scholarly journals A-213 Comparing WAIS-IV Reliable Digit Span and Age Corrected Scaled Score’s Performance Validity Cutoffs when Patients’ Effort is Determined by One or More Performance Validity Tests (PVTs)

2020 ◽  
Vol 35 (6) ◽  
pp. 1008-1008
Author(s):  
Livingstone J ◽  
Reese C
Keyword(s):  
Sensitivity And Specificity ◽  
Clinical Sample ◽  
Digit Span ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Performance Validity ◽  
Card Sorting ◽  
Cut Scores ◽  
Adult Intelligence Scale ◽  
Cut Score

Abstract Objective The purpose of the present study was to compare Wechsler Adult Intelligence Scale-IV (WAIS-IV) Reliable Digit Span (RDS) and Digit Span Age-Corrected Scaled Score (DS-ACSS) sensitivity and specificity, when the effort criterion was determined by between one and five performance validity test (PVT) cut scores. Method Data were collected from 82 adults (18–49) referred for clinical questions of multiple sclerosis, mild traumatic brain injury, and attention deficit hyperactivity disorder. Patients were administered full neuropsychological batteries,with different combinations of PVTs (including Advanced Clinical Solutions Word Choice, Animals raw score, Trails A T-score, Wisconsin Card Sorting Test [WCST; Suhr & Boyer] equation, and California Verbal Learning Test-II Forced Choice). Chi-square and receiver operating characteristic (ROC) analyses were utilized. Results Using established RDS (≤7) and DS-ACSS (≤6) cut scores, specificity was highest (90&37; and 86%, respectively), with equivalent sensitivity (90%), when effort was determined by WCST (Suhr & Boyer) equation failure alone. Related area under the curve for RDS was .90 (CI = .76–1.0) and for DS-ACSS was .88 (CI = .74–1.0). Conclusions In this clinical sample, the highest sensitivity and specificity were observed when the RDS cut score was utilized, and effort was based on the WCST criterion. However, the DS-ACSS cut score resulted in strong sensitivity/specificity combinations across more effort classification groups.

scholarly journals A-48 The Role of Processing Speed in Verbal and Nonverbal Learning within a Clinical Sample of Older Adults.

2019 ◽  
Vol 34 (6) ◽  
pp. 907-907
Author(s):  
N Hawley ◽  
H Brunet ◽  
J Miller
Keyword(s):  
Older Adults ◽  
Processing Speed ◽  
Clinical Sample ◽  
Digit Span ◽  
Memory Performance ◽  
Verbal Learning ◽  
Adult Intelligence Scale ◽  
Nonverbal Learning ◽  
Learning Trials

Abstract Objective Prior research revealed that processing speed predicts nonverbal learning in healthy older adults (Tam & Schmitter-Edgecombe, 2013). This study aims to examine the role of processing speed in both verbal and nonverbal learning in a clinical sample. We expect that processing speed will lend the most variance to the initial learning trials. Method Records from 718 patients were reviewed (mean age = 74). Hierarchical regression analyses were conducted using Brief Visuospatial Memory Test –Revised (BVMT-R) and Hopkins Verbal Learning Test –Revised (HVLT-R) learning trials as outcome variables. Demographics were entered in a first step followed by BVMT-R copy or Wechsler Adult Intelligence Scale (WAIS-IV) Digit Span –longest digit span forward raw score, to account for visuoconstruction or simple auditory attention for nonverbal and verbal learning outcomes respectively. A processing speed composite of sample-standardized raw scores was entered in a final step. Results Processing speed accounted for 5.4% of the variance in BVMT-R trial 1, 7.5% of the variance in trial 2, and 8.5% of the variance in trial 3, all p < .001. Processing speed accounted for 6.6% of the variance in HVLT-R trial 1, 11.1% of the variance in trial 2, and 11.5% of the variance in trial 3, all p < .001. Conclusions Processing speed significantly predicted all verbal and nonverbal learning trials. Contrary to our hypotheses, processing speed actually had a greater contribution during subsequent learning trials. These findings have implications for evaluating memory performance in patients with syndromes where processing speed is typically affected (e.g., cerebrovascular disease, Parkinson’s disease).

