Archives of Clinical Neuropsychology最新文献

Objective: The COVID-19 pandemic highlighted the need to build an evidence base to support teletesting as an equivalent modality for standardized neuropsychological assessment. As such, the purpose of this study was twofold. First, this study evaluated teletesting equivalency of standardized reading achievement measures during COVID-19 in children ages 6-16. Further, to examine the impact of COVID-19 on reading, achievement scores were compared in two samples of children assessed before and during COVID-19.

Methods: Participants were referred for testing at an outpatient neuropsychology clinic at an urban, academic medical center. Aim one compared assessments administered in-person (n = 1039) versus teletesting (n = 283). A two one-sided test (TOST) was used to determine equivalency. Aim two compared children seen pre-COVID-19 (n = 2125) and during COVID-19 (n = 1322) including a subsample of elementary school-aged children. One-way analyses of covariance were employed, with insurance type and Wechsler Intelligence Scale for Children, Fifth Edition Matrix Reasoning (as a proxy for nonverbal IQ) included as covariates.

Results: Results showed equivalence in reading achievement scores administered via teletesting compared to in-person during COVID-19. For aim two, Nonsense Word Decoding scores were significantly higher for the COVID-19 group compared to the pre-COVID-19 group (p = 0.03). No other significant differences in reading scores were found between groups, including no differences among a subsample of elementary school-aged children (ages 6-10; all ps > 0.05).

Conclusions: This provides additional support for teletesting equivalency and suggests the negative impact of COVID-19 on foundational reading skills is less than predicted in a clinically referred sample.

Cognitive intra-individual variability (IIV) is a sensitive marker of neuropathology and is increased in people with HIV (PWH). In a sample of PWH from the United States Deep South, we examined the relationship of cognitive IIV with cognitive impairment and social determinants of health (SDoH). This secondary analysis included 131 PWH from a larger cognitive training protocol. Our primary outcome measure was the coefficient of variation (CoV). We also included the individual standard deviation (iSD), with both calculated from demographically adjusted T-scores and unadjusted sample-based scores. Mixed-effects models investigated the relationship between IIV and cognitive impairment severity (i.e., Global Rating Score), SDoH, and clinical variables. Bivariate correlations were used to further explore these relationships. Greater cognitive IIV was associated with greater cognitive impairment in PWH, when accounting for demographic factors. When IIV is calculated from the sample, then IIV is no longer associated with cognitive impairment, but is associated with race (>IIV in Black and African American participants). Demographically adjusted IIV is associated with global cognition, Wide Range Achievement Test-Fourth Edition reading score, and viral load (iSD only). No correlations were significant when using the unadjusted sample-based IIV metrics. In PWH from the Deep South, greater cognitive variability is seen in those with greater cognitive impairment, in Black participants, and in those with lower reading scores. Further research on the psychometric properties of IIV in HIV and other populations is needed, as results varied depending on the normative adjustments.

Establishing the effect of limited English proficiency (LEP) on cognitive performance within linguistically diverse populations is central to cross-cultural neuropsychological assessments. The present study was designed to replicate previous research on cognitive profiles in Romanian-English bilinguals. Seventy-six participants (54 women, MAge = 23.16, SDAge = 5.91; MEducation = 14.49, SDEducation = 1.57) completed a neuropsychological battery in English. The Digit Span, Animal and Emotion Fluency, and several symptom-report scales were also administered in Romanian. Performance patterns were similar to previous findings: verbal fluency, auditory verbal learning, and picture and speeded color naming were highly sensitive to LEP. In contrast, visuomotor processing speed and mental flexibility were robust to LEP. Participants performed better when ability tests were administered in their native language; there was no difference on symptom inventories. Test performance was related to the degree of LEP, operationalized as performance on the Boston Naming Test-Short Form. Level of verbal mediation and LEP are independent predictors of cognitive performance. Administering tests in the native language may provide a more accurate measure of cognitive functioning in examinees with LEP (especially at the low end of English proficiency). Developing population-specific norms is a necessary safeguard against the multiple confounding factors in the neuropsychological assessment of individuals with LEP.

