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Specificity rates for non-clinical, bilingual, Mexican Americans on three popular performance validity measures* 非临床,双语,墨西哥裔美国人在三个流行的效能效度测量中的特异性率*
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1277786
P. Gasquoine, Amy A. Weimer, Arnoldo Amador
Abstract Objective: To measure specificity as failure rates for non-clinical, bilingual, Mexican Americans on three popular performance validity measures: (a) the language format Reliable Digit Span; (b) visual-perceptual format Test of Memory Malingering; and (c) visual-perceptual format Dot Counting, using optimal/suboptimal effort cut scores developed for monolingual, English-speakers. Methods: Participants were 61 consecutive referrals, aged between 18 and 65 years, with <16 years of education who were subjectively bilingual (confirmed via formal assessment) and chose the language of assessment, Spanish or English, for the performance validity tests. Results: Failure rates were 38% for Reliable Digit Span, 3% for the Test of Memory Malingering, and 7% for Dot Counting. For Reliable Digit Span, the failure rates for Spanish (46%) and English (31%) languages of administration did not differ significantly. Conclusions: Optimal/suboptimal effort cut scores derived for monolingual English-speakers can be used with Spanish/English bilinguals when using the visual-perceptual format Test of Memory Malingering and Dot Counting. The high failure rate for Reliable Digit Span suggests it should not be used as a performance validity measure with Spanish/English bilinguals, irrespective of the language of test administration, Spanish or English.
摘要目的:衡量非临床、双语、墨西哥裔美国人在三个流行的效度测试中的失败率特异性:(a)语言格式可靠数字跨度;(b)视觉-知觉格式记忆伪造测验;(c)视觉感知格式点计数,使用为单语,英语使用者开发的最佳/次优努力削减分数。方法:参与者为61名连续转诊患者,年龄在18 - 65岁之间,受教育程度<16年,主观上使用双语(通过正式评估确认),并选择评估语言西班牙语或英语进行绩效效度测试。结果:误码率为38%,误码率为3%,误码率为7%。对于可靠数字跨度,西班牙语(46%)和英语(31%)管理语言的失败率没有显着差异。结论:单语英语者的最佳/次优努力cut分数可用于西班牙语/英语双语者在使用视觉感知格式的记忆伪造和点计数测试时。可靠数字跨度的高失败率表明,无论考试管理语言是西班牙语还是英语,都不应将其用作西班牙语/英语双语者的表现有效性衡量标准。
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引用次数: 24
Convergent and criterion validity of the CogState computerized brief battery cognitive assessment in women with and without breast cancer CogState计算机简短电池认知评估在患有和不患有乳腺癌的妇女中的收敛性和标准有效性
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1275819
Sunita K. Patel, A. Meier, Nathaniel A. Fernandez, Tracy T. Y. Lo, Colleen Moore, Nicole Delgado
Abstract Objective: Computerized tests have increasingly garnered interest for assessing cognitive functioning due to their potential logistical and financial advantages over traditional ‘pencil and-paper’ neuropsychological tests. However, psychometric information is necessary to guide decisions about their clinical and research utility with varied populations. We explored the convergent construct validity and criterion validity of the CogState computerized tests in breast cancer survivors, a group known to present with mostly mild, subtle cognitive dysfunction. Method: Fifty-three post-menopausal women (26 breast cancer survivors, 27 healthy controls) completed the CogState Brief Battery tests with passed performance checks, conceptually matched traditional neuropsychological tests, and a self-report measure of daily functioning, the Functional Activities Questionnaire. Results: Significant positive correlations were found between the CogState Brief Battery tests and traditional neuropsychological tests, although the traditional tests specifically hypothesized to correlate with CogState tests did not reach statistical significance. Analysis of Covariance results showed preliminary support for criterion validity, as the patient and control groups differed on the traditional test of working memory (Digits Backwards, p = .01), with a trend towards significance for the CogState test of working memory (One Back, p = .02), controlled for age, race, and mood. Conclusions: The results provide preliminary support for further research to determine if the CogState tests are viable as screening tools to detect subtle cognitive differences between breast cancer survivors and healthy women. Our study was limited by the low base rate of cognitive impairment and small sample size. We recommend further research employing sufficiently powered sample sizes and a longitudinal, repeated measures study design.
