Exploring the Semantic Structure of WMS-IV Verbal Paired Associates using the Hub-and-Spoke Model

Objectives: This study aimed to identify a well-fitting and theoretically justified item-level latent factor structure for the Wechsler Memory Scales (WMS)-IV verbal paired associates (VerbalPA) subtest to facilitate the ease and accuracy of score interpretations for patients with lateralized temporal lobe epilepsy (TLE). Methods: Archival data were used from 250 heterogeneous neurosciences patients who were administered the WMS-IV as part of a standard neuropsychological assessment. Three theoretically motivated models for the latent structure of VerbalPA were tested using confirmatory factor analysis. The first model, based on cognitive principles of semantic processing from hub-and-spoke theory, tested whether performance is related to specific semantic features of target words. The second, motivated by the Cattell–Horn–Carroll (CHC) model of cognitive abilities, investigated whether the associative properties of items influence performance. A third, Hybrid model tested whether performance is related to both semantic and associative properties of items. The best-fitting model was tested for diagnostic group effects contrasting the heterogeneous neuroscience patients with subsets of left and right TLE (n = 51, n = 26, respectively) patients. Results: The Hybrid model was found to have the best fit. Patients with left TLE scored significantly less well than the heterogeneous neurosciences sample on selected semantic factor scores, although the effect size was small. Conclusions: Future editions of the WMS may consider implementing a semantic scoring structure for the VerbalPA to facilitate test score interpretation. Additionally, these results suggest that principles of hub-and-spoke theory may be integrated into CHC cognitive ability taxonomy.

Age and Educational Differences on the Trail Making Test and Wechsler Memory Scales

The purposes of this study were (a) to replicate the previously reported influence of age and education on neuropsychological test performance with a much larger sample of adults and (b) to add to the provisional norms for adult medical-surgical patients without evidence of neurological disease. While hospitalized awaiting cardiac surgery, 322 male and female adults between the ages of 40 and 69 yr. were given the Trail Making Test (Parts A and B) from the Halstead-Reitan Battery, the Visual Reproduction subtest from the Wechsler Memory Scale Form II, and the Logical Memory Scale from the Wechsler Memory Scale Form I. Both age and level of education were strongly associated with performance on the Trail Making Test. On the two subtests of the Wechsler Memory Scale, education alone was associated with test performance. These findings point to the potential danger of falsely classifying adults of older ages or with lower education as possibly having an organic brain syndrome. Regression equations are presented which quantify the amount of adjustment of scores appropriate for similar populations.