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.

>objective: Cognitive dysfunction is a common symptom of post-COVID-19 condition (PCC). Few studies have examined rates and predictors of cognitive performance validity test (PVT) failure in patients seeking treatment for PCC.

>methods: We report the rates of PVT failure in 323 patients who received care in a long-COVID-19 clinic for any post-COVID-19 health concern and underwent routine telephone cognitive testing that included two embedded PVTs. Binary logistic regressions examined the demographic, illness, and psychological variables associated with PVT failure.

>results: The prevalence of single PVT failure ranged from 4.7% to 26.1% whereas failure on both PVTs occurred in just 6.3%. Illness characteristics, subjective cognitive dysfunction, and most demographic and psychological variables were unrelated to single PVT failure. Males and those with anxiety were more likely to fail both PVTs.

>conclusion: Failure across multiple PVTs was not common and was unrelated to COVID-19 severity or cognitive complaints.

Background: Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord. This cross-sectional study aimed to validate the Arabic version of the Multiple Sclerosis Impact Scale-29 (MSIS-29) using Rasch analysis to assess quality of life in Jordanian MS patients.

Method: Rasch analysis was conducted to evaluate the suitability of the model for the present study. Model fit was assessed by computing item/person separation reliability, infit and outfit mean square (MSQ) values, Cronbach's alpha, and the Akaike Information Criterion.

Results: A total of 301 MS patients were enrolled in the study. Significant likelihood ratios for all three scales (MSIS-29-PHYSICAL, MSIS-29-PSYCHOLOGICAL, and MSIS-29-TOTAL) supported the use of a partial credit Rasch model. An issue with disordered thresholds was resolved by collapsing adjacent response categories. Item reliability scores for MSIS-29-PHYS and MSIS-29-PSYCH were 0.95 and 0.89, respectively, while person reliability scores were 0.92 and 0.84, respectively. Infit and outfit MSQ were within the acceptable range for all items on the MSIS-29-PSYCH scale. However, for the MSIS-29-PHYS scale, item MSIS-29_17 exceeded the acceptable range in both infit (1.93) and outfit (1.82) MSQs, and item MSIS-29_20 exceeded the acceptable range in infit (1.81). The Wright map also indicated that most items were considered relatively easy by the respondents, exhibiting various difficulty levels on the latent scale.

Conclusion: The Arabic version of the MSIS-29 is a valid and reliable tool for evaluating quality of life in Jordanian MS patients.

Objective: There is a dearth of research on neuropsychological functioning and the validity of assessment measures in American Indian (AI) older adults. The present study sought to comprehensively examine neuropsychological functioning in cognitively normal AI older adults in the southwestern USA (i.e., Arizona).

Participants and methods: Ninety predominantly female participants (45 AIs and 45 non-Hispanic Whites) aged 44 years and older (mean age of mid-60s) were matched on age, decade, gender, and assessment battery. Participants were enrolled in the Arizona Alzheimer's Disease Center database. Data obtained included demographics, medical history, psychiatric variables, and raw neuropsychological scores. Analyses included ANCOVAs, chi-square, and stepwise multiple regression.

Results: AIs generally had lower performance across all neuropsychological measures compared with matched Whites, even after controlling for demographic variables. Performance between groups was most discrepant on several measures of global cognition, attention, executive functioning, and language, while performance was statistically comparable on measures of memory and visuospatial abilities. The AI group had higher proportions of diabetes and obesity, but results showed that higher cardiovascular risk was not predictive of lower cognitive performance with the exception of the Clinical Dementia Rating Scale-Sum of Boxes.

