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Lace JW, Sanborn V, Galioto R. Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis. Assessment 2024; 31:732-744. [PMID: 37303186 DOI: 10.1177/10731911231178289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.
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Affiliation(s)
- John W Lace
- Cleveland Clinic Foundation, OH, USA
- Prevea Health, Green Bay, WI, USA
| | - Victoria Sanborn
- Kent State University, OH, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Rachel Galioto
- Cleveland Clinic Foundation, Mellen Center for Multiple Sclerosis, OH, USA
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Lace JW, Evans LN. The Relationship Between Religiousness/Spirituality and Psychometric Intelligence in the United States. J Relig Health 2022; 61:4516-4534. [PMID: 34449007 DOI: 10.1007/s10943-021-01394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
An inverse relationship between religiousness/spirituality (R/S) and psychometric intelligence (IQ) is well-documented in previous literature. However, the studies that have examined group differences on IQ regarding R/S have limited generalizability. The present study contributed to the literature by evaluating IQ among participants identifying as differentially religious/spiritual (i.e., religious only, spiritual only, both religious and spiritual, or neither religious nor spiritual) and among those classified as either Christian/Catholic, Atheist, or Agnostic. Four hundred and thirty-two participants (M age = 37.9; 36% men) participated online via Amazon's Mechanical Turk as part of a larger study and completed a brief measure of IQ, a scale of religiousness and spirituality, and a demographics questionnaire. Correlations between IQ and self-reported religiousness/spirituality were small and negative (Mean r = -0.17), consistent with previous literature. Multivariate analyses of covariance (MANCOVAs) controlling for age, gender, education, and socioeconomic status (operationalized by estimated annual household income) indicated that IQ scores tended to be lowest (p < 0.001) for "religious only" participants (estimated marginal mean [EMM] = 93.0) and highest for "neither religious nor spiritual" participants (EMM = 103.7). Furthermore, IQ scores were significantly lower (ps < 0.001) for Christian/Catholic participants (EMM = 96.7) compared to both Atheist (EMM = 104.9) and Agnostic participants (EMM = 107.5). Discussion of these findings, relationships to previous theoretical and empirical work, limitations of the present study, and directions for future inquiry are provided.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd, St. Louis, MO, 63108, USA
- Cleveland Clinic Foundation, Neurological Institute, Cleveland, OH, 44124, USA
| | - Luke N Evans
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd, St. Louis, MO, 63108, USA.
- The University of Akron Counseling and Testing Center, Akron, OH, 44325, USA.
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Merz ZC, Lace JW. Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia. Appl Neuropsychol Adult 2022:1-8. [PMID: 35930237 DOI: 10.1080/23279095.2022.2106572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (M age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.
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Affiliation(s)
- Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - John W Lace
- Section of Neuropsychology, Cleveland Clinic, Neurological Institute, Cleveland, OH, USA
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Lace JW, McGrath A, Merz ZC. A factor analytic investigation of the Barkley deficits in executive functioning scale, short form. Curr Psychol 2022. [DOI: 10.1007/s12144-020-00756-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lace JW, Merz ZC, Galioto R. Examining the Clinical Utility of Selected Memory-Based Embedded Performance Validity Tests in Neuropsychological Assessment of Patients with Multiple Sclerosis. Neurol Int 2021; 13:477-486. [PMID: 34698256 PMCID: PMC8544445 DOI: 10.3390/neurolint13040047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Within the neuropsychological assessment, clinicians are responsible for ensuring the validity of obtained cognitive data. As such, increased attention is being paid to performance validity in patients with multiple sclerosis (pwMS). Experts have proposed batteries of neuropsychological tests for use in this population, though none contain recommendations for standalone performance validity tests (PVTs). The California Verbal Learning Test, Second Edition (CVLT-II) and Brief Visuospatial Memory Test, Revised (BVMT-R)—both of which are included in the aforementioned recommended neuropsychological batteries—include previously validated embedded PVTs (which offer some advantages, including expedience and reduced costs), with no prior work exploring their utility in pwMS. The purpose of the present study was to determine the potential clinical utility of embedded PVTs to detect the signal of non-credibility as operationally defined by below criterion standalone PVT performance. One hundred thirty-three (133) patients (M age = 48.28; 76.7% women; 85.0% White) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into “credible” (n = 100) or “noncredible” (n = 33) groups based on a standalone PVT criterion. Classification statistics for four CVLT-II and BVMT-R PVTs of interest in isolation were poor (AUCs = 0.58–0.62). Several arithmetic and logistic regression-derived multivariate formulas were calculated, all of which similarly demonstrated poor discriminability (AUCs = 0.61–0.64). Although embedded PVTs may arguably maximize efficiency and minimize test burden in pwMS, common ones in the CVLT-II and BVMT-R may not be psychometrically appropriate, sufficiently sensitive, nor substitutable for standalone PVTs in this population. Clinical neuropsychologists who evaluate such patients are encouraged to include standalone PVTs in their assessment batteries to ensure that clinical care conclusions drawn from neuropsychological data are valid.
