Discrimination of schizophrenic and brain-injured patients by a standardized version of Luria's Neuropsychological Tests.

Examines the ability of a standardized battery of tests, the Luria-South Dakota Neuropsychological Test Battery, to discriminate between brain-injured and schizophrenic patients. An earlier study by the present authors (see record 1979-25087-001) reported 93% effectiveness for the standardized battery in discriminating brain-injured patients and normal controls. In the present study, the battery was administered to 50 schizophrenic, mean age 41.3 yrs, and 50 brain-injured patients, mean age 44.4 yrs. Chronicity was 121 mo for the schizophrenic group and 56 mo for the neurological patients. Of the 282 items in the battery, schizophrenics showed significantly better performance on 72 items. A discriminant analysis using 60 items demonstrated 100% diagnostic accuracy. Schizophrenics performed significantly better on 10 of 14 summary measures. A discriminant analysis using the 14 summary measures achieved 88% diagnostic accuracy. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Localization of cerebral dysfunction with a standardized version of Luria's Neuropsychological Battery.

Determined if the Luria-Nebraska Neuropsychological Battery, a standardized, comprehensive version by C. J. Golden et al (1979) of A. R. Luria's neuropsychological battery, can discriminate among patients with localized brain injuries. 24 right hemisphere and 36 left hemisphere patients were divided into 8 groups depending on hemisphere and location within the hemisphere (frontal, temporal, sensorimotor, or parietal–occipital). The average age of the sample was 42.5 yrs, with no significant differences in age or education among the groups. It was found that 14 summary scores derived from the Luria battery could identify clinical patterns characteristic of each group as well as suggest implications for modern theories of brain function. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hazards of a standardized neuropsychological test with low content validity: Comment on the Luria-Nebraska Neuropsychological Battery.

The Luria-Nebraska Neuropsychological Battery (LNNB) generates a profile of scaled scores presumed to measure specific neuropsychological functions. The scales of the battery have, however, been validated only for predicting "brain damage" per se and not for assessing the neuropsychological functions. Thus, achievement on a given scale may be erroneously associated with the integrity of the designated cognitive or motor function. The low content validity of LNNB scales precludes a valid assessment of the nature of a patient's neuropsychological functions. These problems promote clinical misinterpretation. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic validity of the Halstead-Reitan Neuropsychological Battery.

Conducted a validity study of the Halstead-Reitan Neuropsychological Battery which compared it with the more popular physical diagnostic techniques. Ss were 89 patients about whom empirical findings could be used as criteria for physical and neuropsychological measures. Results indicate that the neuropsychological procedure, considered as a screening device, surpassed all physical measures in all neuropathological categories. Use of physical measures in a negative sense to exclude possible neuropathological statements may provide spuriously low hit rates. Validity coefficients for the Battery in terms of lateralization and identification of process for different process classifications are presented. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic validity of the Luria-Nebraska Neuropsychological Battery—Children's Revision.

Compared the diagnostic validity of the Luria-Nebraska Neuropsychological Battery—Children's Revision (LNNB—C) and the Wechsler Intelligence Scale for Children—Revised (WISC—R) for 96 8–12 yr olds in 1 of 3 diagnostic groups: neurological, psychiatric, and normal controls. Interrater reliability was demonstrated. Separate stepwise discriminant analyses using 6 variables (subtest scores) selected by each test correctly classified 81% (LNNB—C) and 85% (WISC—R) of the psychiatric and neurological groups. No clear incremental validity for the use of the LNNB—C over the WISC—R was demonstrated. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminative validity of various intelligence and neuropsychological tests.

Compared the discriminative validities of the WAIS, the Halstead-Reitan Neuropsychological Test Battery (HRNTB), and the Luria-Nebraska Neuropsychological Battery (LNNB) with regard to predicting presence or absence of brain damage in 84 neuropsychiatric patients who were divided into brain-damaged (mean age 48.61 yrs) and non-brain-damaged (mean age 43.48 yrs) Ss. Discriminant analysis showed that percentages of correct classification were lower for the WAIS than for the other procedures. A hierarchical analysis indicated that the addition of variables from the HRNTB and LNNB procedures increased discriminative validity above what was obtained on the basis of the WAIS. The discriminative validities of the HRNTB and the LNNB procedures were essentially equal to each other. It is concluded that it is worthwhile to administer the HRNTB and the LNNB in doing neuropsychological assessments despite the reported high correlations between indices derived from these batteries and measures of general intellectual function. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of neuropsychological deficits in epilepsy using the Luria-Nebraska Neuropsychological Battery.