Conclusions: Findings suggest that older AIs perform lower on many neuropsychological measures compared with non-Hispanic Whites, even after controlling for demographic variables. This suggests that other factors, including language, culture, educational quality, overall health, socioeconomic status, and level of acculturation may be impacting test scores and need to be considered when assessing and diagnosing older AIs.

Objective: This study aims to adapt and provide psychometric support for the validation of version B of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) for the Portuguese population, addressing the need for consistent cognitive evaluations in amyotrophic lateral sclerosis (ALS). A second culturally adapted ECAS screen facilitates the accurate characterization of ALS progression, mitigates learning effects, and supports tailored care management.

Methods: The adaptation process included forward-backward translation, cultural adaptation, and cognitive debriefing on a prospective sample of 193 ALS patients and 106 controls. A multiple regression analysis identified predictors relevant for establishing ECAS cut-off scores. Psychometric evaluations, including reliability assessments and tests of convergent, construct, and criterion validity, were conducted. Additionally, version A's psychometric properties were reevaluated with complementary analyses and a larger sample.

Results: Version B demonstrated good internal consistency with Cronbach's alpha of 0.802, comparable to the previously established version A. Moderate inter-item correlations further supported reliability, reflecting internal coherence. Equivalence testing between the Portuguese versions supported convergent validity, confirming version B's alignment with version A's theoretical framework. Exploratory factor analysis provided preliminary support for construct validity, and receiver operating characteristic analyses established cut-off values for both versions, revealing moderate sensitivity with a tendency toward false negatives, and higher specificity.

Conclusions: This study provided evidence for the cultural suitability, reliability, and validity of the Portuguese ECAS B. As evidence supports the equivalence of the Portuguese ECAS versions, they can be used for flexible screenings and applied with the calculated cut-off values to enhance diagnostic accuracy.

Objective: Explore the tip-of-the-tongue (TOT) scores from the Children's Auditory and Visual Naming Tests (cANT, cVNT) as embedded validity indicators (EVIs).

Method: A retrospective design of 98 consecutively referred youth aged 6-15 years (M = 11.28, SD = 2.80) that completed neuropsychological evaluation at a tertiary-care academic medical center.

Results: Invalid performance (i.e., ≥2 failed PVTs) occurred in 12.2% of the sample, with base rates of failure on individual PVTs ranging from 1.0% to 30.6%. Area under the curve (AUC) showed statistical significance for the auditory (AUC = 0.811, p = .004) but not the visual TOT. Logistic regression indicated the combination of both TOT scores with other PVTs increased correct identification of invalid performance to 85.7% versus 75% without TOT scores.

Conclusion: The utility of the TOT as a language-based EVI is one of many potential advantages of the cANT and cVNT compared to other confrontation naming tests. To confirm this, future studies with more diverse populations are warranted.

Objective: Technology can be combined with psychological interventions to support older adults with memory concerns. Using a bi-phasic design, cognitive rehabilitation (CR) was integrated with off-the-shelf technology and delivered to two people with cognitive impairment, and one care partner.

Method: Pre- and post-intervention assessments were completed for all participants. Individuals with memory problems received pre- and post-intervention remote neuropsychological assessment (i.e., Rey auditory verbal learning test; mental alternations test; animal fluency), and the hospital anxiety and depression scale (HADS). The care partner completed the HADS, Zarit burden interview, and neuropsychiatric inventory questionnaire. Change metrics incorporated reliable change indices where possible. Goals were tracked using the Canadian occupation performance measure; these data were analyzed through visual inspection. A research journal (used to document intervention process) was analyzed thematically.

Results: Results cautiously suggested our integration was feasible and acceptable across several technologies and varying goals. Across participants, significant changes in goal progress suggested the integration of technology with CR successfully facilitated goal performance and satisfaction. The research journal underscored the importance of a visual component, intervention flexibility, and a strong therapeutic alliance in integrating technology and CR.

Conclusions: CR and technology present a promising avenue for supporting people living with cognitive impairment. Further exploration of technology and CR with a range of etiologies and target goals is warranted.