Assessing executive abilities following acute stroke with the trail making test and digit span

The Trail Making Test and Digit Span are neuropsychological tests widely used to assess executive abilities following stroke. The Trails B and Digits Backward conditions of these tests are thought to be more sensitive to executive impairment related to frontal lobe dysfunction than the Trails A and Digits Forward conditions. Trails B and Digits Backward are also thought to be more sensitive to brain damage in general. Data from the Stroke and Lesion Registry maintained by the Washington University Cognitive Rehabilitation Research Group were analyzed to compare the effects of frontal versus nonfrontal strokes and to assess the effects of stroke severity. Results showed that the performance of patients with frontal and nonfrontal strokes was comparable in each condition of both the Trail Making Test and Digit Span, providing no support for the widely held belief that Trails B and Digits Backward are more sensitive to frontal lobe damage. Further, Trails A was as strongly correlated with stroke severity as Trails B, whereas Digits Backward was more strongly correlated with stroke severity than Digits Forward. Overall, the Trail Making Test and Digit Span are sensitive to brain damage but do not differentiate between patients with frontal versus nonfrontal stroke.     

Procrastination,Hoarding, and Attention Beyond Age 65 a Community-Based Study

We examined procrastination, hoarding, and attention in 80 older adults in community samples in the American South. Volunteers completed Lay’s General Procrastination Inventory, Frost, Steketee, and Grisham’s Saving Inventory Revised, the Oral Trail Making Test, a computerized Stroop Color Word Test, and measures of semantic and phonemic verbal fluencies. Findings suggest that procrastination affects older adults and it may be reliably measured. As with younger people procrastination and hoarding correlated in a positive direction. Hoarding correlated negatively with performance on the Trail Making Test Part B and the Color Word Score on a modified version of the Stroop Test. Hoarding also correlated negatively with Semantic Fluency though not with Phonemic Fluency. Procrastination correlated significantly and negatively only with Semantic Fluency and not with other attention measures. Limitations of the study and implications for future research are discussed.     

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.     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

Verbal learning and visuomotor attention in Alzheimer's disease and geriatric depression

We compared the verbal learning and visuomotor attention of 34 Alzheimer's patients and 18 depressive patients. Verbal learning was assessed using The Hopkins Verbal Learning Test--Revised (HVLT--R); visuomotor attention was assessed using the Trail Making Test (TMT). The Alzheimer's patients had significantly lower scores on immediate and delayed recall of a word list. There was a nonsignificant trend in this group toward a fewer number of true positives and a greater number of false positives. Alzheimer's patients were significantly slower on Trails A, with a nonsignificant trend toward slower performance on Trails B. No difference was observed in accuracy of attentional processing. The results are discussed in terms of other factors, such as stage of cognitive decline, which might have influenced the findings.     

A Developmental Investigation of Prospective Memory: Effects of Interruption

The effects of interrupting an event-based prospective memory (PM) task and its associated ongoing task were compared for two groups of children: 8- to 9-year-olds (n?=?35) and 12- to 13-year-olds (n?=?28). Additionally, PM performance was examined as a function of attainment on a battery of tests of executive functioning (viz., Controlled Oral Word Association Test, Letter Number Sequencing Test, Stroop Color and Word Test, and Trail Making Test). A significant main effect of age indicated that the older children correctly carried out intended actions more often than the younger children. Consistent with the prefrontal model of PM, interruption had no impact on PM accuracy in the older group but produced reliable decrements to the accuracy of the younger group. Whereas IQ showed no association with PM performance, reliable relations between PM skills and aspects of their executive functioning were found.     

Predictors of decision-making on the Iowa Gambling Task: independent effects of lifetime history of substance use disorders and performance on the Trail Making Test

Poor decision-making and executive function deficits are frequently observed in individuals with substance use disorders (SUDs), and executive deficits may contribute to poor decision-making in this population. This study examined the influence of lifetime history of an alcohol, cocaine, heroin, or polysubstance use disorder on decision-making as measured by the Iowa Gambling Task (IGT) after controlling for executive ability, demographic characteristics, and current substance use. Participants (131 with lifetime history of SUD and 37 controls) completed the IGT and two neuropsychological tests: the Trail Making Test and the Controlled Oral Word Association Test. Control participants performed significantly better than those with a lifetime SUD history on the IGT, but performance on the neuropsychological tests was comparable for the two groups. A lifetime SUD diagnosis was associated with performance on the IGT after controlling for covariates, and Trail Making Test performance was associated with IGT performance in both SUD and control participants.     

