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Objective This study aimed to determine the predictive values of informant-reported memory decline (IMD) among subjective cognitive decline (SCD) older adults from a 7-year community-based cohort study. Method Ninety SCD participants were included. Demographic data and neuropsychological test scores at both baseline and 7-year follow-up were collected. Differences between SCD with IMD (+IMD) and SCD without IMD (−IMD) were compared. Logistic regression models were used to determine whether baseline IMD could predict diagnostic outcomes at 7-year follow-up. Results Forty-one percent of SCD adults had IMD. At baseline, the +IMD group showed more depressive symptoms (p  = 0.016) than the −IMD group. Furthermore, the Beijing-version Montreal Cognitive Assessment (MoCA), Digit Span Test-Forward, Visual Matching and Reasoning, and Wechsler Adult Intelligence Scale-RC Picture Completion (WAIS-PC) scores in the +IMD group were significantly lower than those in the −IMD group. Fifty-four percent of +IMD participants converted to mild cognitive impairment (MCI) or dementia at follow-up, and 22.6% of the −IMD participants converted to MCI. Follow-up Mini-Mental State Examination, MoCA, and Verbal Fluency Test scores of the +IMD group were significantly lower than those in the −IMD group. The +IMD group was more likely to progress to cognitive impairment at 7-year follow-up (OR = 3.361, p  = 0.028). Conclusions SCD participants with +IMD may have poorer cognition and are more likely to convert to cognitive impairment over time. Our long-term follow-up study confirmed the importance of informants' perceptions of SCD, which can help clinicians identify individuals at risk of cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives To describe the characteristics of patients receiving a clinical referral for neuropsychological evaluation in two Huntington's Disease Society of America Centers of Excellence (HDSA COE). In this exploratory pilot study, we used an empirically supported clinical neuropsychological battery to assess differences in cognitive performance between premanifest and manifest HD patient groups (compared with each other and normative expectations). Method Clinical data from 76 adult genetically confirmed patients referred for neuropsychological evaluations was retrospectively collected from two HDSA COEs. ANOVA and Chi-square tests were used to compare variables between pre-manifest (n  = 14) and manifest (n  = 62) groups for demographic, cognitive, neuropsychiatric, and disease severity variables. Results Our clinics serviced a disproportionate number of motor manifest patients. Six measures were excluded from analyses due to infrequent administration. The full WAIS-IV Digit Span was disproportionately administered to the manifest group. The premanifest group showed stronger cognitive performance with effect sizes in the large range on subtests of the WAIS-IV Digit Span, HVLT-R, SDMT, and verbal fluency. Conclusions This is the first study to assess an empirically supported neuropsychological research battery in a clinical setting with a relatively large sample size given the rarity of HD. The battery adequately captured areas of impairment across the disease spectrum. Application of the current battery with larger premanifest samples is warranted. [ABSTRACT FROM AUTHOR]

Objective: The Reliable Digit Span (RDS) is an embedded measure used to assess performance validity. The purpose of this study was to determine whether the RDS can be used with Spanish speakers from Latin America. Method: The Digit Span subtest of the Wechsler Adult Intelligence Scale-IV was administered to 66 Spanish-speaking patients, 66 English-speaking patients, and 30 Spanish-speaking normal controls. The Spanish-speaking patients had a mean age of 65.82 (standard deviation [SD] = 12.44) and mean education of 6.62 years (SD = 4.91), whereas the controls had a mean age of 48.27 (SD = 10.97) and mean education of 8.33 (SD = 3.04). The English-speaking patients had a mean age of 56.44 (SD = 13.53) and mean education of 12.14 (SD = 2.37). Results: The average RDS among the Spanish-speaking patients was 5.36 (SD = 1.27) and the average RDS among the controls was 5.90 (SD = 1.06). The mean RDS of the English-speaking patients was 7.83 (SD = 1.72). The modal RDS among Spanish-speaking patients was 5. The modal RDS among Spanish-speaking controls was also 5, though the distribution was bimodal in nature with nearly as many 7 s as 5 s. The modal RDS among the English-speaking patients was 7. Among patients with ≥9 years of education and controlling for age, there remained a significant difference between both language patient groups on the RDS (F(1, 79) = 30.85, p < .0001). Conclusions: These data suggest that the RDS may not be a valuable measure in assessing performance validity among monolingual Spanish speakers from Latin America, particularly among those with low levels of education. [ABSTRACT FROM AUTHOR]

Objective Reliable Digit Span (RDS), RDS-Revised (RDS-R), and age-corrected scaled score (ACSS) have been previously validated as embedded performance validity tests (PVTs) from the Wechsler Adult Intelligence Scale-IV Digit Span subtest (WAIS-IV DS). However, few studies have directly compared the relative utility of these and other proposed WAIS-IV DS validity indicators within a single sample. Method This study compared classification accuracies of 10 WAIS-IV DS indices in a mixed neuropsychiatric sample of 227 outpatients who completed a standardized neuropsychological battery. Participants with ≤1 PVT failures of the four, freestanding criterion PVTs constituted the valid group (n  = 181), whereas those with ≥2 PVT failures formed the invalid group (n  = 46). Among the valid group, 113 met criteria for mild cognitive impairment (MCI). Results Classification accuracies for all DS indicators were statistically significant across the overall sample and subsamples with and without MCI, apart from indices derived from the Forward trial in the MCI sample. DS Sequencing ACSS, working memory RDS (wmRDS), and DS ACSS emerged as the most effective predictors of validity status, with acceptable to excellent classification accuracy for the overall sample (AUCs = 0.792–0.816; 35%–50% sensitivity/88%–96% specificity). Conclusions Although most DS indices demonstrated clinical utility as embedded PVTs, DS Sequencing ACSS, wmRDS, and DS ACSS may be particularly robust to cognitive impairment, minimizing risk of false positive errors while identifying noncredible performance. Moreover, DS indices incorporating data from multiple trials (i.e. wmRDS, DS ACSS) also generally yielded greater classification accuracy than those derived from a single trial. [ABSTRACT FROM AUTHOR]

Background High-grade glioma (HGG) patients present with variable impairment in neurocognitive function (NCF). Based on that, isocitrate dehydrogenase 1 (IDH1) wild-type HGGs are more aggressive than IDH1 mutant-type ones, we hypothesized that patients with IDH1 wild-type HGG would exhibit more severe NCF deficits than their IDH1 mutant counterparts. Methods NCF was assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT), Digit Span (DS), and Controlled Word Association Test (COWAT) tests in 147 HGG patients preoperatively. Results Analyses between IDH1 groups revealed a significant difference on MMSE concentration component (p ≤.01), DS (p ≤.01), TMTB (p ≤.01), and COWAT (p ≤.01) scores, with the IDH1 wild group performing worse than the IDH1 mutant one. Age and tumor volume were inversely correlated with MMSE concentration component (r = −4.78, p <.01), and with MMSE concentration (r = −.401, p <.01), TMTB (r = −.328, p <.01), and COWAT phonemic scores (r = −.599, p <.01), respectively, but only for the IDH1 wild-type group. Analyses between age-matched subsamples of IDH1 groups revealed no age effect on NCF. Tumor grade showed nonsignificance on NCF (p >.05) between the 2 IDH1 mutation subgroups of grade IV tumor patients. On the contrary, grade III group showed a significant difference in TMTB (p <.01) and DS backwards (p <.01) between IDH1 subgroups, with the mutant one outperforming the IDH1 wild one. Conclusions Our findings indicate that IDH1 wild-type HGG patients present greater NCF impairment, in executive functions particularly, compared to IDH1 mutant ones, suggesting that tumor growth kinetics may play a more profound role than other tumor and demographic parameters in clinical NCF of HGG patients. [ABSTRACT FROM AUTHOR]

Objective This study examined the degree to which verbal and visuospatial memory abilities influence performance validity test (PVT) performance in a mixed clinical pediatric sample. Method Data from 252 consecutive clinical pediatric cases (M age=11.23 years, SD =4.02; 61.9% male) seen for outpatient neuropsychological assessment were collected. Measures of learning and memory (e.g. The California Verbal Learning Test-Children's Version; Child and Adolescent Memory Profile [ChAMP]), performance validity (Test of Memory Malingering Trial 1 [TOMM T1]; Wechsler Intelligence Scale for Children-Fifth Edition [WISC-V] or Wechsler Adult Intelligence Scale-Fourth Edition Digit Span indices; ChAMP Overall Validity Index), and intellectual abilities (e.g. WISC-V) were included. Results Learning/memory abilities were not significantly correlated with TOMM T1 and accounted for relatively little variance in overall TOMM T1 performance (i.e. ≤6%). Conversely, ChAMP Validity Index scores were significantly correlated with verbal and visual learning/memory abilities, and learning/memory accounted for significant variance in PVT performance (12%–26%). Verbal learning/memory performance accounted for 5%–16% of the variance across the Digit Span PVTs. No significant differences in TOMM T1 and Digit Span PVT scores emerged between verbal/visual learning/memory impairment groups. ChAMP validity scores were lower for the visual learning/memory impairment group relative to the nonimpaired group. Conclusions Findings highlight the utility of including PVTs as standard practice for pediatric populations, particularly when memory is a concern. Consistent with the adult literature, TOMM T1 outperformed other PVTs in its utility even among the diverse clinical sample with/without learning/memory impairment. In contrast, use of Digit Span indices appear to be best suited in the presence of visuospatial (but not verbal) learning/memory concerns. Finally, the ChAMP's embedded validity measure was most strongly impacted by learning/memory performance. [ABSTRACT FROM AUTHOR]

