27:82-86. [DOI: 10.1080/23279095.2018.1485678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Patrick Riordan
- Neuropsychology Department, Loyola University Medical Center, Maywood, Illinois, USA
| | - Genessa Lahr
- Neuropsychology Department, Loyola University Medical Center, Maywood, Illinois, USA
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