Archives of Clinical Neuropsychology最新文献

Objective: We report normative data with non-athlete college students for three brief, public-domain performance validity tests (PVT) representing multiple performance domains: Rey's Word Recognition Test (WRT), Rey's Dot Counting Test (DCT), and A Random Letter Test of Auditory Vigilance (A-Test).

Method: One hundred fifty-four non-athlete college students (45% female; representing four college years) were recruited and assigned randomly to Honest-Effort, Fake-Bad, or Instructed Fake-Bad groups. Fifty student-athletes were selected randomly for comparison. Differences for multiple measures of each test among the three effort groups were obtained, and receiver operating curve (ROC) cut scores representing suboptimal performance were reported.

Results: Only the WRT measures met normality and homogeneity of variance assumptions. Multivariate analysis of variance with post-hoc Tukey tests showed significant differences between groups for WRT Total Correct and Combination scores. For DCT Combination Score and Total Errors and A-Test Omission Errors and Total Errors, non-parametric Kruskal-Wallis comparisons were conducted, each resulting in significant differences between Honest-Effort and sub-optimal performance (SOP) groups. Athletes also differed significantly from both SOP groups. ROC cut scores that suggested suboptimal effort were DCT Combination Score ≥ 15; WRT Combination Score ≤ 12; and A-Test Omission Errors ≥1. Measures were considered poor to excellent based on the area under the curve (AUC) percentages obtained through ROC analysis.

Conclusion: The DCT Combination and A-Test Omission Errors were valid indicators of suboptimal performance. The WRT measures fell short of adequate prediction based on the AUC. Combining multiple PVT "failures" maximized identification of suspect performers and minimized inclusion of Honest-Effort participants.

Objectives: To assess changes in neurocognitive test scores among former collegiate American football players over 18 years and examine associations with head trauma history.

Methods: Former collegiate American football players (n = 31; aged = 38.4 ± 1.3 years) self-reported their concussion history and repetitive head impact exposure (Head Impact Exposure Estimate). Neurocognitive testing was conducted at two time-points (during college [T1] and 18-year follow-up [T2]) via Hopkins Verbal Learning Test-Revised Immediate and Delayed Recall; Verbal fluency; Symbol Digit Modalities Test; and Trail-Making Test-B. Raw score changes were calculated, with accompanying Cohen's d effect sizes and coefficients of variation. Repeated-measures analyses of covariance models were fit to examine changes in test performance. Multivariable linear regression models tested associations of sport-related concussion history and repetitive head impact exposure with change scores.

Results: No significant changes in cognitive test performance were observed (ps ≥ .06). Individual-level changes exhibited high variability (coefficients of variation ≥ 244%), and group-level effects were small to medium (d ≤ 0.41). Neither sport-related concussion history nor repetitive head impacts were related to change scores (ps > .05).

Conclusions: Group-level test scores did not change over 18 years among former collegiate football players now in midlife, though individual-level variability was high. Sport-related concussion and head impact exposure estimates were not related to change. Longitudinal studies are essential to understand cognitive trajectories of former football players and factors influencing those trajectories.

Objective: A publisher of the Boston Naming Test recently provided a boomerang item to replace the noose item. We examined response accuracy and speed for these items.

Method: Participants were 300 patients seen for clinical neuropsychological evaluation. Noose and boomerang items were administered consecutively, in counterbalanced order.

Results: Spontaneous response was correct for the noose in 91% and boomerang in 76.7%. Both responses were correct for 72.7% and incorrect for 5% (overall concordance of 77.7%), 18.3% had correct noose/incorrect boomerang, and 4% correct boomerang/incorrect noose. Time to spontaneous response was faster for the noose. Phonemic cues were more helpful in naming the boomerang.

Conclusions: Spontaneous response to the noose and boomerang items showed lack of concordance in 22.3% of patients, and the items showed differences in time to response and benefit from phonemic cuing. These findings raise concern about using the boomerang as a replacement for the noose item.

Objective: Understanding how well older individuals with suspected cognitive impairment are functioning within the real-world environment can have important implications for diagnosis and treatment. To evaluate whether an individual is experiencing functional limitations suggesting the presence of mild cognitive impairment (MCI) or dementia, we establish diagnostic cutoff scores for the informant version of the Instrumental Activities of Daily Living-Compensation (IADL-C) scale.

