Separate Digits tests: A brief history,a literature review,and a reexamination of the factor structure of the test of memory and learning (TOMAL)

Following a brief history of Digit Span, a review of 27 articles, selected from 76, addresses the question of whether to scale Digits Forward and Backward separately. The review begins with studies involving Digits Forward, followed in turn by studies of Digits Backward and of both subtests. Finally, the loadings of four TOMAL subtests, Digits Forward and Backward and Letters Forward and Backward, undergo examination in the context of two, three, and four factor promax solutions, with corresponding varimax solutions provided for comparison. The analysis leads to several conclusions. Though Digits Forward and Backward show similarities, they load differently in the three and four factor solutions; Digits Backward also displays a spatial element, and perhaps a transformative element, not apparent in Digits Forward. Moreover, the differences between the two measures have important neurologic and diagnostic implications.     

Neuropsychological correlates of Greek alcoholic patients who report memory disturbances

We studied 40 male and 37 female (M age=63 yr.) Greek alcoholic patients and an equal number of control subjects. Both groups were evaluated with the Mini-Mental State Examination, the Syndrome Short Test, the Verbal Fluency Test (Category & Letter), the Clock Test, and the Digit Span (Forward and Backward from the Wechsler Adult Intelligence Scale-Revised). Alcoholic patients had statistically significant lower scores on MMSE, Verbal Fluency Test, and Digit Span, and higher scores on the Syndrome Short Test, while positive correlations were found among MMSE, Verbal Fluency Test, Clock Test, Digit Span-Backward, and age. These findings point to frontal lobe dysfunction in Greek alcoholic patients which is not different from that shown in patients from diverse ethnic and cultural backgrounds.     

Verbal Learning in Boys With P-Type Dyslexia,L-Type Dyslexia,and Boys Without Learning Disabilities: Differences in Learning Curves and in Serial Position Curves

Twenty-five boys with P-dyslexia, 23 with L-dyslexia, and 26 boys without reading disabilities were administered the Digit Span (Forward and Backward) and the Dutch version of the Rey Auditory-Verbal Learning Test. Compared to normal boys, dyslexic boys exhibited reduced scores on Digits Backward and recalled fewer words during the five learning trials. Nonlinear modeling of the data for the five learning trials revealed that dyslexic boys showed smaller learning parameters than did normal boys and that L-dyslexic boys exhibited more loss of information during learning than did P-dyslexic boys. In dyslexic boys, the word-list primacy effect was strongly reduced. In normal boys, but not in dyslexic boys, Digits Backward correlated moderately with the primacy measure. The results suggest that reduced word-list learning in dyslexics is a consequence of a temporal ordering deficit rather than a rehearsal deficit.     

Field dependence-independence (FDI) cognitive style: an analysis of attentional functioning

Previous research has indicated that field-dependent children display poorer performance than field-independent children in almost all academic subjects and cognitive tasks. However, the processes underlying this poorer performance remain unclear. The present study aimed to assess whether children with different FDI cognitive styles show differences in performance of tasks measuring aspects of attentional functioning. Specifically, 149 children aged 8 - 11 years were classified according to FDI cognitive style (field-dependent, intermediate, or field-independent), and to storage capacity (Digits Forward Test), verbal working memory (Digits Backward Test), capacity to focus, shift, and maintain attention (Digit Symbol Test), and capacity for sustained attention (Visual Search and Attention Test). Field-independent children displayed better performance than intermediate and field-dependent children on all tests except the Digits Forward Test. Theoretical and practical implications of these results are discussed.     

Examination stress and components of working memory

Previous research suggests that stress can influence a broad range of memory functions. In this study we investigated the effect of a naturalistic stressor, examination stress, on working memory in young adults. In order to accomplish this aim, participants were tested on psychological and hormonal measures of stress and on Digit Span, once during a low stress period and once during a high stress period. The high examination stress condition was associated with an increase in cortisol and subjective impressions of stress. Although Digits Forward performance did not vary with examination stress, Digits Backward performance improved. These findings suggest that mild increases in stress are associated with improvement in the manipulation component of working memory. However, no correlations were found between working memory and either cortisol or psychological stress. Thus the mechanism by which mild naturalistic stressors improve the manipulation component of working memory needs further investigation.     

