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EMG measured reaction time as a predictor of invalid symptom report in psychosomatic patients. 肌电图测量的反应时间作为心身患者无效症状报告的预测指标。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-02 DOI: 10.1080/13854046.2023.2276480
Thorben Weymann, Johannes Achenbach, Jasmin E Guevara, Markus Bassler, Matthias Karst, Alexandra Lambrecht

Background: Symptom validity tests (SVTs) and performance validity tests (PVTs) are important tools in sociomedical assessments, especially in the psychosomatic context where diagnoses mainly depend on clinical observation and self-report measures. This study examined the relationship between reaction times (RTs) and scores on the Structured Inventory of Malingered Symptomatology (SIMS). It was proposed that slower RTs and larger standard deviations of reaction times (RTSDs) would be observed in participants who scored above the SIMS cut-off (>16). Methods: Direct surface electromyography (EMG) was used to capture RTs during a computer-based RT test in 152 inpatients from a psychosomatic rehabilitation clinic in Germany. Correlation analyses and Mann-Whitney U were used to examine the relationship between RTs and SIMS scores and to assess the potential impact of covariates such as demographics, medical history, and vocational challenges on RTs. Therefore, dichotomized groups based on each potential covariate were compared. Results: Significantly longer RTs and larger RTSDs were found in participants who scored above the SIMS cut-off. Current treatment with psychopharmacological medication, diagnosis of depression, and age had no significant influence on the RT measures. However, work-related problems had a significant impact on RTSDs. Conclusion: There was a significant relationship between longer and more inconsistent RTs and indicators of exaggerated or feigned symptom report on the SIMS in psychosomatic rehabilitation inpatients. Findings from this study provide a basis for future research developing a new RT-based PVT.

背景:症状有效性测试(SVT)和表现有效性测试是社会医学评估的重要工具,尤其是在心身环境中,诊断主要取决于临床观察和自我报告措施。本研究检验了反应时间(RT)与恶性症状结构化量表(SIMS)评分之间的关系。有人提出,在得分高于SIMS临界值(>16)的参与者中,会观察到较慢的RT和较大的反应时间标准差(RTSD)。方法:在德国一家身心康复诊所的152名住院患者的计算机RT测试中,使用直接表面肌电图(EMG)捕捉RT。相关性分析和Mann-Whitney U用于检查RT和SIMS评分之间的关系,并评估人口统计学、病史和职业挑战等协变量对RT的潜在影响。因此,对基于每个潜在协变量的二分群进行了比较。结果:在得分高于SIMS临界值的参与者中,发现明显更长的RT和更大的RTSD。目前的精神药物治疗、抑郁症的诊断和年龄对RT测量没有显著影响。然而,与工作相关的问题对RTSD产生了重大影响。结论:在心身康复住院患者的SIMS中,较长且不一致的RT与夸大或假装症状报告的指标之间存在显著关系。这项研究的发现为未来研究开发一种新的基于RT的PVT提供了基础。
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引用次数: 0
Questioning cognitive heterogeneity and intellectual functioning in fetal alcohol spectrum disorders from the Wechsler Intelligence Scale for Children. 从儿童韦氏智力量表对胎儿酒精谱系障碍的认知异质性和智力功能的质疑。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-11-16 DOI: 10.1080/13854046.2023.2281703
Eliot Kerdreux, Justine Fraize, Pauline Garzón, Esther Chalain, Léa Etchebarren, Delphine Sitbon, Anna Maruani, Odile Boespflug-Tanguy, Lucie Hertz-Pannier, Marion Noulhiane, Charlotte Pinabiaux, David Germanaud