Objective To examine the factor structure and sociodemographic correlates of a battery of clinical neuropsychological tests administered in-home and via telephone. Method Participants included 280 healthy adults who completed a 35–40 min battery consisting of seven auditory-verbal neuropsychological tests (i.e. 10 variables) that included digit span, list learning and memory, prospective memory, verbal fluency, and oral trail making. Results After removing oral trail making part A, a three-factor model comprised of executive functions, memory and attention demonstrated the best fit to the data. Nevertheless, the shared variance between the nine remaining neuropsychological variables was also adequately explained by a single-factor model and a two-factor model comprised of executive functions and memory. Factor scores were variably associated with education, race/ethnicity, and IQ, but not with sex or age. Conclusions Findings provide preliminary support for the feasibility and factor structure and sociodemographic correlates of a brief telephone-based screening neuropsychological battery comprised mostly of commonly administered clinical measures. Future studies are needed to determine the test–retest reliability, sensitivity, and ecological relevance of this battery, as well as equivalency to in-person assessment. [ABSTRACT FROM AUTHOR]

Objective 85 years after the description of the Stroop interference effect, there is still a lack of consensus regarding the cognitive constructs underlying scores from standardized versions of the test. The present work aimed to clarify the cognitive mechanisms underlying direct (word-reading, color-naming, and color-word) and derived scores (interference, difference, ratio, and relative scores) from Golden's standardized version of the test. Method After a comprehensive review of the literature, five cognitive processes were selected for analysis: speed of visual search, phonemic verbal fluency, working memory, cognitive flexibility, and conflict monitoring. These constructs were operationalized by scoring five cognitive tasks (WAIS-IV Digit Symbol, phonemic verbal fluency [letter A], WAIS-IV Digit Span, TMT B-A, and reaction times to the incongruent condition of a computerized Stroop task, respectively). About 83 healthy individuals (mean age = 25.2 years) participated in the study. Correlation and regression analyses were used to clarify the contribution of the five cognitive processes on the prediction of Stroop scores. Results Data analyses revealed that Stroop word-reading reflected speed of visual search. Stroop color-naming reflected working memory and speed of visual search. Stroop color-word reflected working memory, conflict monitoring, and speed of visual search. Whereas the interference score was predicted by both conflict monitoring and working memory, the ratio score (color-word divided by color-naming) was predicted by conflict monitoring alone. Conclusion The present results will help neuropsychologists to interpret altered patient scores in terms of a failure of the cognitive mechanisms detailed here, benefitting from the solid background of preceding experimental work. [ABSTRACT FROM AUTHOR]

Introduction: One session of water-pipe tobacco smoking (WPS) can increase carboxyhemoglobin (COHb) to levels comparable to those reported in carbon monoxide poisoning, which may cause memory impairment and confusion.Methods: A prospective study evaluating healthy volunteers pre- and post-30 min of WPS session. Primary outcome parameters were executive cognitive measures [digit span test and Paced Auditory Serial Addition Test (PASAT)]. The effect of repeated cognitive testing 30 min apart without WPS was evaluated in age- and sex-matched healthy volunteers. Secondary outcome parameters included cardio-pulmonary, COHb, serum nicotine, and cytokine changes.Results: Thirty-five subjects aged 25.6 ± 4.5 years smoked water-pipe for a 30-min session. Control group included 20 subjects aged 25.2 ± 5.1 years. Digit span test median score decreased after WPS (16 and 15, respectively, p = .003), insignificant decrease in controls. Median PASAT score increased after WPS (49 and 52, respectively, p = .009); however, a much larger significant increase was observed in controls (p ≤ .001). One WPS session resulted in significant increases in heart and respiratory rates and significant decrease in FEF25-75%. Post WPS, median COHb levels increased (from 2.2% to 10.7%, p < .0001) as did median serum nicotine levels (from 1.2 to 26.8 ng/mL, p < .0001). Serum cytokines levels: IL-2 and IL-6 increased (p < .0001 for each), and IL-10 and IL-5 decreased (p < .0001 and p = .04, respectively).Conclusions: One session of WPS resulted in significant negative effects on cognitive executive measures, significant increases in COHb and serum nicotine levels, and significant changes in serum cytokines. Our findings call for increasing awareness towards the possible consequences of cognitive alterations following a 30-min session of WPS.Implications: One 30-min session of water-pipe smoking resulted in negative effects on executive cognitive measures, increased carboxyhemoglobin and serum nicotine, and significant changes in serum cytokine levels. This study adds to the accumulating evidence on the harmful effects of water-pipe smoking, a growing epidemic, and calls for awareness of its possible consequences of acute cognitive alterations. [ABSTRACT FROM AUTHOR]

Objective Accurate diagnosis of neuropsychological (NP) impairment in Spanish-speaking Latinx women is limited by a lack of appropriate norms. While multiple normative datasets have emerged for Mexican/Mexican-American populations, there is a particular dearth of normative options for Puerto Rican women. This study collected normative data in a sample of Spanish-speaking healthy women in Puerto Rico (PR). Participants and Method The sample consisted of 63 healthy, HIV-seronegative women recruited as comparison participants in a longitudinal HIV-seropositive Latinx Women Cohort study at the University of Puerto Rico during 2002-2017. The NP battery included measures from seven cognitive domains: verbal fluency, executive functioning, processing speed, learning, memory, sensory, perceptual, and motor skills. Results The sample's age ranged from 20-77 years (M = 42.14; SD = 12.71) and education ranged from 9-18 years (M = 13.74; SD = 2.09). The NP test M and SD raw score results were: Trail Making A (M = 41.29; SD = 14.87), Trail Making B (M = 105.14; SD = 49.77), Grooved Pegs Dominant Hand (M = 78.49; SD = 31.91), Stroop Word/Color (M = 47.86; SD = 23.66), Rey Verbal Learning Test Total (M = 42.0; SD = 9.36), Verbal Fluency FAS-F (M = 11.27; SD = 4.20), FAS-A (M = 12.05; SD=4.34), FAS-S (M = 10.67; SD = 4.19), Digit Span (M = 12.16; SD = 3.28), Spatial Span (M = 10.95; SD = 3.62), Benton Judgment of Line Orientation Test (M = 18.10; SD = 5.54), Finger Tapping Left (M = 50.58; SD = 7.78), Finger Tapping Right (M = 53.87; SD = 8.83), Seashore Rhythm Test (M = 23.38; SD = 3.99), and Rey Complex Figure Test Immediate (M = 13.17; SD = 6.99) and Delay (M = 13.58; SD = 7.21). The NP norms were stratified by age (10-year increments and 60+) and education (< 12 years and 12+ years). Conclusions This preliminary study provides initial normative data from a sample of healthy women living in PR, which can improve NP diagnostic accuracy for this population. This is particularly important given that this population experiences worse health outcomes compared to other Latinx subpopulations. [ABSTRACT FROM AUTHOR]

Objective: We examined the influence of acculturation on Generation Z (i.e., persons born between 1997–2004) adults' cognition. Methods: The sample consisted of 15 low-acculturated, 47 moderately-acculturated, and 28 high-acculturated Mexican participants residing in Mexico with a mean age of 20.86 (SD = 1.63). All participants completed the Word Accentuation Test, all the subtests of the Stroop Color Word Test (SCWT), Boston Naming Test, Phonemic Fluency Test (i.e., FAS), Semantic Fluency Test, the copy and long-delayed Rey–Osterrieth Complex Figure (ROCF) tasks, all the subtests of the Digit Span, and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. The AMAS was used to categorize acculturation groups. ANOVA's were used to evaluate neuropsychological performance between our acculturation groups. Results: We found the low-acculturation and moderately acculturation groups outperformed the high-acculturation group on the SCWT reading and color-word tasks, p's < 0.05, np's2 = 0.09–0.10. Results also revealed the high-acculturation group outperformed the low-acculturation and moderately acculturation groups on the Semantic Fluency Test, p = 0.002, np2 = 0.14. Finally, the low-acculturation group outperformed the high-acculturation group on the ROCF copy task, p = 0.042, np2 = 0.07. Conclusions: Our data suggests that Generation Z Mexicans' level of acculturation influences their cognition. A possible explanation can be time perspective, where perception of time is influencing cognition to select and pursue certain goals, cognition, and motivation. Future studies using larger sample sizes should investigate the intersection of time perspective and acculturation on Generation Z adults' cognition. More research that evaluates how acculturation influences cognition will help researchers and clinicians understand Spanish speakers' cognition from a generational cohort perspective. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to cross-validate recent research on three embedded performance validity tests (PVTs) in a Spanish-speaking Mexican sample. Method: The sample consisted of 52 male and 77 female participants residing in Mexico with a mean age of 25.26 (SD = 10.45). Participants were neurologically and psychologically healthy and completed a neuropsychological battery in Spanish. The Reliable Digit Span, Phonemic Fluency Test (i.e., FAS), and Semantic Fluency Tests were used to evaluate failure rates in our sample. Daugherty and colleagues' (2022) PVT cutoff scores were used. Chi-square analysis was used to evaluate failure rates between the groups. Results: Chi-square analysis revealed no significant failure rate differences between gender groups on any PVTs. However, we found that 12% of the male group failed the Phonemic Fluency Test compared to 5% of the female group, X2 = 1.747, p = 0.186. Meanwhile, 2% of the male group failed the Semantic Fluency Test compared to 0% of the female group, X2 = 1.492, p = 0.222. Finally, 6% of the male group failed the Reliable Digit Span compared to 17% of the female group, X2 = 3.529, p = 0.060. Conclusions: Our data shows that male participants demonstrate higher failure rates on verbal fluency tasks than females. Moreover, males had lower failure rates compared to females on Reliable Digit Span. Further exploration with bigger sample sizes is needed to explore what may be influencing validity test performance between gender groups. More studies in this area will help researchers and clinicians determine if persons completing cognitive tasks in Spanish are proving adequate effort. [ABSTRACT FROM AUTHOR]

