RESUMEN
OBJECTIVE: Premorbid estimates of intellectual functioning are a key to assessment. This study aimed to compare 3 common measures and assess their accuracy: the Test of Premorbid Functioning (TOPF), Oklahoma Premorbid Intelligence Estimate (OPIE-3), and what is commonly referred to as the Barona equation. We also sought to provide appropriate adjustment considering the Flynn effect. METHOD: The sample consisted of a cross-section of 189 outpatient veterans receiving neuropsychological assessment including the TOPF and Wechsler Adult Intelligence Scale, 4th ed. (WAIS-IV). Paired sample t tests assessed differences between IQ models. Correlations for all models and actual WAIS-IV Full Scale IQ (FSIQ) to establish which model best predicted variance in current IQ. Mean differences were evaluated to establish how closely the models approximated WAIS-IV FSIQ. RESULTS: The Barona equation estimated higher premorbid IQ than TOPF Simple Demographics Model; however, differences between the models were nonsignificant after a Flynn effect correction for the Barona equation (.23 IQ points per year). The OPIE-3 correlated with FSIQ but overestimated the FSIQ, demonstrating the Flynn effect. TOPF performance models (include word reading) characterized the variance of IQ scores best, but the Flynn-adjusted Barona equation had the smallest mean difference from the actual WAIS-IV FSIQ of any prediction model. CONCLUSION: Demographic models for premorbid IQ accurately estimate IQ in adult populations when normed on the test used to measure IQ, or when adjusted for the Flynn effect. A Flynn-corrected Barona score provided a more accurate estimation of WAIS-IV FSIQ than the TOPF or the OPIE-3. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Asunto(s)
Algoritmos , Pruebas de Inteligencia , Modelos Psicológicos , Adulto , Anciano , Estudios Transversales , Demografía , Etnicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Veteranos , Escalas de WechslerRESUMEN
OBJECTIVE: Performance validity testing is an increasingly vital component of neuropsychological evaluation, though administration of stand-alone performance validity tests (PVTs) can be time-consuming. As the Test of Memory Malingering (TOMM) is among the most commonly used and researched PVTs, much work has focused on creating abbreviated versions while preserving diagnostic accuracy. A recent addition to this effort, errors on the first 10 items of Trial 1 (TOMMe10), was analyzed for its utility in predicting TOMM performance. METHOD: Subjects were 180 veterans seen on a long-term epilepsy monitoring unit. TOMM learning trials, Word Memory Test (WMT), and WAIS-IV Digit Span (for Reliable Digit Span; RDS) were administered as part of a larger battery. Performance invalidity was classified using established cut scores. Diagnostic classification statistics were calculated predicting TOMM, WMT, and RDS performance, including sensitivity, specificity, receiver operating characteristics (ROC), and positive and negative predictive values for multiple TOMMe10 cut scores. RESULTS: A cut score of ≥2 errors on TOMMe10 yielded the highest sensitivity (.88) while maintaining ≥.90 specificity when predicting TOMM (also supported by ROC analysis). This cut score was also optimal when validated against combinations of PVTs (e.g. two of TOMM, WMT, and RDS; WMT and/or RDS). CONCLUSIONS: TOMMe10 shows great promise in predicting future TOMM performance. In settings where time with patients is at a premium, ≥2 errors on TOMMe10 may be used as an early TOMM discontinue criteria, allowing examiners to use their limited time more effectively. The use of TOMMe10 in settings with varying TOMM failure base rates was discussed.
Asunto(s)
Epilepsia/psicología , Pacientes Internos/psicología , Simulación de Enfermedad/psicología , Pruebas de Memoria y Aprendizaje/normas , Veteranos/psicología , Adulto , Anciano , Epilepsia/diagnóstico , Epilepsia/epidemiología , Femenino , Hospitales de Veteranos/normas , Humanos , Masculino , Simulación de Enfermedad/diagnóstico , Simulación de Enfermedad/epidemiología , Memoria/fisiología , Persona de Mediana Edad , Pruebas Neuropsicológicas , Reproducibilidad de los Resultados , Factores de Tiempo , Estados Unidos/epidemiologíaRESUMEN
Previous research has suggested that a significant minority of patients with Alzheimer's disease (AD) exhibit asymmetric cognitive profiles (greater verbal than visuospatial impairment or vice versa) and that these patient subgroups may differ in demographic and other characteristics. Prior studies have been relatively small, and this investigation sought to examine correlates of asymmetry in a large patient sample (N = 438). Patients were classified into the following cognitive profile groups: low verbal, symmetric, and low visuospatial. Consistent with past research, 28.3% of participants were classified as having asymmetric cognitive profiles, with more participants in the low visuospatial subgroup. Low visuospatial participants were younger than members of the other subgroups, and low verbal participants performed worse on a measure estimating premorbid verbal intelligence. Findings regarding apolipoprotein E (ApoE) ε4 genotype were equivocal, although results provided some evidence for an effect of the É4 allele on cognitive asymmetry. These results suggest systematic differences between neuropsychological asymmetry profiles that support the possibility of distinct subgroups of the disease.