Introduction: Fetal Alcohol Spectrum Disorders (FASD) are characterized by a variety of multiple cognitive and behavioral impairments, with intellectual, attentional, and executive impairments being the most commonly reported. In populations with multiple neurodevelopmental disorders, the Full Scale Intelligence Quotient (FSIQ) may not be a proper measure of intellectual abilities, rarely interpreted in FASD clinical practice because the heterogeneity of the cognitive profile is deemed too strong. We propose a quantitative characterization of this heterogeneity, of the strengths and weaknesses profile, and a differential analysis between global cognitive (FSIQ) and elementary reasoning abilities in a large retrospective monocentric FASD sample. Methods: Using clinical and cognitive data (Wechsler Intelligence Scale for Children) from 107 children with FASD, we characterized subject heterogeneity (variance and scatter of scaled/composite scores), searched for strengths and weaknesses, and specified intellectual functioning in terms of FSIQ and elementary reasoning (General Abilities Index, Highest Reasoning Scaled Score), in comparison with standardization norms and a Monte-Carlo-simulated sample from normalization data. Results: Performance of children with FASD was lower on all subtests, with a significant weakness in working memory and processing speed. We found no increase in the variance and scatter of the scores, but a discordance between the assessment of global cognitive functioning (28% borderline, 23% deficient) and that of global and elementary reasoning abilities (23-9% borderline, 15-14% deficient). Conclusion: Our results question the notion of WISC profile heterogeneity in FASD and point to working memory and processing speed over-impairment, with global repercussions but most often preserved elementary reasoning abilities.

胎儿酒精谱系障碍(FASD)以多种认知和行为障碍为特征,以智力、注意力和执行障碍为最常见的报道。在患有多种神经发育障碍的人群中,全量表智商(FSIQ)可能不是智力能力的适当衡量标准,在FASD临床实践中很少被解释,因为认知特征的异质性被认为太强。我们提出了这种异质性的定量表征,优势和劣势概况,并在一个大型回顾性单中心FASD样本中,对全球认知(FSIQ)和基本推理能力进行差异分析。方法:利用107名FASD儿童的临床和认知数据(韦氏儿童智力量表),我们对受试者的异质性(量表/综合得分的方差和散点)进行了表征,寻找优势和劣势,并在FSIQ和基本推理(一般能力指数,最高推理量表得分)方面指定了智力功能,并与标准化规范和蒙特卡罗模拟样本进行了比较。结果:FASD儿童在所有子测试中的表现都较低,在工作记忆和处理速度上有明显的弱点。我们发现得分的方差和散点没有增加,但总体认知功能评估(28%边缘,23%缺陷)与总体和基本推理能力评估(23-9%边缘,15-14%缺陷)之间存在不一致。结论:我们的研究结果质疑了FASD中WISC谱异质性的概念,并指出工作记忆和处理速度过度损伤,具有全球性影响,但大多数情况下保留了基本的推理能力。
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引用次数: 0
The prevalence and correlates of scores falling below ImPACT embedded validity indicators among adolescent student athletes. 青少年学生运动员得分低于 ImPACT 嵌入式有效性指标的普遍性和相关性。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2024-01-17 DOI: 10.1080/13854046.2023.2287777
Brian C Liu, Grant L Iverson, Nathan E Cook, Philip Schatz, Paul Berkner, Charles E Gaudet

Objective: Valid performance on preseason baseline neurocognitive testing is essential for accurate comparison between preseason and post-concussion test results. Immediate Post-Concussion and Cognitive Testing (ImPACT) is commonly used to measure baseline neurocognitive function in athletes. We examined the prevalence of invalid performance on ImPACT baseline testing and identified correlates of invalid performance. Method: The sample included 66,998 adolescents (ages 14-18, M = 15.51 years, SD = 1.22) who completed ImPACT baseline tests between 2009 and 2019. Invalid performance was determined by the embedded validity indicators (EVI). Associations between invalid performance, demographic characteristics, and health conditions were assessed using chi-square tests and odds ratios (ORs). Results: Overall, 7.2% of adolescents had baseline tests identified as invalid by one or more of the EVIs. Individual validity indicators classified between 0.5% and 3.7% tests as invalid. Higher frequencies of invalid scores were observed among youth with neurodevelopmental, academic, and medical conditions. Youth who reported having learning disabilities (n = 3126), receiving special education (n = 3563), or problems with attention-deficit/hyperactivity disorder (ADHD; n = 5104) obtained invalid baselines at frequencies of 16.4%, 16.0%, and 11.1%, respectively. Moreover, youth who reported receiving treatment for a substance use disorder (n = 311) or epilepsy (n = 718) obtained invalid baselines at frequencies of 17.0% and 11.1%, respectively. Conclusions: The base rate of invalid performance on ImPACT's EVIs was approximately 7%, consistent with prior research. Adolescents self-reporting neurodevelopmental conditions, academic difficulties, or a history of treatment for medical conditions obtained invalid baseline tests at higher frequencies. More research is needed to better understand invalid scores in youth with pre-existing conditions.