Objective: Cross-linguistic evidence suggests that the word length effect (WLE; rate of syllables, phonemes, or pronunciation times per word) significantly contributes to capacity estimates in the storage, but not manipulation, phase of verbal working memory (WM). However, the role of the WLE on WM limits across these phases has not been reported in monolingual Spanish-speakers. Method: Latin American-born, monolingual Spanish-speakers (N = 84) age 18–65 were administered forward and backward directions of the digit span test across three cognitive load conditions of Spanish syllabic word length: Mexican WAIS-IV Digit Span ("Standard Load"), and two modified measures with relative ~20% decrease ("Low Load") or ~ 20% increase ("High Load") in total syllables/digit. Results: A reverse WLE was observed during storage WM (digit span forward), where Spanish-speakers attained higher capacity estimates (p < 0.01) in High Load relative to Low Load syllabic word length. The WLE was detected during manipulation WM (digit span backward), where lower capacity limits (p < 0.001) were observed in the High Load, compared to Standard Load, condition. Conclusions: Unexpectedly, high loads did not yield a WLE in the storage phase, but evidence of the WLE was present in the manipulation phase. Executive-function mnemonic strategies (chunking) may have superseded the role of a WLE on storage memory, whereas a traditional WLE was observed when chunking strategies were more difficult to implement during manipulation memory. These findings aim to reduce cultural disparities in estimates of WM performance in neurocognitive and neuropsychological research with Hispanics. [ABSTRACT FROM AUTHOR]

Objective: Working memory (WM) function requires attentional focus and resisting distracting stimuli (i.e., resistance to attentional capture [RAC]). People with histories of mild traumatic brain injury (mTBI) or posttraumatic stress (PTSD) often report difficulties with WM and attention. To better understand the relationship between these two executive functions, we collected neuropsychological and electrophysiological data from a sample of individuals with PTSD and/or mTBI. Methods: We characterized WM function in 128 US military veterans (61 controls, 22 PTSD, 24 mTBI, 21 PTSD and mTBI) using the WAIS-IV Digit Span (DS). To examine RAC we completed electroencephalography recordings during an Erikson Flanker task. Flanker task trials were coded as either Congruent (flanker stimuli same direction as target) or Incongruent (opposite direction). We characterized the P1 event-related potential which has shown sensitivity to RAC. Results: There was an interaction between Flanker Type and DS such that poorer WM performance was related to greater difficulties on Incongruent trials. Analyses of P1 amplitude revealed an interaction between DS scores and P1 amplitude with better DS performance related to larger P1 amplitudes in trials with Incongruent compared to Congruent flankers. There was also an interaction between PTSD and Flanker Type such that PTSD was associated with larger P1 amplitudes for Incongruent than Congruent flanker trials. Conclusions: Our observations suggest greater RAC aids in WM function, and is also associated with early perception-related brain responses (i.e., P1) that modulate with demands to resist distracting stimuli. Our results also suggest PTSD is related to electrophysiological functions tied to RAC. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the influence of depression on cognition in a healthy Mexican Spanish speaking population. Methods: The sample consisted of 41 Mexican adolescents all residing in Mexico with a mean age of 18.59 (SD = 0.50). They were divided into two depression groups: normal symptoms of depression (NSD; n = 26) and abnormal symptoms of depression (ASD; n = 15). Participants completed the Word Accentuation Test, all the subtests of the Stroop Color Word Test (SCWT), Boston Naming Test, Phonemic Fluency Test (i.e., FAS), Semantic Fluency Test, Rey–Osterrieth Complex Figure, and all the subtests of the Digit Span in Spanish. Additionally, participants completed the Hospital Anxiety and Depression Scale in Spanish to report their current level of depression. Independent Sample T-tests were used to examine cognition performance. We used a threshold of p < 0.05 for statistical significance. Results: Results revealed the NSD group outperformed the ASD group on the SCWT-Color, Phonemic Fluency Test, Semantic Fluency Test, Boston Naming Test, and Digit Span backwards tasks, p's < 0.05. Conclusions: As expected, the NSD group demonstrated better cognitive abilities compared to the ASD group. Our data suggests that the current level of depression had a significant influence on cognitive abilities in an adolescent Spanish speaking population. Future studies with larger sample size should evaluate if current symptoms of depression influence non-verbal cognitive abilities in a Spanish speaking Mexican population. More research that evaluates both verbal and non-verbal abilities will help researchers and clinicians determine if current level of depression influences Spanish speaking adolescents' cognition. [ABSTRACT FROM AUTHOR]

Objective: Patient's bilingual status has significant implications for neuropsychological assessment, namely, performance validity. However, linguistic diversity has made the evaluation of non-credible performance difficult for clinicians and researchers alike. The goal of this research is to supplement the current understanding of Hispanic bilingual individuals' performance on a commonly administered working memory task. Method: Participants included 82 Hispanic, Spanish-English bilingual adults. (Age: Education: M = 15.68, SD = 2.26; Gender: Female (n = 44; 53.7%). Measures included the Wechsler Adult Intelligence Scale –Fourth Edition (WAIS-IV) Digit Span subtest and Language and Social Background Questionnaire (LSBQ). Participants were collected via snowball sampling method within the general community and social media, i.e., Twitter, LinkedIn. Participants were administered Digit Span in English. Results: Statistical analyses indicate 2.4% of participants met failure rate criteria for Reliable Digit Span (RDS; ≤ 7) and 1.2% of participants for Reliable Digit Span - Revised (RDS-R; ≤ 11). Conclusion(s): Results suggest highly educated Hispanic Spanish-English bilingual individuals perform within the expected range when using traditional cut-off scores of embedded performance validity measures for the Digit Span subtest. [ABSTRACT FROM AUTHOR]

Objective: Novel performance validity tests (PVTs) for the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R), derived from infrequent patterns of performance (IPOP), were developed to examine invalid memory performance while reducing false positive misclassification. To examine their classification accuracy, these indicators were compared to several existing embedded PVTs in a mixed clinical sample. Method: A chart review was completed for 75 adult outpatients (Mean Age = 52, Range = 19–85) referred to an academic medical center outpatient clinic for neuropsychological evaluation. Twenty-eight percent of the sample failed the Medical Symptom Validity Test (MSVT), which was used as the criterion to indicate invalid performance. Several established embedded validity indicators were calculated from HVLT-R and BVMT-R scores, including the recognition discrimination index (RDI) and percent retention (PR), as well as the Reliable Digit Span (RDS) validity indicator. Classification statistics, including sensitivity, specific, likelihood ratios, predictive values, and overall accuracy, were calculated and compared. Results: The HVLT-R IPOP had a higher overall classification accuracy (72%) compared to the RDI indicator (68%) while maintaining excellent specificity (97%). The BVMT-R IPOP had identical classification accuracy (75%) compared to the RDI and PR indicators with very high specificity (96%). Both indicators were more accurate than RDS (72%). Conclusions: The HVLT-R and BVMT-R IPOP performance validity indicators produced adequate classification statistics when compared to existing embedded PVTs. Both indicators maintained excellent specificity, which is crucial in reducing false positive classification. Future research will focus on further examining the validity of these indicators in other clinical groups and known groups, including medico-legal populations. [ABSTRACT FROM AUTHOR]

Objective: This study examined the relationship between Posttraumatic Stress Disorder (PTSD) symptom severity and cognitive test performance in veterans, hypothesizing that PTSD Checklist for DSM-5 (PCL-5) scores would be correlated with test performance on commonly used neuropsychological measures. Method: Clinically-referred veterans without a neurocognitive disorder who passed the Test of Memory Malingering (TOMM), completed the PCL-5, and completed Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span or Coding, Weschler Memory Scale-Fourth Edition (WMS-IV) Logical Memory (LMI/LMII), letter fluency (FAS), or Trail Making Test (Parts A and B) were included. The sample included 38 veterans (81.6% male); mean age = 58.79 (SD = 14.71; range 22–80) and mean education level = 13.97 years (SD = 2.42, range 6–20). Primary diagnoses included PTSD (47.4%), depression (21.1%), and no diagnosis (23.7%). Pearson, Spearman, and partial correlations were calculated. Results: Moderate negative correlations were found between PCL-5 and FAS raw scores (r = −0.41, p = 0.014; 95%CI [−0.654,-0.089]) and LMI raw scores (r = −0.453, p = 0.02; 95%CI [−0.715,-0.080]). After controlling for age and education, moderate negative correlations remained for FAS (r = −0.46, p = 0.004) and LMI (r = −0.43, p = 0.018) and a weak, non-significant correlation with LMII (r = −0.297, p = 0.079). Conclusions: In veterans with valid cognitive test performance and no neurocognitive disorder, PTSD symptom severity negatively correlated with FAS and WMS-IV LM performance. This suggests PTSD symptoms may influence performance on phonemic fluency and story recall task. Assessing and addressing PTSD symptoms may result in more accurate diagnoses and improved cognitive functioning. Understanding the PTSD-cognition relationship can inform interventions and support strategies to enhance veterans' quality of life. [ABSTRACT FROM AUTHOR]