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.     

Level of performance accuracy for core Halstead-Reitan measures by pooling normal controls from published studies: comparison with existing norms in a clinical sample

The Halstead-Reitan Neuropsychological Test Battery offers a multifaceted, empirically supported interpretive framework for neuropsychological assessment founded upon raw scores referenced to a brain-damaged sample. Complementary approaches have used T scores from normal samples often composed of community volunteers or medical patients, augmented by regression. By pooling normal controls of all types from published studies, a sample large enough for stratification of core Halstead-Reitan measures by age and education was obtained (206 studies, N1 = 17,980). Comparisons based on T scores with two published normative systems in an outpatient sample produced a continuum: liberal norms for medical patients, intermediate pooled values from many types of subjects, and stringent norms for community volunteers. Features recommending clinical application of pooled norms include enhanced accuracy in clinical situations precluding a full battery, few empty cells or inversions for nonelderly subjects, and a screening application based upon a very large Trail Making Test sample (Trails B: n > 14,000).     

Use of the Torrance Tests of Creative Thinking in an Exploratory Study of Creativity in Hong Kong Primary School Children: A Cross-cultural Comparison

This exploratory study reports an empirical attempt to (1) establish inter-scorer and parallel-forms reliabilities as well as convergent validity of the Chinese version of the TTCT, (2) measure the level of fluency, flexibility, and originality in 10–12 year-old Hong Kong children, and (3) compare the scores of the Hong Kong sample with those from other studies. The Figural and Verbal Forms A and B were administered. The overall results showed high inter-rater reliability of the Chinese version of the Test. The parallel-forms reliability between the Verbal Forms (P > 0.001) of the Test was higher than that between the Figural Forms (P > 0.05). The Hong Kong results on the Figural Test were generally higher than those obtained in Taiwan, Singapore, and USA, but slightly lower than the German results. This trend in the results was reversed on the Verbal Forms. The absence of sex differences on the TTCT was noted.     

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.     

Predictors of driving outcomes in advancing age

This study aimed to develop predictive models for real-life driving outcomes in older drivers. Demographics, driving history, on-road driving errors, and performance on visual, motor, and neuropsychological test scores at baseline were assessed in 100 older drivers (ages 65-89 years [72.7]). These variables were used to predict time to driving cessation, first moving violation, or crash. Using Cox proportional hazards regression models, significant individual predictors for driving cessation were greater age and poorer scores on Near Visual Acuity, Contrast Sensitivity, Useful Field of View, Judgment of Line Orientation, Trail Making Test-Part A, Benton Visual Retention Test, Grooved Pegboard, and a composite index of overall cognitive ability. Greater weekly mileage, higher education, and "serious" on-road errors predicted moving violations. Poorer scores from Trail Making Test-Part B or Trail Making Test (B-A) and serious on-road errors predicted crashes. Multivariate models using "off-road" predictors revealed (a) age and Contrast Sensitivity as best predictors for driving cessation; (b) education, weekly mileage, and Auditory Verbal Learning Task-Recall for moving violations; and (c) education, number of crashes over the past year, Auditory Verbal Learning Task-Recall, and Trail Making Test (B-A) for crashes. Diminished visual, motor, and cognitive abilities in older drivers can be easily and noninvasively monitored with standardized off-road tests, and performances on these measures predict involvement in motor vehicle crashes and driving cessation, even in the absence of a neurological disorder. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

A functional neuroimaging analysis of the Trail Making Test-B: implications for clinical application