目的:季前基线神经认知测试的有效表现对于准确比较季前和脑震荡后测试结果至关重要。脑震荡后即刻认知测试(ImPACT)通常用于测量运动员的基线神经认知功能。我们研究了 ImPACT 基线测试中无效表现的发生率,并确定了无效表现的相关因素。研究方法样本包括在 2009 年至 2019 年期间完成 ImPACT 基线测试的 66,998 名青少年(14-18 岁,M = 15.51 岁,SD = 1.22)。无效表现由嵌入式有效性指标(EVI)确定。采用卡方检验和几率比(ORs)评估无效表现、人口统计学特征和健康状况之间的关联。结果显示总体而言,有 7.2% 的青少年的基线测试被一个或多个 EVI 识别为无效。0.5%到3.7%的测试被单项有效性指标归为无效。在有神经发育、学业和医疗状况的青少年中,发现无效分数的频率较高。报告有学习障碍(n = 3126)、接受特殊教育(n = 3563)或有注意力缺陷/多动障碍(ADHD;n = 5104)问题的青少年的基线无效频率分别为 16.4%、16.0% 和 11.1%。此外,报告接受药物使用障碍(n = 311)或癫痫(n = 718)治疗的青少年获得无效基线的频率分别为 17.0% 和 11.1%。结论:ImPACT的EVIs无效基线率约为7%,与之前的研究结果一致。自我报告有神经发育问题、学业困难或有医疗史的青少年,其基线测试无效的频率较高。要想更好地了解患有先天性疾病的青少年的无效分数,还需要进行更多的研究。
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引用次数: 0
Optimizing baseline and post-concussion assessments through identification, confirmation, and equivalence of latent factor structures: Findings from the NCAA-DoD CARE Consortium. 通过识别、确认和等效潜在因素结构优化基线和脑震荡后评估:NCAA DoD CARE联盟的研究结果。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-07-01 Epub Date: 2023-10-19 DOI: 10.1080/13854046.2023.2271614
Landon B Lempke, Adrian J Boltz, Gian-Gabriel P Garcia, Reid A Syrydiuk, Himadri S Pandey, Paul F Pasquina, Michael A McCrea, Thomas W McAllister, Steven P Broglio

Objective: Concussion evaluations use a multidimensional assessment to evaluate unique patient function dimensions (e.g., subjective symptoms differ from balance assessments), but the overarching latent factor structure has not been empirically substantiated. Our objective was to determine the cumulative latent factor structure of pre-injury baseline and acute (<48-h) post-concussion assessment battery outcomes, and determine measurement equivalence among common factors in collegiate student-athletes. Methods: Collegiate student-athletes at baseline (n = 21,865) and post-concussion (n = 1,537) across 25-institutions completed standardized assessments. Individual items were used from the baseline and post-concussion assessments and consisted of: Sport Concussion Assessment Tool, Brief Symptom Inventory-18, Standardized Assessment of Concussion, Balance Error Scoring System, Immediate Post-Concussion Assessment and Cognitive Test, and vestibular-ocular motor screening. Exploratory factor analysis was used on half the baseline data, and confirmatory factor analysis on the remaining baseline data and post-concussion data separately. Measurement equivalence was assessed between sex, sport contact classification, concussion history, and time. Results: A 10-factor exploratory model was established and comprised of: depression, somatic, vestibulo-ocular, headache, postural stability, neurocognition, emotional, fatigue, cognitive, consciousness clouding. The 10-factor model was confirmed at baseline and post-concussion with strong measurement equivalence between timepoints. Strong to strict measurement equivalence was observed for sex, sport contact classification, and concussion history at both timepoints separately. Conclusion: Our findings established a robust 10-factor latent factor model equivalent across timepoints and common factors among healthy and concussed collegiate athletes. Clinicians can use these findings to target specific factors while reducing redundant elements to provide efficient, comprehensive post-concussion assessments.

