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Abo-El-Ata GA, Abdelghany FHA, Ahmed MF, Abdelgwad M, Ramadan MA. Assessing neuropsychological disorders affecting pottery workers occupationally exposed to air pollutants. Neurotoxicology 2023; 95:164-172. [PMID: 36736786 DOI: 10.1016/j.neuro.2023.01.011] [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: 07/14/2022] [Revised: 11/17/2022] [Accepted: 01/30/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Pottery-related activities are characterized by the emission of multiple air pollutants in the form of particulate matter, gases, and organic compounds. These pollutants are associated with adverse neuropsychological effects. This study aimed at investigating the effect of occupational exposure to air pollutants on the neuropsychiatric health. METHODS A total of 180 male workers (90 exposed workers and 90 administrative employees) were recruited from pottery-making activities in the Fawakher region located in old Cairo (Misr Al-Kadema); the administrative employees were the control group. Personal, medical, and family histories, general and neurological clinical examination, and neuropsychological assessments were recorded. Serum levels of 4-hydroxy-2-nonenal levels (4HNE) were measured by ELISA. Environmental measurement of workplace air pollutants was performed. RESULTS Environmental monitoring of the workplace revealed that workers are exposed to high levels of SO2 and NO2 as these exceeded the national standard levels. Compared to the control group, the exposed workers' group demonstrated a significant decrease in digit forwards score, digit backward score, and symbol digit score and a significant higher Hamilton Depression Scale score, and Benton Visual Retention score. The level of 4HNE was significantly increased among the exposed workers' group compared to that of the control group. CONCLUSION Occupational exposure to air pollutants is associated with impairment in neuropsychological functions, with a corresponding increase in the serum level of 4HNE, which is a biomarker for oxidative stress among Egyptian pottery workers.
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Affiliation(s)
- Gehad Ahmed Abo-El-Ata
- Occupational and Environmental Medicine Department, Faculty of Medicine, Cairo University, Egypt.
| | | | | | - Marwa Abdelgwad
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Egypt.
| | - Mona Abdallah Ramadan
- Occupational and Environmental Medicine Department, Faculty of Medicine, Cairo University, Egypt.
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Sweet JJ, Heilbronner RL, Morgan JE, Larrabee GJ, Rohling ML, Boone KB, Kirkwood MW, Schroeder RW, Suhr JA. American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering. Clin Neuropsychol 2021; 35:1053-1106. [PMID: 33823750 DOI: 10.1080/13854046.2021.1896036] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Citation and download data pertaining to the 2009 AACN consensus statement on validity assessment indicated that the topic maintained high interest in subsequent years, during which key terminology evolved and relevant empirical research proliferated. With a general goal of providing current guidance to the clinical neuropsychology community regarding this important topic, the specific update goals were to: identify current key definitions of terms relevant to validity assessment; learn what experts believe should be reaffirmed from the original consensus paper, as well as new consensus points; and incorporate the latest recommendations regarding the use of validity testing, as well as current application of the term 'malingering.' Methods: In the spring of 2019, four of the original 2009 work group chairs and additional experts for each work group were impaneled. A total of 20 individuals shared ideas and writing drafts until reaching consensus on January 21, 2021. Results: Consensus was reached regarding affirmation of prior salient points that continue to garner clinical and scientific support, as well as creation of new points. The resulting consensus statement addresses definitions and differential diagnosis, performance and symptom validity assessment, and research design and statistical issues. Conclusions/Importance: In order to provide bases for diagnoses and interpretations, the current consensus is that all clinical and forensic evaluations must proactively address the degree to which results of neuropsychological and psychological testing are valid. There is a strong and continually-growing evidence-based literature on which practitioners can confidently base their judgments regarding the selection and interpretation of validity measures.
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Affiliation(s)
- Jerry J Sweet
- Department of Psychiatry & Behavioral Sciences, NorthShore University HealthSystem, Evanston, IL, USA
| | | | | | | | - Martin L Rohling
- Psychology Department, University of South Alabama, Mobile, AL, USA
| | - Kyle B Boone
- California School of Forensic Studies, Alliant International University, Los Angeles, CA, USA
| | - Michael W Kirkwood
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | - Ryan W Schroeder
- Department of Psychiatry and Behavioral Sciences, University of Kansas School of Medicine, Wichita, KS, USA
| | - Julie A Suhr
- Psychology Department, Ohio University, Athens, OH, USA
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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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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: 11] [Impact Index Per Article: 2.2] [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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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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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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Armistead-Jehle P, Cooper DB, Grills CE, Cole WR, Lippa SM, Stegman RL, Lange RT. Clinical utility of the mBIAS and NSI validity-10 to detect symptom over-reporting following mild TBI: A multicenter investigation with military service members. J Clin Exp Neuropsychol 2017; 40:213-223. [DOI: 10.1080/13803395.2017.1329406] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Douglas B. Cooper
- Department of Neurology, San Antonio Military Medical Center, San Antonio, TX, USA
- Defense and Veterans Brain Injury Center, USA
| | - Chad E. Grills
- Brain Injury Clinic, US Army Health Clinic, Schofield Barracks, HI, USA
| | - Wesley R. Cole
- Defense and Veterans Brain Injury Center, USA
- Department of Brain Injury Medicine, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Sara M. Lippa
- Defense and Veterans Brain Injury Center, USA
- Neurology Department, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Bethesda, MD, USA
| | - Robert L. Stegman
- Department of Brain Injury Medicine, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Rael T. Lange
- Defense and Veterans Brain Injury Center, USA
- Neurology Department, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Bethesda, MD, USA
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