Verbal fluency in children with ADHD: Strategy using and temporal properties

Verbal fluency tasks are commonly used in cognitive and developmental neuropsychology in assessing executive functions, language skills as well as divergent thinking. Twenty-two typically developing children and 22 children with ADHD between the ages of 8 and12 years were examined using verbal fluency tasks, prepotent response inhibition, and working memory tests. The clinical group showed impaired inhibitory and spatial working memory processes. We used different qualitative analyses of verbal fluency tasks to explore the lexical and executive strategies (word clustering and switching), and the temporal properties of the responses. Children with ADHD had a leeway in applying relevant lexical or executive strategies related to difficulties in strategy using. The reduced efficiency of children with ADHD in semantic fluency task is based on suboptimal shifting between word clusters and is related to the lack of ability of producing new clusters of items. The group difference appeared at the level of accessing and/or activating common words; however, the executive process of searching the lexicon extensively is intact.     

An interview to measure vital exhaustion. I. development and comparison with the maastricht questionnaire

Abstract

This article presents an interview designed to measure vital exhaustion (VE), a state characterized by unusual fatigue, increased irritability and feelings of demoralization, which has been found to be a short-term risk indicator of myocardial infarction (MI). This state can be measured by means of the Maastricht Questionnaire (MQ). However, the MQ was found to have some major shortcomings for the selection of subjects for laboratory or clinical investigations. For this reason we designed an interview to assess VE. To test the hypothesis that the interview registers prodromal feelings of MI, the interview was administered to a sample of 81 males who were hospitalized because of a first myocardial infarction (mean age 55.6 years; sd 6.8) and a sample of 168 healthy males (mean age 54.9 years; sd 6.9). Mean scores of cases and controls differed significantly (7.8; sd 6.0 and 3.6; sd 4.0, respectively; t=5.65; p=.000). Mean scores on the questionnaire discriminated significantly too, but the discriminating power was much lower (t=2.31; p=.02). The article gives detailed instructions on the way in which the interview should be administered and scored.     

The ADP-IV questionnaire: differential validity and concordance with the semi-structured interview

The Assessment of DSM-IV Personality Disorders questionnaire (ADP-IV) is a self-report measure of the DSM-IV Axis II personality disorders (PDs). The ADP-IV assesses for each DSM-IV criterion its typicality as well as the accompanying distress and impairment. This study investigates two important aspects of the construct validity of the ADP-IV: (a) the differential validity (i.e., the ability to differentiate between a sample of the general Flemish population ( n = 659) and a sample of psychiatric inpatients ( n = 487) with a high prevalence of clinical PD diagnoses, and patients with and without a PD in the psychiatric sample; (b) the convergent validity with the SCID-II semi-structured interview in a population of psychiatric inpatients ( n = 59). The results indicate a good differential validity: the dimensional scales and the categorical measures discriminated well between both groups and between patients with and without a PD diagnosis in the psychiatric sample. Concerning the concordance with the SCID-II, a decent level of agreement is exemplified by a correlation of.67 between the dimensional total scores of both instruments and by kappa coefficients for an "any" Axis II diagnosis at the.50 level. In conclusion, the results indicate that the ADP-IV is an efficient method for assessing PD in dimensional and categorical ways.     

Assessment of DSM-IV personality disorders in obsessive-compulsive disorder: comparison of clinical diagnosis, self-report questionnaire, and semi-structured interview

In patients with obsessive-compulsive disorder, personality disorders are not many times assessed according to DSM-IV criteria. The purpose of the present study is to examine the prevalence of personality disorders diagnosed according to the DSM-IV in a severely disordered OCD population (n=65) with three different methods of assessing personality disorders (structured interview, questionnaire, and clinical diagnoses). Furthermore, correspondence between these different methods was investigated and their construct validity was examined by relating the three methods to external variables. Each method resulted in a predominance of Cluster C personality disorders, and obsessive-compulsive personality disorder had the highest prevalence. However, there was generally low correspondence regarding which patient had which personality disorder. Results concerning the relation of external variables were the most promising for the structured clinical interview.     