目的:脑震荡评估使用多维评估来评估独特的患者功能维度(例如,主观症状与平衡评估不同),但总体潜在因素结构尚未得到实证证实。我们的目的是确定受伤前基线和急性(方法:大学生运动员在基线(n = 21865)和脑震荡后(n = 1537)完成了标准化评估。使用基线和脑震荡后评估中的个别项目,包括:运动性脑震荡评估工具、简要症状清单-18、脑震荡标准化评估、平衡误差评分系统、脑震荡后即时评估和认知测试,以及前庭眼运动筛查。对一半的基线数据进行探索性因素分析,对其余基线数据和脑震荡后数据分别进行验证性因素分析。评估性别、运动接触分类、脑震荡史和时间之间的测量等效性。结果:建立了一个10因素探索性模型,包括:抑郁、躯体、前庭-眼部、头痛、姿势稳定性、神经认知、情绪、疲劳、认知、意识模糊。10因素模型在基线和脑震荡后得到证实,时间点之间的测量具有很强的等效性。在两个时间点分别观察到性别、运动接触分类和脑震荡史的强到严格的测量等效性。结论:我们的研究结果在健康和脑震荡的大学生运动员中建立了一个跨时间点和常见因素的稳健的10因素潜在因素模型。临床医生可以利用这些发现来针对特定因素,同时减少冗余因素,以提供有效、全面的脑震荡后评估。
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引用次数: 0
Relationships between cognitive flexibility performance and adaptive behavior outcomes in survivors of pediatric brain tumor. 小儿脑肿瘤幸存者的认知灵活性表现与适应行为结果之间的关系。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-06-30 DOI: 10.1080/13854046.2024.2361967
Kylie A Szymanski, Jordan E Pincus, Tricia Z King

Objective: Survivors of pediatric brain tumors are at increased risk of executive function (EF) and adaptive behavior difficulties. While previous research suggests that executive dysfunction impacts suboptimal adaptive outcomes, the specific elements of EF influencing this relationship remain unexplored. This study examines the relationship between cognitive flexibility and adaptive behavior in survivors compared to healthy controls. Methods: 86 survivors (Mage(SD)=23.41(4.24), 44 females) and 86 controls (Mage(SD)=23.09(4.50), 44 females) completed the Delis-Kaplan Executive Function System Trail Making Test (TMT) and Verbal Fluency Test (VFT). The Letter-Number Sequencing (LNS) and Category Switching (CS) conditions were isolated as measures of cognitive flexibility. Informants provided responses to obtain adaptive behavior ratings using the Scales of Independent Behavior-Revised (SIB-R). Linear regressions explored relationships between cognitive flexibility and SIB-R scores in survivors compared to controls. Results: For both TMT and VFT, the relationship between cognitive flexibility and adaptive behavior was significantly different between survivors and controls for SIB-R scores in Social Communication, Community Living, and Personal Living Skills (p<.0125). Survivors' better LNS performance predicted greater SIB-R scores across the same 3 domains (all p= <.001, r2semipartial=.08). Similarly, survivors' better CS performance predicted greater SIB-R scores across the same 3 domains (p = 0.002 to .02, r2semipartial =.03 to .04). No significant relationships were found in controls (all p >.05). After adjusting for working memory and inhibitory control, most relationships remained significant in survivors (p= <.001 to .046, r2semipartial=.02 to .08). Conclusion: These findings reveal a robust, positive relationship between cognitive flexibility performance and adaptive behaviors specific to survivors.