Disorders in planning and strategy application in frontal lobe lesion patients

The aim of this study was to investigate deficits in planning ability using an adapted version of the Modified Six Elements Test, from the Behavioral Assessment of the Dysexecutive Syndrome—BADS [Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H., & Evans, J. J. (1996). Behavioural Assessment of the Dysexecutive Syndrome (BADS). Bury St Edmunds, U.K.: Thames Valley Test Company. Trans. Ricardo O Souza, Sergio L Schmidt. Rio de Janeiro: Cognição]. Subjects were left- and right-frontal lobe lesion patients. Other measures of executive dysfunctions used were verbal fluency, the Wisconsin Card Sorting Test, and the Trail Making Test. These other instruments were sensitive to detect executive deficits in the left frontal lobe lesion group, except the Wisconsin Card Sorting Test, which showed impairment only for the frontal lobe lesion group as a whole. The Modified Six Elements Test detected planning disorders in left frontal lobe lesion patients. The deficit of these patients was due to a greater likelihood to break the rules of the task, that is, in plan-following processes, rather than in planning the strategic approach to solve it.     

Normative data for a brief neuropsychological screening battery. Multicenter AIDS Cohort Study.

This study reports normative data for a group of 733 homosexual/bisexual men stratified by age (range 25 to 54 years) and by education on the following six neuropsychological tests: (1) Digit Span (WAIS-R), (2) Rey Auditory Verbal Learning Test, (3) Symbol Digit Modalities Test, (4) Controlled Oral Word Association Test, (5) Grooved Pegboard, and (6) The Trail Making Test. Analysis demonstrates that both age and education are important determinants of performance for several of these measures.     

Emotional impact on trail making test performance

This study assessed the effect of emotional factors on Trail Making Test Part B performance for a sample of 105 neuropsychological referrals for whom there was no neurodiagnostic evidence of brain damage. Trails B scores declined in relation to elevated MMPI scores on Scales 6, 7, and 8, though only nine patients performed within the impaired range. The results suggest that (a) Trails B performance is resilient to a variety of emotional influences, (b) psychotic symptoms and severe anxiety impede Trails B performance, though rarely to the extent caused by brain damage, and (c) the MMPI provides objective criteria that help rule out emotional effects on Trails B performance.     

Comparison of the Trail Making and Color Trails Tests in a Chinese context: a preliminary report

The Color Trails Test developed as a culturally fair analogue of the Trail Making Test, was used to examine the relationship between the two tests with 35 undergraduate Chinese in Hong Kong recruited as the subjects. The scores on these two tests of the 12 men and 23 women were significantly correlated .71. The equivalence of the Trail Making and Color Trails Tests when applied to Chinese in Hong Kong was discussed.     

Loss of Financial Capacity in Alzheimer's Disease: The Role of Working Memory

Recent research has demonstrated that loss of financial capacity is a common consequence of Alzheimer's disease (AD). While progressive cognitive decline is a defining feature of AD, the relationship between such decline and loss of financial capacity in AD remains unclear. Working memory may be strongly associated with financial abilities, as many financial tasks require temporary storage and manipulation of numerical and other data. The present study examined the relationship between financial capacity and working memory in AD patients. Participants included 20 AD patients and 23 cognitively intact older controls. Working memory was conceptualized using Baddeley and colleagues' model, which posits that the three components of the working memory system are the visuospatial sketchpad, phonological loop, and central executive system. The present study examined only the latter two components of working memory. Each participant was administered the Financial Capacity Instrument (FCI), an instrument that directly assesses eight domains of financial activity, and the WAIS-III Working Memory subtests (Digit Span, Arithmetic, Letter–Number Sequencing). AD patients as a group performed significantly below controls on the FCI Total Score and on each of the eight FCI domains and working memory subtests. Within the AD group, measures of the central executive component of working memory (WAIS-III Digits Backward, Arithmetic, and Letter-Number Sequencing tests) showed strong correlations with the FCI domains of basic monetary skills, checkbook management, bank statement management, and bill payment and FCI total score, while a measure of the phonological loop component of working memory (WAIS-III Digits Forward) was not significantly correlated with any FCI domains or with the FCI total score. The results suggest that the multiple domains of financial capacity are primarily correlated with the central executive component of working memory.     

Impact of executive dysfunctions on episodic memory abilities in patients with ruptured aneurysm of the anterior communicating artery

Executive and memory dysfunctions are among the most frequently reported deficits following a ruptured aneurysm of the anterior communicating artery (ACoA). In order to study the impact of the dysexecutive syndrome on episodic and semantic memory, the data obtained from 59 ACoA patients were examined retrospectively. All patients were assessed on a variety of episodic memory tests (Rey Auditory-Verbal Learning Test, Rey Complex Figure Test, Weschler Memory Scale), semantic memory (verbal fluency), and standardized tests of executive functions (Trail Making Test, Maze tests, Wisconsin Card Sorting Test). There was a strong positive correlation between executive dysfunction and retrieval difficulties in episodic and semantic memory tasks. Comparisons of subgroups of patients with high and low frontal lobe functioning on delayed recall and recognition revealed a significant group X condition interaction in addition to significant group and condition main effects. ACoAs patients with low frontal lobe functioning were particularly deficient in free recall (immediate and delayed) while recognition was equally well preserved in the two subgroups. Neither subgroup presented with an abnormal forgetting over time suggesting a retrieval deficit rather than a true retention impairment.     