Recent progress has been made using fMRI as a clinical assessment tool, often employing analogues of traditional "paper and pencil" tests. The Trail Making Test (TMT), popular for years as a neuropsychological exam, has been largely ignored in the realm of neuroimaging, most likely because its physical format and administration does not lend itself to straightforward adaptation as an fMRI paradigm. Likewise, there is relatively more ambiguity about the neural systems associated with this test than many other tests of comparable clinical use. In this study, we describe an fMRI version of Trail Making Test-B (TMTB) that maintains the core functionality of the TMT while optimizing its use for both research and clinical settings. Subjects (N=32) were administered the Functional Trail Making Test-B (f-TMTB). Brain region activations elicited by the f-TMTB were consistent with expectations given by prior TMT neurophysiological studies, including significant activations in the ventral and dorsal visual pathways and the medial pre-supplementary motor area. The f-TMTB was further evaluated for concurrent validity with the traditional TMTB using an additional sample of control subjects (N=100). Together, these results support the f-TMTB as a viable neuroimaging adaptation of the TMT that is optimized to evoke maximally robust fMRI activation with minimal time and equipment requirements.     

The adaptation of Chinese adolescents in two societies: a comparison of Chinese adolescents in Hong Kong and Australia

This study aimed to compare the adaptation of two groups of migrant Chinese adolescents with their nonmigrant peers. The migrant adolescents included 55 Chinese migrant adolescents who migrated to Australia (Chinese‐Australian) and 111 China‐born adolescents who migrated to Hong Kong (Chinese‐Hong Kong). The nonmigrant adolescents included 157 Anglo‐Australian adolescents residing in Australia and 456 Hong Kong‐born Chinese adolescents residing in Hong Kong. There were three research questions in this study. First, would there be any differences in the adaptation of Chinese migrant adolescents in different societies of settlement? Second, would migrant adolescents experience more adaptation problems than nonmigrant adolescents? Third, would there be any differences in the adaptation of adolescents in the two societies, Australia and Hong Kong? It was hypothesized that: (1) mainland Chinese migrant adolescents in Hong Kong would experience more adaptation problems than Chinese migrant adolescents in Australia; (2) migrant adolescents would report better adaptation than nonmigrant adolescents; (3) adolescents in Hong Kong would report poorer adaptation than adolescents in Australia. The participants were requested to complete a questionnaire on various adaptation outcome measures including life satisfaction, self‐esteem, psychological symptoms, academic satisfaction, and behaviour problems. The results indicated that Chinese‐Australian adolescents reported better psychological adaptation but Chinese‐Hong Kong adolescents reported better sociocultural adaptation. Adolescents resident in Australia reported higher psychological adaptation but lower sociocultural adaptation than those in Hong Kong. Migrant adolescents reported better psychological and sociocultural adaptation than their nonmigrant counterparts. The results were discussed in relation to the social and educational systems of the two societies.     

Performances on Symbol Digit Modalities Test,Color Trails Test,and modified Stroop test in a healthy,elderly Danish sample

ABSTRACT

This study presents Danish data for the Symbol Digit Modalities Test (SDMT), Color Trails Test (CTT), and a modified Stroop test from 100 subjects aged 60–87 years. Among the included demographic variables, age had the highest impact on test performances. Thus, the study presents separate data for different age groups. For SDMT and CTT1, Danish Adult Reading Test (DART) score also had a significant impact on test performances. The incongruent version of the modified Stroop test was significantly correlated to education. Moderate and significant correlations were found between the three tests. Even though the three tests are commonly used, few normative data for elderly exists. SDMT and CTT performances from this study were in the same range as previously published international norms, but the validity of the result from the modified Stroop test could not be investigated.     

The Trail Making Test and Canter Background Interference Procedure in screening for organicity in chronic schizophrenia: a preliminary report

For 10 male organic chronic schizophrenics scores on the Trail Making Test and Canter Background Interference Procedure were compared. These patients had severe hyponatremia, a condition that results in brain damage. The hit rate for correctly classifying the oranicity was 100% on the basis of sequence binding on Trial Making B and 50% on Canter's procedure. The findings suggested that the Trial Making Test may prove useful in discriminating organic from nonorganic schizophrenics. Implications for research were discussed.     