目的:小儿脑肿瘤幸存者出现执行功能(EF)和适应行为障碍的风险增加。虽然以往的研究表明,执行功能障碍会影响次优的适应结果,但影响这种关系的EF的具体因素仍未得到探讨。本研究探讨了幸存者与健康对照组相比认知灵活性与适应行为之间的关系。方法:86 名幸存者(平均年龄(SD)=23.41(4.24),44 名女性)和 86 名对照组(平均年龄(SD)=23.09(4.50),44 名女性)完成了德利斯-卡普兰执行功能系统寻迹测试(TMT)和言语流畅性测试(VFT)。字母-数字排序(LNS)和类别转换(CS)条件被单独作为认知灵活性的测量项目。信息提供者通过独立行为量表-修订版(SIB-R)对适应行为进行评分。与对照组相比,线性回归探讨了幸存者认知灵活性与 SIB-R 评分之间的关系。结果:对于 TMT 和 VFT,幸存者和对照组在社会交流、社区生活和个人生活技能方面的 SIB-R 分数,认知灵活性和适应行为之间的关系存在显著差异(pp= r2semipartial=.08)。同样,幸存者更好的 CS 表现也预示着他们在这三个领域的 SIB-R 得分更高(p = 0.002 至 0.02,r2semipartial = 0.03 至 0.04)。在对照组中没有发现明显的关系(所有 p >.05)。在对工作记忆和抑制控制进行调整后,幸存者的大多数关系仍然显著(p= r2semipartial=.02至.08)。结论这些研究结果表明,认知灵活性表现与幸存者特有的适应行为之间存在稳健的正相关关系。
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引用次数: 0
Normative data for executive function tests in an Ecuadorian Waranka minority population. 厄瓜多尔瓦兰卡少数民族人口执行功能测试的标准数据。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-06-30 DOI: 10.1080/13854046.2024.2367748
María José Fierro Bósquez, Laiene Olabarrieta-Landa, Bryan R Christ, David Arjol, Paul B Perrin, Juan Carlos Arango-Lasprilla, Diego Rivera

Objective: To generate normative data (ND) for executive functions tests in the Waranka minority population of Ecuador. Method: Four-hundred participants aged 6-17 completed the Symbol-Digit Modalities Test (SDMT), Trail-Making Test (TMT), Modified-Wisconsin Card Sorting Test (M-WCST), and Test of Colors-Words (STROOP). Scores were normed using multiple linear regressions, including age, age2, natural logarithm of mean parent education (MPE), sex, bilingualism, and two-way interactions as predictors. Results: Age by MPE and Age2 by MPE interactions arose for SDMT, so that children with illiterate parents scored lower than those with literate parents. Girls scored higher in SDMT. All TMT and M-WCST scores were influenced by age2. Age by MPE interaction was found for TMT-A, so that children with higher MPE went faster; and age by bilingualism interaction for TMT-B, so that more bilingual children needed less time. Stroop-Word and Color were influenced by age2 by MPE interaction, so that children, while older, scored higher, especially those with higher MPE. Also, age2 by sex interaction arose, so that girls increased scores curvilinearly while boys linearly. Word-Color was influenced by age, while Stroop-interference by age2. Age by MPE interaction was found for MCST-Categories and Perseveration, so that perseverations decreased to then increased, especially in those with illiterate parents. M-WCST-Category scores increased to then decrease later on age in children with illiterate parents. Z-scores calculated through indigenous ND were significantly lower than generated through non-indigenous norms. Conclusions: ND for minority populations are critical since Waranka sample performed worse when using non-indigenous norms for z-score calculation.

目的为厄瓜多尔瓦兰卡少数民族人群的执行功能测试生成标准数据(ND)。方法:四百名 6-17 岁的参与者完成符号-数字模态测试(SDMT):四百名 6-17 岁的参与者完成了符号-数字模态测验(SDMT)、寻迹测验(TMT)、改良-威斯康星卡片分类测验(M-WCST)和颜色-单词测验(STROOP)。采用多元线性回归法(包括年龄、年龄2、父母平均受教育程度(MPE)的自然对数、性别、双语能力和双向交互作用作为预测因子)对得分进行标准化。结果如下年龄与父母平均教育程度(MPE)和年龄2与父母平均教育程度(MPE)的交互作用出现在 SDMT 中,因此父母不识字的儿童的得分低于父母识字的儿童。女孩在 SDMT 中得分更高。所有 TMT 和 M-WCST 分数均受年龄 2 的影响。在 TMT-A 中,年龄与 MPE 相互影响,因此 MPE 越高的儿童得分越快;在 TMT-B 中,年龄与双语能力相互影响,因此双语能力越强的儿童所需的时间越短。Stroop-Word 和颜色受年龄 2 与 MPE 交互作用的影响,因此年龄越大的儿童得分越高,尤其是 MPE 越高的儿童。此外,年龄 2 与性别之间也存在交互作用,因此女孩的得分呈曲线上升,而男孩则呈直线上升。单词颜色受年龄影响,而 Stroop 干扰受年龄 2 影响。在 MCST 类别和毅力方面,发现了年龄与 MPE 的交互作用,因此毅力从下降到上升,特别是在父母是文盲的情况下。在父母都是文盲的儿童中,MC-WCST-类别得分随着年龄的增长先升高后降低。通过本土 ND 计算出的 Z 值明显低于通过非本土标准计算出的 Z 值。结论:少数民族的 ND 非常重要,因为 Waranka 样本在使用非土著标准计算 Z 分数时表现较差。
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引用次数: 0
Age-stratified norms for Raven's standard progressive matrices for Sri Lankan adults. 斯里兰卡成年人的瑞文标准渐进矩阵年龄分层常模。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-06-27 DOI: 10.1080/13854046.2024.2370908
Tharaka L Dassanayake, Dewasmika I Ariyasinghe, Anuradha Baminiwatta, Chandana Hewawasam