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Affiliation(s)
- John W. Lace
- Neurological Institute, Section of Neuropsychology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA;
- Correspondence:
| | - Zachary C. Merz
- LeBauer Department of Neurology, The Moses H. Cone Memorial Hospital, Greensboro, NC 27401, USA;
| | - Rachel Galioto
- Neurological Institute, Section of Neuropsychology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA;
- Mellen Center for Multiple Sclerosis, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Lace JW, Merz ZC, Galioto R. Nonmemory Composite Embedded Performance Validity Formulas in Patients with Multiple Sclerosis. Arch Clin Neuropsychol 2021; 37:309-321. [PMID: 34467368 DOI: 10.1093/arclin/acab066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited work has examined embedded PVTs in this population. As previous investigations indicated that nonmemory-based embedded PVTs provide clinical utility in other populations, this study sought to determine if a logistic regression-derived PVT formula can be identified from selected nonmemory variables in a sample of patients with MS. METHOD A total of 184 patients (M age = 48.45; 76.6% female) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 146) or "noncredible" (n = 38) groups according to performance on standalone PVT. Missing data were imputed with HOTDECK. RESULTS Classification statistics for a variety of embedded PVTs were examined, with none appearing psychometrically appropriate in isolation (areas under the curve [AUCs] = .48-.64). Four exponentiated equations were created via logistic regression. Six, five, and three predictor equations yielded acceptable discriminability (AUC = .71-.74) with modest sensitivity (.34-.39) while maintaining good specificity (≥.90). The two predictor equation appeared unacceptable (AUC = .67). CONCLUSIONS Results suggest that multivariate combinations of embedded PVTs may provide some clinical utility while minimizing test burden in determining performance validity in patients with MS. Nonetheless, the authors recommend routine inclusion of several PVTs and utilization of comprehensive clinical judgment to maximize signal detection of noncredible performance and avoid incorrect conclusions. Clinical implications, limitations, and avenues for future research are discussed.
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Affiliation(s)
- John W Lace
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA
| | - Zachary C Merz
- LeBauer Department of Neurology, The Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - Rachel Galioto
- Section of Neuropsychology, P57, Cleveland Clinic, Cleveland, OH, USA.,Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA
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Merz ZC, Lichtenstein JD, Lace JW. Methodological considerations of assessing meaningful/reliable change in computerized neurocognitive testing following sport-related concussion. Appl Neuropsychol Child 2021; 11:725-733. [PMID: 34293970 DOI: 10.1080/21622965.2021.1952413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Traditional reliable change index (RCI) methods may be psychometrically limited due to their inability to account for particularly high or low baseline performance and regression to the mean following serial testing. The current study sought to examine differences between RCI and standardized regression-based (RBz) methods in a cohort of adolescent athletes engaged in sport-related concussion recovery. METHODS Consultation records and results of computerized testing data via the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery were retrospectively reviewed among 240 adolescent athletes involved in return-to-play protocols following a sport-related concussion. RESULTS High concordance rates were found between RCI and RBz metrics across ImPACT composites, consistent with previous literature. However, especially for those with lower baseline performance, RBz scores tended to suggest cognitive performance not meeting or exceeding baseline scores despite RCI metrics being appropriate across speed-based ImPACT composites. In contrast, results revealed high rates of RCI scores suggesting continued cognitive difficulties despite RBz metrics being within normal limits, especially for adolescents with higher baseline performance. CONCLUSIONS Results suggest value in interpreting RBz values in addition to RCI values as these allow for clinical interpretation more sensitive to statistical confounds, including baseline performance and regression to the mean.