80 hospitalized patients, 22 diagnosed as having idiopathic seizures, 18 who developed epilepsy secondary to brain trauma or another CNS disorder, and 40 who demonstrated no evidence of CNS involvement, were given the Luria-Nebraska Neuropsychological Battery. Mean ages of Ss were 38.3, 35.2, and 41.1 yrs, respectively. Results demonstrate that the standardized Luria test may be useful in the evaluation of neuropsychological deficits in adult epileptics. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability and validity of standardized case management simulations.

Examined the reliability and validity of 3 computerized case management simulations in counseling, similar to patient management problems in medicine. The simulations depicted a 40-yr-old female with chronic back pain, a 22-yr-old female with a personality disorder, and a 51-yr-old male with alcoholism. The simulations were administered to a criterion sample of 15 experienced counseling practitioners (mean age 35.7 yrs) and to 3 additional samples (n?=?15 in each) representing high, moderate, and low levels of professional training/experience. The mean ages of these 3 groups were 27.7, 25.6, and 24.1 yrs, respectively. Alternate forms reliability coefficients were moderately high, and coefficients for composite scores based on all 3 simulations were somewhat higher. Significant relations were found between performance on the simulations and levels of training and experience. Results support the potential usefulness of standardized case management simulations in evaluating clinical problem-solving skills. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Wechsler Memory Scale—Revised within a comprehensive neuropsychological battery.

Performed 2 principal factor analyses to examine the construct validity of the Wechsler Memory Scale—Revised (WMS—R) and to determine whether abstraction and memory factors can be extracted from the Halstead-Reitan Neuropsychological Test Battery (HRNB) results. Results from 237 patients support the validity of the verbal memory, delayed recall, and attention and concentration indices of the WMS—R but not the visual memory indices. No separate abstraction factor was found, and none of the HRNB measures loaded substantially on the memory factors defined by WMS—R subtests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological differences among empirically derived clinical subtypes of schizophrenia.

Neuropsychological profile differences between empirically derived clinical subtypes of schizophrenia were examined. Two hundred five patients and 209 demographically matched controls were administered a neuropsychological battery examining 8 domains. Subtypes included negative, disorganized, paranoid, Schneiderian, and mild. All subtypes displayed a neuropsychological profile of generalized impairment with greater deficits in learning, memory, and attention. Results were suggestive of diffuse cognitive dysfunction in schizophrenia with more severe deficits in learning and memory relative to executive skills. This pattern of greater learning and memory impairment was pronounced for disorganized patients. In contrast, paranoid patients outperformed disorganized and negative patients in several domains. These findings reflect bilateral frontal–temporal dysfunction, particularly in disorganized and negative patients. Subtype differences highlight the importance of conceptualizing schizophrenia as a multifocal disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic validity statistics and the MCMI-III.

This article (a) describes and illustrates the nonredundant and clinically important information that may be obtained from 5 diagnostic validity statistics (DVSs): incremental validities of positive and negative test diagnoses, Cohen's kappas, Cohen's effect sizes, and areas under receiver operating characteristic (ROC) curves and (b) determines values of these DVSs for 24 Millon Multiaxial Clinical Inventory III scales from results reported in 1994 and 1997 validity studies. The DVSs for the 1997 study (T. Millon, R. Davis, & C. Millon, 1997) were often more than 3 times larger than corresponding DVSs for the 1994 study (T. Millon, 1994). The author suggests these large differences could reflect not only effects of factors that caused underestimation of validities by DVSs of the 1994 study, but also effects of factors that may have caused overestimation of validities by DVSs of the 1997 study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting Age-Related Dual-Task Effects With Individual Differences on Neuropsychological Tests.

This study examined the relation of dual-task performance to individual differences on neuropsychological tests. Neuropsychological test scores from 16 young and 16 older participants were simultaneously submitted to a factor analysis that yielded 2 factors (Attention/Executive and Memory) that differed by age and 2 (Motor Speed and Cognitive Status) that did not. Regression analyses revealed that these factors were significant predictors of performance on a delayed visual recognition task, but the relationship varied as a function of task condition. The Memory and Motor Speed factors were the strongest predictors of single-task performance, but the Attention/Executive factor was the most important predictor of dual-task performance. The authors conclude that compromised central executive may underlie age-related decline in dual-task performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic accuracy of four approaches to interpreting neuropsychological test data.