摘要目的:计算机化测试越来越引起人们对评估认知功能的兴趣,因为它们比传统的“纸笔”神经心理学测试具有潜在的后勤和经济优势。然而,心理测量信息是必要的,以指导决策的临床和研究的效用与不同的人群。我们探讨了CogState计算机化测试在乳腺癌幸存者中的聚合结构效度和标准效度,乳腺癌幸存者是一组已知的主要表现为轻微、微妙的认知功能障碍的人群。方法:53名绝经后妇女(26名乳腺癌幸存者,27名健康对照)完成了CogState简短电池测试,并通过了性能检查,概念上与传统的神经心理学测试相匹配,以及日常功能自我报告测量,功能活动问卷。结果:CogState简短电池测试与传统神经心理学测试之间存在显著的正相关,尽管传统测试专门假设与CogState测试相关,但没有达到统计学意义。协方差分析结果初步支持标准效度,因为患者和对照组在传统的工作记忆测试(Digits Backwards, p = 0.01)上存在差异,而在工作记忆的CogState测试(One Back, p = 0.02)上有显著的趋势,控制了年龄、种族和情绪。结论:结果为进一步研究提供了初步支持,以确定CogState测试是否可行,作为筛查工具,以检测乳腺癌幸存者和健康女性之间的细微认知差异。我们的研究受到认知障碍基础率低和样本量小的限制。我们建议进一步研究,采用足够有力的样本量和纵向、重复测量的研究设计。
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引用次数: 25
Development of a version of the self-ordered pointing task: a working memory task for Brazilian preschoolers 自顺序指向任务的发展:巴西学龄前儿童的工作记忆任务
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1275818
Isabela Sallum, Fernanda Gomes da Mata, Nathália Falcone Cheib, C. Mathias, D. Miranda, L. Malloy-Diniz
Abstract Objective: Working memory is a fundamental cognitive function and is predictive of outcomes and achievement in a wide range of domains from an early age. The focus of this study was to develop a computerized Brazilian version of the Self-Ordered Pointing Task (SOPT) for preschoolers and to provide initial normative and validation data for this task. Methods: The sample of the present study was composed of 248 children aged 3 (n = 41), 4 (n = 88) and 5 (n = 119) years from 13 private and public schools in Belo Horizonte. Children were evaluated with the SOPT and the Columbia Mental Maturity Scale (CMMS), a measure of intelligence, and their parents completed the Brazilian Criterion of Economic Classification (CCEB) to assess their SES. A subsample of parents of 184 children also filled the Child Behavior Checklist for Ages 11/2–5 years (CBCL 11/2–5), a measure of psychopathology. Results: A multiple regression analysis found chronological age, intelligence, and SES to be predictive of performance on the SOPT. Furthermore, five-year olds performed better than three- and four-year olds in the task. A difference between children in private and public kindergartens also emerged. Additionally, SOPT performance was negatively correlated with Internalizing, Externalizing, and Total psychopathological problems, as well as to several other psychopathological measures as accessed by the CBCL, although the correlations were small. Conclusion: Taken together, this study provides initial normative and validation data for the SOPT, but further validation studies are needed.