Fluency and fluency disorders: Their definition,measurement, and modification

Attempts at designing clinical procedures that would directly enhance fluency in disfluent speakers have been increased in the recent past. However, some of the basic problems relating to the definition, measurement, and modification of fluency and fluency disorders have not received much systematic attention. Some of these problems are examined in this article with a view to identify important research and clinical needs. Published studies on fluency therapy are also reviewed.     

Estimating the reliability of interview data

A model for a score based on an interview is presented which identifies the effect due to the subject, to the manner in which the interviewer tends to conduct his interviews, to the criteria he tends to use in scoring subjects' responses, to the compromises he tends to adopt between the demands of interviewing and those of scoring, and to chance errors. A suggested experimental design calls for each ofK investigators to interview a different sample ofN subjects, but for all investigators to score each subject. The drawing of inferences when interest is only in theK participants in the reliability study is considered, and a numerical example is given.This work was supported in part by grant DE R01 00793 from the National Institute of Dental Research, and in part by grants MH 08534 and MH 09191 from the National Institute of Mental Health, and forms part of the author's Ph.D. dissertation at Columbia University. The guidance provided by Professor T. W. Anderson is gratefully acknowledged.     

The adult attachment interview and the relationship questionnaire: Relations to reports of mothers and partners

The study asked the following questions: How do interview and self-report assessments of attachment status correspond? What is the relation between attachment status assessed by these methods to self-reports of relationships with mothers and partners? Participants were 53 married white women assessed with the Adult Attachment Interview (AAI), and the Relationship Questionnaire (RQ), and a variety of questionnaires assessing love, trust, and closeness in relationships with mothers and partners. Results indicated a trend toward a relation between AAI and RQ classifications: 81% of women classified as Secure with the AAI identified themselves as Secure with the RQ, but only 42% of AAI-Insecure women identified themselves as Insecure with the RQ. Secure and Insecure AAI groups did not differ in their reports of mothers or partners, whereas Secure and Insecure RQ groups did. Results indicated classifications derived from the measures are not equivalent.     

Verbal fluency and creativity: General and specific contributions of broad retrieval ability (Gr) factors to divergent thinking

The Cattell–Horn–Carroll (CHC) model of intelligence views creativity as a first-level factor within the second-level factor of broad retrieval ability (Gr), alongside other first-level abilities such as ideational fluency and word fluency. Traditional methods of measuring creativity, however, confound idea quality with idea quantity, which might exaggerate the relationship between creativity scores and verbal fluency factors. Participants (n = 131 adults) completed two divergent thinking tasks (unusual uses for a rope and a box), which were scored using newer methods that effectively separate creativity (scored via subjective ratings) and fluency (scored as number of responses). They then completed 16 verbal fluency tasks that assessed six lower-order Gr factors: word fluency, associational fluency, associative flexibility, ideational fluency, letter fluency, and dissociative ability. Viewed singly, many of the lower-order factors significantly predicted creative quality and fluency. General Gr had substantial effects on creative quality (standardized β = .443) and fluency (β = .339) in a higher-order model as well as in a bifactor model (quality β = .380, fluency β = .327). Moreover, general Gr was the only significant predictor in the bifactor model, suggesting that it, not the specific factors, was most important. All effects were essentially the same after controlling for typing speed and vocabulary knowledge. The findings thus support the CHC view of creativity/originality as a lower-order component of Gr, illuminate the relationships between creativity and first-level Gr factors, extend the study of creativity and intelligence beyond fluid intelligence, and further indicate that creativity is more closely tied to cognitive abilities than creativity research has yet recognized.     