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Affiliation(s)
- Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, North Carolina, USA
| | - Jonathan D Lichtenstein
- Departments of Psychiatry, Pediatrics, and The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - John W Lace
- Cleveland Clinic, Section of Neuropsychology, Neurological Institute, Cleveland, Ohio, USA
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Galioto R, Macaron G, Lace JW, Ontaneda D, Rao SM. Is computerized screening for processing speed impairment sufficient for identifying MS-related cognitive impairment in a clinical setting? Mult Scler Relat Disord 2021; 54:103106. [PMID: 34217998 DOI: 10.1016/j.msard.2021.103106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/10/2021] [Accepted: 06/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Annual screening for processing speed impairment (PSI) is recommended for patients with multiple sclerosis (pwMS). However, cognitive deficits in pwMS are heterogeneous, and whether PSI screening identifies patients with impairment in other cognitive domains is unclear. The objective of this study was to examine sensitivity and specificity of the self-administered, computerized Processing Speed Test (PST) in identifying cognitive impairment defined by a comprehensive neuropsychological battery (NPT). METHODS Ninety-one pwMS completed PST and NPT, with raw scores demographically adjusted. Cognitive impairment on NPT was defined as performance <5th percentile in at least one domain. Receiver operating characteristic (ROC) analyses were performed to determine the ability of the PST to discriminate between cognitively normal (CN) and cognitively impaired with PSI (CI-PSI) and cognitively impaired with normal processing speed (CI-PSN) groups. RESULTS Cognitive impairment was observed in 23.1% of pwMS on PST and in 42.9% on NPT. PST demonstrated excellent ability to discriminate between CN (57.1%) and CI-PSI (20.9%) groups (Area Under the Curve [AUC] = 0.86, p < 0.001). In contrast, PST was unable to discriminate CN and CI-PSN (22.0%) groups (AUC = 0.42, p = 0.32). CONCLUSION The PST demonstrates excellent ability to detect PSI in pwMS but is unable to identify cognitively impaired pwMS without PSI, highlighting the importance of developing additional screening measures.
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Affiliation(s)
- Rachel Galioto
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States.
| | - Gabrielle Macaron
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Faculté de médecine, Université Saint Joseph de Beyrouth, Department of Neurology, Hôtel Dieu de France Hospital, Beirut, Lebanon
| | - John W Lace
- Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States
| | - Daniel Ontaneda
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Department of Neurology, Neurological Institute, Cleveland Clinic, OH, United States
| | - Stephen M Rao
- Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, OH, United States; Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH
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Merz ZC, Lace JW, Garcia J. Verbal Short-Form FSIQ Estimations for Possible Use With Individuals With Motor and Visual Impairment or in Virtual Environments. Arch Clin Neuropsychol 2021; 36:620-625. [PMID: 33009801 DOI: 10.1093/arclin/acaa077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/24/2020] [Accepted: 09/01/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Abbreviated and virtual neuropsychological assessment practices are growing in popularity and viable alternatives to traditional testing methods are needed, especially in the face of global health concerns. This study generated and examined short form (SF) full-scale IQ (FSIQ) estimations, which lend themselves to virtual test administration. METHODS Archival data were procured from 318 concurrent cognitive evaluations at a university clinic. Twenty-six unique SF combinations, including dyads, triads, tetrads, and pentads, were created from Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) subtests within verbal comprehension and working memory indices due to these tests' ability to be administered without visual stimuli or psychomotor involvement. RESULTS Stepwise regression analyses revealed 9 SF combinations (i.e., 1 pentad, 3 tetrads, 2 triads, and 3 dyads) that significantly accounted for unique variance in FSIQ scores and provided good accuracy estimating FSIQ. CONCLUSION Results suggest the potential viability of verbal WAIS-IV SF FSIQ estimations for clinical use when assessing patients with motor or visual impairments, as well as performing tele-neuropsychological services.