摘要目的:工作记忆是一项基本的认知功能,从早期开始就对许多领域的结果和成就具有预测作用。本研究的重点是开发一个电脑化的巴西版学龄前儿童自顺序指向任务(SOPT),并为该任务提供初步的规范和验证数据。方法:本研究的样本由贝洛奥里藏特市13所私立和公立学校的248名3岁(n = 41)、4岁(n = 88)和5岁(n = 119)的儿童组成。采用SOPT和哥伦比亚心理成熟度量表(CMMS)对儿童进行智力评估,父母完成巴西经济分类标准(CCEB)评估儿童的SES。184名儿童父母的子样本也填写了11/2-5岁儿童行为检查表(CBCL 11/2-5),这是一种精神病理学的测量方法。结果:多元回归分析发现,实足年龄、智力和社会经济地位可以预测在SOPT上的表现。此外,五岁的孩子比三岁和四岁的孩子表现得更好。私立幼儿园和公立幼儿园的孩子之间的差异也出现了。此外,SOPT表现与内在化、外在化和总精神病理问题,以及CBCL获取的其他几个精神病理指标呈负相关,尽管相关性很小。结论:本研究为SOPT提供了初步的规范和验证数据,但还需要进一步的验证研究。
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引用次数: 8
Performance of Hispanics and Non-Hispanic Whites on the NIH Toolbox Cognition Battery: the roles of ethnicity and language backgrounds 西班牙裔和非西班牙裔白人在NIH工具箱认知电池上的表现:种族和语言背景的作用
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1276216
Ilse Flores, K. Casaletto, M. Marquine, A. Umlauf, D. Moore, D. Mungas, R. Gershon, J. Beaumont, R. Heaton
Abstract Objective: This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB). Method: Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses. Results: Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group. Conclusions: On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.
摘要目的:本研究考察了西班牙裔和语言/文化背景对NIH工具箱认知电池(NIHTB-CB)成绩的影响。方法:参与者包括健康的、主要讲英语的西班牙裔(n = 93;西班牙-英语),主要是讲西班牙语的西班牙裔(n = 93;西班牙裔西班牙人)和说英语的非西班牙裔白人(n = 93;NH(白人)成年人在年龄、性别和教育水平上匹配。所有参与者均在NIH工具箱国家规范项目中,并完成了NIHTB-CB的流体和结晶组件。t分数(未经人口统计学调整)是基于当前样本开发的,并用于分析。结果:在人口统计学未调整的NIHTB-CB流体综合评分上,说西班牙语的西班牙裔美国人比说英语的西班牙裔美国人和NH白人表现更差(ps < 0.01)。包括流体组合的个体测量结果显示,在执行抑制控制(p = 0.001)、处理速度(p = 0.003)和工作记忆(p < 0.001)的测试中,组间差异显著,但在认知灵活性或情景记忆的测试中没有差异。西班牙裔西班牙人的考试成绩与语言/文化背景有关:在美国以外出生、以西班牙语为第一语言、在美国以外的学校上学、在家多说西班牙语,都预示着他们的词汇量和阅读能力会更好。然而,在西班牙裔西班牙人组中,许多相同的背景因素与较差的流体复合材料有关。结论:在流体认知测试中,西班牙语-西班牙语组在所有组中表现最差。社会人口和语言因素与这些差异有关。这些发现强调了在解释神经心理学测试表现时考虑语言/文化背景的重要性。重要的是,在应用先前公布的NIHTB-CB规范并进行人口统计校正后,这些语言/种族群体差异被消除了。
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引用次数: 31
Relationship between 18F-Flutemetamol uptake and RBANS performance in non-demented community-dwelling older adults 非痴呆社区老年人18f -氟替他莫摄取与rban表现的关系
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1278039
D. Hammers, T. J. Atkinson, B. C. Dalley, K. Suhrie, B. Beardmore, L. Burrell, K. Horn, K. Rasmussen, N. Foster, K. Duff, J. Hoffman
Abstract Objective: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has been used extensively for clinical care and in research for patients with mild cognitive impairment and Alzheimer’s disease (AD); however, relatively few studies have evaluated the relationship between RBANS performance and AD imaging biomarkers. The purpose of the current study was to evaluate the association between a relatively new amyloid positron emission tomography imaging biomarker and performance on the RBANS. Methods: Twenty-seven nondemented community-dwelling adults over the age of 65 underwent 18F-Flutemetamol amyloid– positron emission tomography imaging, along with cognitive testing using the RBANS and select behavioral measures. Partial correlation coefficients were used to identify relationships between the imaging and behavioral markers. Results: After controlling for age and education, amyloid deposition and RBANS Indexes of Immediate Memory, Delayed Memory, and Total Scale score were significantly correlated (p’s < .001, r’s = −.73 to −.77, d’s = 2.13–2.39), with greater amyloid burden being associated with lower RBANS scores. The Delayed Memory Index was particularly highly associated with 18F-Flutemetamol binding (r2 = .59, p < .001, d = 2.39). Neither 18F-Flutemetamol binding nor RBANS performance was significantly correlated with levels of depression, subjective cognitive difficulties, or premorbid intellect. Conclusions: Because of the limited use of amyloid imaging in clinical settings due to high cost and lack of reimbursement, these findings suggest that in particular RBANS Delayed Memory Index may be a cost-efficient tool to identify early signs of AD pathology, and its use may enlighten clinical decision-making regarding potential progression to dementia due to AD.
