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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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Duff K, Dixon AM, Embree L, Hoffman JM. Change on the Repeatable Battery for the Assessment of Neuropsychological Status and its relationship to brain amyloid. J Clin Exp Neuropsychol 2023; 45:105-117. [PMID: 37224404 PMCID: PMC10330480 DOI: 10.1080/13803395.2023.2216920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/13/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated with commonly used biomarkers of Alzheimer's disease (AD), including brain amyloid plaque density. However, less is known about if changes in the RBANS across time are also related to brain amyloid deposition. The current study sought to expand on prior work by examining the relationship between changes over time on the RBANS and amyloid deposition via positron emission tomography (PET). METHOD One-hundred twenty-six older adults with intact or impaired cognition and daily functioning underwent repeat assessment with the RBANS across nearly 16 months, as well as had a baseline amyloid PET scan. RESULTS In the entire sample, amyloid deposition was significantly related to change on all five Indexes and the Total Scale score of the RBANS, with greater amyloid being associated with worsening cognition. This pattern was also observed in 11 of 12 subtests. CONCLUSIONS Whereas prior studies have identified a relationship between baseline RBANS and amyloid status, the current findings support that changes in the RBANS are also indicative of AD brain pathology, even if these findings are mediated by cognitive status. Although replication in a more diverse sample is needed, these results continue to support the use of the RBANS in AD clinical trials.
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Affiliation(s)
- Kevin Duff
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ava M. Dixon
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Lindsay Embree
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - John M. Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute
- Department of Radiology and Imaging Sciences, University of Utah
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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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Duff K, Suhrie KR, Hammers DB, Dixon AM, King JB, Koppelmans V, Hoffman JM. Repeatable battery for the assessment of neuropsychological status and its relationship to biomarkers of Alzheimer's disease. Clin Neuropsychol 2023; 37:157-173. [PMID: 34713772 PMCID: PMC9271322 DOI: 10.1080/13854046.2021.1995050] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Abstract
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated with commonly used biomarkers of Alzheimer's disease (AD). However, prior studies have typically utilized small and poorly characterized samples, and they have not analyzed the subtests of the RBANS. The current study sought to expand on prior work by examining the relationship between the Indexes and subtest scores of the RBANS and three AD biomarkers: amyloid deposition via positron emission tomography, hippocampal volume via magnetic resonance imaging, and APOE ε4 status. One-hundred twenty-one older adults across the AD continuum (intact, amnestic Mild Cognitive Impairment, mild AD), who were mostly Caucasian and well-educated, underwent assessment with the RBANS and collection of the three biomarkers. Greater amyloid deposition was significantly related to lower scores on all five Indexes and the Total Scale score of the RBANS, as well as 11 of 12 subtests. For bilateral hippocampal volume, significant correlations were observed for 4 of the 5 Indexes, Total Scale score, and 9 of 12 subtests, with smaller hippocampi being related to lower RBANS scores. Participants with at least one APOE ε4 allele had significantly lower scores on 3 of the 5 Indexes, Total Scale score, and 8 of the 12 subtests. In this sample of participants across the dementia spectrum, most RBANS Indexes and subtests showed relationships with the amyloid deposition, hippocampal volumes, and APOE status, with poorer performance on the RBANS being associated with biomarker positivity. Although memory scores on the RBANS have traditionally been linked to biomarkers in AD, other Index and subtest scores also hold promise as indicators of AD. Replication in a more diverse sample is needed.