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Affiliation(s)
- Zachary C Merz
- LeBauer Department of Neurology, Moses H. Cone Memorial Hospital, Greensboro, NC, USA
| | - John W Lace
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Julian Garcia
- Department of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA
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Lace JW, Seitz DJ, Austin TA, Kennedy EE, Ferguson BJ, Mohrland MD. The dimensionality of the Behavior Rating Inventory of Executive Function, Second Edition in a clinical sample. Appl Neuropsychol Child 2021; 11:579-590. [PMID: 33908814 DOI: 10.1080/21622965.2021.1910950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The parent-report Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is a widely used pediatric neuropsychological measure. Unfortunately, despite meaningful changes from its predecessor, few studies have examined its internal factor structure (now with Behavioral Regulation [BRI], Emotion Regulation [ERI], and Cognitive Regulation [CRI]), and no available literature has investigated higher order models for the BRIEF-2. This study sought to address this shortcoming in the literature by investigating and reporting on the dimensionality of the parent-report BRIEF-2 in a clinical sample. Two hundred and two (202) pediatric neuropsychology examinees (M age = 9.90; 68% males) with complete data for the parent-report BRIEF-2 were included. Descriptive results revealed generally elevated scores across BRIEF-2 scales (Global Executive Composite M T = 70.16). Exploratory factor analyses suggested two factors (CRI and BRI/ERI) should be extracted, and that higher order models should be considered. Confirmatory factor analyses suggested that a direct hierarchical/bifactor two-factor structure (which was more parsimonious than the theoretical three-factor model) provided the best fit, with a bulk of the variance explained by the general GEC factor. The BRIEF-2 may be best interpreted at the overall level, with relatively less weight given to the index variables, particularly within clinical samples with high levels of reported executive functioning difficulties. Implications of these findings, limitations of the present study, and appropriate directions for future inquiry were discussed.
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Affiliation(s)
- John W Lace
- Neuropsychology Section, Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA
| | - Dylan J Seitz
- Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA
| | - Tara A Austin
- Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA
| | - Erin E Kennedy
- Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA
| | - Bradley J Ferguson
- Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA.,Department of Radiology, University of Missouri, Columbia, Missouri, USA.,Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri, USA
| | - Michael D Mohrland
- Department of Health Psychology, Univerisity of Missouri, Columbia, Missouri, USA.,Thompson Center for Autism and Neurodevelopmental Disorders, Columbia, Missouri, USA
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Kosky KM, Lace JW, Austin TA, Seitz DJ, Clark B. The utility of the Wisconsin card sorting test, 64-card version to detect noncredible attention-deficit/hyperactivity disorder. Applied Neuropsychology: Adult 2020; 29:1231-1241. [DOI: 10.1080/23279095.2020.1864633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karen M. Kosky
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
| | - John W. Lace
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Tara A. Austin
- University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Dylan J. Seitz
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brook Clark
- Department of Health Psychology, University of Missouri, Columbia, MO, USA
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Lace JW, Merz ZC. DSM-5 Level 1 cross-cutting measure in an online sample: evaluating its latent dimensionality and utility detecting nonspecific psychological distress. Psychiatry Res 2020; 294:113529. [PMID: 33137552 DOI: 10.1016/j.psychres.2020.113529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/20/2020] [Indexed: 01/22/2023]
Abstract
Included in the most recent Diagnostic and Statistical Manual of Mental Disorders is the Level 1 Cross-Cutting Symptom Measure (CCSM), a self-report checklist with 23 items assessing 13 major psychiatric symptom clusters. To date, minimal literature has examined the factor structure of the CCSM and its utility identifying significant psychological distress, and existing studies pose notable limitations. Four hundred (400) American adults (M age = 34.13; 50.2% female) participated online via Amazon Mechanical Turk as part of a larger study, which included the CCSM. The sample was randomly split to conduct exploratory and confirmatory factor analyses (EFAs and CFAs). EFAs revealed structures with one (general psychopathology) and two (externalizing/serious mental illness and internalizing/affective) factors accounting for 67.3% and 73.7% of the variance, respectively. CFAs indicated good fit for both models, though statistical comparison of the models via χ2 difference test revealed the two-factor model provided significantly better fit. Areas under the receiver operating curve (AUCs) suggested that all CCSM variables of interest poorly differentiated those currently receiving mental health treatment from those who have never received mental health treatment (AUCs ranged from .57 to .68). Implications of these findings, various limitations, and recommendations for future lines of inquiry were discussed.