【摘要】目的:神经心理状态评估重复性测试(rban)已广泛应用于轻度认知障碍和阿尔茨海默病(AD)患者的临床护理和研究中;然而,相对较少的研究评估了rban性能与AD成像生物标志物之间的关系。本研究的目的是评估一种相对较新的淀粉样蛋白正电子发射断层成像生物标志物与rban表现之间的关系。方法:27名65岁以上的无痴呆社区居民接受了18f -氟地他莫淀粉样蛋白正电子发射断层扫描成像,同时使用rban进行认知测试和选择行为测量。偏相关系数用于识别影像学和行为标志物之间的关系。结果:在控制年龄和受教育程度后,淀粉样蛋白沉积与即时记忆、延迟记忆、总量表评分的rban指数呈显著相关(p < 0.001, r =−)。73 ~−。77, d 's = 2.13-2.39),淀粉样蛋白负荷越大,rban评分越低。延迟记忆指数与18f -氟替他莫结合高度相关(r2 = 0.59, p < 0.001, d = 2.39)。18f -氟替他莫结合和rban表现与抑郁水平、主观认知困难或病前智力均无显著相关性。结论:由于高成本和缺乏报销,淀粉样蛋白成像在临床环境中的使用有限,这些研究结果表明,特别是RBANS延迟记忆指数可能是一种经济有效的工具,可以识别阿尔茨海默病病理的早期迹象,它的使用可能启发临床决策,判断阿尔茨海默病可能进展为痴呆。
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引用次数: 12
Assessing social cognition: age-related changes in moral reasoning in childhood and adolescence 评估社会认知:儿童和青少年道德推理的年龄相关变化
Pub Date : 2017-01-12 DOI: 10.1080/13854046.2016.1268650
V. Chiasson, E. Vera-Estay, G. Lalonde, J. Dooley, Miriam H. Beauchamp
Abstract Objective: There is increasing recognition that socio-cognitive skills, such as moral reasoning (MR), are affected in a wide range of developmental and neuropsychological conditions. However, the lack of appropriate measures available to neuropsychologists poses a challenge for the direct assessment of these skills. This study sought to explore age-related changes in MR using an innovative visual tool and examine the developmental sensitivity of the task. Method: To address some of the methodological limitations of traditional measures of MR, a novel, visual task, the Socio-Moral Reasoning Aptitude Level (So-Moral), was used to evaluate MR in 216 healthy participants aged 6–20 years. Results: The findings show a linear increase in MR from childhood to late adolescence with significant group differences between childhood (6–8 years) and preadolescence (9–11 years), and between early adolescence (12–14 years) and middle adolescence (15–17 years). Conclusions: Interpreted in light of current brain development research, the results highlight age-related changes in MR that offer insight into typical MR development and opportunities for comparisons with clinical populations. The findings also provide evidence of the potential of the So-Moral as a developmentally appropriate measure of MR throughout childhood and adolescence.