Agomelatine vs fluoxetine: Efficacy and improvement of cognitive functions in patients with MDD

2016 ◽  
Vol 33 (S1) ◽  
pp. S405-S405
Author(s):  
E. Aydın ◽  
M. Güleç ◽  
E. Oral ◽  
A.G. Daloğlu
Keyword(s):  
Cognitive Functions ◽  
Rating Scale ◽  
Word Association ◽  
Digit Span ◽  
Verbal Learning ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Neurocognitive Functions ◽  
Significant Difference ◽  
Competing Interest

IntroductionIn major depressive disorder (MDD) neurocognitive functions are impaired. In addition to melatonergic properties of agomelatine, via 5-HT2C antagonism it increases extracellular noradrenaline and dopamine in frontal cortex and may improve the neurocognitive functions of patients with MDD.Aims and objectivesTo investigate the extent of neurocognitive improvement and efficacy of agomelatine and fluoxetine in patients with MDD.Material and methodAgomelatine 25 mg/day (n: 24) and fluoxetine 20 mg/day (n: 24) were administered to drug-naive unipolar, non-psychotic, non-suicidal MDD patients according to DSM-IV. Evaluations were performed just before the treatment and at the sixth week of treatment via administering Hamilton Depression Rating Scale, Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test (COWAT), Digit Span Test (DST), Trail Making Test (TMT-A/B), Stroop Test and Wisconsin Card Sorting Test.ResultsBoth agomelatine and fluoxetine was found to be efficacious for the treatment of MDD (P < 0.05 for both). Further there was no difference between the antidepressant efficacy of two drugs. Both of the drugs improved measured neurocognitive functions (P < 0.05), except scores of DST (P > 0.05) and only fluoxetine improved significantly scores of COWAT (P < 0.05). Only in terms of TMT-B there was significant difference between groups and agomelatine was superior to fluoxetine (P < 0.05).ConclusionAgomelatine and fluoxetine were efficacious in treatment of MDD. Furthermore both of the drugs improved cognitive functions in patients with MDD. Superiority of agomelatine in improvement of executive functioning (TMT-B) is important and therefore it could be an appropriate choice for MDD patients who have pronounced executive disturbances.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Lack of executive function deficits among adult ADHD individuals from a Brazilian clinical sample

2009 ◽  
Vol 3 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Eloisa Saboya ◽  
Gabriel Coutinho ◽  
Daniel Segenreich ◽  
Vanessa Ayrão ◽  
Paulo Mattos
Keyword(s):  
Executive Function ◽  
Executive Functions ◽  
Adult Adhd ◽  
Clinical Sample ◽  
Digit Span ◽  
Wisconsin Card Sorting Test ◽  
Adhd Group ◽  
Card Sorting ◽  
Control Subjects ◽  
Executive Function Deficits

Abstract Executive function deficits have been previously documented in individuals with Attention Deficit Hyperactivity Disorder (ADHD). Objective: The current study aimed to compare measures of executive functions among a clinical sample of adults with ADHD and normal control subjects, matched for age, gender and education. Methods: Twenty-three self-referred adults diagnosed with ADHD according to DSM-IV criteria, and twenty-five control subjects were assessed using a neuropsychological battery which included the Wisconsin Card Sorting Test, Tower of Hanoi, Digit Span, Trail Making Test (A and B), Stroop Test and Raven's Progressive Matrices. Results: The ADHD group did not differ significantly from the control subjects on any of the measures assessed. Conclusion: Measures of executive functions using this test battery were unable to discriminate between adults with ADHD and control subjects in this clinical sample.

Dynamic Assessment of Cognitive Rehabilitation Potential in Schizophrenic Persons and in Elderly Persons With and Without Dementia

2001 ◽  
Vol 17 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Karl H. Wiedl ◽  
Henning Schöttke ◽  
M. Dolores Calero Garcia
Keyword(s):  
Cognitive Rehabilitation ◽  
Clinical Training ◽  
Dynamic Assessment ◽  
Verbal Learning ◽  
Verbal Working Memory ◽  
Wisconsin Card Sorting Test ◽  
Elderly Persons ◽  
Card Sorting ◽  
Static Test ◽  
Rehabilitation Potential

Summary: Dynamic assessment is a diagnostic approach in which specific interventions are integrated into assessment procedures to estimate cognitive modifiability. The study investigates the utility of this approach in persons with compelling rehabilitational needs. Samples of schizophrenic patients and of elderly with and without dementia were assessed with dynamic versions of the Wisconsin Card Sorting Test and the Auditory Verbal Learning Test. Both tests were administered by applying specific procedures of verbal mediation designed to increase performance. Results demonstrated superior predictive validity with regard to proficiency in a clinical training in schizophrenic subjects and better discrimination of nondemented and demented elderly with the help of dynamic measures compared to static test scores. Subsequent correlational analyses indicated that, for both tests, performance change following intervention is related to the processing of verbal context information. Results are discussed with respect to the concept of verbal working memory as one component of the patients' rehabilitation potential.