Verbal fluency over time as a measure of automatic and controlled processing in children with ADHD

The performance of ADHD children on semantic category fluency (SCF) versus initial letter fluency (ILF) tasks was examined. For each participant, word production was recorded for each 15-s time slice on each task. Performance on both fluency tasks was compared to test the hypothesis that children with ADHD are characterized by a performance deficit on the ILF task because performance on this task is less automated than performance on the SCF. Children classified with ADHD (N = 20) were compared to children with other psychopathology (N = 118) and healthy controls (N = 130). Results indicated that the groups could not be differentiated by the total number of words produced in 60 s in either fluency task. As hypothesized, a significant interaction of group by productivity over time by type of fluency task was found: ADHD children had more problems finding words in the first 15 s of the IFL than did children in the other two groups, and as compared with their performance on the SCF. Results were taken to indicate that children with ADHD symptoms show a delay in the development of automating skills for processing abstract verbal information.     

Convergence of scores on the interview and questionnaire versions of the Eating Disorder Examination: a meta-analytic review

Significant discrepancies have been found between interview- and questionnaire-based assessments of psychopathology; however, these studies have typically compared instruments with unmatched item content. The Eating Disorder Examination (EDE), a structured interview, and the questionnaire version of the EDE (EDE-Q) are considered the preeminent assessments of eating disorder symptoms and provide a unique opportunity to examine the concordance of interview- and questionnaire-based instruments with matched item content. The convergence of EDE and EDE-Q scores has been examined previously; however, past studies have been limited by small sample sizes and have not compared the convergence of scores across diagnostic groups. A meta-analysis of 16 studies was conducted to compare the convergence of EDE and EDE-Q scores across studies and diagnostic groups. With regard to the EDE and EDE-Q subscale scores, the overall correlation coefficient effect sizes ranged from .68 to .76. The overall Cohen's d effect sizes ranged from .31 to .62, with participants consistently scoring higher on the questionnaire. For the items measuring behavior frequency, the overall correlation coefficient effect sizes ranged from .37 to .55 for binge eating and .90 to .92 for compensatory behaviors. The overall Cohen's d effect sizes ranged from -0.16 to -0.22, with participants reporting more binge eating on the interview than in the questionnaire in 70% of the studies. These results suggest the interview and questionnaire assess similar constructs but should not be used interchangeably. Additional research is needed to examine the inconsistencies between binge frequency scores on the 2 instruments.     

Assessment of eating disorder psychopathology in obese children and adolescents: interview versus self-report questionnaire

The present study compared two methods for assessing binge eating and related eating disorder psychopathology in obese children and adolescents. A comparison was made between the child version of the Eating Disorder Examination (ChEDE) and the self-report version of the interview (ChEDE-Q). A total of 139 children and adolescents (aged 10-16 years) seeking inpatient treatment for obesity completed the ChEDE questionnaire and were administered the ChEDE interview afterwards. The ChEDE and ChEDE-Q were significantly correlated for the four subscales: restraint, eating concern, weight concern and shape concern. The ChEDE-Q generated consistently higher levels of eating disorder psychopathology. There was a significant discrepancy for the assessment of a more complex feature such as binge eating. Overall, the current study found lower levels of agreement between the EDE and EDE-Q than previously reported in adult samples. It appears that children and adolescents have difficulties in identifying binge-eating episodes when they receive no detailed instruction. It is concluded that a clinical interview is necessary to identify eating disorders in obese children and that a self-report questionnaire can only be used as a screening tool. Even then, thorough clarification of the definition of the eating disorder features is needed when using a self-report questionnaire.     