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Affiliation(s)
- John W Lace
- Cleveland Clinic, Department of Neurology, Section of Neuropsychology, Cleveland, OH, USA.
| | - Zachary C Merz
- Moses H. Cone Memorial Hospital, LeBauer Department of Neurology, Greensboro, NC, USA
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Abstract
A review of the literature investigating the relationship between religion and spirituality and broad personality traits reveals methodological limitations. The present study sought to contribute to the present literature by investigating differences on personality traits among men and women who identified as either religious only (R), spiritual only (S), both spiritual and religious (B), or neither spiritual nor religious (N). One thousand thirty-seven (1037) adults (M age = 36.34, SD = 12.62) participated online via Amazon's Mechanical Turk as part of a larger study and completed the IPIP-NEO-120, Spiritual Transcendence Scale, Duke University Religion Index, and demographic information. Results revealed that men were more likely to identify as R and N than women, and women were more likely to identify as B than men. Women showed more significant differences among Big Five traits than men. Compared to other women, R-women reported the lowest levels of Openness, Agreeableness, and Neuroticism, and highest levels of Extraversion. N-women reported the highest levels of Neuroticism, while S-women reported highest Openness. Among men, R-men reported the lowest Openness, and S-men reported the highest Openness. B-men reported higher Extraversion than N-men. Additionally, Big Five traits appeared to account for significantly more variance in self-reported religiousness for women than men. Implications of these findings and recommendations for future research are provided and discussed.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, St. Louis, USA.
| | - Luke N Evans
- Department of Psychology, Saint Louis University, St. Louis, USA
| | - Zachary C Merz
- Department of Physical Medicine and Rehabilitation, University of North Carolina Chapel Hill, Chapel Hill, USA
| | - Paul J Handal
- Department of Psychology, Saint Louis University, St. Louis, USA
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Grant AF, Lace JW, Teague CL, Lowell KT, Ruppert PD, Garner AA, Gfeller JD. Detecting feigned symptoms of depression, anxiety, and ADHD, in college students with the structured inventory of malingered symptomatology. Appl Neuropsychol Adult 2020; 29:443-451. [PMID: 32456475 DOI: 10.1080/23279095.2020.1769097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms to accesses academic accommodations, making the assessment of symptom validity important in both populations.Method: Using a between-subjects design, 75 college students were randomly assigned to one of three groups: (1) coached feigning of ADHD, (2) coached feigning of depression and anxiety (DA), and (3) honest responding (HR). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Structured Inventory of Malingered Symptomatology (SIMS).Results: The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified as feigning by the SIMS typically reported more severe symptoms than participants not identified on the DASS-21.Conclusions: The SIMS equally classified the feigned ADHD and DA participants for both cutoff scores utilized. Potential reasons for low sensitivity rates are discussed and future research recommendations are made.
