Archives of Clinical Neuropsychology - recent issues

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Fri, 30 Oct 2009 08:07:17 PDT

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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

Contents Page

Thu, 01 Oct 2009 09:15:39 PDT

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Thu, 01 Oct 2009 09:15:39 PDT

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Thu, 01 Oct 2009 09:15:39 PDT

Relationship of Prospective Memory to Neuropsychological Function and Antiretroviral Adherence

Contardo, C., Black, A. C., Beauvais, J., Dieckhaus, K., Rosen, M. I. — Thu, 01 Oct 2009 09:15:39 PDT

Prospective memory is defined as the ability to "remember to remember" something at a future time despite intervening distractions and may be particularly important in remembering to take prescribed medication among people infected with HIV. Ninety-seven HIV-positive participants in a clinical trial had their adherence measured by electronic pillcaps and were administered neuropsychological screening tests and the memory for intentions screening test (MIST). Factor analysis of the MIST and other neuropsychological measures identified four factors. Two were derived from MIST subscales and accounted for approximately 50% of the variance in cognitive functioning. Only one factor was significantly correlated with adherence, and this was a MIST factor. In this preliminary study, the MIST assessed a memory function that (a) could be distinguished from traditional retrospective recall and executive functioning and (b) was correlated with antiretroviral adherence.

Rhythm Reproduction in Kindergarten, Reading Performance at Second Grade, and Developmental Dyslexia Theories

Dellatolas, G., Watier, L., Le Normand, M.-T., Lubart, T., Chevrie-Muller, C. — Thu, 01 Oct 2009 09:15:39 PDT

Temporal processing deficit could be associated with a specific difficulty in learning to read. In 1951, Stambak provided preliminary evidence that children with dyslexia performed less well than good readers in reproduction of 21 rhythmic patterns. Stambak's task was administered to 1,028 French children aged 5–6 years. The score distribution (from 0 to 21) was quasi-normal, with some children failing completely and other performing perfectly. In second grade, reading was assessed in 695 of these children. Kindergarten variables explained 26% of the variance of the reading score at second grade. The Stambak score was strongly and linearly related to reading performance in second grade, after partialling out performance on other tasks (oral repetition, attention, and visuo-spatial tasks) and socio-cultural level. Findings are discussed in relation to perceptual, cerebellar, intermodal, and attention-related theories of developmental dyslexia. It is concluded that simple rhythm reproduction tasks in kindergarten are predictive of later reading performance.

Development of Set-Shifting Ability from Late Childhood Through Early Adulthood

Kalkut, E. L., Han, S. D., Lansing, A. E., Holdnack, J. A., Delis, D. C. — Thu, 01 Oct 2009 09:15:39 PDT

This cross-sectional study examined the development of set-shifting ability from childhood into early adulthood. Six hundred and forty-nine participants (aged 8–30) were assessed on the verbal fluency, design fluency, trail making, color-word interference, and card sorting subtests of the Delis–Kaplan Executive Function System (D-KEFS). Multiple regression analyses revealed modest effects of age and gender on set-shifting tasks, after controlling for IQ and component skills. The current study provides evidence for generally increased performance of set-shifting abilities through adolescence. Women overall had statistically better performance than men on all executive functioning tasks. There were significant age by gender interactions suggesting differential age-related improvements between men and women. On color-word interference and verbal fluency switching tasks, men tended to show larger improvements than women, whereas on a design fluency switching task, women showed larger improvements than men.

Naming Test of the Neuropsychological Assessment Battery: Convergent and Discriminant Validity

Yochim, B. P., Kane, K. D., Mueller, A. E. — Thu, 01 Oct 2009 09:15:39 PDT

This study investigated the convergent and discriminant validity of the naming subtest of the Neuropsychological Assessment Battery (NAB), a measure of word-finding. Seventy community-dwelling adults age 60 and above completed the NAB naming test (Forms 1 and 2), the Boston Naming Test (BNT), and other measures of verbal and visual memory, visuoperceptual skills, processing speed, and abstraction. The NAB naming test correlated highly with the BNT and with established measures of memory. The BNT correlated more strongly with education and with sex. The BNT correlated more strongly with a measure of visuoperceptual skills than the NAB naming test did, suggesting that visuoperception is more involved in the BNT. Divergent validity of the NAB naming was demonstrated by a lack of correlations with less-related measures. Findings suggest that the NAB naming test possesses convergent and divergent validity as a measure of word-finding.

Executive Functions and the Obsessive-Compulsive Disorder: On the Importance of Subclinical Symptoms and Other Concomitant Factors

Bedard, M.-J., Joyal, C. C., Godbout, L., Chantal, S. — Thu, 01 Oct 2009 09:15:39 PDT

Although reviews concerning the neuropsychology of obsessive-compulsive disorder (OCD) put great emphasis on impaired executive functioning, the overall conclusions are notoriously divergent. The main goal of the present study was to use a battery of neuropsychological tasks to assess nine cognitive domains with a special focus on executive functions in 40 patients with OCD. A secondary objective was to examine the relationships between clinical or demographic variables and neuropsychological performances. The third goal was to separate executive functions in more homogeneous components to verify whether specific impairment might be found in persons with OCD. Confirming the main hypothesis, few neuropsychological differences emerged between the OCD and healthy participants when concomitant factors were controlled. Moreover, subclinical symptoms appeared to play a different and independent role on the cognitive results. Future studies should include more specific tasks of lower-order executive functions among persons with OCD to confirm this possibility.

