RESUMEN

INTRODUCTION: The development of population specific norms for the Automated Neuropsychological Assessment Metrics (ANAM) is to help expand the utility for use with other population groups. Currently, normative data are available for general military, special operations, athletic, and community populations. The current study provides normative reference values for use in assessing physicians. MATERIALS AND METHODS: Retrospective data from a sample of 2,288 physicians who completed the ANAM were examined. The data were gathered from practicing civilian physicians serving in the National Guard or Reserves who completed the assessment as part of the mandated Department of Defense clinical testing policy. The effects of age and sex on performance were examined for all subtests. Normative tables were stratified by age (23-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-79) and sex. Base rates of low scores among the physician population were also examined. RESULTS: Older age was associated with lower performance on all subtests with small-to-medium effect sizes. A mixed pattern of performance was observed as a factor of sex with females scoring better on one subtest and males scoring better on three subtests. However, effects sizes associated with sex were small and likely of minimal clinical significance. A total of 11.3% of the physician sample scored below average on two or more tests in the battery. CONCLUSIONS: This study provides normative data for practicing physicians that can be used to help inform clinical decision-making.

RESUMEN

The Automated Neuropsychological Assessment Metrics (ANAM) is one of the most widely used and validated neuropsychological instruments for assessing cognition. The ANAM Test System includes a reporting tool, the ANAM Validity Indicator Report that generates scores for the embedded effort measure, the ANAM Performance Validity Index (APVI). The current study seeks to develop a proxy for the APVI, using raw subtest summary test scores. This would be useful for situations where the APVI score is unavailable (e.g., validity report not generated at the time of the assessment) or when the item level data needed to generate this score are inaccessible. ANAM scores from a large data set of 1,000,000+ observations were used for this retrospective analysis. Results of linear regression analysis suggest that the APVI can be reasonably estimated from the raw subtest summary test scores that are presented on the ANAM Performance Report. Clinically, this means that an important step in the interpretation process, checking the validity of test data, can still be performed even when the APVI is not available.

Asunto(s)

Trastornos del Conocimiento , Humanos , Pruebas Neuropsicológicas , Estudios Retrospectivos , Trastornos del Conocimiento/psicología , Cognición , Reproducibilidad de los Resultados

RESUMEN

The current study tests the hypothesis that the "mountains and valleys pattern" (MVP) observed within the Attention and Concentration domain of the Meyers Neuropsychological Battery reflects the interference of emotional distress/anxiety on the patient's cognitive test performance. First, the MVP was objectively quantified using a formula that took into account both increased and decreased scores, rather than canceling them out through averaging. Using a total sample of 787 subjects, the Minnesota Multiphasic Personality Inventory-Second Edition Restructured Form (MMPI-2-RF) profile scores of cases with and without this pattern were then compared using an extensive database followed by a smaller, matched-groups design. The presence of the MVP was related to MMPI-2-RF test performance. In particular, this pattern was related to emotional distress/anxiety scales but was not related to scales reflecting neurological or cognitive complaints. The degree of emotional distress experienced may affect attention and concentration test performance in a way that sometimes heightens focus and at other times disrupts focus. The MVP may be used to assess the effects of emotional distress on the consistency of an individual patient's attention and concentration test performance.

Asunto(s)

Trastorno por Déficit de Atención con Hiperactividad/etiología , Trastornos de la Personalidad/etiología , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Lesiones Encefálicas , Femenino , Humanos , MMPI , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Trastornos de la Personalidad/diagnóstico , Trastornos de la Personalidad/psicología , Reproducibilidad de los Resultados

RESUMEN

This study presents a short form of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV; Wechsler, 2008 ) using the subtests (Block Design, Similarities, Digit Span, Arithmetic, Information, Coding, and Picture Completion) suggested by Ward ( 1990 ). These seven subtests were used to predict the full WAIS-IV Full-Scale IQ, as well as the Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed Index scores. Two different data sets were used: the first consisted of 70 subjects and the second consisted of 32 subjects. The first data set was used to create a linear regression and the second data set was used to validate the results and compare to the prorated score method from the WAIS-IV manual. The prorated estimated scores correlated significantly with their counterparts and proved to be a better method of estimating the Full-Scale IQ and most of the index scores, but the regression equation was better at predicting the Processing Speed Index. The current study is consistent with the Ward ( 1990 ) and Pilgrim, Meyers, Bayless, & Whetstone (1999) studies and represents a reliable and valid way of assessing intellectual functioning in an abbreviated format.

RESUMEN

In this study, we compared objective neuropsychological data using the Meyers Neuropsychological Battery (MNB; Meyers & Rohling, 2004 ) and self-report measures of emotional distress using the Symptom Checklist 90-Revised (SCL-90-R; Derogatis, 1994 ) with self-ratings of functional difficulties as measured by the Patient Competency Rating Scale (PCRS; Prigatano, 1986 ). The results showed a high correlation between the PCRS and scales on the SCL-90-R (r = .65), whereas correlation with the overall test battery mean of the MNB was quite small (r = .18). Our results indicate that self-report of cognitive difficulties is more related to current emotional distress than to objective measures. Therefore, any diagnostic considerations that rely on self-report need to be tempered by considerations of current emotional status. This has implications for diagnoses such as posttraumatic stress disorder and other diagnoses that rely on self-report as a source of diagnostic information.