Objective: The aim of this study was to create age-stratified norms for the Raven's Standard Progressive Matrices (SPM) for Sri Lankan adults.

Methods: A sample of 610 adults (age: 18-72 years; education: 1-19 years), underwent the 60-item version of the SPM under individual supervision of a test administrator. The sample was stratified into 5-year age bands, and the norms are presented as percentile tables and percentile curves.

Results: The age-related changes were more accurately predicted by a curvilinear model (overall R2 = 0.961) than a linear regression model (R2 = 0.639). The SPM norms are presented as age-stratified percentile tables, as well as sex-, age- and education-adjusted multiple regression equations. The highest percentiles in the younger end of the age spectrum showed a ceiling effect. In the context of age-stratified US (1993) and British (1992) norms, older individuals in the Sri Lankan sample scored much lower than their Western counterparts. However, the difference narrowed in the younger age bands, showing no difference among the 18-to-22-year age bands in the three countries.

Conclusions: This age-by-country interaction can be partly explained by poorer education in the older individuals in the present sample compared to those in the US and UK standardization samples. SPM norms presented in this paper fill a hiatus in assessment of general intellectual ability in Sri Lankan adults. Given that Sri Lanka improves its educational, socioeconomic and health standards faster than the nations who have already reached higher standards, these norms would require re-standardization in the coming decades.

目的:本研究旨在为斯里兰卡成年人建立瑞文标准进行矩阵(SPM)的年龄分层常模:本研究旨在为斯里兰卡成年人制定瑞文标准进行矩阵(SPM)的年龄分层常模:抽样调查了 610 名成人(年龄:18-72 岁;教育程度:1-19 岁),在测试管理者的个别指导下进行了 60 个项目的 SPM 测试。样本按 5 岁年龄段进行分层,并以百分位数表和百分位数曲线的形式展示了常模:结果:曲线模型(总 R2 = 0.961)比线性回归模型(R2 = 0.639)更能准确预测与年龄有关的变化。SPM 标准以年龄分层百分位数表以及性别、年龄和教育程度调整多元回归方程的形式呈现。年龄越小,百分位数越高,显示出天花板效应。根据美国(1993 年)和英国(1992 年)的年龄分层标准,斯里兰卡样本中年龄较大者的得分远低于西方同龄人。然而,在较年轻的年龄段,差异有所缩小,在这三个国家中,18 至 22 岁年龄段之间没有差异:结论:与美国和英国的标准化样本相比,本样本中年龄较大的人受教育程度较低,这在一定程度上解释了年龄与国家之间的相互影响。本文介绍的 SPM 标准填补了斯里兰卡成人一般智力评估的空白。鉴于斯里兰卡在教育、社会经济和健康标准方面的改善速度要快于那些已经达到较高标准的国家,这些标准在未来几十年内需要重新标准化。
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引用次数: 0
Neuropsychological profile of a patient with multiple sclerosis and psychiatric symptoms that masked and delayed the diagnosis. A case report using teleneuropsychology. 一名多发性硬化症患者的神经心理学特征以及掩盖和延迟诊断的精神症状。利用远程神经心理学的病例报告。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-06-24 DOI: 10.1080/13854046.2024.2370963
Carolina Reyes-Méndez, Denise Gómez-Bautista, Guillermina Yáñez-Téllez, Emmanuel Rodríguez-Chávez, Julieta Moreno-Villagómez

