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Fri, 30 Oct 2009 08:07:17 PDT

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Fri, 30 Oct 2009 08:07:17 PDT

Test Security in Medicolegal Cases: Proposed Guidelines for Attorneys Utilizing Neuropsychology Practice

Morel, K. R. — Fri, 30 Oct 2009 08:07:17 PDT

In the context of forensic neuropsychological assessments, the professional interaction of law and psychology is viewed primarily as one where the retaining attorney or court dictates its needs to psychologists when resolving legal disputes. While this perspective is conceptually accurate, the positive and practical collaboration of law and psychology also relies on attorneys adhering to basic protections of sensitive psychological assessment procedures and tests. Objective testing is undermined when a practitioner of law engages in actions prior to, during, or following a neuropsychological examination in a manner that threatens the test security. An appreciation among practitioners of law and psychology regarding the necessity of test security is essential. This article reviews attorney actions that can affect test security, proposes a distinction by psychology between appropriate and problematic client preparation for a neuropsychological examination, integrates the available legal precedent regarding test security, and suggests productive measures to protect test security in medicolegal settings.

Advanced Interpretation of the Neuropsychological Assessment Battery with Older Adults: Base Rate Analyses, Discrepancy Scores, and Interpreting Change

Brooks, B. L., Iverson, G. L., White, T. — Fri, 30 Oct 2009 08:07:17 PDT

The purpose of this study is to provide sophisticated psychometric information for advanced interpretation of the Neuropsychological Assessment Battery (NAB) with older adults. This information includes the base rates of low scores, intellectual-cognitive discrepancy scores, and a method for determining change. The NAB contains 24 co-normed neurocognitive tests across five domains (i.e., Attention, Language, Memory, Spatial, and Executive Functions); provides 36 primary T-scores, five domain indexes, and a total index score; and was co-normed with a measure of intellectual abilities (Reynolds Intellectual Assessment Scales; Reynolds Intellectual Screening Test [RIST]). Participants for this study were 742 older adults from the NAB standardization sample (mean age = 68.1, SD = 6.9). From the standardization sample, 42 older adults (mean age = 67.3 years, SD = 8.3) were administered the NAB two times (mean retest interval = 6.7 months, SD = 0.7). The base rates of low index scores and low primary scores are presented for the entire sample, as well as stratified by the level of intellectual abilities. RIST–NAB discrepancy scores are presented for the entire sample and for the different levels of intellectual abilities. Finally, information needed to interpret change in test performance on serial assessments is provided.

The Diagnostic Accuracy of Symptom Validity Tests when Used with Postsecondary Students with Learning Disabilities: A Preliminary Investigation

Lindstrom, W. A., Lindstrom, J. H., Coleman, C., Nelson, J., Gregg, N. — Fri, 30 Oct 2009 08:07:17 PDT

The current exploratory investigation examined the diagnostic accuracy of the Word Memory Test (WMT), Test of Memory Malingering (TOMM), and Word Reading Test (WRT) with three groups of postsecondary students: controls, learning disability (LD) simulators, and a presumed honest LD group. Each measure achieved high overall diagnostic accuracy, yet each contributed differently to suboptimal effort detection. False-negative classifications varied by measure, yet no simulator went undetected by all three tests. The WMT and WRT identified different members of the presumed honest LD group as demonstrating poor effort, whereas the TOMM identified none. Each measure contributed unique variance in a logistic regression, with effort status best predicted by WMT Consistency. Findings provided preliminary evidence that all three measures may be useful when assessing effort during postsecondary LD evaluations. Implications for future practice and research are discussed.

Examination of the MMPI-2 Restructured Form (MMPI-2-RF) Validity Scales in Civil Forensic Settings: Findings from Simulation and Known Group Samples

Fri, 30 Oct 2009 08:07:17 PDT

The current study examined the effectiveness of the MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath and Tellegen, 2008) over-reporting indicators in civil forensic settings. The MMPI-2-RF includes three revised MMPI-2 over-reporting validity scales and a new scale to detect over-reported somatic complaints. Participants dissimulated medical and neuropsychological complaints in two simulation samples, and a known-groups sample used symptom validity tests as a response bias criterion. Results indicated large effect sizes for the MMPI-2-RF validity scales, including a Cohen's d of .90 for Fs in a head injury simulation sample, 2.31 for FBS-r, 2.01 for F-r, and 1.97 for Fs in a medical simulation sample, and 1.45 for FBS-r and 1.30 for F-r in identifying poor effort on SVTs. Classification results indicated good sensitivity and specificity for the scales across the samples. This study indicates that the MMPI-2-RF over-reporting validity scales are effective at detecting symptom over-reporting in civil forensic settings.