The diagnostic accuracy of 4 approaches to interpreting neuropsychological test results are evaluated in 672 cognitively normal and 407 cognitively impaired persons using the Mayo Cognitive Factor Scales (G. E. Smith et al., 1994). The interpretation approaches studied are absolute scores, difference scores, profile variability, and change scores at 1- to 2-year test-retest intervals. All dependent measures were "highly significant" when diagnostic groups were compared on null hypothesis significance testing analyses. In contrast, varied accuracy rates were obtained when each measure's ability to correctly classify individuals was evaluated relative to overall diagnostic accuracy. Odds ratios were also highly varied and ranged from ≤ 1.0 (i.e., chance) to 34.9. The clinical usefulness of absolute scores and difference scores in data interpretation is supported. Neither profile variability measures nor measures of change over time were diagnostically useful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent structure and factorial invariance of a neuropsychological test battery for the study of preclinical Alzheimer's disease.

Objective: To examine the latent structure of a test battery currently being used in a longitudinal study of asymptomatic middle-aged adults with a parental history of Alzheimer's disease (AD) and test the invariance of the factor solution across subgroups defined by selected demographic variables and known genetic risk factors for AD. Method: An exploratory factor analysis (EFA) and a sequence of confirmatory factor analyses (CFA) were conducted on 24 neuropsychological measures selected to provide a comprehensive estimate of cognitive abilities most likely to be affected in preclinical AD. Once the underlying latent model was defined and the structural validity established through model comparisons, a multigroup confirmatory factor analysis model was used to test for factorial invariance across groups. Results: The EFA solution revealed a factor structure consisting of five constructs: verbal ability, visuospatial ability, speed & executive function, working memory, and verbal learning & memory. The CFA models provided support for the hypothesized 5-factor structure. Results indicated factorial invariance of the model across all groups examined. Conclusions: Collectively, the results suggested a relatively strong psychometric basis for using the factor structure in clinical samples that match the characteristics of this cohort. This confirmed an invariant factor structure should prove useful in research aimed to detect the earliest cognitive signature of preclinical AD in similar middle aged cohorts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current and emergent applications of neuropsychological assessment: Problems of validity and utility.

The author argues that the knowledge base in support of applying neuropsychological data to the assessment of functional competence and rehabilitation potential is not extensive. Clinical neuropsychology will have to develop new assessment concepts and methods. Reasons for the shift from a neurodiagnostic to a functional emphasis are reviewed. The author proposes a simple framework whereby assessment is referenced to different problems: medical, ecological, and rehabilitative. Within this framework, assessments vary in terms of validity and utility. Empirical examples are given to illustrate weaknesses in traditional assessment approaches. These weaknesses are analyzed in light of recent research and the implications of a problem-referenced strategy for the future development of clinical and professional neuropsychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative diagnostic accuracy of the Halstead-Reitan and standardized Luria-Nebraska neuropsychological batteries in a mixed psychiatric and brain-damaged population.

Compared the diagnostic accuracies of the Halstead-Reitan Neuropsychological Test Battery and the standardized Luria-Nebraska Neuropsychological Test Battery in 23 brain damaged and 24 psychiatric adults whose mean age was 35.25 yrs. All Ss were given both tests and classified as either brain-damaged or psychiatric by experienced raters. The hit rates obtained using the different batteries were comparable (approximately 80%) and in line with those obtained in previous research. It is concluded that the standardized Luria-Nebraska battery appears promising. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early neuropsychological impairment in HIV-seropositive intravenous drug users: evidence from the Italian Multicentre Neuropsychological HIV Study

