The Interchangeability of CVLT-II and WMS-IV Verbal Paired Associates Scores: A Slightly Different Story

We investigated the similarity of the Wechsler Memory Scale-Fourth Edition (WMS-IV) Auditory Memory Index (AMI) scores when California Verbal Learning Test-Second Edition (CVLT-II) scores are substituted for WMS-IV Verbal Paired Associates (VPA) subtest scores. College students (n = 103) were administered select WMS-IV subtests and the CVLT-II in a randomized order. Immediate and delayed VPA scaled scores were significantly greater than VPA substitute scaled scores derived from CVLT-II performance. At the Index level, AMI scores were significantly lower when CVLT-II scores were used in place of VPA scores. It is important that clinicians recognize the accepted substitution of CVLT-II scores can result in WMS-IV scores that are inconsistent with those derived from standard administration. Psychometric issues that plausibly contribute to these differences and clinical implications are discussed

Comparison of Wechsler Memory Scale–Fourth Edition (WMS–IV) and Third Edition (WMS–III) dimensional structures: Improved ability to evaluate auditory and visual constructs

Dimensional structures underlying the Wechsler Memory Scale–Fourth Edition (WMS–IV) and Wechsler Memory Scale–Third Edition (WMS–III) were compared to determine whether the revised measure has a more coherent and clinically relevant factor structure. Principal component analyses were conducted in normative samples reported in the respective technical manuals. Empirically supported procedures guided retention of dimensions. An invariant two-dimensional WMS–IV structure reflecting constructs of auditory learning/memory and visual attention/memory (C1 = .97; C2 = .96) is more theoretically coherent than the replicable, heterogeneous WMS–III dimension (C1 = .97). This research suggests that the WMS–IV may have greater utility in identifying lateralized memory dysfunction

The Role of Neurocognitive Tests in the Assessment of Adult Attention-Deficit/Hyperactivity Disorder

Despite widespread recognition that attention-deficit/hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder, optimal methods of diagnosis among adults remain elusive. Substantial overlap between ADHD symptoms and cognitive symptoms of other mental health conditions, such as depression and anxiety, and concerns about validity in symptom reporting have made the use of neuropsychological tests in ADHD diagnostic assessment appealing. However, past work exploring the potential diagnostic utility of neuropsychological tests among adults has often relied on a relatively small subset of tests, has failed to include symptom and performance validity measures, and often does not include comparison groups of participants with commonly comorbid disorders, such as depression. The current study examined the utility of an extensive neuropsychological measure battery for diagnosing ADHD among adults. Two hundred forty-six participants (109 ADHD, 52 depressed, 85 nondisordered controls) completed a multistage screening and assessment process, which included a clinical interview, self, and informant report on behavior rating scales, performance and symptom validity measures, and an extensive neuropsychological testing battery. Results indicated that measures of working memory, sustained attention, response speed, and variability best discriminated ADHD and non-ADHD participants. While single test measures provided performed poorly in identifying ADHD participants, analyses revealed that a combined approach using self and informant symptom ratings, positive family history of ADHD, and a reaction time (RT) variability measure correctly classified 87% of cases. Findings suggest that neuropsychological test measures used in conjunction with other clinical assessments may enhance prediction of adult ADHD diagnoses

The Impact of Failing to Identify Suspect Effort in Patients Undergoing Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Assessment

This retrospective study examines how many adult patients would plausibly receive a diagnosis of attention-deficit/hyperactivity disorder (ADHD) if performance and symptom validity measures were not administered during neuropsychological evaluations. Five hundred fifty-four patients were extracted from an archival clinical dataset. A total of 102 were diagnosed with ADHD based on cognitive testing, behavior rating scales, effort testing, and clinical interview; 115 were identified as putting forth suspect effort in accordance with the Slick, Sherman, and Iverson (1999) criteria. From a clinical decision-making perspective, suspect effort and ADHD groups were nearly indistinguishable on ADHD behavior, executive function, and functional impairment rating scales, as well as on cognitive testing and key clinical interview questions. These results suggest that a significant percentage of those making a suspect effort will be diagnosed with ADHD using the most commonly employed assessment methods: an interview alone (71%); an interview and ADHD behavior rating scales combined (65%); and an interview, behavior rating scales, and most continuous performance tests combined (57%). This research makes clear that it is essential to evaluate task engagement and possible symptom amplification during clinical evaluations