Executive Functioning in Twins with Bipolar I Disorder and Healthy Co-Twins

Juselius, S., Kieseppa, T., Kaprio, J., Lonnqvist, J., Tuulio-Henriksson, A. — Thu, 01 Oct 2009 09:15:39 PDT

The aims of the study were to compare performance of twins with bipolar disorder (BPD) and healthy co-twins in neuropsychological tests assessing various aspects of executive functioning and to examine the relationship of clinical factors with executive functions. Twenty-six euthymic BPD twins, 19 co-twins, and 114 control twins were examined using the Stroop test, the Wisconsin card sorting test (WCST), the trail making test (TMT), and semantic and phonemic verbal fluency tests. BPD twins and co-twins performed worse than controls in the Stroop test. BPD twins scored lower than controls in semantic fluency. Clinical factors correlated with scores in TMT, WCST, and semantic fluency. Our results suggest that the response inhibition impairment may associate with genetic risk of BPD and represent a potential endophenotype for BPD. The impaired performance in the semantic fluency test among the patients may result from semantic memory retrieval problems.

The Indiana Faces in Places Test: Preliminary Findings on a New Visuospatial Memory Test in Patients with Mild Cognitive Impairment

Beglinger, L. J., Duff, K., Moser, D. J., Cross, S. A., Kareken, D. A. — Thu, 01 Oct 2009 09:15:39 PDT

Memory assessment is an important component of a neuropsychological evaluation, but far fewer visual than verbal memory instruments are available. We examined the preliminary psychometric properties and clinical utility of a novel, motor-free paper and pencil visuospatial memory test, the Indiana faces in places test (IFIPT). The IFIPT and general neuropsychological performance were assessed in 36 adults with amnestic mild cognitive impairment (aMCI) and 113 older adults with no cognitive impairment at baseline, 1 week, and 1 year. The IFIPT is a visual memory test with 10 faces paired with spatial locations (three learning trials and non-cued delayed recall). Results showed that MCI participants scored lower than controls on several variables, most notably total learning (p < .001 at all three time points), delayed recall (baseline p = .03, 1 week p < .001, 1 year p < .001), and false-positive errors (range p = .03 to <0.001). The IFIPT showed similar test–retest reliability at 1-week and 1-year follow-up to other neuropsychological tests (r = 0.71–0.84 for MCI and 0.53–0.72 for controls). Diagnostic accuracy was modest for this sample (areas under the receiver operating characteristic curve between 0.64 and 0.66). Preliminary psychometric analyses support further study of the IFIPT. The measure showed evidence of clinical utility by demonstrating group differences between this sample of healthy adults and those with MCI.

Demographic Adjustments for the Spanish Version of the WAIS-III

Choca, J. P., Krueger, K. R., de la Torre, G. G., Corral, S., Garside, D. — Thu, 01 Oct 2009 09:15:39 PDT

The Spanish version of the third edition of the Wechsler Adult Intelligence Scale (WAIS-III) by TEA Ediciones is an excellent addition to available instruments for Spanish speakers. The Spanish norms function similarly to US norms for individuals aged 16–35. The norms become increasingly different for individuals 35 and older, seemingly because of the lower levels of formal education of the older Spanish cohorts. Using data from a random half of the Spanish sample, the authors developed regression equations to adjust the scaled scores for individuals with a low level of education. The adjustment is made to the level that would have been expected if the individual had 12 years of education, the median level of education of the US norms. The article includes the methodology and values necessary to make the adjustments. The scaled scores were then adjusted for individuals on the second random half of the Spanish sample and compared to the United States norms. The results showed the adjustments succeed in bringing the Spanish norms closer to the US norms.

Correcting Fallacies About Educational and Psychological Testing

Lilienfeld, S. O., Thames, A. D. — Thu, 01 Oct 2009 09:15:39 PDT

Author Index

Tue, 15 Sep 2009 09:25:07 PDT

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Tue, 15 Sep 2009 09:25:07 PDT

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Tue, 15 Sep 2009 09:25:08 PDT

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Tue, 15 Sep 2009 09:25:08 PDT

Grand Rounds

Tue, 15 Sep 2009 09:25:08 PDT

Objective: The paper describes the case of a 27-year-old, right-handed woman, KF, who sustained a left thalamic ischemic infarct. KF's case is unusual in that she presented with ipsilateral hemiparesis. No similar cases were found in the existing literature. Young-Mok et al. (2005) describe two cases of ipsilateral hemiparesis following a corona radiata infarct that they attribute to re-organization of the brain following previous right-sided supratentorial stroke; however, there is no radiologic evidence of prior stroke for KF. Method: KF reported that on July 15, 2008 she had difficulty awakening and problems with vision and comprehension. Her mother noted that KF was disoriented, had slurred speech, and did not understand the seriousness of her situation. She presented to the emergency department with visual disturbance and unsteady gate. An MRI (July 15, 2008) revealed subacute left thalamic ischemic infarct. Results: Results of neuropsychologic evaluation suggest characteristic cognitive difficulties consistent with left thalamic infarct: verbal expression impairment (mildly impaired verbal abstract reasoning, mildly impaired vocabulary, borderline semantic fluency), memory deficits (visual memory mildly impaired initially and profoundly impaired following delay, word list learning severely impaired and delayed word list recall profoundly impaired), as well as exacerbation of premorbid attentional difficulties (sustained visual attention profoundly impaired). She also presented with characteristic right-hand fine motor dexterity deficits (borderline) and uncharacteristic left hemiparesis (severely impaired left hand strength and fingertip dexterity). Conclusions: KF's case offers the opportunity to discuss possible explanations for the observed deficits that are previously not described in the literature. This case allows for further understanding of the motor pathways through the thalamus.