Frontal lobe deficits in domestic violence offenders

Functional frontal lobe deficits were examined in 38 men who committed domestic violence and 38 control participants. Dependent measures that examine frontal lobe deficits, including the Wisconsin Card Sorting Test (D. A. Grant & E. A. Berg, 1948), the Stroop Color-Word Test (J. R. Stroop, 1935), and Trails B (R. M. Reitan & L. A. Davidson, 1974), were used. The prediction that men who commit domestic violence would perform more poorly on neuropsychological measures related to frontal lobe deficits was only partially supported. A discriminate analysis was significant (p < .05), explaining approximately 7% of the variance; Trails B was the only contributor to that equation. The men who committed battery took significantly longer to complete Trails B than the control participants, suggesting that the men who committed battery may not have been as good as the control participants at inhibiting the competing response and therefore took longer to complete the task. The groups did not significantly differ on the other neuropsychological measures.     

The utility of the spatial span in a clinical geriatric population

Spatial Span subtest of the Wechsler Memory Scale has been viewed as an indicator of working memory and visuospatial processing. The current study examined the impact of cognitive impairment and its severity on Spatial Span performance. A neuropsychological battery including Spatial Span was administered to 538 individuals (65-89) who were grouped by consensus into Alzheimer's disease, Vascular Dementia, Amnestic Mild Cognitive Impairment, Non-Amnestic Mild Cognitive Impairment and cognitively normal. Increase in level of impairment resulted in a decrease in Spatial Span Total Score. A weak relationship between age and Spatial Span Total Score was found. Spatial Span Forward remains relatively stable regardless of level of impairment. Spatial Span Backward was more sensitive to severity. No significant differences were found between individuals diagnosed with Alzheimer's disease and those with Vascular Dementia suggesting similar deficit patterns in the cognitive abilities measured by the Spatial Span. Mild Cognitive Impairment groups and normals did not differ suggesting visuospatial processes are not affected early in the dementing process.     

Associations between evaluation anxiety,cognitive interference and performance on working memory tasks

According to Cognitive Interference Theory, evaluation anxiety leads to increased negative off‐task self‐dialogue which then results in diminished cognitive performance. Given that negative off‐task self‐dialogue is primarily verbal, the phonological loop and central executive components of the working memory system should be most affected by evaluation anxiety. Eighty‐eight participants were randomly assigned to receive evaluation anxiety inducing instructions or supportive instructions prior to administration of three tests (Digit Span, Visual Memory Span, and StroopColour‐Word) that measured the phonological loop, visuospatial sketchpad, and central executive components of working memory. Measures of evaluation anxiety and negative off‐task self‐dialogue were obtained during and after testing. Results showed that participants receiving anxiety inducing instructions reported significantly more evaluation anxiety and off‐task self‐dialogue. They also had significantly lower performance on the Digit Span Test and the StroopColour‐Word Test. Negative off‐task self‐dialogue also mediated the relationship between evaluation anxiety and performance on the Digit Span Test. Copyright © 2011 John Wiley & Sons, Ltd.     

White matter hyperintensities and working memory: an explorative study

White matter hyperintensities (WMH) are commonly observed in elderly people and may have the most profound effect on executive functions, including working memory. Surprisingly, the Digit Span backward, a frequently employed working memory task, reveals no association with WMH. In the present study, it was investigated whether more detailed analyses of WMH variables and study sample selection are important when establishing a possible relationship between the Digit Span backward and WMH. To accomplish this, the Digit Span backward and additional working memory tests, WMH subscores, and cardiovascular risk factors were examined. The results revealed that performance on the Digit Span backward test is unrelated to WMH, whereas a relationship between other working memory tests and WMH was confirmed. Furthermore, a division between several white matter regions seems important; hyperintensities in the frontal deep white matter regions were the strongest predictor of working memory performance.     