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Affiliation(s)
- Kevin Duff
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Kayla R. Suhrie
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Dustin B. Hammers
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Ava M. Dixon
- Center for Alzheimer’s Care, Imaging and Research, Department of Neurology, University of Utah
| | - Jace B. King
- Department of Radiology and Imaging Sciences, University of Utah, United States
| | | | - John M. Hoffman
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah
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Kanser RJ, Logan PM, Steward KA, Vanderbleek EN, Kamper JE. Specificity of Embedded Performance Validity Tests in Elderly Veterans with Mild and Major Neurocognitive Disorder. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2022:6964520. [PMID: 36578198 DOI: 10.1093/arclin/acac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study explored the specificity of four embedded performance validity tests (PVTs) derived from common neuropsychological tasks in a sample of older veterans with verified cognitive decline and whose performance was deemed valid by licensed psychologists. METHOD Participants were 180 veterans who underwent comprehensive neuropsychological evaluation, were determined to have valid performance following profile analysis/conceptualization, and were diagnosed with mild neurocognitive disorder (i.e., MCI; n = 64) or major neurocognitive disorder (i.e., Dementia; n = 116). All participants completed at least one of four embedded PVTs: Reliable Digit Span (RDS), California Verbal Learning Test-2nd ed. Short Form (CVLT-II SF) Forced choice, Trails B:A, and Delis-Kaplan Executive Function System (DKEFS) Letter and Category Fluency. RESULTS Adequate specificity (i.e., ≥90%) was achieved at modified cut-scores for all embedded PVTs across MCI and Dementia groups. Trails B:A demonstrated near perfect specificity at its traditional cut-score (Trails B:A < 1.5). RDS ≤ 5 and CVLT-II SF Forced Choice ≤7 led to <10% false positive classification errors across MCI and dementia groups. DKEFS Letter and Category Fluency achieved 90% specificity at extremely low normative cut-scores. CONCLUSIONS RDS, Trails B:A, and CVLT-II SF Forced Choice reflect promising embedded PVTs in the context of dementia evaluations. DKEFS Letter and Category Fluency appear too sensitive to genuine neurocognitive decline and, therefore, are inappropriate PVTs in adults with MCI or dementia. Additional research into embedded PVT sensitivity (via known-groups or analogue designs) in MCI and dementia is needed.
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Affiliation(s)
- Robert J Kanser
- Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Patrick M Logan
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA.,Mental Health and Behavioral Science, Louisville VA Medical Center, Louisville, KY, USA
| | - Kayla A Steward
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Emily N Vanderbleek
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Joel E Kamper
- Mental Health and Behavioral Science, James A. Haley Veterans' Hospital, Tampa, FL, USA
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Grewal KS, Trites M, Kirk A, MacDonald SWS, Morgan D, Gowda-Sookochoff R, O'Connell ME. CVLT-II short form forced choice recognition in a clinical dementia sample: Cautions for performance validity assessment. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-10. [PMID: 35635794 DOI: 10.1080/23279095.2022.2079088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Performance validity tests are susceptible to false positives from genuine cognitive impairment (e.g., dementia); this has not been explored with the short form of the California Verbal Learning Test II (CVLT-II-SF). In a memory clinic sample, we examined whether CVLT-II-SF Forced Choice Recognition (FCR) scores differed across diagnostic groups, and how the severity of impairment [Clinical Dementia Rating Sum of Boxes (CDR-SOB) or Mini-Mental State Examination (MMSE)] modulated test performance. Three diagnostic groups were identified: subjective cognitive impairment (SCI; n = 85), amnestic mild cognitive impairment (a-MCI; n = 17), and dementia due to Alzheimer's Disease (AD; n = 50). Significant group differences in FCR were observed using one-way ANOVA; post-hoc analysis indicated the AD group performed significantly worse than the other groups. Using multiple regression, FCR performance was modeled as a function of the diagnostic group, severity (MMSE or CDR-SOB), and their interaction. Results yielded significant main effects for MMSE and diagnostic group, with a significant interaction. CDR-SOB analyses were non-significant. Increases in impairment disproportionately impacted FCR performance for persons with AD, adding caution to research-based cutoffs for performance validity in dementia. Caution is warranted when assessing performance validity in dementia populations. Future research should examine whether CVLT-II-SF-FCR is appropriately specific for best-practice testing batteries for dementia.
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Affiliation(s)
- Karl S Grewal
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Michaella Trites
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Andrew Kirk
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Debra Morgan
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | | | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
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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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Suhrie KR, Hammers DB, Porter SM, Dixon AM, King JB, Anderson JS, Duff K, Hoffman JM. Predicting biomarkers in intact older adults and those with amnestic Mild Cognitive Impairment, and mild Alzheimer's Disease using the Repeatable Battery for the Assessment of Neuropsychological Status. J Clin Exp Neuropsychol 2021; 43:861-878. [PMID: 35019815 DOI: 10.1080/13803395.2021.2023476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 12/23/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been associated, to varying degrees, with commonly used biomarkers of Alzheimer's disease (AD). Given the ease of RBANS administration as a screening tool for clinical trials and other applications, a better understanding of how RBANS performance is associated with presence of APOE ε4 allele[s], cerebral amyloid burden, and hippocampal volume is warranted. METHOD One hundred twenty-one older adults who were classified as intact, amnestic Mild Cognitive Impairment, or mild AD underwent cognitive assessment with the RBANS, genetic analysis, and quantitative brain imaging. APOE ε4 carrier status, 18F-Flutemetamol composite standardized uptake value ratio (SUVR), and hippocampal volume were each regressed on demographic variables and RBANS Total Scale score, Index scores, and subtest scores. RESULTS Lower RBANS Total Scale score or Delayed Memory Index (DMI) predicted the presence of APOE ε4 allele[s], higher cerebral amyloid burden, and lower hippocampal volumes. DMI was a slightly better predictor than Total Scale score for most AD biomarkers. No demographic variables consistently contributed to these models. CONCLUSIONS The RBANS - DMI in particular - is sensitive to AD pathology. As such, it could be used as a predictive tool, particularly in clinical drug trials to enrich samples prior to less accessible AD biomarker investigation.