摘要目的:越来越多的人认识到社会认知技能,如道德推理(MR),在广泛的发育和神经心理条件下受到影响。然而,神经心理学家缺乏适当的测量方法,这对直接评估这些技能提出了挑战。本研究试图使用一种创新的视觉工具来探索与年龄相关的MR变化,并检查任务的发展敏感性。方法:为了解决传统MR测量方法的一些方法局限性,采用一种新颖的视觉任务,即社会道德推理能力水平(So-Moral),对216名6-20岁的健康参与者进行MR评估。结果:研究结果显示,从儿童期到青春期晚期,MR呈线性增长,儿童期(6-8岁)和青春期前(9-11岁)、青春期早期(12-14岁)和青春期中期(15-17岁)之间存在显著组间差异。结论:根据目前的大脑发育研究,结果强调了MR的年龄相关变化,为典型的MR发展提供了见解,并为与临床人群进行比较提供了机会。研究结果还提供了证据,证明了So-Moral作为一种适合儿童和青少年发展的MR测量方法的潜力。
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引用次数: 39
The statistical crisis in science: how is it relevant to clinical neuropsychology? 科学中的统计危机:它如何与临床神经心理学相关?
Pub Date : 2017-01-11 DOI: 10.1080/13854046.2016.1277557
A. Gelman, H. Geurts
Abstract There is currently increased attention to the statistical (and replication) crisis in science. Biomedicine and social psychology have been at the heart of this crisis, but similar problems are evident in a wide range of fields. We discuss three examples of replication challenges from the field of social psychology and some proposed solutions, and then consider the applicability of these ideas to clinical neuropsychology. In addition to procedural developments such as preregistration and open data and criticism, we recommend that data be collected and analyzed with more recognition that each new study is a part of a learning process. The goal of improving neuropsychological assessment, care, and cure is too important to not take good scientific practice seriously.
目前,科学界对统计(和复制)危机的关注越来越多。生物医学和社会心理学一直是这场危机的核心,但类似的问题在许多领域都很明显。我们讨论了三个来自社会心理学领域的复制挑战的例子和一些提出的解决方案,然后考虑这些想法在临床神经心理学中的适用性。除了预先注册、公开数据和批评等程序性发展之外,我们建议在收集和分析数据时更多地认识到,每项新研究都是学习过程的一部分。改善神经心理学评估、护理和治疗的目标太重要了,不能不认真对待良好的科学实践。
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引用次数: 29
Concussion-like symptom reporting in non-concussed adolescent athletes 非脑震荡青少年运动员的脑震荡样症状报告
Pub Date : 2017-01-02 DOI: 10.1080/13854046.2016.1246672
Breton M. Asken, Aliyah R. Snyder, M. S. Smith, Jason L Zaremski, R. Bauer
Abstract Objective: The primary goals of this study were (1) to report rates of concussion-like symptoms in healthy adolescent student athletes assessed using the Sport Concussion Assessment Tool, 3rd edition (SCAT3) at baseline, (2) to examine rates of psychiatric diagnoses in this population, and (3) to evaluate effects of baseline symptoms on SCAT3 cognitive and balance performance.Methods: 349 adolescent student athletes (245 male) were administered the SCAT3 during pre-participation physical examinations. We described the prevalence rate of student athletes meeting criteria for International Classification of Diseases, 10th revision, post-concussional syndrome (ICD-10 PCS) diagnosis at baseline, and evaluated associations between symptom reporting and demographic/medical history factors using chi-square tests. Rates of self-reported psychiatric diagnosis were compared to general population estimates with one-sample binomial tests. We also compared SCAT3 cognitive and balance performance between adolescents with and without baseline ICD-10 PCS symptoms.Results: Overall, 20.3% of participants met ICD-10 PCS criteria at baseline. Rates were similar across sexes and age groups. We found no statistical association with medical history factors. The proportion of student athletes reporting a history of psychiatric diagnosis (5.2%) was significantly lower than general population estimates (14.0%; p < .001), and this effect was consistent across sexes and age groups. SCAT3 cognitive and balance performance did not differ based on baseline symptom reporting.Conclusions: Healthy adolescent student athletes frequently report concussion-like symptoms at baseline. Clinicians should factor pre-injury symptomatology and medical history into concussion management when determining symptom etiology throughout the course of recovery.