Qualitative analysis of verbal fluency output: review and comparison of several scoring methods

We compared three approaches to scoring qualitative aspects of verbal fluency performance in 88 healthy young adults. Phonemic and semantic fluency output was scored for word clustering and switching between clusters. Convergent validity analyses using other tests presumed to tap into strategy use (California Verbal Learning Test, Ruff Figural Fluency Test) support scoring of phonemic and semantic clusters on both fluency tasks. Task-discrepant clustering (e.g., semantic clustering on phonemic fluency) may index intentional strategy use on both fluency tasks, whereas task consistent clustering (e.g., phonemic clustering on phonemic fluency) appears strategic only on semantic fluency. Switching can be decomposed into subtypes that appear to reflect different cognitive processes on phonemic versus semantic fluency. Principal components analyses suggest that earlier scoring methods do not fully capture the "process" aspects of verbal fluency performance.     

The cognitive-somatic anxiety questionnaire: Psychometric and validity data

The Cognitive-Somatic Anxiety Questionnaire (CSAQ) is a 14-item self-report inventory that is divided into two 7-item scales (Cognitive and Somatic) that appear to reflect cognitive or somatic anxiety. In an attempt to evaluate the construct validity of this multidimensional instrument, the CSAQ was administered to 109 college students along with several other measures of physical and psychological symptoms. The results suggest that (a) despite considerable overlap between the Cognitive and the Somatic scales (r=.62), an exploratory factor analysis is able to identify a single large somatic factor along with three lesser cognitive-appearing factors, and (b) the correlations with concurrent measures of related constructs provide some limited evidence of the construct validity of the CSAQ. For males, both the Cognitive and the Somatic scales of the CSAQ correlated significantly with several anxietyrelated measures. However, for females CSAQ scores correlated less consistently with the other test scales, although Somatic scale scores for females were positively related to measures of health and exercise involvement. Suggestions for improving the CSAQ are offered.     

Improving the metric quality of questionnaire data

A procedure is proposed whereby questionnaire data, which is usually ordinal in nature and often error-ridden, may be transformed to reduce the error variance in the data and to improve the metric properties of the individual variables. The technique is suggested by a result of Eckart and Young. The properties of the method are investigated by means of a Monte Carlo study. Various matrices were generated representing the usual concept of true scores. These matrices were distorted using two levels of random errors and two kinds of categorization. The distorted matrices were in turn transformed by the proposed methods and compared to the true scores. In all cases an overall measure of similarity reveals the transformed matrices are better approximations to the true scores than the untransformed data. Some properties of the transformation are discussed and some possible applications of the general technique are suggested.     

Tachistoscopic and questionnaire methods for the measurement of psychological defences

Only few attempts have been made to compare different methods aiming at quantifying defensive strategies. In this study the tachistoscopic Defence Mechanism Test (Kragh, 1960b and 1985) is compared to paper-and-pencil tests of defence. There were virtually no correlations between the DMT and the other measures of defence. This may indicate that the concept of defence is a highly complex one. It is suggested that the Defence Mechanism Test may be measuring primary defence while defence questionnaires may be assessing more secondary forms of defence. The two questionnaires used for assessing defence correlated significantly, while a scale for social desirability showed no correlation with DMT or the two defence questionnaires.     

A comparison of the category fluency deficits associated with Alzheimer's and Huntington's disease

The supermarket verbal fluency test of the Dementia Rating Scale (DRS) was administered to 20 patients with mild Alzheimer's disease (Mi-DAT), 20 patients with moderately severe Alzheimer's disease (Mo-DAT), 20 patients with Huntington's disease (HD), and 40 normal control subjects. The findings confirmed previous reports that Mo-DAT patients retrieved fewer words per category of supermarket items sampled and had a greater propensity to generate category labels (superordinates) than did intact controls. Similar disruptions of the structure of semantic knowledge were also noted in the fluency performances of the Mi-DAT and HD patients. The Mi-DAT patients' tendency to generate few exemplars for each category sampled suggested that a significant disruption in the structure of semantic knowledge occurred even in the earliest stages of DAT. When the present fluency findings for the HD patients were considered with previous reports of linguistic changes in this disorder, it appeared that HD patients' deterioration in semantic knowledge involved associative changes rather than the bottom-up breakdown associated with DAT.