A-102 Performance Validity Testing in Telehealth Research: A VA Traumatic Brain Injury Model Systems Study

2021 ◽  
Vol 36 (6) ◽  
pp. 1151-1151
Author(s):  
Justin O'Rourke ◽  
Robert J Kanser ◽  
Marc A Silva
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Digit Span ◽  
Secondary Analysis ◽  
Primary Objective ◽  
Model Systems ◽  
Performance Validity ◽  
Cut Scores ◽  
Chi Square ◽  
Severe Tbi

Abstract Objective Studies on Performance Validity Tests (PVTs) for tele-neuropsychology (TeleNP) are sparse. Verbal PVTs appear to better translate to TeleNP, so the primary objective of this study was to provide initial data on two well-established, verbal PVTs administered via TeleNP for research participants with traumatic brain injury (TBI). Methods This secondary analysis of the Veterans Affairs TBI Model Systems data included 53 participants enrolled in a PVT module study (3/01/2020–09/20/2020) with documented moderate-to-severe TBI per Glasgow Coma Score (M = 6.5, SD = 4.4), posttraumatic amnesia duration (M = 42.7 days, SD = 47.1), and/or time to follow commands (M = 10.5 days, SD = 16.3). Participants completed two PVTs—Reliable Digit Span (RDS) and the 21-Item Test (21-IT)—alongside telephone-based cognitive assessment 1–7 years after TBI. Descriptive analyses were performed to compare PVT performances to previously established cut scores. Chi square analyses were employed to examine 21-IT and RDS as dichotomous outcomes (pass/fail) at selected cutoffs. Results RDS ranged from 5 to 16 (M = 10.5, SD = 2.4). 21-IT ranged from 7 to 21 (M = 16.4, SD = 3.1). For RDS, 9.8% were invalid with a cutscore of ≤7 and 19.6% using a cutscore of ≤8. For the 21-IT, 7.8% were in invalid using a cutscore of ≤11, and 13.7% using a cutscore of ≤12. Conclusion(s) Using previously established cut scores, telephone-administered RDS and 21-IT resulted in relatively low rates of invalid performance among individuals with moderate-to-severe TBI. These findings provide preliminary support for the RDS and 21-IT in TeleNP.

Is the Cutoff of the MoCA too High? Longitudinal Data From Highly Educated Older Adults

2019 ◽  
Vol 33 (3) ◽  
pp. 155-160 ◽  
Author(s):  
Odelia Elkana ◽  
Noy Tal ◽  
Noga Oren ◽  
Shani Soffer ◽  
Elissa L. Ash
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Repeated Measures ◽  
Cognitive Assessment ◽  
Digit Span ◽  
Verbal Learning ◽  
Cutoff Score ◽  
Adult Intelligence Scale ◽  
Cognitively Normal ◽  
Highly Educated

Background: The Montreal Cognitive Assessment (MoCA) is widely used to evaluate cognitive decline in older individuals. Although, age and education-related norms have been published, the vast majority of diagnostic clinicians use the MoCA cutoff score to identify patients with cognitive impairment. Aim: To identify whether the MoCA cutoff is too stringent for cognitively normal older adults. Methods: Twenty-seven participants aged 68 to 83 (mean = 75.07, standard deviation [SD] = 4.62), with high education level (mean = 17.14 years, SD = 3.21) underwent cognitive assessment once a year for 5 consecutive years. The cognitive assessment included MoCA; Rey Auditory Verbal Learning Test; Rey Osterrieth Complex Figure test; Wechsler Adult Intelligence Scale Information and Digit Span Subtest; Trail Making Test; Verbal Fluency Test; and Beck Depression Inventory questionnaire. Repeated measures analysis of variance (ANOVA) was used to analyze all standardized scores as well as MoCA standardized and raw scores across all years. Results: Repeated-measures ANOVA for MoCA raw scores yielded significant decline across the years ( P < .05). From the second year and forward, the average MoCA total score was below the cutoff of 26/30. However, in substantial contrast, all other neuropsychological scores and the MoCA standardized scores were within the normal range and even above in all years. Conclusion: Our study demonstrates that the currently used MoCA cutoff is too high even for highly educated, cognitively normal older adults. Therefore, it is crucial to use the age- and education-related norms for the MoCA in order to avoid misdiagnosis of cognitive decline.

