The validity of aphasic subtypes

The validity of aphasic subtypes derived by the Norwegian Basic Aphasia Assessment, NBAA, is discussed. 193 aphasic patients were reclassified according to the criteria of classification used by the Western Aphasia Battery. 85% agreement was established with mixed cases held apart, Wernicke's and Counduction aphasia being the least stable groups. Cluster analysis produced 9 clusters, of which 8 proved statistically valid through discriminant analysis and clinically valid through inspection of the derived test profiles. These were: Global, Broca's, Wernicke's and Anomic aphasia, each separated in a major and a minor impaired group. Accepting unclassifiable cases and specifying the desired domain of validity when classifying aphasia, are discussed.     

Verbal and nonverbal recognition memory in aphasic and nonaphasic stroke patients

The ability to retain lists of verbal and nonverbalizable items across recurrent recognition tasks was tested in three groups: (1) stroke patients with a left-brain lesion and aphasia, (2) stroke patients with a right-brain lesion and left hemiplegia, and (3) nonneurologically impaired outpatients. As determined with signal detection measures, aphasics were deficient in discriminating words that were to be remembered from those that were not; their recognition of nonverbal visual (geometric art) or auditory (bird calls) patterns, however, was unimpaired. Left hemiplegics showed the opposite pattern. After a long-term interval (<10 min), correct recognition of words was diminished in all groups whereas recognition of visual patterns increased. Both groups of stroke patients adopted material-specific decision criteria which in part accounted for the dissociation of verbal and nonverbal recognition memory by laterality of lesion. Item analysis indicated that aphasics' verbal memory difficulties were affected by acoustic-semantic confusion of list words.     

The neuropsychological assessment of dementia

It has become standard practice to base the diagnosis of dementia on the combination of neuropsychological and non-behavioral findings. The present article provides a short, clinically oriented synopsis of the targets, investigational procedures, and difficulties of the modern neuropsychological approach to the diagnosis of dementia. Over the years, neuropsychology has developed assessment tools to evaluate the cognitive and behavioral abnormalities of many dementias. Validated tests of memory, language, executive, and other cognitive functions are used to screen for dementia and identifying certain dementia profiles. Behavioral assessment procedures are available for non-cognitive neurodegenerative alterations. At present, problems arise mainly with the behavioral heterogeneity of certain dementia syndromes. Especially problematic are discrimination of age-associated or mild cognitive impairments from incipient dementia and the impact of psychiatric symptoms on cognitive functions. It is concluded that neuropsychology offers a valuable contribution to the diagnosis and differential diagnosis of dementia.     

The interface between counselling and neuropsychological assessment of patients with AIDS/HIV

Manifestations of central nervous system dysfunction in adults and children with AIDS/HIV are common. The contribution of counselling in relation to these patients is described. This includes: contributing to the assessment of patients, addressing ‘dreaded issues' while patients are still well, helping patients to find solultions and manage problems, engaging the support of friends and the family in managing patients, ‘translating’ the results for the patient from formal assessments, discussing treatment options and helping parents and prospective parents to manage behaviour problems in their children. Counsellors also have a special role in advising and consulting colleagues about the management of these patients. Counselling in a clinical setting is, however, inextricably bound to limitations in the medical care of this patient group.     

The detection of malingering in neuropsychological assessment

Although malingering, or the manipulation of data by the patient, is a problem commonly faced by neuropsychologists, there has been little systematic investigation of this problem. This paper reviews the literature on the detection of malingering in assessment instruments commonly used by clinical neuropsychologists. Criticism of previous research is discussed, and suggestions are made both for future research and for clinical practice.     

Desirable features in neuropsychological tests

Seven desirable features are presented as guidelines for the design and evaluation of neuropsychological tests. Such features are not systematically present in most commonly used testing procedures because the field's methods have been borrowed from disciplines whose theories and measurement goals are quite different from those of modern neuropsychology. In the course of the presentation, three meanings of the term deficit are differentiated.     

Factorial pattern description and comparison of functional abilities in neuropsychological assessment.

A principal factor analysis of 36 neuropsychological test variables yielded eight readily definable factors. These factors represent the kinds of general functions evaluated in the assessment of organic brain damage. The functional categorical scheme produced by the factor analysis was compared with other empirical and theoretical schemes. Shortcomings of the traditional neuropsychological battery were discussed in terms of the factors.     

