Cumulative False Positive Rates Given Multiple Performance Validity Tests: Commentary on Davis and Millis (2014) and Larrabee (2014)

Controversy has arisen over interpretation of performance validity tests (PVTs) when multiple PVTs are given. Some papers state that more stringent criteria are needed to judge overall performance as invalid, while others argue that concerns about the number of PVTs are overstated and that widely used criteria are appropriate. We examine theoretical models and assumptions, and analyze published data to determine the magnitude of effects implied by theory and observed in practice. Assertions advanced in the primary papers are examined for consistency with the empirical data. Existing theoretical models do not account well for the diverse empirical data, substantial empirical effects remain poorly understood, and the primary papers include assertions that are not empirically supported. The results indicate that: (a) neuropsychology lacks solid theoretical bases for estimating PVT failure rates given various combinations of PVTs, and thus needs to rely on empirical data; (b) existing empirical data fail to support the application of any uniform criteria across the broad range of scenarios involving multiple PVTs; and (c) practice should rely on empirical studies involving combinations of PVTs that have been studied together, in samples clearly appropriate to the individual case, using experimental designs germane to the questions under consideration

Developmental trajectories of joint attention

This study follows 40 children who were participants in a randomized controlled early intervention trial (Kasari et al.) from early childhood (2-5 years of age) to elementary school age (8-10 years). To fully utilize the available longitudinal data, the general linear mixed model was the primary analytical approach. The growth trajectories of joint attention skills (pointing, coordinated joint looking, and showing) and expressive language outcomes in these children were estimated based on five time points during the measurement period. The children were grouped by diagnosis at the last follow-up (autism, autism spectrum disorder (ASD), no diagnosis) and by their original treatment group assignment (joint attention, symbolic play, control), and differences between these groups were evaluated. Results showed that joint attention skills of coordinated joint looking and showing increased over time, and pointing to share interest increased over the first year measured and decreased thereafter. These trajectories were influenced by both original treatment assignment and diagnostic status at follow-up. In addition, a cross-lagged panel analysis revealed a causal relationship between early pointing and later language development. This study highlights the longitudinal and developmental importance of measures of early core deficits in autism, and suggests that both treatment and ASD symptomatology may influence growth in these skills over time

Cumulative False Positive Rates Given Multiple Performance Validity Tests: Commentary on Davis and Millis (2014) and Larrabee (2014)

Controversy has arisen over interpretation of performance validity tests (PVTs) when multiple PVTs are given. Some papers state that more stringent criteria are needed to judge overall performance as invalid, while others argue that concerns about the number of PVTs are overstated and that widely used criteria are appropriate. We examine theoretical models and assumptions, and analyze published data to determine the magnitude of effects implied by theory and observed in practice. Assertions advanced in the primary papers are examined for consistency with the empirical data. Existing theoretical models do not account well for the diverse empirical data, substantial empirical effects remain poorly understood, and the primary papers include assertions that are not empirically supported. The results indicate that: (a) neuropsychology lacks solid theoretical bases for estimating PVT failure rates given various combinations of PVTs, and thus needs to rely on empirical data; (b) existing empirical data fail to support the application of any uniform criteria across the broad range of scenarios involving multiple PVTs; and (c) practice should rely on empirical studies involving combinations of PVTs that have been studied together, in samples clearly appropriate to the individual case, using experimental designs germane to the questions under consideration

Cigarette exposure, dependence, and craving are related to insula thickness in young adult smokers.

The age period spanning late adolescence to emergent adulthood is associated with the highest prevalence of cigarette smoking in the United States, and is also a time of continued brain development. Nonetheless, although prior research has shown group differences in brain structure associated with smoking status in adults, few studies have examined how smoking and associated behavioral states relate to brain structure in this age group. Neuroimaging and lesion studies have suggested that the insula, a cortical region that integrates heterogeneous signals about internal states and contributes to executive functions, plays an important role in cigarette smoking behavior. Using high-resolution structural magnetic resonance imaging, we therefore measured cortical thickness of the insula in 18 smokers and 24 nonsmokers between the ages of 16 and 21 years. There were no group differences in insula thickness, but cigarette exposure (pack-years) was negatively associated with thickness in right insula. Cigarette dependence and the urge to smoke were negatively related to cortical thickness in the right ventral anterior insula. Although the results do not demonstrate causation, they do suggest that there are effects of cigarette exposure on brain structure in young smokers, with a relatively short smoking history. It is possible that changes in the brain due to prolonged exposure or to the progression of dependence lead to more extensive structural changes, manifested in the reported group differences between adult smokers and nonsmokers. Structural integrity of the insula may have implications for predicting long-term cigarette smoking and problems with other substance abuse in this population

Do cognition and other person-level characteristics determine housing outcomes among homeless-experienced adults with serious mental illness?