Objective: Multiple sclerosis (MS) may include not only severe neurological signs and symptoms, but also cognitive and psychiatric disturbances. When psychiatric symptoms precede or are comorbid with MS, it poses a clinical challenge, because it may lead to a mistaken diagnosis of MS as a psychiatric disorder, delaying proper treatment. We describe the neuropsychological profile of a female patient with MS whose diagnosis was delayed due to neuropsychiatric symptoms. Method: A comprehensive analysis of the medical history and the results of a teleneuropsychological assessment of a 36-year-old Mexican woman with a diagnosis of relapsing--remitting MS (RRMS) was performed. Results: The patient indicates a long history of psychotic, anxious, and depressive features years before the first neurological symptom that led to MS going unnoticed for several years. Language, attentional, perceptual, motor, and learning skills were found to be preserved. Short-term memory and spatial orientation problems were identified, with decreased processing speed and executive dysfunction, including working memory and planning deficits. Conclusions: The patient has a non-typical presentation of neuropsychological alterations with cognitive and behavioral symptoms that resemble dorsolateral frontal lobe syndrome. This case study highlights the importance of considering MS in differential diagnosis of patients with psychiatric symptoms, even in the absence of obvious neurological signs.

目的:多发性硬化症(MS多发性硬化症(MS)不仅会出现严重的神经系统体征和症状,还会出现认知和精神障碍。当精神症状出现在多发性硬化症之前或与多发性硬化症并发时,就会带来临床挑战,因为这可能会导致将多发性硬化症误诊为精神障碍,从而延误正确的治疗。我们描述了一名女性多发性硬化症患者的神经心理学特征,该患者因神经精神症状而延误了诊断。研究方法对一名诊断为复发-缓解型多发性硬化症(RRMS)的 36 岁墨西哥女性患者的病史和远程神经心理学评估结果进行了综合分析。评估结果该患者在首次出现神经系统症状前数年就有精神病、焦虑症和抑郁症的长期病史,导致多发性硬化症数年未被察觉。患者的语言、注意力、知觉、运动和学习能力均得以保留。发现了短期记忆和空间定向问题,以及处理速度下降和执行功能障碍,包括工作记忆和计划障碍。结论:该患者的神经心理改变非典型表现,其认知和行为症状类似于额叶背外侧综合征。本病例研究强调了在对有精神症状的患者进行鉴别诊断时考虑多发性硬化症的重要性,即使患者没有明显的神经系统体征。
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引用次数: 0
Impact of text difficulty and visual emphasis on pediatric neuropsychological evaluation reports: The parent's perspective. 文字难度和视觉重点对儿科神经心理评估报告的影响:家长的视角。
IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-06-20 DOI: 10.1080/13854046.2024.2366018
Melissa Gerstle, Julia Fleming Beattie, James Peugh, Thea L Quinton, Anne Bradley, Brenna LeJeune, Dean W Beebe

Objective: Despite varying opinions, little research has examined how to best write pediatric neuropsychology reports. Method: This study gathered input from 230 parents on how text difficulty (reading level) and visual emphasis (bullets, underline, italics) affect report readability and utility. We focused on the most-read report section: summary/impressions. Each parent rated the readability and usefulness of a generic summary/impressions section written in four different styles. The four styles crossed text difficulty (high school-vs-collegiate) with use of visual emphasis (absent-vs-present). Results: Parents found versions with easier text to be more clearly written, easier to follow, and easier to find information (p<.001). Parents rated those with harder text to be overly detailed, complex, hard to understand, and hard to read (p<.001). Visual emphasis made it easier to find key information and the text easier to follow and understand - but primarily for versions that were written in difficult text (interaction p≤.026). After rating all four styles, parents picked their preference. They most often picked versions written in easier text with visual emphasis (p<.001). Conclusions: Findings support writing styles that use easier text difficulty and visual emphasis.