Patterns of spontaneous recovery in aphasic groups: A study of adult stroke patients

The recovery of 31 aphasic stroke patients in the first three months postonset was investigated. Improvements on eight comprehension, repetition, and expression tasks were documented for four groups. These groups, retrospectively defined on the basis of initial scores on a fluency and a comprehension task, were: Low Fluency/Low Comprehension (LFLC), Low Fluency/High Comprehension (LFHC), High Fluency/Low Comprehension (HFLC), and High Fluency/High Comprehension (HFHC). Examination of each group's recovery revealed (1) equal improvement on nearly all language tasks for the two High Comprehension groups and (2) a more selective improvement largely in comprehension and imitation tasks for the two Low Comprehension groups. Implications of this selective improvement in initially low comprehending aphasics are discussed.     

Reliability and validity of the functional assessment rating scale.

The Functional Assessment Rating Scale was developed as a measure of psychiatric symptomatology and psychosocial impairments. This study was designed to report estimates of reliability and validity with a population of schizophrenic patients. The scale showed very good interrater agreement, test-retest reliability, construct validity, and concurrent validity, so the scale seems a useful measure of psychopathology which may be used to assess and monitor patients displaying severe mental illnesses.     

An evaluation of the convergent validity of a face-to-face and virtual neuropsychological assessment counter balanced

The COVID-19 pandemic has highlighted the need for further research evaluating the validity of conducting a battery of neuropsychological assessments virtually compared with face-to-face administration. Previous research has suggested that some neuropsychological assessments yield valid results when administered virtually, however, much of the previous research focused on older adults. To determine the validity of virtually administered neuropsychological tests, 28 healthy participants were assessed using a within-subjects, counter-balanced design. Participants completed a neuropsychological assessment battery covering tests of general intellectual functioning, memory and attention, executive functioning, language and information processing speed, as well as effort. There was no significant difference between face-to-face administration of the neuropsychological battery compared with virtual administration for the majority of the tests used. However, there were significant differences in the Colour Naming Task, with participants making fewer errors on the colour naming task and inhibition/switching task when administered virtually compared with face-to-face administration. There was also a significant age cohort effect in the inhibition/switching task. There was also a trending significant difference in mode of administration for the Verbal Fluency Task. Virtually administered neuropsychological assessments largely provide a valid alternative to face-to-face assessments; however, consideration must be given to test selection as well as the population of participants that are being assessed. Other important considerations must focus on preserving the security and integrity of test materials, as well as administration in a medico-legal setting. Future research should focus on validating assessments with specific patient populations and developing a neuropsychological assessment battery using information technology.     

Idiom comprehension in aphasic patients

Idiom comprehension was assessed in 10 aphasic patients with semantic deficits by means of a string-to-picture matching task. Patients were also submitted to an oral explanation of the same idioms, and to a word comprehension task. The stimuli of this last task were the words following the verb in the idioms. Idiom comprehension was severely impaired, with a bias toward the literal interpretation. Very few errors were produced with words, making impossible to establish a correlation between comprehension of idioms and of individual words. The difficulties in idiom comprehension seemed to be due to the fact that patients rely on a literal-first strategy, accessing a figurative interpretation only when the linguistic analysis fails to yield acceptable results.     

Construct validity and case validity in assessment

Clinical assessment relies on both construct validity, which focuses on the accuracy of conclusions about a psychological phenomenon drawn from responses to a measure, and case validity, which focuses on the synthesis of the full range of psychological phenomena pertaining to the concern or question at hand. Whereas construct validity is grounded in understanding causal influences of a distinct phenomenon on responses to various measures and life contexts, case validity encompasses the joint influences of multiple phenomena on individuals' responses. Two sets of distinctions essential to understanding psychological phenomena, hence to understanding construct validity, are (a) implicit and explicit versions of personality constructs and (b) ability and personality as versions of constructs measured by performance tests presenting maximal and typical conditions, respectively. Since both implicit and explicit versions of constructs interface with maximal or typical performance conditions, case validity requires systematic inclusion of these distinctions in assessment protocols.     

The validity of interpersonal skills assessment via situational judgment tests for predicting academic success and job performance

This study provides conceptual and empirical arguments why an assessment of applicants' procedural knowledge about interpersonal behavior via a video-based situational judgment test might be valid for academic and postacademic success criteria. Four cohorts of medical students (N = 723) were followed from admission to employment. Procedural knowledge about interpersonal behavior at the time of admission was valid for both internship performance (7 years later) and job performance (9 years later) and showed incremental validity over cognitive factors. Mediation analyses supported the conceptual link between procedural knowledge about interpersonal behavior, translating that knowledge into actual interpersonal behavior in internships, and showing that behavior on the job. Implications for theory and practice are discussed.