Antiserotonergic antipsychotics are associated with obsessive–compulsive symptoms in schizophrenia

2011 ◽  
Vol 41 (11) ◽  
pp. 2361-2373 ◽  
Author(s):  
F. Schirmbeck ◽  
C. Esslinger ◽  
F. Rausch ◽  
S. Englisch ◽  
A. Meyer-Lindenberg ◽  
...  
Keyword(s):  
Visual Memory ◽  
Negative Impact ◽  
Block Design ◽  
Wisconsin Card Sorting Test ◽  
Antipsychotic Treatment ◽  
Card Sorting ◽  
Obsessive Compulsive ◽  
Adult Intelligence Scale ◽  
Obsessive Compulsive Symptoms ◽  
Group I

BackgroundEpidemiological investigations show that up to 30% of schizophrenic patients suffer from obsessive–compulsive symptoms (OCS) associated with negative impact on the general prognosis. It has been proposed that antiserotonergic second-generation antipsychotics (SGAs) might induce OCS, but investigations of large samples integrating psychopathology, neuropsychology and psychopharmacology are missing.MethodWe stratified 70 patients with schizophrenia according to their mode of antipsychotic treatment: clozapine and olanzapine (group I) compared with aripiprazole and amisulpride (group II). The groups were matched according to age, sex, educational levels and severity of the psychotic disorder (Positive and Negative Syndrome Scale). As the primary endpoint, we evaluated OCS severity (Yale–Brown Obsessive–Compulsive Scale).ResultsOCS were significantly more prevalent and severe in group I, in which OCS severity correlated with dosage of clozapine and duration of treatment. Pronounced cognitive deficits in group I were found in visuospatial perception and visual memory (Wechsler Adult Intelligence Scale-Revised block design, Rey–Osterrieth Complex Figure Test), impulse inhibition (go/no-go test), higher perseveration scores (Wisconsin Card Sorting Test) and reduced set-shift abilities (Trail Making Test Part B, Set-shift Task). These cognitive domains correlated with OCS severity.ConclusionsOCS in schizophrenia are associated with antiserotonergic SGA treatment, but longitudinal studies have to prove causality. Before starting treatment with antiserotonergic SGAs, specific neurocognitive domains should be evaluated, as visuospatial learning and impulse inhibition performance might allow early detection of OCS secondary to antipsychotic treatment in schizophrenia.

scholarly journals A-011 Stability of Impairment Rating Discrepancies in a Longitudinal Observational Alzheimer’s Study

2020 ◽  
Vol 35 (6) ◽  
pp. 801-801
Author(s):  
Kaylegian J ◽  
Ritter A ◽  
Caldwell J
Keyword(s):  
Rating Scale ◽  
Digit Span ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Clinical Dementia Rating ◽  
Adult Intelligence Scale ◽  
Wechsler Adult Intelligence Scale ◽  
Wide Range Achievement Test ◽  
Wide Range ◽  
Wechsler Adult Intelligence

Abstract Objective The present study investigated frequency and 12-month persistence of discrepant Clinical Dementia Rating (CDR) and comprehensive neuropsychological assessment ratings of impairment. Methods We examined CDR and neuropsychological test scores from year 1 and 2 visits of 162 adults enrolled in a longitudinal observational study. Neuropsychological measures included Wide Range Achievement Test, American National Adult Reading Test, Rey Auditory Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Dementia Rating Scale 2nd edition, Boston Naming, Verbal Fluency/Color Word Interference from the Delis-Kaplan Executive Function System, Judgment of Line Orientation, Trail Making Test, Symbol Digit Modalities Test, and Digit Span/Letter Number Sequencing from The Wechsler Adult Intelligence Scale 4th edition. Discrepancies were defined as: CDR = 0 and 2 test impairments, CDR = 0.5 and &gt; 5 or 0 impairments, CDR = 1 and 0 impairments. Results Including all test domains, 40.1% of participants in year 1 and 44.3% in year 2 showed discrepancies. 69% maintained this discrepancy at year 2 and 68% of these showed no change in discrepancy type. Considering only memory tests, 37% of participants in year 1 and 28.4% in year 2 showed discrepancies, with 45% maintaining at year 2 (74% showing no change in discrepancy type). A majority of discrepancies observed in both years 1 and 2 revealed the CDR was under reporting impairment compared to the neuropsychological battery year. Conclusions The results provide evidence that within our study population, impairment as rated by the CDR frequently does not match the level of measured cognitive impairment and this observation is stable year to year.