Rates of executive dysfunction in undergraduate research participants

It is infrequently recognized that healthy individuals occasionally obtain impaired scores on neuropsychological measures. This research was conducted to determine how often healthy undergraduate research participants obtain impaired scores on popular measures of executive functioning. Specifically, performance on the Delis-Kaplan Executive Function System (D-KEFS) Trail Making and Color-Word Interference subtests was investigated in a sample of 335 undergraduate research participants. Rates of impaired performance varied across subtests and ranged from 11% (Color-Word Interference Word Reading) to 3% (Trail Making Test Motor Speed). In general, individuals with greater intellectual functioning had higher scores and fewer impaired scores. Findings are consistent with a broad literature describing the psychometric properties of neuropsychological measures. Researchers should recognize that it is relatively common to observe impaired scores in healthy research participants when interpreting research and clinical data

Young Women’s Knowledge About Fertility and Their Fertility Health Risk Factors

Objective To explore the relationships among young women’s demographic characteristics, their self-perceived and actual knowledge about fertility, and their fertility health risk factors. Design A quantitative, cross-sectional study. Setting Online survey. Participants Young women between the ages of 18 and 24 years (N = 342). Methods We used an online survey to collect data from young women regarding their demographic characteristics, their self-perceived and actual knowledge about fertility, and their fertility health risk factors. We used multiple linear regression to explore the relationships among these factors. Results Participants were mainly White, had some form of college education, and used a variety of contraception methods. Regression modeling indicated that participants’ self-perceived knowledge and actual knowledge about fertility and their methods of contraception were significantly associated with their fertility health risks (R2 = .13, p \u3c .001). Participants who had higher actual scores of knowledge about fertility and who used fertility awareness methods had fewer self-reported fertility health risk factors. A greater level of self-perceived knowledge about fertility was associated with more fertility health risk factors. Age, education level, and pregnancy history were not significantly associated with fertility health risks. Conclusion Our findings provide evidence that knowledge about fertility is important to enhance fertility self-care for young women. The significant relationship between young women’s knowledge about fertility and their fertility health risks highlights the need to assess their knowledge and teach them about fertility as important components of preconception care. Such education may help them avoid fertility health risks and protect young women’s current and future fertility

Neuropsychological evaluation of blast-related concussion: Illustrating the challenges and complexities through OEF/OIF case studies

Background/objective: Soldiers of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) sustain blast-related mild traumatic brain injury (concussion) with alarming regularity. This study discusses factors in addition to concussion, such as co-morbid psychological difficulty (e.g. post-traumatic stress) and symptom validity concerns that may complicate neuropsychological evaluation in the late stage of concussive injury. Case report: The study presents the complexities that accompany neuropsychological evaluation of blast concussion through discussion of three case reports of OEF/OIF personnel. Discussion: The authors emphasize uniform assessment of blast concussion, the importance of determining concussion severity according to acute-injury characteristics and elaborate upon non-concussion-related factors that may impact course of cognitive limitation. The authors conclude with a discussion of the need for future research examining the impact of blast concussion (particularly recurrent concussion) and neuropsychological performance

Evaluation Context Impacts Neuropsychological Performance of OEF/OIF Veterans with Reported Combat-Related Concussion

Although soldiers of Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) encounter combat-related concussion at an unprecedented rate, relatively few studies have examined how evaluation context, insufficient effort, and concussion history impact neuropsychological performances in the years following injury. The current study explores these issues in a sample of 119 U.S. veterans (OEF/OIF forensic concussion, n = 24; non-OEF/OIF forensic concussion, n = 20; OEF/OIF research concussion, n = 38; OEF/OIF research without concussion, n = 37). The OEF/OIF forensic concussion group exhibited significantly higher rates of insufficient effort relative to the OEF/OIF research concussion group, but a comparable rate of insufficient effort relative to the non-OEF/OIF forensic concussion group. After controlling for effort, the research concussion and the research non-concussion groups demonstrated comparable neuropsychological performance. Results highlight the importance of effort assessment among OEF/OIF and other veterans with concussion history, particularly in forensic contexts