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Affiliation(s)
- Alexandra F Grant
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - John W Lace
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Carson L Teague
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Kimberly T Lowell
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Phillip D Ruppert
- Department of Psychiatry, Saint Louis University, St. Louis, MO, USA
| | - Annie A Garner
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - Jeffrey D Gfeller
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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Lace JW, Merz ZC, Kennedy EE, Seitz DJ, Austin TA, Ferguson BJ, Mohrland MD. Examination of five- and four-subtest short form IQ estimations for the Wechsler Intelligence Scale for Children-Fifth edition (WISC-V) in a mixed clinical sample. Appl Neuropsychol Child 2020; 11:50-61. [PMID: 32297810 DOI: 10.1080/21622965.2020.1747021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Evaluating general cognitive ability (i.e., intelligence) is common in neuropsychological practice, and identifying abbreviated assessments of intelligence is often advantageous. Despite the Wechsler Intelligence Scale for Children, Fifth Edition's (WISC-V) widespread contemporary use, limited research has identified clinically useful short form (SF) full scale IQ (FSIQ) estimations in clinical samples. This study sought to address this gap in the literature. Two hundred sixty-eight pediatric participants (M age = 9.79; 69% male; 88% Caucasian/White) who underwent psychological/neuropsychological evaluation were included. Mean scores for WISC-V scores fell in the low average-to-average ranges, consistent with the clinical nature of this sample (e.g., M FSIQ = 85.3). Ten unique SF combinations with five (pentad) and four (tetrad) subtests, each intentionally selected to represent a breadth of domains subsumed by WISC-V FSIQ, were described by summing subtest age-corrected scaled scores. Regression-based and prorated FSIQ estimates were calculated, and mean differences suggested some prorated estimates should be arithmetically adjusted. Both regression-based and prorated/adjusted methods provided FSIQ estimates that were accurate within five Standard Score points of true FSIQ for approximately 81-92% (pentad) and 65-76% (tetrads) of participants. Prorated/adjusted estimates appeared to provide somewhat better accuracy than regression-based estimates. Relationships between SFs and true FSIQ did not appear to be moderated by participant age, gender, nor how many WISC-V subtests were administered to participants within this archival sample (i.e., 7 vs. 10). Implications of these findings, including benefits, detriments, and other considerations of each SF combination, in addition to limitations of this study, are discussed in detail.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA.,Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Zachary C Merz
- Department of Physical Medicine and Rehabilitation, University of North Carolina, Chapel Hill, NC, USA
| | - Erin E Kennedy
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Dylan J Seitz
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Tara A Austin
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA
| | - Bradley J Ferguson
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA.,Department of Radiology, University of Missouri, Columbia, MO, USA.,Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, USA
| | - Michael D Mohrland
- Department of Health Psychology, Univerisity of Missouri, Columbia, MO, USA.,Thompson Center for Autism & Neurodevelopmental Disorders, Columbia, MO, USA
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Lace JW, Merz ZC, Grant AF, Teague CL, Aylward S, Dorflinger J, Gfeller JD. Relationships Between the BRIEF/BRIEF-SR and Performance-Based Neuropsychological Tests in Adolescents with Mild Traumatic Brain Injury. J Pediatr Neuropsychol 2019. [DOI: 10.1007/s40817-019-00074-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Merz ZC, Lace JW, Eisenstein AM, Grant AF. Examination of Wechsler adult Intelligence Scale-Fourth Edition short-form IQ estimations in an outpatient psychoeducational sample. Appl Neuropsychol Adult 2019; 28:707-716. [PMID: 31747821 DOI: 10.1080/23279095.2019.1687480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) is a commonly utilized cognitive battery across many clinical settings. However, due to various patient variables, an abbreviated assessment of intellectual abilities, may be clinically advantageous to allow for a more thorough assessment of other cognitive domains. The current study represents an attempt to propose additional short-form IQ estimations in an outpatient clinical sample. METHODS We examined archival data from 318 concurrent psychological/psychoeducational evaluations performed within a university clinic (Mage = 28.67; 53.8% women). Thirty-six unique 4-subtest short-form IQ combinations were created to ensure that each WAIS-IV index score was represented by a single subtest. RESULTS Complete data for the ten core subtests and FSIQ were available for 192 cases. Stepwise regression analyses revealed three short-form combinations that significantly accounted for unique variance in true FSIQ scores in the final model (R2 = .981, F[3, 188] = 3257.597, p < .001). Regression-based and prorated FSIQ estimates were calculated, and both methods revealed that approximately 70-75% of participants' FSIQ estimates fell within five Standard Score points of true FSIQ. CONCLUSION Results suggest the utility of three derived 4-subtest short-form IQ estimations for use within a clinical sample.