摘要目的:本研究的主要目的是(1)报告使用运动脑震荡评估工具第3版(SCAT3)评估的健康青少年学生运动员在基线时脑震荡样症状的发生率,(2)检查该人群的精神诊断率,以及(3)评估基线症状对SCAT3认知和平衡表现的影响。方法:对349名青少年学生运动员(男245名)在赛前体检时进行SCAT3测试。我们描述了符合国际疾病分类第10版,脑震荡后综合征(ICD-10 PCS)诊断标准的学生运动员的患病率,并使用卡方检验评估症状报告与人口统计学/病史因素之间的关系。用单样本二项检验将自我报告的精神病诊疗率与一般人群估计值进行比较。我们还比较了有和没有基线ICD-10 PCS症状的青少年的SCAT3认知和平衡表现。结果:总体而言,20.3%的参与者在基线时符合ICD-10 PCS标准。不同性别和年龄组的发病率相似。我们未发现与病史因素有统计学关联。学生运动员报告有精神病史的比例(5.2%)显著低于一般人群的估计(14.0%;P < 0.001),并且这种效应在性别和年龄组中是一致的。SCAT3认知和平衡表现在基线症状报告的基础上没有差异。结论:健康的青少年学生运动员在基线时经常报告脑震荡样症状。在确定整个恢复过程中的症状病因时,临床医生应将损伤前症状学和病史纳入脑震荡管理。
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引用次数: 29
Traumatic brain injury history is associated with earlier age of onset of Alzheimer disease 创伤性脑损伤史与阿尔茨海默病发病年龄较早有关
Pub Date : 2017-01-02 DOI: 10.1080/13854046.2016.1257069
C. LoBue, H. Wadsworth, K. Wilmoth, M. Clem, J. Hart, Kyle B. Womack, N. Didehbani, L. Lacritz, H. Rossetti, C. Cullum
Abstract Objective: This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 status (Apoe4) and gender.Method: Participants with a clinical diagnosis of AD (n = 7625) were obtained from the National Alzheimer’s Coordinating Center Uniform Data Set, and categorized based on self-reported lifetime TBI with loss of consciousness (LOC) (TBI+ vs. TBI−) and presence of Apoe4. ANCOVAs, controlling for gender, race, and education were used to examine the association between history of TBI, presence of Apoe4, and an interaction of both risk factors on estimated age of AD onset.Results: Estimated AD onset differed by TBI history and Apoe4 independently (p’s < .001). The TBI+ group had a mean age of onset 2.5 years earlier than the TBI− group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years earlier than non-carriers. While the interaction was non-significant (p = .34), participants having both a history of TBI and Apoe4 had the earliest mean age of onset compared to those with a TBI history or Apoe4 alone (MDifference = 2.8 and 2.7 years, respectively). These results remained unchanged when stratified by gender.Conclusions: History of self-reported TBI can be associated with an earlier onset of AD-related cognitive decline, regardless of Apoe4 status and gender. TBI may be related to an underlying neurodegenerative process in AD, but the implications of age at time of injury, severity, and repetitive injuries remain unclear.
摘要目的:本研究探讨创伤性脑损伤(TBI)病史是否与阿尔茨海默病(AD)早期发病相关,且与载脂蛋白ε4 (Apoe4)状态和性别无关。方法:从国家阿尔茨海默病协调中心统一数据集中获得临床诊断为AD的参与者(n = 7625),并根据自我报告的终身TBI伴意识丧失(LOC) (TBI+与TBI -)和Apoe4的存在进行分类。在控制性别、种族和教育的情况下,使用ANCOVAs来检查TBI病史、Apoe4的存在以及这两种危险因素对AD发病年龄的相互作用之间的关系。结果:脑外伤史和Apoe4对AD发病的影响不同(p < 0.001)。TBI+组的平均发病年龄比TBI -组早2.5年。同样,Apoe4携带者的平均发病年龄比非携带者早2.3年。虽然相互作用不显著(p = .34),但与有TBI病史或仅有Apoe4的参与者相比,同时有TBI病史和Apoe4的参与者的平均发病年龄最早(MDifference分别为2.8和2.7岁)。这些结果在按性别分层时保持不变。结论:与Apoe4状态和性别无关,自我报告的TBI病史可能与ad相关认知能力下降的早期发病有关。TBI可能与AD中潜在的神经退行性过程有关,但损伤时的年龄、严重程度和重复性损伤的影响尚不清楚。
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引用次数: 65
Immediate Post-Concussion and Cognitive Testing (ImPACT): a systematic review of the prevalence and assessment of invalid performance 脑震荡后立即认知测试(ImPACT):对无效表现的普遍性和评估的系统回顾
Pub Date : 2017-01-02 DOI: 10.1080/13854046.2016.1220622