Objective: In the United States (U.S.), educational experiences can be wide-ranging. We examine educational experiences in an Alzheimer's disease (ad) research cohort to understand how the representation and distribution of these experiences may affect the generalizability of conclusions in ad research. Method: An online survey was administered to cognitively unimpaired participants (n = 135) in the UPenn ad Research Center clinical cohort. Self-report questionnaires gather sociodemographic data, including age, race, disability, education, and schooling. We report comparisons to U.S. educational attainment and examine correlations between education variables and executive function as measured by trail making test (TMT) B and digit span backward. Results: The sample of 135 older adults averaged 74 years old, had about 17 years of schooling, and were mostly women (61%). All had at least a high school degree. About 11% had a high school diploma, about 8% had an associate's degree, 24% had a 4-year college degree, 33% had a master's degree, and over 20% had professional degrees. The distribution of educational attainment is not representative of the U.S. older adult population. More education associates with higher performance on TMT-B and digit span (both p < 0.008), particularly among those with the highest attainment. Conclusion: Our findings suggest older adults enrolled in ad research have more education than the U.S. older adult population and a range of experiences in their schooling. We discuss three ways that the underlying distribution of educational experiences may affect the generalizability of conclusions drawn from ad research cohorts. [ABSTRACT FROM AUTHOR]

Purpose Performance validity testing (PVT) provides information about response bias in neuropsychological testing. Adult football players have increased risk of invalid performance on baseline testing, perhaps due to wanting to resume play following concussion. Youth athletes have shown similar behavior, yet youth football players remain under-studied. This study examined which PVTs have the best utility for youth athletes. Methods Three univariate analyses of covariance compared mean baseline test performance on three PVT's (Rey-15 item test combined, TOMM Trial 1, and Reliable Digit Span) in a youth athlete baseline evaluation sample (n=143, 79.9% male) ages 8-18 (mean=11.94) who played football (n=79) to those who played other sports (n=64). Gender was included as a covariate. Results Mean scores on TOMM trial 1 for youth football players were significantly lower than athletes who did not play football (M=45.96, 47.81, respectively, p=.033). There were no group differences on the RDS or Rey-15 item tests (p=.14,.88, respectively). Further, five football players failed TOMM trial 1, compared to one non-football player. Conclusions These results may indicate that the TOMM is more sensitive to validity performance in youth football players, compared to RDS and Rey-15. Youth may benefit from increased education on the consequences of premature return to play and importance of optimal performance on baseline testing. Continued research on PVTs for youth may help neuropsychologists make more informed decisions on PVT selection. [ABSTRACT FROM AUTHOR]

Motivation: The accuracy of predicting protein local and global structural properties such as secondary structure and solvent accessible surface area has been stagnant for many years because of the challenge of accounting for non-local interactions between amino acid residues that are close in three-dimensional structural space but far from each other in their sequence positions. All existing machine-learning techniques relied on a sliding window of 10-20 amino acid residues to capture some 'short to intermediate' non-local interactions. Here, we employed Long Short-Term Memory (LSTM) Bidirectional Recurrent Neural Networks (BRNNs) which are capable of capturing long range interactions without using a window. Results: We showed that the application of LSTM-BRNN to the prediction of protein structural properties makes the most significant improvement for residues with the most long-range contacts (ji-jj>19) over a previous window-based, deep-learning method SPIDER2. Capturing long-range interactions allows the accuracy of three-state secondary structure prediction to reach 84% and the correlation coefficient between predicted and actual solvent accessible surface areas to reach 0.80, plus a reduction of 5%, 10%, 5% and 10% in the mean absolute error for backbone φ, ψ, θ and τ angles, respectively, from SPIDER2. More significantly, 27% of 182724 40-residue models directly constructed from predicted Cx atom-based θ and τ have similar structures to their corresponding native structures (6A° RMSD or less), which is 3% better than models built by φ and ψ angles. We expect the method to be useful for assisting protein structure and function prediction. [ABSTRACT FROM AUTHOR]

Objective: The Reliable Digit Span (RDS) is a well-validated embedded indicator of performance validity. An RDS score of ≤7 is commonly referenced as indicative of invalid performance; however, few studies have examined the classification accuracy of the RDS among individuals suspected for dementia. The current study evaluated performance of the RDS in a clinical sample of 934 non-litigating individuals presenting to an outpatient memory disorders clinic for assessment of dementia. Method: The RDS was calculated for each participant in the context of a comprehensive neuropsychological assessment completed as part of routine clinical care. Score distributions were examined to establish the base rate of below criterion performance for RDS cutoffs of ≤7, ≤6, and ≤5. One-way ANOVA was used to compare performance on a cognitive screening measure and informant reports of functional independence of those falling below and above cutoffs. Results: A cutoff score of ≤7 resulted in a high prevalence of below-criterion performance (29.7%), though an RDS of ≤6 was associated with fewer below-criterion scores (12.8%) and prevalence of an RDS of ≤5 was infrequent (4.3%). Those scoring below cutoffs performed worse on cognitive measures compared with those falling above cutoffs. Conclusions: Using the RDS as a measure of performance validity among individuals presenting with a possibility of dementia increases the risk of misinterpreting genuine cognitive impairment as invalid performance when higher cutoffs are used; lower cutoffs may be useful when interpreted in conjunction with other measures of performance validity. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to assess the corpus callosum microstructural changes in children with memory related learning disability. Methods: DTI was performed in 20 patients with memory related learning disabilities (MRLD +) and 22 matched healthy control subjects (MRLD -) aged 7– 13 years. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for corpus callosum. Comparison between patients with memory related learning disabilities (MRLD +) and healthy control subjects (MRLD -) was performed. DTI metrics were correlated to clinical digit span backward scores in (MRLD +) group. A pvalue less than .05 was considered significant. Results: The corpus callosum showed a highly significant higher FA and lower diffusivity indices in (MRLD +) group compared to the (MRLD -) group (p < 0.001). No significant correlation between the clinical test “digit span backward” scores and DTI metrics of the corpus callosum was found. Conclusion: Changes in DTI metrics of corpus callosum in patients with memory related learning disabilities reflects white matter micro-structural changes. Higher FA values and lower diffusivity indices do not necessarily indicate healthier white matter but, can indicate pathology. [ABSTRACT FROM AUTHOR]

Objective: Compare neuropsychological test performance of native English speakers (NES) and English as a second language speakers (ESLS), and investigate the effect of native language writing systems. Method: Dataset was obtained from the National Alzheimer's Coordinating Center (NACC). Participants were required to have normal cognition, which was determined by the evaluating clinicians. All neuropsychological tests were administered in English. Participants were age and education-matched. Twenty-five ESLS (Mage= 69.80; MEdu= 15.44) and 25 NES (Mage= 69.84; MEdu= 15.68) met inclusion criteria. Results: Independent samples t-test revealed statistically significant group differences for: Digit Span Forward (DSF) length, Digit Span Backward (DSB), DSB length, Animal Fluency, Trail Making Test-Part A (TMT-A), Trail Making Test-Part B (TMT-B), WAIS-R Digit Symbol (WAIS-R), and Boston Naming Test (BNT). Results showed medium effect sizes that ranged from.62–.78; although, group means were in the average range. The 50 participants were further divided into three groups: native-English speakers only (NES-O), English as a second language speakers with Latin-based language origin (ESLS-LO), and English as a second language speakers with symbolic language origin (ESLS-SO). Post-hoc Hochberg's GT2 test showed ESLS-LO and NES-O significantly differed on DSB, TMT-B, and WAIS-R. Additionally, ESLS-SO and NES-O significantly differed on the BNT. For these measures, the standardized mean difference was large (d=.80-1.10). Conclusions: These preliminary findings indicate that NES significantly differ in most areas of cognition than ESLS, which suggests that although considered "cognitively normal," there is greater need for neuropsychological measures that utilize normative samples that better represent all cultures, including ones with different linguistic backgrounds. [ABSTRACT FROM AUTHOR]

Objective: Treatment for pediatric acute lymphoblastic leukemia/non-Hodgkin's lymphoma (ALL/NHL) confers risk of long-term cognitive sequelae, though many survivors lose access to neuropsychological monitoring once they transition to adult-centered care. The objective of this study is to describe the frequency/severity of cognitive concerns of ALL/NHL survivors who are about to transition care in relation to occupational status and school service utilization. Method: Thirty-eight young adult (x ̅=19.5 years), primarily Latino, survivors of ALL/NHL underwent neuropsychological evaluation. Domains included working memory (Wechsler Adult Intelligence Scale–Fourth Edition [WAIS-IV] Digit Span [DS]), processing speed (Symbol Digit Modalities Test [SDMT]/WAIS-IV Coding), and sustained attention (Conners Continuous Performance Test–Third Edition [CPT-3]). Occupational status was determined during interview. Results: Survivors exhibited lower working memory (z=-4.44, p=.00001) and processing speed (SDMT z=-3.82, p=.00014; CPT-3 Hit Reaction Time z=2.57, p=.01) compared to normative expectations. Nearly 90% of the sample was in school and/or working at the time of evaluation. Of those attending higher education (74%), over 35% performed at least one standard deviation below the mean across DS and SDMT/Coding (which is over twice as frequent as in the normative population), though less than 15% were receiving accommodations. Conclusion: Despite increased risk of working memory and processing speed deficits, the majority of our sample was in school and/or working at the time of evaluation. While this confirms the resiliency of young adult survivors, their need for supportive services that address cognitive barriers may be under-recognized. Neuropsychological monitoring in this age group remains critical to create avenues for support during the transition to adult-centered care. [ABSTRACT FROM AUTHOR]