Method: Informants of research (n = 488) and clinical (n = 119) samples of participants designated as healthy older controls, MCI, or dementia completed the IADL-C. Receiver operating characteristic curve analyses and diagnostic statistics were used to determine optimal cutoffs on the IADL-C for both the 27-item IADL-C and an 11-item short form created using item-level analysis.

Results: The optimal cutoff scores that maximized the Youden Index for the research sample long-form were 1.41 in distinguishing cognitively healthy versus MCI participants, and 3.60 in distinguishing dementia from MCI participants, favoring specificity for the clinical sample, the optimal cutoffs were 1.32 and 3.06, yielding higher sensitivity.

Conclusions: These cutoff scores, when used as a screening measure or combined with other clinical and cognitive measures, may be useful for understanding whether an individual may be experiencing functional difficulties in everyday life consistent with a diagnosis of MCI or dementia.

Objective: Emotion recognition tests are essential for differential diagnostics when assessing patients with Alzheimer's disease (AD) dementia. However, there remains a lack of emotion recognition tests appropriate for culturally and educationally diverse populations. The aim of this study was to develop an emotion recognition test (the TIE-93) appropriate for these populations. We then examined whether the TIE-93 could reduce emotion recognition performance differences between populations with a native French versus a culturally and educationally diverse background (participants who had immigrated to France). This was assessed by comparing performance between controls of each cultural group. We also assessed the effect of demographic variables on TIE-93 test performance and whether performance in an AD patient group was consistent with the research literature.

Methods: Fifty-seven patients with AD dementia and 240 healthy controls, from native French and culturally and educationally diverse backgrounds, were included in the study. The TIE-93 is composed of eight panels with photos of actors displaying six basic emotions. Participants were asked to identify which of the six facial expressions displayed matched an oral description of a context.

Results: When comparing French and culturally and educationally diverse controls, Quade's ANCOVA revealed that there remained an effect of culture and education on TIE-93 test performance. Nonetheless, while controlling for years of education, age, sex, and cultural group, patients with AD dementia scored significantly more poorly than controls, specifically for most negative emotions.

Conclusion: The TIE-93 represents a first step toward developing appropriate emotion recognition tests for culturally and educationally diverse populations.

Objective: Stroke is the third leading cause of death and disability worldwide in 2019. In stroke patients, about one-third or more are affected by depression, which makes it a serious social and public health problem. This study aims to create and validate a nomogram for early prediction and identification of depression in stroke patients.

Methods: Cross-sectional data from 605 stroke survivors aged 60 and over in the CHARLS 2011, 2015 was used. Participants were split into training and testing groups. Predictive factors were identified using Least Absolute Shrinkage and Selection Operator (LASSO) and multivariable logistic regression, leading to the creation of a nomogram model. The model's performance was assessed with Receiver Operating Characteristic (ROC) curves, the Concordance Index (C-index), calibration plots, and Decision Curve Analysis (DCA).

Results: It identified Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), sleep hours, uric acid, and Triglyceride-Glucose-Body Mass Index (TyG-BMI) as risk factors for depression post-stroke, which were integrated into the final model. The nomogram's predictive performance was deemed acceptable, with ROC curve values of 0.7512 (95% CI: 0.705-0.798) for the training set and 0.723 (95% CI: 0.65-0.797) for the testing set. The calibration curve confirmed the model's accuracy, and the DCA showed it had clinical utility.

Conclusions: Five key factors were chosen to create a nomogram predicting depression in stroke patients. This nomogram demonstrates evaluation performance and serves as a tool for forecasting depression in this population.

Objective: An increasing focus in Alzheimer's disease and aging research is to identify transitional cognitive decline. One means of indexing change over time in serial cognitive evaluations is to calculate standardized regression-based (SRB) change indices. This paper includes development and preliminary validation of SRB indices for the Uniform Data Set 3.0 Neuropsychological Battery, as well as base rate data to aid in their interpretation.

Method: The sample included 1341 cognitively intact older adults with serial assessments over 0.5-2 years in the National Alzheimer's Coordinating Center Database. SRB change scores were calculated in half of the sample, then validated in the other half of the sample. Base rates of SRB decline were evaluated at z-score cut-points, corresponding to two-tailed p-values of .20 (z = -1.282), 0.10 (z = -1.645) and .05 (z = -1.96). We examined convergent associations of SRB indices for each cognitive measure with each other, as well as concurrent associations of SRB indices with Clinical Dementia Rating sum of box scores (CDR-SB).