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Affiliation(s)
- Kayla R Suhrie
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Dustin B Hammers
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Sariah M Porter
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Ava M Dixon
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Jeffrey S Anderson
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, Utah, USA
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
- Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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A Meta-Analysis of Neuropsychological Effort Test Performance in Psychotic Disorders. Neuropsychol Rev 2020; 30:407-424. [PMID: 32766940 DOI: 10.1007/s11065-020-09448-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/15/2020] [Indexed: 12/28/2022]
Abstract
Psychotic disorders are characterized by a generalized neurocognitive deficit (i.e., performance 1.5 SD below controls across neuropsychological domains with no specific profile of differential deficits). A motivational account of the generalized neurocognitive deficit has been proposed, which attributes poor neuropsychological testing performance to low effort. However, findings are inconsistent regarding effort test failure rate in individuals with psychotic disorders across studies (0-72%), and moderators are unclear, making it difficult to know whether the motivational explanation is viable. To address these issues, a meta-analysis was performed on data from 2205 individuals with psychotic disorders across 19 studies with 24 independent effects. Effort failure rate was examined along with moderators of effort test type, forensic status, IQ, positive symptoms, negative symptoms, diagnosis, age, gender, education, and antipsychotic use. The pooled weighted effort test failure rate was 18% across studies and there was a moderate pooled association between effort failure rate and global neurocognitive performance (r = .57). IQ and education significantly moderated failure rate. Collectively, these findings suggest that a nontrivial proportion of individuals with a psychotic disorder fail effort testing, and failure rate is associated with global neuropsychological impairment. However, given that effort tests are not immune to the effects of IQ in psychotic disorders, these results cannot attest to the viability of the motivational account of the generalized neurocognitive deficit. Furthermore, the significant moderating effect of IQ and education on effort test performance suggests that effort tests have questionable validity in this population and should be interpreted with caution.
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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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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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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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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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14
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RBANS Validity Indices: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:269-284. [DOI: 10.1007/s11065-018-9377-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 05/01/2018] [Indexed: 11/27/2022]
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Predictors and Impact of Self-Reported Suboptimal Effort on Estimates of Prevalence of HIV-Associated Neurocognitive Disorders. J Acquir Immune Defic Syndr 2017; 75:203-210. [PMID: 28328547 DOI: 10.1097/qai.0000000000001371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prevalence estimates of HIV-associated neurocognitive disorders (HAND) may be inflated. Estimates are determined via cohort studies in which participants may apply suboptimal effort on neurocognitive testing, thereby inflating estimates. Additionally, fluctuating HAND severity over time may be related to inconsistent effort. To address these hypotheses, we characterized effort in the Multicenter AIDS Cohort Study. METHODS After neurocognitive testing, 935 participants (525 HIV- and 410 HIV+) completed the visual analog effort scale (VAES), rating their effort from 0% to 100%. Those with <100% then indicated the reason(s) for suboptimal effort. K-means cluster analysis established 3 groups: high (mean = 97%), moderate (79%), and low effort (51%). Rates of HAND and other characteristics were compared between the groups. Linear regression examined the predictors of VAES score. Data from 57 participants who completed the VAES at 2 visits were analyzed to characterize the longitudinal relationship between effort and HAND severity. RESULTS Fifty-two percent of participants reported suboptimal effort (<100%), with no difference between serostatus groups. Common reasons included "tired" (43%) and "distracted" (36%). The lowest effort group had greater asymptomatic neurocognitive impairment and minor neurocognitive disorder diagnosis (25% and 33%) as compared with the moderate (23% and 15%) and the high (12% and 9%) effort groups. Predictors of suboptimal effort were self-reported memory impairment, African American race, and cocaine use. Change in effort between baseline and follow-up correlated with change in HAND severity. CONCLUSIONS Suboptimal effort seems to inflate estimated HAND prevalence and explain fluctuation of severity over time. A simple modification of study protocols to optimize effort is indicated by the results.