Neuropsychological effects of stress on social phobia with and without comorbid depression

BACKGROUND: The influence of stress on neuropsychological functioning was assessed in socially phobic (SP), comorbid socially phobic/major depression (CM), and asymptomatic control subjects (AC) under baseline and stressor conditions. METHODS: Subjects were 33 clinically diagnosed undergraduates aged 18 to 41 years. Neuropsychological measures included the Trail Making Test, Wisconsin Card Sorting Test (WCST), Spatial Span, and Digit Span administered during a baseline condition and a psychosocial stress condition (videotaping). RESULTS: Spatial Span scores were reduced for SP during stress, improved for AC, and showed no change for CM. TMT B times showed an interaction effect, with completion time improving significantly less for SP than for AC and CM during stress. Analyses of the normative data for WCST total errors indicated that AC and CM improved significantly during stress, while SP performance declined during stress. CONCLUSIONS: The present findings suggest that comorbid depressed versus non-depressed SP subjects respond uniquely to stress in terms of their neuropsychological functioning and self-reported mood and experiences; generalized social phobia may be associated with spatial working memory disturbance during social stress. Therefore, situations involving potential social and personal evaluation (e.g., examinations or presentations) may have a significant impact on the neuropsychological functioning of SP individuals.     

White Matter Hyperintensities and Working Memory: An Explorative Study

ABSTRACT

White matter hyperintensities (WMH) are commonly observed in elderly people and may have the most profound effect on executive functions, including working memory. Surprisingly, the Digit Span backward, a frequently employed working memory task, reveals no association with WMH. In the present study, it was investigated whether more detailed analyses of WMH variables and study sample selection are important when establishing a possible relationship between the Digit Span backward and WMH. To accomplish this, the Digit Span backward and additional working memory tests, WMH subscores, and cardiovascular risk factors were examined. The results revealed that performance on the Digit Span backward test is unrelated to WMH, whereas a relationship between other working memory tests and WMH was confirmed. Furthermore, a division between several white matter regions seems important; hyperintensities in the frontal deep white matter regions were the strongest predictor of working memory performance.     

The development of executive functions and early mathematics: A dynamic relationship

Background. The relationship between executive functions and mathematical skills has been studied extensively, but results are inconclusive, and how this relationship evolves longitudinally is largely unknown. Aim. The aim was to investigate the factor structure of executive functions in inhibition, shifting, and updating; the longitudinal development of executive functions and mathematics; and the relation between them. Sample. A total of 211 children in grade 2 (7–8 years old) from 10 schools in the Netherlands. Method. Children were followed in grade 1 and 2 of primary education. Executive functions and mathematics were measured four times. The test battery contained multiple tasks for each executive function: Animal stroop, local global, and Simon task for inhibition; Animal Shifting, Trail Making Test in Colours, and Sorting Task for shifting; and Digit Span Backwards, Odd One Out, and Keep Track for updating. The factor structure of executive functions was assessed and relations with mathematics were investigated using growth modelling. Results. Confirmatory factor analysis (CFA) showed that inhibition and shifting could not be distinguished from each other. Updating was a separate factor, and its development was strongly related to mathematical development while inhibition and shifting did not predict mathematics in the presence of the updating factor. Conclusions. The strong relationship between updating and mathematics suggest that updating skills play a key role in the maths learning process. This makes updating a promising target for future intervention studies.     

Comprehensive Trail Making Test performance in children and adolescents with traumatic brain injury

The sensitivity of the Trail Making Test to brain damage has been well-established over many years, making it one of the most commonly used tests in clinical neuropsychological evaluations. The current study examined the validity of scores from a newer version of the Trail Making Test, the Comprehensive Trail Making Test (CTMT), in children and adolescents with traumatic brain injury (TBI). Participants included 242 children and adolescents, 121 with sustained TBI and 121 normal control participants, who were matched to the individuals with TBI on age and sex. Receiver operating characteristic analysis indicated that the CTMT composite index provided the best overall classification, with a correct classification rate of 79%. Differences between the TBI and control groups remained stable across age. These findings indicate that the CTMT is sensitive to TBI and overall demonstrates classification rates that are comparable with some other versions of the Trail Making Test. Whether the CTMT will exhibit similar classification accuracy in adults with TBI and for other neurological disorders awaits further investigation.     

联想学习与工作记忆在流体智力发展中的作用

以115名7、10、13岁儿童为研究对象,采用配对联想学习、倒序背数、字母-数字排序、图画概念和矩阵推理等测验,考察联想学习与工作记忆在流体智力发展中的作用。结果发现:联想学习与工作记忆在流体智力发展中均起着重要的作用,然而,在不同年龄上,两者对流体智力的作用并不相同。具体来说,在7岁时,联想学习对流体智力的作用显著,而工作记忆的作用不显著;到10岁和13岁时,工作记忆对流体智力的作用显著,而联想学习的作用不再显著。从效应量来看,随着年龄的增长,联想学习对流体智力的作用逐渐减小,而工作记忆的作用则逐渐增加。