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Affiliation(s)
- Zachary C Merz
- Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John W Lace
- Psychology, Saint Louis University, St. Louis, MO, USA
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Lace JW, Emmert NA, Merz ZC, Zane KL, Grant AF, Aylward S, Dorflinger J, Gfeller JD. Investigating the BRIEF and BRIEF-SR in Adolescents with Mild Traumatic Brain Injury. J Pediatr Neuropsychol 2018. [DOI: 10.1007/s40817-018-00063-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lace JW, Haeberlein KA, Handal PJ. Religious Integration and Psychological Distress: Different Patterns in Emerging Adult Males and Females. J Relig Health 2018; 57:2378-2388. [PMID: 29564618 DOI: 10.1007/s10943-018-0608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examined differences between male and female emerging adults on low, moderate, and high levels of religious integration in relation to psychological distress. Participants were recruited from undergraduate courses at a religiously affiliated, Midwestern university and completed the integration scale of the Personal Religious Inventory and the Langner Symptom Survey. Due to significantly higher reports of religious integration in female participants, the sample was separated by sex. A significant, negative correlation between religious integration and psychological distress was found only for females. Similarly, females in the low religious integration group reported significantly higher levels of psychological distress than females high in religious integration, while no differences were found among males. This study corroborates previous research suggesting a general link between religion and mental health, but further suggests religious integration and psychological distress are uniquely related for males and females. Possible reasons and future areas of study are noted.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd, Ste 1200, St. Louis, MO, 63108, USA.
| | - Kristen A Haeberlein
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd, Ste 1200, St. Louis, MO, 63108, USA
| | - Paul J Handal
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd, Ste 1200, St. Louis, MO, 63108, USA
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Lace JW, Merz ZC, Grant AF, Emmert NA, Zane KL, Handal PJ. Validation of the K6 and its depression and anxiety subscales for detecting nonspecific psychological distress and need for treatment. Curr Psychol 2018. [DOI: 10.1007/s12144-018-9846-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
The present study provided a methodological critique regarding psychometric investigations of the Duke University Religion Index (DUREL) and its variants. Nine hundred seventeen (630 females and 287 males) university students (M age = 19.24) completed the DUREL, the Personal Religious Inventory, and the Daily Spiritual Experiences Scale online. Confirmatory factor analyses were performed to assess a three-factor (organizational religious activity; non-organizational religious activity; and intrinsic religiosity) and a unidimensional model of the DUREL. Chi-square difference tests were performed, and Akaike information criterion values and Bayesian information criterion values were compared between the models, each of which supported the three-factor model for the DUREL over the unidimensional model. Convergent validity for the three factors of the DUREL emerged through Spearman's rho correlations with measures of personal prayer, ritual religious attendance, religious integration, Closeness to the Divine. This study concluded that the DUREL is a multidimensional measurement of religion for use in English-speaking university students, and it provided a broad methodological note regarding future investigations of measures of religion or spirituality that possess an existing theoretical model.
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Abstract
This study investigated the dimensionality of the Langner Symptom Survey and replicated a recent finding regarding a clinically validated cutoff score in emerging adults. Nine hundred thirteen (631 females and 282 males) students at a private university in the Midwestern United States participated online as part of a larger study and completed the Langner Symptom Survey and a demographic questionnaire. Results from exploratory principal components and confirmatory factor analyses provided support for both a six- and three-factor model of the Langner Symptom Survey, with the three-factor model offering marginally better confirmatory fit indices and greater parsimony of interpretation. A cutoff score of 5 denoting clinically significant psychological distress and need for treatment was supported through analysis of receiver-operating characteristic, sensitivity, specificity, and total classification accuracy based on psychological service utilization, and this result successfully replicated a recently published finding. The Langner Symptom Survey may function as a multidimensional measure of psychological distress and need for treatment in emerging adults that may need a lexical update.