C. Gaudet, L. Weyandt
Abstract Objective: Computerized neuropsychological assessment of concussion has rapidly expanded and Immediate Post-Concussion and Cognitive Testing (ImPACT) is among the most commonly used measures in this domain. ImPACT was primarily developed for use with athletic populations but continues to expand beyond athletics to settings such as the workplace and schools where motivational dispositions may vary. The purpose of the present study was to conduct a systematic review of existing research investigating the prevalence of invalid baseline results and the effectiveness of ImPACT’s embedded invalidity indicators in detecting suspect effort.Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in order to systematically structure a search across four databases and analysis of studies that presented data related to the prevalence of invalid performance and/or the effectiveness of ImPACT’s embedded invalidity indicators.Results: A total of 17 studies included prevalence rates of invalid performances or examined the effectiveness of ImPACT’s invalidity indicators. Of the 17 studies, 12 included prevalence rates of invalid baseline results; and across this group of studies (after removing an outlier), the weighted prevalence rate of invalid baseline results was 6%. Four of the 17 studies examined the effectiveness of ImPACT’s embedded invalidity indicators. ImPACT’s embedded invalidity indicators correctly identified suboptimal effort in approximately 80% of individuals instructed to perform poorly and avoid detection (‘coached’) or instructed to perform poorly (‘naïve’).Conclusions: These findings raise a number of issues pertaining to the use of ImPACT. Invalid performance incidence may increase with large group versus individual administration, use in nonclinical settings, and among those with Attention Deficit-Hyperactivity Disorder or learning disability. Additionally, the older desktop version of ImPACT appears to be associated with a higher rate of invalid performances than the online version. Although ImPACT’s embedded invalidity indicators detect invalid performance at a rate of 6% on average, known group validity studies suggest that these measures miss invalid performance approximately 20% of the time when individuals purposefully underperform.
摘要目的:脑震荡的计算机化神经心理学评估已经迅速扩大,脑震荡后即时认知测试(ImPACT)是该领域最常用的测量方法之一。ImPACT最初是为运动人群而开发的,但它继续扩展到运动之外的环境,如工作场所和学校,那里的动机倾向可能会有所不同。本研究的目的是对现有研究进行系统回顾,调查无效基线结果的流行程度以及ImPACT嵌入的无效指标在检测可疑努力方面的有效性。方法:遵循系统评价和荟萃分析指南的首选报告项目,以便系统地构建跨四个数据库的搜索和研究分析,这些研究提供了与无效绩效的普遍性和/或ImPACT嵌入的无效指标的有效性相关的数据。结果:共有17项研究纳入了无效表演的患病率或检验了ImPACT的无效指标的有效性。在17项研究中,12项包括无效基线结果的患病率;在这组研究中(剔除异常值后),无效基线结果的加权患病率为6%。17项研究中有4项检查了ImPACT嵌入的无效指标的有效性。ImPACT嵌入的无效指标正确地识别了大约80%被指示表现不佳并避免被发现(“指导”)或被指示表现不佳(“naïve”)的个人的次优努力。结论:这些发现提出了一些与ImPACT使用有关的问题。在非临床环境中、在有注意缺陷多动障碍或学习障碍的人群中,大群体与个人给药相比,无效表现的发生率可能会增加。此外,与在线版本相比,较旧的桌面版本的ImPACT似乎具有更高的无效性能率。尽管ImPACT嵌入的无效指标平均检测无效绩效的率为6%,但已知的群体效度研究表明,当个人故意表现不佳时,这些测量方法遗漏了大约20%的无效绩效。
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引用次数: 47
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The Clinical neuropsychologist
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