The Utility of the Revised Life Orientation Test to Measure Optimism among Hong Kong Chinese

To examine the utility of the revised Life Orientation Test (LOT-R) to measure optimism among Hong Kong Chinese, the psychometric properties of the revised and the original versions of the Life Orientation Test were compared. A total of 248 Hong Kong Chinese undergraduates were studied in the fall and 165 of these participants were tested again 5 months later. Results indicated that the LOT-R is a reliable and valid measure of dispositional optimism among Hong Kong Chinese. Confirmatory factor analysis showed that the LOT-R represents a one-factor model of optimism better than does the original version. Despite its brevity, the LOT-R is psychometrically sounder than the original sclae. These findings point to the feasibility of replacing the original with the revised scale in future research among Hong Kong Chinese. However, the utility of the revised test in cross-cultural comparisons may still be limited by the absence of emic components. Further research on optimism in the Chinese people with the LOT-R should pay more attention to the identification of emic dimensions.     

Episodic future thinking: Linking neuropsychological performance with episodic detail in young and old adults

Episodic future thinking (EFT) has been linked with our ability to remember past events. However, its specific neurocognitive subprocesses have remained elusive. In Experiment 1, a study of healthy older adults was conducted to investigate the candidate subprocesses of EFT. Participants completed a standard EFT cue word task, two memory measures (Verbal Paired Associates I, Source Memory), and two measures of executive function (Trail Making Test, Tower Test). In Experiment 2, healthy young adults also completed an EFT task and neuropsychological measures. The link between neurocognitive measures and five characteristics of EFT was investigated. Specifically, it was found that Source Memory and Trail Making Test performance predicted the episodic specificity of future events in older but not younger adults. Replicating previous findings, older adults produced future events with greater semantic but fewer episodic details than did young adults. These results extend the data and emphasize the importance of the multiple subprocesses underlying EFT.     

What do we learn from the Implicit Association Test about intergroup attitudes in Hong Kong? The case of social identification inclusiveness and need for closure

The current study tests an implication of the Associative-Propositional Evaluation model of implicit and explicit attitude measures in Hong Kong's intergroup context. We argued that the Implicit Association Test taps associative intergroup evaluations that are not necessarily consistent with the propositional implications of one's social identification inclusiveness and need for closure. In contrast, explicit intergroup attitude measures tap propositional evaluations resulting from validating the inferences drawn from pertinent propositional information in the evaluation context. Thus, explicit intergroup attitude should be consistent with the propositional implications of social identification inclusiveness and need for closure. We tested and found support for these hypotheses in a study of Hong Kong adolescents' ( N  = 65) perception of Hong Kong people and Mainland Chinese.     

Health beliefs,optimism, and health‐related decisions: A study with Hong Kong Chinese

T he Health Belief Model (HBM; Rosenstock, 1966) is the most widely used psychological theory of health‐related behaviours but its applicability to non‐Western, especially Asian, populations has not been systematically studied. The main objective of the current study was to examine the effects of components of the HBM and dispositional optimism on preventive intention in two separate samples of 220 Hong Kong Chinese adults and 340 Hong Kong Chinese adolescents. Two HBM variables, benefits and barriers, were experimentally manipulated for an imaginary flu outbreak and a hypothetical vaccine. Optimism in the two samples was assessed using the Chinese revised Life Orientation Test (Lai et al., 1998). Participants indicated their intention to take the hypothetical vaccine after reading information for each of the treatment combinations defined by the two HBM variables. The order of the presentation of each of the six treatment conditions was counterbalanced. Results of ANOVA showed that the effects of the two HBM variables were similar in the two groups. Higher benefits and lower barriers were associated with stronger behavioural intention to take the vaccine. The two HBM variables interacted significantly in the adolescent but not the adult sample. Among the adolescents, the difference in intention scores between low and high barriers became larger when the benefits of taking the vaccine increased. In addition, optimism had significant effect on preventive intention only among the adolescents. These findings suggest that age may be an important factor moderating the effects of HBM components as well as optimism on preventive intention in Hong Kong Chinese. Implications of these findings to future research among Chinese were discussed.