目的:尽管众说纷纭,但很少有研究探讨如何更好地撰写儿科神经心理学报告。研究方法:本研究收集了 230 位家长关于文字难度(阅读水平)和视觉强调(子弹、下划线、斜体)如何影响报告可读性和实用性的意见。我们重点研究了报告中阅读次数最多的部分:摘要/印象。每位家长都对用四种不同风格撰写的通用摘要/印象部分的可读性和实用性进行了评分。这四种风格的文字难度(高中-大学)与视觉强调的使用(无-有)相互交叉。结果:家长们认为文字难度较低的版本文字更清晰,更容易理解,也更容易找到信息(ppp≤.026)。在对所有四种文体进行评分后,家长们选出了自己的偏好。他们最常选择的是文字更通俗易懂、有视觉重点的版本(p结论:研究结果支持使用难度较低的文字和视觉强调的写作风格。
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引用次数: 0
The Making Change Test: Initial validation of a novel digitized performance validity test for tele-neuropsychology. 做出改变测试:用于远程神经心理学的新型数字化绩效有效性测试的初步验证。
IF 3.9 3区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-05-22 DOI: 10.1080/13854046.2024.2352898
Mira I Leese, John-Christopher A Finley, Jarett E Roseberry, S Kristian Hill

Objective: The Making Change Test (MCT) is a brief, digitized freestanding performance validity test (PVT) designed for tele-neuropsychology (TeleNP). The objective of this study was to report the initial validation of the MCT in a mixed neuropsychiatric sample referred for neuropsychological evaluation using a known-groups design.

Method: The sample consisted of 136 adult outpatients who underwent a neuropsychological evaluation. Patients were classified as valid (n = 115) or invalid (n = 21) based on several established PVTs. Two validity indicators were calculated and assessed, including an Accuracy Response-Score and an Abbreviated Index. The Accuracy Response-Score incorporated both response time and errors. The Abbreviated Index aggregated response time and errors across the most sensitive test items in terms of predicting performance validity status.

Results: Correlational analyses indicated that the MCT Accuracy Response-Score and Abbreviated Index were more similar to non-memory-based PVTs than memory-based PVTs. Both the MCT Accuracy Response-Score and Abbreviated Index indicated acceptable classification accuracy (area under the curve of .77). The optimal cut score for the MCT Accuracy Response-Score (≥24) yielded a sensitivity of .38 and specificity of .90. The optimal cut score associated with the Abbreviated Index yielded slightly better operating characteristics, with a sensitivity of .50 and specificity of .90.

Conclusions: Initial findings provide support for the criterion and construct validity of the MCT and suggest a promising TeleNP future for this performance validity tool. However, additional support is necessary before the MCT can be used clinically.

目的:做出改变测验(MCT)是一种简短的数字化独立性能效度测验(PVT),专为远程神经心理学(TeleNP)设计。本研究的目的是采用已知组设计,在转诊进行神经心理学评估的混合神经精神疾病样本中对 MCT 进行初步验证:样本包括 136 名接受神经心理学评估的成年门诊患者。根据几种已确立的 PVT,患者被分为有效(115 人)和无效(21 人)两类。我们计算并评估了两个有效性指标,包括准确度反应分数和简略指数。准确性响应分数包括响应时间和错误。在预测成绩有效性状况方面,缩略指数汇总了最敏感测试项目的反应时间和错误:相关分析表明,MCT 准确度反应分数和简短指数与非记忆型 PVT 的相似度高于记忆型 PVT。MCT 精确度反应分和简略指数均显示出可接受的分类精确度(曲线下面积为 0.77)。MCT 准确性反应分数的最佳切分分数(≥24 分)的灵敏度为 0.38,特异性为 0.90。与简略指数相关的最佳切分分数的操作特性稍好,灵敏度为.50,特异性为.90:初步研究结果为 MCT 的标准有效性和构建有效性提供了支持,并为这一绩效有效性工具的 TeleNP 前景提供了希望。不过,在将 MCT 用于临床之前,还需要更多的支持。
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引用次数: 0
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Clinical Neuropsychologist
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