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Affiliation(s)
- John W Lace
- Department of Psychology, Saint Louis University, MO, USA
| | | | - Paul J Handal
- Department of Psychology, Saint Louis University, MO, USA
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Abstract
This study examined measures of religion and spirituality in a sample of male and female emerging adult college students whose parents were either divorced or intact using the Personal Religious Inventory, the Duke University Religion Index, the Daily Spiritual Experiences Scale, the Spiritual Transcendence Scale, and the Spiritual Involvement and Beliefs Scale. Data were collected online, and 66% of participants received extra credit for participating. A main effect of sex was found, as females reported significantly higher scores than men on all but one measure of religion and spirituality, and the dataset was separated by sex. No differences were found between males from divorced and intact families. However, females from intact families scored significantly higher on all religion and spirituality measures than females from divorced families. This study suggests that females may respond differently than males to their parents' divorce in the context of religion and spirituality, and discusses possible reasons.
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Affiliation(s)
- Paul J Handal
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - John W Lace
- Department of Psychology, Saint Louis University, St. Louis, MO, USA.
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Abstract
Multiple strips of choroid (56) and sclera (64) from eight pairs of human eye-bank eyes were subjected to simple tension in a test apparatus to determine the rigidity (modulus of elasticity) of these tissues. The modulus of elasticity of the chorodial complex (choroid-Bruch's membrane-pigment epithelium) was significantly greater in posteriorly located samples than in anteriorly located ones (7.5 +/- 7.0 vs. 2.2 +/- 1.5 x 10(5) N m-2, mean +/- S.D.). The modulus of elasticity for the complex averaged across all locations was 6.0 +/- 2.8 x 10(5) N m-2 and the average stress at failure was 3.3 +/- 1.3 x 10(5) N m-2. The modulus of elasticity for scleral strips also varied with location and averaged 2.9 +/- 1.4 x 10(6) N m-2 for anterior sclera and 1.8 +/- 1.1 x 10(6) N m-2 for posterior sclera at stress levels ranging from 20- to 260 x 10(4) N m-2. There was a significant correlation of scleral stiffness with age (P less than 0.05, r = 0.80). The elastic properties of the choroidal complex may be relevant to the pathogenesis of a variety of ocular diseases, including macular degeneration, angioid streaks, choroidal folds, and choroidal ruptures.
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Affiliation(s)
- T R Friberg
- Eye and Ear Institute of Pittsburgh, PA 15213
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Lace JW, Schneider CW, Hartline RA. The ethanol sensitivity of calcium taken up by a depolarization-dependent process in mouse strains DBA and C57BL. Pharmacol Biochem Behav 1986; 24:1137-9. [PMID: 3714771 DOI: 10.1016/0091-3057(86)90468-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In vitro effects of ethanol on calcium taken up by synaptosomes were examined in two strains of mice, C57BL and DBA, that exhibit marked differences in alcohol sensitivity and preference. There were no significant strain differences in basal or depolarization-dependent synaptosomal calcium levels. Ethanol did not reduce the basal calcium level but instead reduced depolarization-dependent calcium levels with the same potency in both strains. These results do not support a role for changes of calcium levels as the basis for differences in ethanol sensitivity in these mouse strains.
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Lace JW, Antelman SM. Cortical beta-adrenergic subsensitivity after desmethylimipramine may depend on the passage of time rather than daily treatment. Brain Res 1983; 278:359-61. [PMID: 6315162 DOI: 10.1016/0006-8993(83)90272-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Earlier data from our laboratory indicated that the effects of antidepressants on dopamine autoreceptors are dependent on the passage of time rather than repeated treatment. The present study inquired whether the same might be true of cortical beta-adrenergic receptors. Our findings indicate that beta-adrenergic subsensitivity is obtained whether rats were treated with desmethylimipramine daily for 17 days or only on day 1 and day 17. These data suggest that antidepressant-induced changes in beta-receptor sensitivity may, like those in dopamine autoreceptors, also depend on the passage of time.
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