Objective: Combining multiple embedded performance validity tests (PVTs) can produce similar classification accuracy to freestanding PVTs. However, there is a lack of research on the incremental predictive power of various combinations of PVTs. Thus, we compared eight embedded PVTs to assess those that best predict classification accuracy on the Dot Counting Test (DCT). Method: Sample included 225 patients (mean age=45.96; mean education=13.96; 56% female, 44% male; 35% White, 40% Black, 17% Hispanic, 5% Asian, 2% Other) undergoing neuropsychological evaluation that included multiple embedded PVTs, including: Brief Visuospatial Memory Test-Revised Recognition Discrimination (BVMT-R RD), Stroop Color and Word Test Word Reading T-Score (Stroop-T), Trail Making Test Part A T-Score (TMT-A), Rey Auditory Verbal Learning Test (RAVLT) Forced Choice, RAVLT Effort Score, Digit Span Age Corrected Scaled Score, Reliable Digit Span, and Letter Fluency T-Score. Patients were classified into valid/invalid groups based on four independent criterion PVTs. Results: A forward stepwise logistic regression was performed to predict DCT pass/fail using the aforementioned embedded PVTs as predictors. The model was achieved in three steps (p<.05); Step 1: BVMT-R RD (Classification Accuracy=87.6%; Nagelkerke R2 =.30), Step 2: BVMT-R RD + Stroop-T (Classification Accuracy=89.6%; Nagelkerke R2 =.44); Step 3: BVMT-R RD + Stroop-T + TMT-A (Classification Accuracy=90.1%; Nagelkerke R2 =.49). Conclusion: BVMT-R RD + Stroop-T + TMT-A reliably predicted the DCT pass/fail group. Thus, this combination of embedded PVTs may be reliable predictors of validity classification when time prohibits delivery of freestanding PVTs, such as the DCT. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to validate an abbreviated 10-item version of the Word Choice Test (WCT). Method: One hundred and ten clinically-referred participants (M age=55.92, SD=14.07; M education=13.74, SD=2.43; 84.5% Male; 47.3% White, 32.7% Hispanic, 15.5% African American, 2.7% Multiracial, 0.9% American Indian, 0.9% Other) completed the WCT as part of a larger battery of neuropsychological tests in a Veterans Affairs (VA) outpatient clinic. The sample included individuals with no cognitive diagnosis (n=37), individuals with a cognitive diagnosis (n=43), and individuals that were determined to have invalid performance across multiple criterion PVT measures (n=30). Results: Total scores on the 10-item abbreviated Word Choice Test (WCT-10) were significantly correlated with total scores on the 50-item WCT standard form (r(108) =.88, p <.01), the Test of Memory Malingering (TOMM) Trial 1 (r(108) =.60, p <.01), and the Reliable Digit Span (RDS) forward/backward (r(108) =.34, p <.01). Receiver operating characteristic curve (ROC) analysis for the WCT-10 indicated optimal cutoff of ≥ 2 errors, with 53% sensitivity and 96% specificity (AUC=.825, p <.001), while ROC analysis for the standard 50-item WCT indicated an optimal cutoff of ≥ 8 errors with 70% sensitivity and 91% specificity (AUC=.890, p <.001). Conclusions: Results provide evidence for the clinical utility of the WCT-10 as a brief, freestanding performance validity test in a mixed clinical sample of Veterans with and without cognitive impairment. Utilizing the WCT-10 may reduce overall neuropsychological evaluation time, while providing evidence for validity of cognitive test performance. [ABSTRACT FROM AUTHOR]

Objective: Evidence of incomplete effort is sometimes attributed to common symptoms of depression, anxiety, or somatic preoccupations. The objective of this study was to examine the role of mood disturbance severity in failed performance validity testing (PVT) in referrals to a memory disorders clinic. Participants and Method: 164 non-compensation-seeking referrals, 66% women, 84% white non-Hispanic, were divided into two groups (n = 82) based on passed or failed PVT results. Participants had an average age 60.4 ± 15.7 and education 14.9 ± 2.9 years. However, 51% of participants had diagnoses of depression and anxiety. Protocols were screened for performance invalidity using Reliable Digit Span and Digit Span SS. Results: MMPI-2 content scales were factor analyzed (PCA/varimax) yielding three factors: Internalizing, Externalizing, and Thought Dysfunction. Mean scores on the three MMPI-2 factors were contrasted across the failed PVT and passed PVT samples. No significant differences emerged (all ps >.13). Mean scores on the MMPI-2 validity scales (F, Fb, Fp, and FBS) were also compared. No significant differences emerged (all ps >.29). Conclusions: Although it is often believed that psychological symptoms such as motivational inertia, apathy and indifference, emotional withdrawal and isolation, preoccupations and distractibility, and acting out tendencies contribute to incomplete effort and failed PVT, these results failed to support such a perspective. They are consistent with other published results that suggest that self-report validity on SVTs can be largely independent of performance validity. This proposition might be setting-specific. In this memory disorders clinic setting, psychopathology showed no measurable impact on effort or performance validity. [ABSTRACT FROM AUTHOR]

Objective: Many individual embedded performance validity tests (PVTs) have been independently cross-validated as validity indices among various clinical populations; however, research examining the additional predictive value from combining multiple embedded PVTs is more limited. The study's purpose was to examine the accuracy of eight embedded PVTs for predicting pass/failure performance on a well-validated freestanding PVT, the Advanced Clinical Solutions: Word Choice Test (WCT). Method: The study consisted of 225 adults referred for outpatient neuropsychological evaluation that included the following embedded PVTs: Rey Auditory Verbal Learning Test (RAVLT) Forced Choice (FC), RAVLT Effort Score, Brief Visual Memory Test-Revised Recognition Discrimination (BVMT-RD), Digit Span Age Corrected Scaled Score, Reliable Digit Span, Stroop Color and Word Test Word Reading T-Score, Letter Fluency T-Score, and Trail Making Test Part A T-Score. The sample was 56% female and racially diverse (40% Black, 35% White, 17% Hispanic, 5% Asian, and 2% other ethnicities) with a mean age of 45.96 (SD=16.12) and mean education of 13.96 (SD=2.73) years. Results: A forward stepwise logistic regression was performed to predict WCT pass/fail using the embedded PVTs as predictors. The model was achieved in three steps (p95% accuracy in correctly classifying WCT pass group. Conclusion: RAVLT-FC, BVMT-RD, and TMT-A combined reliably predict WCT pass/fail group. Verbal and attention based embedded PVTs were found to have the most robust predictive capacity of WCT validity status. [ABSTRACT FROM AUTHOR]

Objective: Prior cross-validation studies have demonstrated the utility of embedded Performance Validity Tests (PVT) as reliable indicators of performance validity, though studies of the incremental predictive power from potential combinations of embedded PVTs remain sparse. The goal of the study was to compare the relative utility of eight embedded PVTs to predict pass/fail on the Medical Symptom Validity Test (MSVT). Methods: The study comprised 225 mixed neuropsychiatric patients referred for outpatient neuropsychological evaluation. The sample was 56% female and racially diverse (40% Black, 35% White, 17% Hispanic, 5% Asian, and 2% other ethnicities). The patients were administered the following eight embedded PVTs: Rey Auditory Verbal Learning Test Forced Choice (RAVLT-FC), RAVLT Effort Score, Digit Span Age Corrected Scaled Score (DS-ACSS), Stroop Color and Word Test Word Reading T-Score, Brief Visual Memory Test-Revised Recognition Discrimination (BVMT-RD), Reliable Digit Span, Letter Fluency T-Score, and Trail Making Test Part A T-Score. The patients were classified into valid/invalid groups based on standard MSVT cut scores. Results: A forward entry logistic regression model was attained in three steps (p<.05); Step 1: RAVLT-FC (Classification Accuracy=83.2%; Nagelkerke R2 =.27), Step 2: RAVLT-FC + DS-ACSS (Classification Accuracy=84.2%; Nagelkerke R2 =.36); Step 3: RAVLT-FC + DS-ACSS + Stroop Word-T (Classification Accuracy=85.1%; Nagelkerke R2 =.39). Conclusion: The RAVLT-FC + DS-ACSS + Stroop Word-T combination provides robust predictive power. The study provided a novel approach to selecting embedded PVTs that best stand in place of the MSVT when time constraints limit the use of freestanding PVTs. [ABSTRACT FROM AUTHOR]

Objective: To investigate if attentional control (AC) predicts the amount of order errors made within serial memory tasks. We also investigated the relationship between AC and item memory (IM), and the relationship between IM and order memory (OM). Methods: Data were collected from undergraduate students at the University of South Alabama. Participants completed three attentional conflict tasks (Bivalent shape task, Global local task, and Flanker task) and three serial memory tasks (symmetry span, digit span, and reading span). The final sample of 112 participants completed all memory tasks and at least two conflict tasks. Confirmatory factor analysis was used to form an AC latent variable from response time difference scores (congruent versus incongruent trials), and IM and OM variables were formed from item and order errors in the memory tasks. Structural equation modeling was used to test correlations among latent variables. Results: The latent AC factor failed to converge. We ran three structural equation models using each conflict task as a predictor variable for both IM and OM. The relationship between IM and OM was significant in all three models. The only other significant pathway across all three models was the relationship between the Flanker task and IM (β =.278, SE =.105, p =.001). Conclusions: Overall, performance on the three conflict tasks did not directly predict order errors. Flanker task performance did directly predict item errors, thus indirectly predicting the amount of order errors in those same tasks. [ABSTRACT FROM AUTHOR]