Changes in Intellectual Functioning Associated with Normal Aging

Miller, L. J., Myers, A., Prinzi, L., Mittenberg, W. — Fri, 30 Oct 2009 08:07:17 PDT

Declines in IQ scores with advancing age have been observed in each successive revision of the Wechsler Intelligence Scales. This study examined age-related changes on the fourth edition of the Wechsler Adult Intelligence Scale and compared these to the effects seen on the 1955, 1981, and 1997 standardizations of the scales. The most pronounced declines were in measures of processing speed and nonverbal reasoning. Declines in nonverbal reasoning were similar on timed and un-timed measures. Verbal abilities remained relatively stable across the life span. General intelligence as assessed by the Full Scale IQ was reduced about 1 SD by age 75 when corrections for age were removed. Age-related declines have become less pronounced since 1955, particularly on measures of processing speed. This effect was essentially linear, unrelated to concurrent IQ increases in the general population, and paralleled a 9-year increase in life expectancy during this time period.

Course of Cognitive Decline in Hematopoietic Stem Cell Transplantation: A Within-subjects Design

Fri, 30 Oct 2009 08:07:17 PDT

This study examined the course of clinically significant cognitive change in hematopoietic stem cell transplant (HSCT), using a Reliable Change Index (RCI). Neuropsychological evaluations were administered to 117 patients before HSCT. Thirty-three received subsequent evaluations 6 and 28 weeks later. Of 117 patients, 39% were classified as impaired before HSCT. Of the 33 receiving subsequent evaluations, 47% showed reliable decline at 6-weeks; of these, 33% showed reliable decline again at 28-weeks. Mood and QOL did not account for declines. Verbal learning, psychomotor speed, and executive function showed greatest vulnerability to pre-HSCT impairment, and verbal learning showed greatest likelihood of further, subsequent decline. In conclusion, a subgroup of patients showed cognitive impairment before HSCT, indicating that factors other than HSCT contributed to cognitive deficits. Another subgroup showed further decline after HSCT. This study demonstrated the utility of the RCI in describing cognitive change in HSCT patients.

Predictors of Health Status in Nondepressed and Nondemented Individuals with Parkinson's Disease

Schiehser, D. M., Han, S. D., Lessig, S., Song, D. D., Zizak, V., Filoteo, J. V. — Fri, 30 Oct 2009 08:07:17 PDT

Recent studies have shown that self-perceived health status (HS) in Parkinson's disease (PD) is associated with motor, cognitive, or mood symptoms, with the greatest association typically occurring with mood. The purpose of this study was to determine if these associations are present in nondepressed and nondemented individuals with PD by using sensitive neuropsychological measures and statistically derived factors from mood and motor scales. The best predictors of poor HS in PD participants (N = 32) without dementia or depression were mood symptoms, specific to self-reported cognitive impairment and anxiety. Bivariate correlations between HS and number of correct categories on the Wisconsin Card Sorting Test and the gait–balance factor from the Unified Parkinson's Disease Rating Scale Part III were also significant or approached significance. These findings suggest that specific mood and cognitive symptoms continue to be important factors in HS in those individuals who lack clinical levels of depression or dementia.

Is the N-Back Task a Valid Neuropsychological Measure for Assessing Working Memory?

Miller, K.M., Price, C.C., Okun, M.S., Montijo, H., Bowers, D. — Fri, 30 Oct 2009 08:07:17 PDT

The n-back is a putative working memory task frequently used in neuroimaging research; however, literature addressing n-back use in clinical neuropsychological evaluation is sparse. We examined convergent validity of the n-back with an established measure of working memory, digit span backward. The relationship between n-back performance and scores on measures of processing speed was also examined, as was the ability of the n-back to detect potential between-groups differences in control and Parkinson's disease (PD) groups. Results revealed no correlation between n-back performance and digit span backward. N-back accuracy significantly correlated with a measure of processing speed (Trail Making Test Part A) at the 2-back load. Relative to controls, PD patients performed less accurately on the n-back and showed a trend toward slower reaction times, but did not differ on any of the neuropsychological measures. Results suggest the n-back is not a pure measure of working memory, but may be able to detect subtle differences in cognitive functioning between PD patients and controls.

Assessment of Autism Spectrum Disorders

Christodulu, K. V. — Fri, 30 Oct 2009 08:07:17 PDT