Objective: Many persons with serious mental illness (SMI) who have experienced homelessness struggle to sustain stable and independent housing. We know little about determinants of this population's housing status. This study aimed to identify person-level determinants of housing status among homeless-experienced veterans with SMI, focused primarily on cognition. Method: We administered cross-sectional surveys and detailed cognitive assessments on a convenience sample of homeless-experienced veterans with SMI (n = 90); we also reviewed these participants' medical records. We captured person-level potential predictors of housing status (demographics, cognition, diagnoses, symptoms, and service utilization) and 2 years of retrospective housing history. Participants' housing status was conceptualized as the setting (stable housing, other sheltered settings, and streets) they lived in for >50% of the past 2 years. We used the chi-square test and analysis of variance to determine how potential predictors differed by housing status. We used recursive partitioning to identify the combination of potential predictors and corresponding scores that best-differentiated participants by housing status. Results: No between-groups differences (p < .05) in cognition, symptoms, or other person-level factors were found among participants grouped by housing status. Recursive partitioning did not yield a stable model to predict housing status from the potential predictor variables. Conclusions and Implications for Practice: These data suggest that clinical interventions addressing studied person-level factors (e.g., cognitive rehabilitation) may not affect housing status for homeless-experienced veterans. As housing is highly influenced by social determinants of health, policies, and practices that affect contextual factors (e.g., affordable housing supply) may be more likely to improve housing status. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Cognitive Assessment Interview (CAI): Validity as a co-primary measure of cognition across phases of schizophrenia

BackgroundProgress has been made in developing interview-based measures for the assessment of cognitive functioning, such as the Cognitive Assessment Interview (CAI), as co-primary measures that compliment objective neurocognitive assessments and daily functioning. However, a few questions remain, including whether the relationships with objective cognitive measures and daily functioning are high enough to justify the CAI as an co-primary measure and whether patient-only assessments are valid.MethodsParticipants were first-episode schizophrenia patients (n=60) and demographically-similar healthy controls (n=35), chronic schizophrenia patients (n=38) and demographically similar healthy controls (n=19). Participants were assessed at baseline with an interview-based measure of cognitive functioning (CAI), a test of objective cognitive functioning, functional capacity, and role functioning at baseline, and in the first episode patients again 6 months later (n=28).ResultsCAI ratings were correlated with objective cognitive functioning, functional capacity, and functional outcomes in first-episode schizophrenia patients at similar magnitudes as in chronic patients. Comparisons of first-episode and chronic patients with healthy controls indicated that the CAI sensitively detected deficits in schizophrenia. The relationship of CAI Patient-Only ratings with objective cognitive functioning, functional capacity, and daily functioning were comparable to CAI Rater scores that included informant information.ConclusionsThese results confirm in an independent sample the relationship of the CAI ratings with objectively measured cognition, functional capacity, and role functioning. Comparison of schizophrenia patients with healthy controls further validates the CAI as an co-primary measure of cognitive deficits. Also, CAI change scores were strongly related to objective cognitive change indicating sensitivity to change

Variability in Cognitive Task Performance in Early Adolescence Is Associated With Stronger Between-Network Anticorrelation and Future Attention Problems

BackgroundIntraindividual variability (IIV) during cognitive task performance is a key behavioral index of attention and a consistent marker of attention-deficit/hyperactivity disorder. In adults, lower IIV has been associated with anticorrelation between the default mode network (DMN) and dorsal attention network (DAN)-thought to underlie effective allocation of attention. However, whether these behavioral and neural markers of attention are 1) associated with each other and 2) can predict future attention-related deficits has not been examined in a developmental, population-based cohort.MethodsWe examined relationships at the baseline visit between IIV on 3 cognitive tasks, DMN-DAN anticorrelation, and parent-reported attention problems using data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,878 participants, ages 9 to 10 years, female = 47.8%). We also investigated whether behavioral and neural markers of attention at baseline predicted attention problems 1, 2, and 3 years later.ResultsAt baseline, greater DMN-DAN anticorrelation was associated with lower IIV across all 3 cognitive tasks (B = 0.22 to 0.25). Older age at baseline was associated with stronger DMN-DAN anticorrelation and lower IIV (B = -0.005 to -0.0004). Weaker DMN-DAN anticorrelation and IIV were cross-sectionally associated with attention problems (B = 1.41 to 7.63). Longitudinally, lower IIV at baseline was associated with less severe attention problems 1 to 3 years later, after accounting for baseline attention problems (B = 0.288 to 0.77).ConclusionsThe results suggest that IIV in early adolescence is associated with worsening attention problems in a representative cohort of U.S. youth. Attention deficits in early adolescence may be important for understanding and predicting future cognitive and clinical outcomes

Factors Associated With Premature Exits From Supported Housing

OBJECTIVE: Many homeless consumers who enroll in supported housing programs—which offer subsidized housing and supportive services—disengage prematurely, before placement in permanent community-based housing. This study explored factors associated with exiting a supported housing program before achieving housing placement. METHODS: With the use of administrative data, a roster was obtained for consumers enrolled in the Veterans Affairs (VA) Greater Los Angeles supported housing program from 2011 to 2012. Fewer (4%) consumers exited this program before achieving housing (“exiters”) compared with consumers described in national VA figures (18%). Exiters with available demographic data (N=51) were matched 1:1 on age, gender, marital status, and race-ethnicity with consumers housed through this program (“stayers,” N=51). Medical records were reviewed to compare diagnoses, health care utilization, housing histories, vocational history, and criminal justice involvement of exiters versus stayers. Exiters' housing outcomes were identified. Recursive partitioning identified variables that best differentiated exiters from stayers. RESULTS: Several factors were associated with premature exits from this supported housing program: residing in temporary housing on hospital grounds during program enrollment, poor adherence to outpatient care, substance use disorders, hepatitis C, chronic pain, justice involvement, frequent emergency department utilization, and medical-surgical admissions. The first of these factors and poor adherence to outpatient medical-surgical care best differentiated exiters from stayers. Moreover, >50% of exiters became street homeless or incarcerated after leaving the program. CONCLUSIONS: In that diverse social factors, diagnoses, and health care utilization patterns were associated with premature disengagement from supported housing, future research is needed to implement and evaluate rehabilitative services that address these factors, adapted to the context of supported housing