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Hammers DB, Atkinson TJ, Dalley BCA, Suhrie KR, Beardmore BE, Burrell LD, Horn KP, Rasmussen KM, Foster NL, Duff K, Hoffman JM. Relationship between 18F-Flutemetamol uptake and RBANS performance in non-demented community-dwelling older adults. Clin Neuropsychol 2017; 31:531-543. [PMID: 28077020 DOI: 10.1080/13854046.2016.1278039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with mild cognitive impairment and Alzheimer's disease (AD); however, relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS. METHODS Twenty-seven nondemented community-dwelling adults over the age of 65 underwent 18F-Flutemetamol amyloid- positron emission tomography imaging, along with cognitive testing using the RBANS and select behavioral measures. Partial correlation coefficients were used to identify relationships between the imaging and behavioral markers. RESULTS After controlling for age and education, amyloid deposition and RBANS Indexes of Immediate Memory, Delayed Memory, and Total Scale score were significantly correlated (p's < .001, r's = -.73 to -.77, d's = 2.13-2.39), with greater amyloid burden being associated with lower RBANS scores. The Delayed Memory Index was particularly highly associated with 18F-Flutemetamol binding (r2 = .59, p < .001, d = 2.39). Neither 18F-Flutemetamol binding nor RBANS performance was significantly correlated with levels of depression, subjective cognitive difficulties, or premorbid intellect. CONCLUSIONS Because of the limited use of amyloid imaging in clinical settings due to high cost and lack of reimbursement, these findings suggest that in particular RBANS Delayed Memory Index may be a cost-efficient tool to identify early signs of AD pathology, and its use may enlighten clinical decision-making regarding potential progression to dementia due to AD.
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Affiliation(s)
- Dustin B Hammers
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Taylor J Atkinson
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Bonnie C A Dalley
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Kayla R Suhrie
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Britney E Beardmore
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Lance D Burrell
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kevin P Horn
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Kelli M Rasmussen
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
| | - Norman L Foster
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - Kevin Duff
- a Department of Neurology, Center for Alzheimer's Care, Imaging, and Research , University of Utah , Salt Lake City , UT , USA
| | - John M Hoffman
- b Center for Quantitative Cancer Imaging, Huntsman Cancer Institute , University of Utah , Salt Lake City , UT , USA
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Carter KR, Scott JG, Adams RL, Linck J. Base rate comparison of suboptimal scores on the RBANS effort scale and effort index in Parkinson’s disease. Clin Neuropsychol 2016; 30:1118-25. [DOI: 10.1080/13854046.2016.1206145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kirstine R. Carter
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - James G. Scott
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Russell L. Adams
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - John Linck
- Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Lippa SM, Lange RT, Bhagwat A, French LM. Clinical utility of embedded performance validity tests on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) following mild traumatic brain injury. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:73-80. [DOI: 10.1080/23279095.2015.1100617] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jones A. Repeatable Battery for the Assessment of Neuropsychological Status: Effort Index Cutoff Scores for Psychometrically Defined Malingering Groups in a Military Sample. Arch Clin Neuropsychol 2016; 31:273-83. [DOI: 10.1093/arclin/acw006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/12/2022] Open
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Absorbed in the task: Personality measures predict engagement during task performance as tracked by error negativity and asymmetrical frontal activity. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2011; 10:441-53. [PMID: 21098805 DOI: 10.3758/cabn.10.4.441] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We hypothesized that interactions between traits and context predict task engagement, as measured by the amplitude of the error-related negativity (ERN), performance, and relative frontal activity asymmetry (RFA). In Study 1, we found that drive for reward, absorption, and constraint independently predicted self-reported persistence. We hypothesized that, during a prolonged monotonous task, absorption would predict initial ERN amplitudes, constraint would delay declines in ERN amplitudes and deterioration of performance, and drive for reward would predict left RFA when a reward could be obtained. Study 2, employing EEG recordings, confirmed our predictions. The results showed that most traits that have in previous research been related to ERN amplitudes have a relationship with the motivational trait persistence in common. In addition, trait-context combinations that are likely associated with increased engagement predict larger ERN amplitudes and RFA. Together, these results support the hypothesis that engagement may be a common underlying factor predicting ERN amplitude.
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