Objective: Describe cognitive function in patients seeking treatment for Post-Acute Sequelae of COVID-19 (PASC). Method: Ninety-two patients underwent neuropsychological evaluation secondary to reported "brain fog" following COVID-19 infection. Patients were referred from the University of Alabama at Birmingham (UAB) Post-COVID Treatment Program. Patients were on average 49 years of age (range: 18-74), female (77%), and White/Caucasian (73%)/Black/AA (25%), with 15.49 years of education (SD = 2.43). Results: Overall, many patients demonstrated mild impairment on a brief global cognitive screener (MoCA; M = 24.78, SD = 3.46). On specific tasks of cognitive abilities, processing speed was variable; ranging from low average (Oral TMT Part A; M = 88.31, SD = 28.78) to below average (Oral SDMT; M = 72.80, SD = 20.37). Memory for immediate recall was low average (CVLT3-Brief Form (BF) Trials 1-4, M = 88.01, SD = 17.11), while delayed recall was average (CVLT3-BF, M = 94.17, SD = 19.11). Performances on measures of attention/working memory (WAIS-IV Digit Span; M = 96.75, SD = 12.54), executive functioning (Oral TMT Part B; M = 92.71, SD = 28.48), language (COWAT; M = 92.03, SD = 14.19) and visuospatial abilities (RBANS Figure Copy M = 104.04, SD = 16.08) were intact. Performance on embedded validity measures was also intact (RDS [95% valid]; CVLT-3 FC [93% valid]). Conclusion: Overall, patients with "brain fog" following COVID-19 infection experience difficulties in specific domains of cognitive functioning. Further investigation of neuropsychological profiles associated with PASC is warranted to inform diagnosis, neurocognitive trajectory, and treatment planning. [ABSTRACT FROM AUTHOR]

Purpose: Demographic adjustments (e.g. age, sex, race/ethnicity) to neuropsychological tests can assist clinical interpretation and avoid false-positive diagnoses of cognitive impairment. The issue of "race" as a criterion for normative adjustment has been highlighted in recent cases among former NFL players. We examined the impact of different normative reference comparisons on neuropsychological scores among cognitively normal Black and White NFL retirees. Methods: Cognitively normal Black (n = 20) and White (n = 20) retirees were age- and education-matched. Measures of attention (Digit Span), processing speed (Coding, TMTA), memory (ROCFT, CVLT), language (FAS, Animals, BNT), and executive function (TMTB) were examined. Independent samples t-tests (using p < 0.01) were conducted between raw and normative scores of Black and White retirees that adjusted for 1) age/education (Mitrushina); 2) age/education/sex (NACC); and 3) age/education/sex/race (Heaton, MOANS/MOAANS). An additional ANCOVA evaluated group differences controlling for baseline estimated IQ. Results: Raw scores differed between groups on TMTB, Coding, and BNT. Mitrushina normative data showed differences on TMTB (p = 0.007) and BNT (p < 0.001). NACC normative data showed differences on the BNT (p < 0.001). ANCOVA (controlling for IQ) of raw scores between groups differed on the BNT (p = 0.002). Heaton and MOANS/MOAANS normative scores did not reveal differences between groups on any test. Conclusions: As expected, the use of different neuropsychological norms influences findings across different sociodemographic groups to various degrees, depending on the test. The underlying contributors to group differences using "race" as a proxy need to be disentangled and understood. Cautious use of demographically-adjusted norms as interpretive guidelines is warranted until these factors are identified. [ABSTRACT FROM AUTHOR]

Objective Cognitive impairment is a common sequelae of multiple sclerosis(MS), however, relatively little is known about cognitive impairment in late-onset MS (LOMS; symptom onset >50 years old). The present study investigated differences in disease characteristics and cognition in LOMS and adult-onset MS (AOMS). Methods Archival medical records and neuropsychological evaluations from an MS specialty center were reviewed. Differences in disease characteristics between 57 LOMS and 124 AOMS patients were compared using chi-square or ANOVA. To investigate differences in cognitive functioning, age-adjusted standardized scores were compared via ANCOVA, using cardiac risk factors and disease duration as covariates. Results Compared to AOMS (age range: 21–88; mean age: 49.66 +/−12.83), LOMS patients (age range 42–82; mean age: 61.88 +/− 8.57) had significantly more cardiac comorbidities (mean: 1.12+/−1.1 vs. 0.6+/−0.9; p < 0.01), shorter disease duration (mean years: 13.14+/−7.9 vs. 21.0+/−12.6; p < 0.001), and shorter time to diagnosis (mean years: 3.0+/−4.2 vs 6.5+/−8.5; p < 0.01). LOMS patients had similar Expanded Disability Status Scale scores and number of prescribed disease-modifying therapy as AOMS. LOMS patients demonstrated greater impairment on Brief Visuospatial Memory Test-Revised learning (F(1,169) = 8.03, p < 0.05; d = 0.36) and delayed recall (F(1,169) = 4.44, p < 0.05; d = 0.27), and on Wechsler Adult Intelligence Scale-4th edition Digit Span Backward (F(1,176) = 5.68, p < 0.05; d = 0.41) and Sequencing (F(1, 176) = 11.90, p < 0.001; d = 0.55) subtests. Conclusion Despite a shorter disease duration and quicker diagnosis, LOMS patients demonstrate similar levels of physical impairment. Moreover, even after accounting for differences in disease duration and cardiac risk, LOMS showed a greater burden of cognitive impairment than AOMS, which taken together, suggests an elevated rate of disease progression in LOMS. [ABSTRACT FROM AUTHOR]

Objective The Memory Validity Profile (MVP) is a standalone performance validity test developed specifically for use with children. Prior research has demonstrated the MVP's strength in its ease of administration to children with a wide range of intellectual abilities. However, it has been found to lack sensitivity in detecting noncredible performance in select clinical populations using published cut-offs. The current study examines the MVP's performance in a diagnostically heterogeneous clinical sample and proposes a new cut-off for optimization of sensitivity and specificity. Method Archival clinical data was examined from 96 participants referred for a comprehensive neuropsychological evaluation (ages 6–18). Receiver operating characteristic analysis was used to assess the discriminative ability of MVP in detecting cases of noncredible performance defined as failures on both the Test of Memory Malingering and Reliable Digit Span. Results Using published cut-offs, the MVP demonstrated perfect specificity (100%) but suboptimal sensitivity (33.3%). Receiver operating characteristic analysis revealed strong discrimination using MVP Total score (AUC = 0.891 (p < 0.001) and a MVP Total cut-score of ≤30 resulted in optimal sensitivity (89%) and specificity (63%). Conclusions Our findings provide additional evidence that published MVP cut-offs may be too lenient to adequately capture instances of noncredible performance and indicate an MVP Total score cut-off of ≤30 may be more appropriate for use with heterogeneous clinical populations. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of Type 2 Diabetes (T2D) on performance on attention and executive function measures in a sample of MCI patients. Method Individuals with a clinician diagnosis of MCI with T2D and [n = 719,Mage = 75.24,50.3% female] and MCI persons without T2D [n = 719,Mage = 75.21,47.1% female] were selected from the Alzheimer's Disease Research Centers database by the National Institute on Aging. Those with motor disturbances were excluded from the analysis. Significant differences (p < 0.001) were found for race and education between groups. Results Multiple ANCOVAs controlled for gender, education, age, and race on performance. Significant differences (p < 0.001) were found in performance on the Trail Making Test [A, B], Digit Span forward [longest recall, correct trials], Digit Span backward [longest recall, correct trials], and Verbal Fluency tasks [F word, L words]. No significant differences were found in the animal and vegetable naming fluency tasks. The T2D group showed poorer mean scores on every test analyzed. Conclusion Results indicated modestly lower performance on measures of attention and executive functioning in MCI patients with comorbid T2D. Previous research supports these conclusions, as T2D has been associated with increased risk for dementia, accelerated decline from MCI to dementia, and modestly lower scores on cognitive tests via effects of microvascular function and altered glucose metabolism. Future studies should aim to identify protective factors in T2D cognitive decrements while controlling for exercise, diet, SES, and underlying medical comorbidities. The NACC database is funded by NIA/NIH Grant U01 AG016976. NACC data are contributed by the NIA-funded Alzheimer's Disease Research Centers. [ABSTRACT FROM AUTHOR]

Objective To see how strongly performance on a computerized visual digit span task correlates with non-computerized digit span subtests. Method The data were chosen from a de-identified database. Undiagnosed adult volunteers (n = 105) took the WAIS-IV Digit Span and TMB Digit Span subtests. Demographic characteristics were as follows: Age (M = 28.5, SD = 11.2), education (M = 16.2, SD = 1.9), gender (60% Female), race (69.8% White). A Pearson correlation was run on the TMB and WAIS-IV longest digit span forward (ldsf) and longest digit span backward (ldsb) raw scores of the same individuals. Results Results suggest a moderate correlation between WAIS-IV ldsf (M = 7.14, SD = 1.31) and TMB (M = 6.90, SD = 1.29) ldsf raw scores, r = 0.45, p > 0.01. Moreover, results indicated a moderate correlation between WAIS-IV ldsb (M = 7.69, SD = 1.43) and TMB (M = 5.66, SD = 1.81) ldsb raw scores, r = 0.38, p > 0.01. 73.1% of participants had the same or were within one digit on ldsf scores on both assessments, while 93% were within two digits. 63.8% of participants had the same ldsb scores on both assessments, while 81.9% were within two digits. Conclusion Clinicians must note the risk of assuming computerized tests measure the same cognitive functions as standardized paper-and-pencil tests. These results underscore this point. Future studies should continue to assess how well in-person tests align with other computerized tests purporting to measure the same cognitive abilities by examining other variables (i.e. auditory vs. visual, controlled vs. non-controlled environment). [ABSTRACT FROM AUTHOR]