Results: SRB equations were able to significantly predict the selected cognitive variables. The base rate of at least one significant SRB decline across the entire battery ranged from 28.91% to 64.90%. SRB indices for cognitive measures demonstrated theoretically expected significant positive associations with each other. Additionally, CDR-SB impairment was associated with decline on three different SRB indices.

Conclusions: This paper provides preliminary validation of SRB indices in a large sample, and we present a user-friendly tool for calculating SRB values.

Objective: The social cognitive abilities of emotion perception, cognitive theory of mind (ToM), affective ToM, and emotional empathy change across adulthood. Few existing studies have examined the performance of a single social cognitive domain in later life, with no known studies having examined all four abilities together. Although it is well understood how non-social cognitive performance changes with age, and this has helped inform diagnostic methods for age-related disorders, relatively little is known about typical age-related social cognitive performance in later life. The current study aimed to investigate the association between age and social cognitive performance within a sample of healthy midlife to older adults.

Method: This cross-sectional study examined emotion perception using the Mini-SEA Facial Emotion Recognition Test, cognitive and affective ToM using The Shortened Awareness of Social Inference Test-Short Form, and emotional empathy using the Interpersonal Reactivity Index in 236 healthy adults aged 43-80 years (M = 60.30, SD = 6.88, 76% female).

Results: Multiple linear regression analyses revealed that age only had a significant, medium, negative association with cognitive (B = -.08, p < .001) and affective (B = -.05, p < .001) ToM and was not significantly associated with emotion perception or emotional empathy.

Conclusions: These findings enhance our understanding of normal social cognitive aging in later life, which can inform decisions around adding social cognitive measures into existing neuropsychological diagnostic tools for psychiatric, neurological, and developmental disorders.

Objective: Neuropsychological testing has traditionally been performed on site using standardized paper-pencil tests. Online platforms now offer the potential of conducting such testing at home but requires validation before widespread use. In this pilot study with healthy adults, we examine the convergent validity of the newly developed test battery Mindmore Remote.

Method: Fifty-two healthy participants were tested using both Mindmore Remote at home and traditional neuropsychological testing on site. The order of presentation was randomized. Associations between test performance on the two batteries were compared using Pearson and Spearman correlations.

Results: Results revealed significant correlations between all Mindmore Remote tests and traditional tests. Verbal tests showed stronger correlations (r = .71-.83) than non-verbal tests (r = .48-.71). Further, correlations were stronger for users who made responses using a computer mouse than for touchpad users.

Conclusions: Mindmore Remote tests that rely on verbal in- and output were comparable to traditional face-to-face neuropsychological tests. However, although promising, further validation is needed for tests that require visuo-motor interaction. In comparison with similar studies, the results indicate that test modification, rather than remote administration, is accountable for weaker correlations.

Objective: The present study aimed to examine facial emotion recognition in a sample from the general population with elevated schizotypal traits, as defined by the four-factor model of schizotypy, and the association of facial emotion recognition and the schizotypal dimensions with psychological well-being.

Method: Two hundred and thirty-eight participants were allocated into four schizotypal groups and one control group. Following a cross-sectional study design, facial emotion recognition was assessed with a computerized task that included images from the Radboud Faces Database, schizotypal traits were measured with the Schizotypal Personality Questionnaire, and psychological well-being was evaluated with the Flourishing scale.

Results: The results revealed distinct patterns of performance across the schizotypal groups and the application of a dimensional approach that included all participants as one group indicated specific associations between the four schizotypal dimensions and psychological well-being. Specifically, (a) negative schizotypes showed poor identification of sadness and fear potentially due to the activation of coping mechanisms, (b) disorganized schizotypes inaccurately recognized surprise, possibly reflecting the effects of disorganized thought on distinguishing this ambiguous emotion, and (c) psychological well-being was predicted by high cognitive-perceptual along with low negative and disorganized schizotypy as well as the accurate recognition of specific emotional states that are common in daily social interactions.

Conclusions: In conclusion, the study findings further advance the identification of emotion-processing difficulties in schizophrenia-vulnerable individuals and further highlight the need for highly personalized early intervention strategies.