The purpose of this study was to document the emetogenic potential of intrathecal chemotherapy (IC) in children and to evaluate the efficacy of ondansetron in reducing nausea and vomiting with this chemotherapy treatment. Patients less than 18 years of age with acute lymphoblastic leukemia were eligible to participate in a survey project measuring the emetogenic potential of various chemotherapy treatments. Patients surveyed for 1 or more IC treatments were included in this report. The IC consisted of methotrexate, hydrocortisone and cytarabine, dosed according to patient age. A nausea/vomiting survey instrument was completed by each patient and/or parent following IC treatment. The instrument rated nausea, vomiting and daily activity interference (DAI) on a 4-point scale of 0 = none, 1 = mild, 2 = moderate and 3 = severe, and collected data on the number of vomiting and/or retching episodes in addition to the child's appetite following the chemotherapy treatment. When ondansetron was employed, it was administered in an i.v. infusion at a dose of 0.15 mg/kg before and after chemotherapy or as an oral dose of 4 mg or 8 mg before chemotherapy. Courses of IC without antiemetics were analyzed to determine the emetogenic potential of IC. For patients receiving IC both with and without ondansetron, courses were compared with each patient used as their own control to determine the influence of ondansetron upon survey responses. Statistical analysis consisted of nonparametric Friedman 2-way ANOVA for ordinal variables and a paired t-test for continuous variables. The binomial test was employed to analyze for differences between ondansetron and no antiemetic in the number of patients with complete control of both nausea and vomiting or vomiting alone. A total of 63 children with a mean age of 7.6 +/- 4.2 years were each studied on one or more occasions. Thirty-seven children were surveyed for 87 IC treatments without antiemetics (group I), and 17 children from this group were surveyed for 48 IC courses with i.v. ondansetron (group IA). An additional 18 children were subsequently surveyed for 39 IC courses with i.v. ondansetron (group II). Fifteen patients (7 of whom were members of group I) were surveyed following 33 IC courses with oral ondansetron (group III). The survey scores for group I patients were: nausea severity 1.3 +/- 1.1, vomiting severity 1.2 +/- 1.1, DAI 1.2 +/- 1.0 and mean number of emetic episodes 4.7 +/- 8.4. The mean appetite score was 1.5 +/- 1.1. For patients in group IA, nausea severity (0.8 +/- 0.9), vomiting severity (0.5 +/- 0.8), DAI (0.7 +/- 0.8), and the number of emetic episodes (1.4 +/- 2.8) were all significantly lower than with prior IC treatments without ondansetron. For complete protection, children receiving i.v. ondansetron had greater complete protection rates from both nausea and vomiting or vomiting alone than did patients receiving no antiemetic. Survey responses were also lower for patients receiving oral ondansetron, but insufficient control data did not allow for statistical analysis. IC results in mild to moderate nausea and vomiting in children. The emetogenic potential of IC is significantly reduced by i.v. ondansetron.     

Diagnostic Interview for Borderlines: Psychometric properties and validity.

The Diagnostic Interview for Borderlines (DIB) developed by J. G. Gunderson and J. E. Kolb (1976) performed well in distinguishing 59 patients with Diagnostic and Statistical Manual of Mental Disorders (DSM-III) diagnoses of borderline personality disorder from 31 psychotic inpatients and 50 personality-disordered outpatients (ages 16–55 yrs). However, there was no evidence to support the psychometric rationale for combining the 29 statements used to assess the borderline construct into the 5 area scores (social adaptation, impulse, affects, psychosis, and interpersonal relations) presently utilized in making a DIB borderline diagnosis. Findings do not replicate a previous discriminant function model (Gunderson and Kolb; see record 1979-23763-001) and suggest that further improvements in the construct validity of the DIB will require a clearer delineation of the features of the construct as well as additional studies of the psychometric properties of the present instrument. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the structure of a neuropsychological battery across healthy elders and those with questionable dementia and Alzheimer's disease.

An exploratory factor analysis (EFA) and a series of confirmatory factor analyses were conducted on 17 variables designed to assess different cognitive abilities in a sample of healthy older adults. In the EFA, 4 factors emerged corresponding to language, memory, processing speed, and fluid ability constructs. The results of the confirmatory factor analyses suggested that a 5-factor model with an additional Attention factor improved the fit. The invariance of the 5-factor model was examined across 3 groups: a group of cognitively healthy older adults, a group of patients diagnosed with questionable dementia (QD), and a group of patients diagnosed with probable Alzheimer's disease (AD). Results of the invariance analysis suggest that the model may have configural invariance across the 3 groups but not metric invariance. Specifically, preliminary analyses suggest that the memory construct may represent something different in the QD and AD groups as compared to the healthy older adult group, consistent with the underlying pathology in early AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)