Objective In neuropsychological assessments, it is critical to evaluate examinee performance validity. Reliable Digit Span (RDS) and the Rey-15 Item Test (FIT) are performance validity tests (PVTs) used to assess the accuracy of results during neuropsychological assessment (NA; Lichtenstein et al. 2017). While many studies have examined adult populations, few examined children to determine the base rate level of PVT failure even in a healthy population. The present study assessed RDS and FIT as PVTs in youth athletes, with valid performance operationalized by Test of Memory Malingering (TOMM) performance. Method Youth athletes (n = 109, 79% male, Mage = 11.9) completed a NA including RDS (cutoff <7), TOMM Trial 2 (cutoff <50), and FIT (cutoff <26) during baseline evaluation for sport participation. A stringent TOMM cutoff was used to improve sensitivity (Schroeder et al. 2012). Receiver operator characteristic (ROC) curve analysis determined whether RDS or FIT performance accurately categorized participants' validity test performance, based upon TOMM Pass/Fail. Results Both RDS and FIT produced minimal accuracy in categorizing participants performance on TOMM; areas under the curve ranged from 0.41 to 0.60 and did not significantly differ from chance (0.50). Additionally, there was a lack of agreement across PVTs, as no participant failed all three PVTs. Conclusion RDS and FIT did not adequately predict TOMM performance in healthy youth. These findings illustrate that even in a brief NA, healthy children demonstrated variable performance across validity measures, with low consistency across three commonly used PVTs. Findings highlight the importance of clinical judgment in evaluating discrepant PVT performance in children. [ABSTRACT FROM AUTHOR]

Objective Literature supports the use of the Delis-Kaplan Executive Function System Trail Making Test Conditions 4/2 ratio (TMT 4/2) and Stroop Color Word Test Word Reading (WR) as embedded validity indicators (EVIs) with adults (Erdodi et al. 2018; Guise et al. 2012) and the Wechsler Abbreviated Scale of Intelligence, 2nd Edition Matrix Reasoning (MR) as an EVI with children (Sussman et al. 2017). This study assessed the utility of these measures as EVIs in healthy children, compared to the Test of Memory Malingering Trial 1 (TOMM1 < 45; Perna & Loughan, 2013) and Reliable Digit Span (RDS). Method Participants (n = 99, 68.7% male, Mage = 11.9) completed baseline neuropsychological evaluations for sport participation, including the aforementioned measures. Receiver operator characteristic curve analysis was used to determine whether TMT 4/2, MR, and WR accurately categorized valid performance. Results TMT 4/2 yielded adequate sensitivity (0.83–1.00) but poor specificity (0.07–0.09) when predicting TOMM1 and RDS pass/fail performances. MR yielded adequate sensitivity (1.00) and specificity (0.92) when predicting RDS pass/fail performance and adequate specificity (0.92) and poor sensitivity (0.18) when predicting TOMM1 pass/fail performance. The only EVI that produced better than chance accuracy was MR when predicting RDS pass/fail performance (area under the curve [AUC] = 0.98). All participants failed the WR cutoff, suggesting poor specificity. Conclusion Results suggest that MR was the only EVI that achieved minimally acceptable specificity (≥0.90) in children. MR performed adequately when detecting valid performances but variably when detecting invalid performances; therefore, MR may be used alongside well-established performance validity tests with children but not independently. [ABSTRACT FROM AUTHOR]

Objective Studies on Performance Validity Tests (PVTs) for tele-neuropsychology (TeleNP) are sparse. Verbal PVTs appear to better translate to TeleNP, so the primary objective of this study was to provide initial data on two well-established, verbal PVTs administered via TeleNP for research participants with traumatic brain injury (TBI). Methods This secondary analysis of the Veterans Affairs TBI Model Systems data included 53 participants enrolled in a PVT module study (3/01/2020–09/20/2020) with documented moderate-to-severe TBI per Glasgow Coma Score (M = 6.5, SD = 4.4), posttraumatic amnesia duration (M = 42.7 days, SD = 47.1), and/or time to follow commands (M = 10.5 days, SD = 16.3). Participants completed two PVTs—Reliable Digit Span (RDS) and the 21-Item Test (21-IT)—alongside telephone-based cognitive assessment 1–7 years after TBI. Descriptive analyses were performed to compare PVT performances to previously established cut scores. Chi square analyses were employed to examine 21-IT and RDS as dichotomous outcomes (pass/fail) at selected cutoffs. Results RDS ranged from 5 to 16 (M = 10.5, SD = 2.4). 21-IT ranged from 7 to 21 (M = 16.4, SD = 3.1). For RDS, 9.8% were invalid with a cutscore of ≤7 and 19.6% using a cutscore of ≤8. For the 21-IT, 7.8% were in invalid using a cutscore of ≤11, and 13.7% using a cutscore of ≤12. Conclusion(s) Using previously established cut scores, telephone-administered RDS and 21-IT resulted in relatively low rates of invalid performance among individuals with moderate-to-severe TBI. These findings provide preliminary support for the RDS and 21-IT in TeleNP. [ABSTRACT FROM AUTHOR]

Objective Recent debate regarding the use of race-adjusted normative data (RAND) in the neuropsychological evaluation of former National Football League (NFL) players has sparked intrigue. This pilot study explored the use of RAND in a community-based sample of cognitively normal Black and White NFL retirees. Methods Cognitively normal Black (n = 20) and White (n = 20) NFL retirees were selected to be similar in age and education from a larger community sample of retired athletes. All participants underwent consensus neurological diagnosis and standard tests of memory, executive functioning, and language. Five tests utilized Heaton RAND (TMT A and B; FAS, Animal fluency, BNT) and four used age-and education- adjusted manual norms (RCFT, CVLT-II, WAIS-IV Coding and Digit Span). Independent samples t-tests compared raw and normative scores between Black and White retirees. ANCOVA was also used that included estimated IQ and head-injury exposure. Results Raw score differences (p < 0.01) were observed between Black and White retirees on 3/9 tests (TMT B, BNT, Coding). No significant differences were noted between groups on TMT B and the BNT using Heaton RAND, and differences on TMT B and Coding were no longer significant after controlling for IQ. Head-injury exposure did not affect findings. Conclusions The use of RAND raises complex issues. In this pilot sample of Black and White NFL retirees of similar age and education, few differences were seen, and these were largely attenuated using specialized norms and/or adjustment for estimated global cognitive ability. Potential demographic and environmental influences on test scores require examination in similar populations. [ABSTRACT FROM AUTHOR]

Retention of old (n = 27; M age = 72.4 years) and young (i = 46; M age = 20.5 years) adults was compared in a Brown-Peterson task. Participants were instructed to recall letters after either reading digit pairs or summing each pair of digits and reporting the sum as odd or even. Old adults recalled a substantially smaller proportion of letters correctly than did the young adults, and the magnitude of the difference between groups was related positively to the length of the retention interval. The main effect of age and the age by retention interval interaction were significant with both serial and free recall scoring criteria. In a multiple regression analysis with letter span, age and interpolated task regressed on brown-peterson recall, letter span, and interpolated task accounted for most of the variance in performance. [ABSTRACT FROM PUBLISHER]

