Archives of Clinical Neuropsychology

Axelrod, Bradley N.; Ryan, Joseph J.; Ward, L. Charles

doi: 10.1093/arclin/16.1.1pmid: N/A

AbstractThe application of seven-subtest short forms of the Wechsler Adult Intelligence Scale-III (WAIS-3) was evaluated in a sample of 281 mixed clinical patients from three Veterans Affairs Medical Centers. Short-form summary scores were derived from deviation quotient tables and from prorating. They included either Block Design or Matrix Reasoning. Short-form summary scores for Full-Scale IQ (FSIQ) and Verbal IQ (VIQ) demonstrated good alternate-forms reliability with the full WAIS-3 scores, whereas Performance IQ (PIQ) summary scores were less accurate. Short forms derived from deviation quotients and prorating did not differ from each other. However, the inclusion of Matrix Reasoning resulted in somewhat better accuracy with WAIS-3 PIQ than did Block Design. The results of this study support the use of the seven-subtest short form of the WAIS-3 in estimating full WAIS-3 summary scores, especially for FSIQ and VIQ.

McCaffrey, Robert J.; Westervelt, Holly James; Haase, Richard F.

doi: 10.1093/arclin/16.1.9pmid: N/A

AbstractThe effect of repeated administration of the (NIMH) AIDS Abbreviated Neuropsychological Battery was evaluated in a group of “at risk” individuals who served as control subjects in a larger research project. Subjects' performance across five assessment points was evaluated by repeated measures analysis. Statistically significant trends were obtained on the California Verbal Learning Test, the Paced Auditory Serial Addition Task, and the State scale of the State-Trait Anxiety Inventory. No discernable trends were detected on the Vocabulary subtest of the Wechsler Adult Intelligence Scale-Revised, total time or errors on the Visual Search Task, the Hamilton Depression Rating Scale, or the Trait scale of the State-Trait Anxiety Inventory. The implications of these findings in both clinical and research settings are discussed.

Libon, David J.; Bogdanoff, Bruce; Leopold, Norman; Hurka, Roberta; Bonavita, John; Skalina, Stefan; Swenson, Rod; Gitlin, Heather L.; Ball, Susan K.

doi: 10.1093/arclin/16.1.19pmid: N/A

AbstractDespite the emergence of a number of new classification systems, the diagnosis of cerebrovascular dementia remains controversial. Also controversial is the significance of periventricular and deep white matter alterations (WMA) as seen on magnetic resonance imaging (MRI). To further clarify this issue, MRI scans were used to regroup patients clinically diagnosed with Alzheimer's disease (AD) or subcortical ischemic vascular dementia (IVD) into cohorts presenting with either little versus significant WMA on MRI. These two groups were then compared to demented patients diagnosed with idiopathic Parkinson's disease (PD) using a comprehensive neuropsychological protocol. Neuropsychological assessment failed to distinguish between patients with PD and significant WMA. By contrast, both of these patient groups exhibited disproportionate impairment on tests of executive systems functioning, whereas patients with little WMA showed greater impairment on tests of declarative memory and semantic knowledge. These findings constitute further evidence that the pattern of cognitive impairment associated with significant WMA is distinctly different when compared to AD. These results are discussed within the context of a growing body of literature suggesting that elements of the underlying neuropathologies in AD and IVD are linked. Implications for the diagnosis of dementia are also discussed.

Perna, Robert B.; Bordini, Ernest J.; Deinzer-Lifrak, Maria

doi: 10.1093/arclin/16.1.33pmid: N/A

AbstractMany anecdotal cases and some clinical studies have demonstrated that formaldehyde exposure can cause multiple health-related problems and cerebral dysfunction. The U.S. Consumer Product Safety Commission has documented multiple hazards related to formaldehyde exposure. Some of this research has suggested that low levels of exposure can be very hazardous to one's health and can potentially result in heightened chemical sensitivities, seizures, and cognitive decline. Some research suggests that exposure results in long-term immunological changes, cell neurofilament protein changes, and demyelination. Symptomatically, exposure has been associated with respiratory problems, excessive fatigue, headaches, mood changes, and impaired attention, concentration, and memory functioning. This article outlines the case of a biology teacher whose chronic formaldehyde exposure resulted in heightened sensitivity to formaldehyde, three tonic-clonic seizures, and dramatic amnesia as well as other cognitive dysfunction.

Vickery, Chad D.; Berry, David T.R.; Inman, Tina Hanlon; Harris, Monica J.; Orey, Stephen A.

doi: 10.1093/arclin/16.1.45pmid: N/A

AbstractThirty-two studies of commonly researched neuropsychological malingering tests were meta-analytically reviewed to evaluate their effectiveness in discriminating between honest responders and dissimulators. Overall, studies using the Digit Memory Test (DMT), Portland Digit Recognition Test (PDRT), 15-Item Test, 21-Item Test, and the Dot Counting Test had average effect sizes indicating that dissimulators obtain scores that are approximately 1.1 standard deviations below those of honest responders. The DMT separated the means of groups of honest and dissimulating responders by approximately 2 standard deviations, whereas the 21-Item Test and the PDRT separated the groups by nearly 1.5 and 1.25 standard deviations, respectively. The 15-Item Test and the Dot Counting Test were less effective, separating group means by approximately 3/4 of a standard deviation. Although the DMT, PDRT, 15-, and 21-Item Tests all demonstrated very high specificity rates, at the level of individual classification, the DMT had the highest sensitivity and overall hit-rate parameters. The PDRT and 15-Item Test demonstrated moderate sensitivity, whereas the 21-Item Test demonstrated poor sensitivity. The less than perfect sensitivities of all the measures included in this review argue against their use in isolation as malingering screening devices.

Heaton, Robert K.; Temkin, Nancy; Dikmen, Sureyya; Avitable, Nanci; Taylor, Michael J.; Marcotte, Thomas D.; Grant, Igor

doi: 10.1093/arclin/16.1.75pmid: N/A

AbstractDetecting change in individual patients is an important goal of neuropsychological testing. However, limited information is available about test-retest changes, and well-validated prediction methods are lacking. Using a large nonclinical subject group (N = 384), we recently investigated test-retest reliabilities and practice effects on the Wechsler Adult Intelligence Scale and Halstead-Reitan Battery. Data from this group also were used to develop models for predicting follow-up test scores and establish confidence intervals around them. In this article we review those findings, examine their generalizability to new nonclinical and clinical groups, and explore the sensitivity of the prediction models to real change. Despite similarities across samples in reliability coefficients and practice effects, limits to the generalizability of prediction methods were found. Also, when multiple test measures were considered together, one or more “significant” changes were common in all (including stable) subject groups. By employing normative cut-offs that correct for this, sensitivity of the models to neurological recovery and deterioration was modest to good. More complex regression models were not more accurate than the simpler Reliable Change Index with correction for practice effects when confidence intervals for all methods were adjusted for variations in level of baseline test performance.

Hartlage, Lawrence C.

doi: 10.1093/arclin/16.1.93pmid: N/A