scholarly journals A-202 A Normative Study of Neuropsychological Functioning in a Clinical Sample of Aviation Pilots

2020 ◽  
Vol 35 (6) ◽  
pp. 997-997
Author(s):  
Crane A ◽  
Dacosta A ◽  
Roccaforte A ◽  
Davies M ◽  
Prewett D ◽  
...  
Keyword(s):  
Clinical Sample ◽  
Neuropsychological Functioning ◽  
Neuropsychological Test ◽  
Verbal Learning ◽  
Federal Aviation Administration ◽  
Normative Study ◽  
Short Delay ◽  
Adult Intelligence Scale ◽  
Neuropsychological Evaluations ◽  
Aviation Pilots

Abstract Objective Neuropsychological evaluations are mandated by the Federal Aviation Administration (FAA) to ensure that pilots with certain known or suspected medical/neurological or psychiatric conditions do not have neurocognitive sequelae that would impair their ability to safely carry out their responsibilities (Federal Aviation Administration, 2020). However, intact pilots’ performance on cognitive measures appears unique compared to the general population (Causse, Dehias, Arexis, & Pastor, 2011). In an effort to make appropriate comparisons, the current study thus presents normative data on the FAA core neuropsychological test battery. Method Sixty-three aviation pilots (age 25–62, M = 44.9, SD = 0.235) underwent neuropsychological testing using the FAA core battery following referral for alcohol utilization. All participants were considered to be cognitively intact at the time of their evaluations. Results Participants’ average IQ on the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV) fell in the Superior range using traditional norms (M = 125.29, SD = 10.04). Pilots performed better than “average” across a number of neuropsychological measures. For example, pilots completed Trails-A in 19.38 seconds (SD = 4.10) and Trails-B in 40.73 seconds (SD = 10.56), which is approximately 10 seconds faster than average among individuals aged 35–44 years. Meanwhile, pilots recalled an average of 15.08 out of 16 words on the California Verbal Learning Test Version 2 (CVLT-II) short delay and 15.34 words on the CVLT-II long delay. Conclusion(s) This study provides comparison data for future neuropsychological evaluations of pilots with alcohol concerns. The data suggests that pilots generally outperform the civilian population across neuropsychological tests.

scholarly journals A-223 Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) Embedded Performance Validity Analyses in a Healthy Non-Clinical Sample

2020 ◽  
Vol 35 (6) ◽  
pp. 1018-1018
Author(s):  
Arzuyan A ◽  
Mathew A ◽  
Rosenblatt A ◽  
Gracian E ◽  
Osmon D
Keyword(s):  
Cognitive Ability ◽  
Digit Span ◽  
Verbal Learning ◽  
Memory Test ◽  
Visuospatial Memory ◽  
Performance Validity ◽  
Significant Difference ◽  
Embedded Measures ◽  
Hopkins Verbal Learning Test ◽  
Learning Test

Abstract Objective The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) are memory tests with embedded measures of performance validity (Recognition Discrimination [RD] and Discrimination Index [DI], respectively). We evaluated whether cognitive ability and age influenced embedded measures of effort. Methods Participants included 30 young adults (YA) and 29 older adults (dichotomized into unimpaired [OAu] and impaired [OAi]). Participants completed a medication management ability assessment (MMAA), daily memory lapses survey (DM), digit span, and the Transverse Patterning (TP) and Reversal Learning (RL) computerized tests. Two Repeated-Measures MANOVAs were conducted to determine if Passing PVT and Age/Cognitive Ability influenced performance. An ROC analysis was conducted for HVLT-RD and BVMT-DI to determine pass/fail, and false positives/negatives on embedded measures. Results Those in the YA group who failed RDS (YA-fail), performed better than OAi-fail and OAi-pass groups on RT Errors (p &lt; .0001). On TP Errors, the YA group differed from all four OA groups (p &lt; .0001). On MMAA a significant difference was observed between OAi-fail and all other groups (p &lt; .001). On RD, YA groups differed from both OAi groups (p = .0008). On DI, the YA groups differed from the OAi-fail group (p = .002). A logistic regression classified 43/57 participants successfully into the three cognitive groups using the six predictors (χ2 = 55.73, p &lt; .0001, R2 = .468). RT Errors and TP were significant (Likelihood χ2 = 7.25, p = .027). Conclusion HVLT-RD failed to detect validity for OAi, as did BVMT-DI for YA and OAu. Instead, impairment effects are seen on HVLT-RD and BVMT-DI where YA groups differed from some combination of both/one of the OA groups.

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