Objective: The goal of this study is to examine the cognitive factors that account for omission errors on the Benton Visual Retention Test (BVRT) copy and memory trials using factorial indices based on raw subtest scores of the Wechsler Adult Intelligence Scale-III (WAIS-III) and the Multilingual Aphasia Examination (MAE). Method: Participants were referred for assessment at the VA Palo Alto Health Care System. One hundred and forty-three participants were sampled. BVRT omission error scores for the copy and memory trials were factor analyzed with age, education level, WAIS-III Digit Span Forward (DSpF), and Letter-Number Sequencing (LNS). These variables were refactored with the spoken language components of the MAE (naming, repetition, verbal fluency, and auditory comprehension). Results: BVRT copy and memory omission scores were factorially grouped with age and inversely correlated with LNS. A second factor was composed of positive loadings on DSpF, LNS, and education. The BVRT Copy-and-Memory-Omissions-Age-LNS component was inversely and specifically related to the MAE measure of auditory comprehension. The Digit Span Forward-LNS-Education variable loaded strongly on the MAE Repetition component and secondarily on the MAE Verbal Fluency and Naming components. Conclusions: BVRT copy and memory trial omission errors are strongly and specifically related to failure of auditory comprehension. Errors of this type are not related to the other three components of spoken language. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the psychometric characteristics of the Cognitive Difficulties Scale (CDS; McNair & Kahn, 1983), a 39-item Likert-type self-report instrument that requires a fifth-grade reading level. The CDS is a popular instrument that has been shown to predict cognitive decline. Evaluation included an exploratory factor analysis, measures of internal consistency, relation to demographics, criterion validity, and normative table for raw to T score/percentile transformation. Method: Participants were 643 consecutive referrals (71% women, mean age 60.6 and education 14.6 years) for a neuropsychological examination in a memory disorders clinic as part of a broader neurodiagnostic workup for cognitive decline. A principal components analysis was conducted followed by varimax rotation (Kaiser). Factor scores were investigated in relation to multiple internal and external criteria. Results: Six dimensions of cognitive complaint emerged accounting for 64% of the variance: Attention/Concentration, Fine Motor Skill, Prospective Memory, Speech Problems, Memory for Names, and Temporal Orientation. Factors showed good internal consistencies (alphas > .850). Correlations with Logical Memory, Visual Reproduction, and Digit Span were all nonsignificant. CDS factor scores were highly predictive of MMPI-2 measures of anxiety, depression, and somatic preoccupation. Percentiles and T-scores were derived for the CDS total score and its six component scales. Conclusion: The CDS is a multidimensional measure of subjective cognitive complaints that provides clinicians with a psychometrically sound basis for deriving a profile with six subscale scores. The test has substantial clinical utility, and is a potentially useful tool in exploring subjective cognitive decline as a prodrome to dementia. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the patterns of Longest Digit Span from the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V), including understanding the newest sequencing condition. While there is a large body of research discriminating the cognitive demands of the forward and backward conditions, there is less literature devoted to the cognitive underpinnings of the sequencing task, and no studies looking at the applicability of this task with children. Patterns observed clinically on these conditions have suggested that the sequencing condition may involve less executive demand than the backwards condition (Least Executive Demand model). Therefore, it was predicted that Longest Digit Span Backwards (LDSB) would predict the most amount of variance in Working Memory scores on the Comprehensive Executive Functioning Inventory (CEFI). Method: Hierarchal multiple regression analysis controlling for FSIQ was completed utilizing an archival database (n = 38) of children and adolescences (ages 6–15) referred to a university-based neuropsychological assessment clinic. Results: Longest digit span scores were not significant predictors of Working Memory scores on the CEFI [F (4, 27) =1.746, p = .169]. However, digit span capacity was weakly predictive of CEFI Attention scores [F (4, 27) = 2.818, p < .05; R2 = .295]; with sequencing capacity as the only significant predictor (beta = .62, p < .05). Conclusions: While there was no evidence that working memory capacity predicts real world working memory skills, there was evidence that digit sequencing capacity is predictive of parent reported attentional difficulties. Poor performance on DSS in children may be due to difficulties concentrating, sustaining attention or with avoiding distractions. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the relation between depression and performance on six widely used tests: the Boston Naming Test, Category Fluency Test, Controlled Oral Word Association Test, Corsi Block Tapping Test, Mazes and Trail Making Test (TMT), Parts Speed, A and B. Method: Participants: 77 women and 33 men referred for a comprehensive neuropsychological examination in an outpatient memory disorders clinic as part of a broader neurodiagnostic workup for memory complaints and possible cognitive decline. Referral sources: neurologists (78%), primary care physicians (21%). Patients' mean age: 59.3 (SD =12.1); education: 15.1 (SD = 2.7) years. They were screened from a larger sample (N = 175) for any known history of brain disorder or positive neurodiagnostic findings. They met performance and symptom validity criteria (Reliable Digit Span and scores on MMPI-2 validity scales). Diagnostically, 62% of the sample had mood disorders. Using their median score on the Depression scale of the MMPI-2 (T = 70), patients were classified into High and Low Depression groups (ns = 55). The two groups were no different on age, education, or predicted level of intelligence (Test of Premorbid Function). Results: On all six of the neuropsychological tests (eight measures), scores were compared across the two groups. There was no main effect (MANOVA) for group, F(8,101) = 1.03, p = .427. Univariate comparisons revealed no intergroup differences across tests. Conclusion: Results suggest that severity of depressive symptoms is not related to performance on these neuropsychological tests. In cooperative examinees, these tests are valid for assessing brain-based abilities independent of the examinees' emotional status. [ABSTRACT FROM AUTHOR]

Objective: Analyze neurocognitive and structural brain changes associated with conversion from normal cognition/MCI to Alzheimer's disease (AD). Method: Thirty-two participants from the National Alzheimer's Coordinating Center included 22 women; mean (SD): age = 77.06 (8.1); education = 14.59 (3.5). All had either normal cognition or MCI at first visit when MRI was obtained and were diagnosed with AD at follow-up MRI; mean time between MRI's = 4.1 years. Imaging of Dementia & Aging lab performed calculations for MRI structural change using Linux-based software. Participants took neuropsychological tests within three months of each MRI visit. Results: MRI structural degeneration occurred in: left (d = .46) and right (d = .47) entorhinal cortical thickness; left (d = .82) and right (d = .95) hippocampal volume; left (d = .74) and right (d = .43) middle temporal gray matter volume; left parahippocampal cortical thickness (d = .55); total white matter volume (d = .55); total brain volume (d = .78); and total CSF volume (d = 1.14). Significant neuropsychological decline included Animal fluency (d = 1.02), Vegetable fluency (d = .69), Digit Symbol (d = .53), Trails B (d = .42), and Digit Span Backward (d = .56). There was not a significant change in Logical Memory. Conclusions: Participants who converted from normal cognition/MCI to AD showed MRI degeneration in medial temporal structures as well as generalized atrophy and white matter loss. These structural changes accompanied a significant decline in semantic verbal fluency, working memory, and processing speed. There was not a significant change in verbal memory. [ABSTRACT FROM AUTHOR]

Objective: Previously, the Grooved Pegboard Test (GPB) has shown potential as an embedded measure of performance validity (PVT) using a T-score cutoff for either hand (≤ 29) or both hands (≤ 31). This study sought to validate these cutoffs with established PVTs (Medical Symptom Validity Test [MSVT], Non-Verbal Medical Symptom Validity Test [NV-MSVT], and Reliable Digit Span [RDS]). Method: Subjects (N = 190) were primarily Caucasian (85%) and male (81%). Average age and education were 41 (SD = 11.62) and 16 years (SD = 2.35), respectively. Participants were stratified as GPB "pass or fail" based on previously proposed cutoff criteria. MSVT, NV-MSVT, and RDS were also dichotomized as pass or fail based on manual or conventional recommendations. Results: Chi-Square analyses revealed significant associations between GPB "fails" for both hands and MSVT, NV-MSVT, and RDS (χ2 (1, n = 190) ranging from 5.80 to 15.98, Phi ranging from.18 to.29, p ranging from < .05 to < .0001). Similar findings were observed for dominant hand "fails"; however, non-dominant hand was only related to the MSVT. Sensitivity and specificity values from the GPB measures ranged from.47 to.58 and from.89 to.92, respectively. Positive and negative predictive power ranged from.38 to.45 and.93 to.94, respectively. Conclusion: These data demonstrate the relative utility of the GPB as an embedded PVT. In particular, dominant and both hand cutoffs are likely to be more clinically useful in determining sub-optimal performance. However, as sensitivity is relatively low, this measure should not be employed as the sole PVT administered. [ABSTRACT FROM AUTHOR]

Objective: The Hopkins Verbal Learning Test–Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) are memory tests with embedded measures of performance validity (Recognition Discrimination [RD] and Discrimination Index [DI], respectively). We evaluated whether cognitive ability and age influenced embedded measures of effort. Methods: Participants included 30 young adults (YA) and 29 older adults (dichotomized into unimpaired [OAu] and impaired [OAi]). Participants completed a medication management ability assessment (MMAA), daily memory lapses survey (DM), digit span, and the Transverse Patterning (TP) and Reversal Learning (RL) computerized tests. Two Repeated-Measures MANOVAs were conducted to determine if Passing PVT and Age/Cognitive Ability influenced performance. An ROC analysis was conducted for HVLT-RD and BVMT-DI to determine pass/fail, and false positives/negatives on embedded measures. Results: Those in the YA group who failed RDS (YA-fail), performed better than OAi-fail and OAi-pass groups on RT Errors (p < .0001). On TP Errors, the YA group differed from all four OA groups (p < .0001). On MMAA a significant difference was observed between OAi-fail and all other groups (p < .001). On RD, YA groups differed from both OAi groups (p = .0008). On DI, the YA groups differed from the OAi-fail group (p = .002). A logistic regression classified 43/57 participants successfully into the three cognitive groups using the six predictors (χ2 = 55.73, p < .0001, R2 = .468). RT Errors and TP were significant (Likelihood χ2 = 7.25, p = .027). Conclusion: HVLT-RD failed to detect validity for OAi, as did BVMT-DI for YA and OAu. Instead, impairment effects are seen on HVLT-RD and BVMT-DI where YA groups differed from some combination of both/one of the OA groups. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the present study was to compare Wechsler Adult Intelligence Scale-IV (WAIS-IV) Reliable Digit Span (RDS) and Digit Span Age-Corrected Scaled Score (DS-ACSS) sensitivity and specificity, when the effort criterion was determined by between one and five performance validity test (PVT) cut scores. Method: Data were collected from 82 adults (18–49) referred for clinical questions of multiple sclerosis, mild traumatic brain injury, and attention deficit hyperactivity disorder. Patients were administered full neuropsychological batteries,with different combinations of PVTs (including Advanced Clinical Solutions Word Choice, Animals raw score, Trails A T-score, Wisconsin Card Sorting Test [WCST; Suhr & Boyer] equation, and California Verbal Learning Test-II Forced Choice). Chi-square and receiver operating characteristic (ROC) analyses were utilized. Results: Using established RDS (≤7) and DS-ACSS (≤6) cut scores, specificity was highest (90&37; and 86%, respectively), with equivalent sensitivity (90%), when effort was determined by WCST (Suhr & Boyer) equation failure alone. Related area under the curve for RDS was.90 (CI = .76–1.0) and for DS-ACSS was.88 (CI = .74–1.0). Conclusions: In this clinical sample, the highest sensitivity and specificity were observed when the RDS cut score was utilized, and effort was based on the WCST criterion. However, the DS-ACSS cut score resulted in strong sensitivity/specificity combinations across more effort classification groups. [ABSTRACT FROM AUTHOR]