Dementia and mental retardation markers on the Rey 15-item Visual Memory Test

This study examined the qualitative errors of repetitions and confabulations on the Rey 15-item Visual Memory Test among 500 psychiatric patients who were divided into groups with (1) low IQ scores, (2) a diagnosis of dementia, and (3) other psychiatric diagnoses. These groups were compared on the presence of confabulated figures and repetitions on the Rey. The low IQ patients had the highest rate for both confabulations (48.2%) and repetitions (43.6%). Demented patients had the next highest rate of confabulations (39.8%) and repetitions (39.8%). The general psychiatric patients had the lowest rates on confabulations (16.2%) and repetitions (26.8%). Chi squared analysis showed that both confabulations and repetitions significantly differentiated these patients of low IQ and demented patients from general psychiatric patients. These results suggest that clinicians who use the Rey 15-item Visual Memory Test and find either confabulated or repeated figures should further explore the possibility that the patient might have low intellectual functioning or dementia.     

Confirmatory factor analysis of the WAIS-IV/WMS-IV

The Wechsler Adult Intelligence Scale-fourth edition (WAIS-IV) and the Wechsler Memory Scale-fourth edition (WMS-IV) were co-developed to be used individually or as a combined battery of tests. The independent factor structure of each of the tests has been identified; however, the combined factor structure has yet to be determined. Confirmatory factor analysis was applied to the WAIS-IV/WMS-IV Adult battery (i.e., age 16-69 years) co-norming sample (n = 900) to test 13 measurement models. The results indicated that two models fit the data equally well. One model is a seven-factor solution without a hierarchical general ability factor: Verbal Comprehension, Perceptual Reasoning, Processing Speed, Auditory Working Memory, Visual Working Memory, Auditory Memory, and Visual Memory. The second model is a five-factor model composed of Verbal Comprehension, Perceptual Reasoning, Processing Speed, Working Memory, and Memory with a hierarchical general ability factor. Interpretative implications for each model are discussed.     

Memory in traumatic brain injury: The effects of injury severity and effort on the Wechsler Memory Scale‐III

This study examined the effects of traumatic brain injury (TBI) on Wechsler Memory Scale‐III (WMS‐III) performance. Since poor effort potentially contaminates results, effort was explicitly assessed and controlled using two well‐validated cognitive validity indicators, the Portland Digit Recognition Test (PDRT) and Reliable Digit Span (RDS). Participants were 44 mild TBI patients with good effort, 48 mild TBI patients with poor effort, and 40 moderate–severe TBI patients with good effort. A dose–response relationship between injury severity and WMS‐III performance was demonstrated. Effect size calculations showed that the good effort mild TBI patients did not differ from normal (average Cohen's d= 0.07) while moderate–severe TBI had a moderate effect on WMS‐III scores (average Cohen's d=?0.52). Consistent with previous literature, the moderate–severe TBI group scored the lowest on WMS‐III Visual indices. Effort had a larger effect than injury severity on WMS‐III scores (average Cohen's d=?1.27). Clinical implications of these findings are discussed.     

Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion

In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients.     

Commission error rates on a continuous performance test are related to deficits measured by the Benton Visual Retention Test

This study is one in a series investigating the relationship between impulsive behavior on a Continuous Performance Test (i.e., the Immediate and Delayed Memory Task) and other cognitive deficits measured by clinical instruments. Forty-two adolescents were selected for two groups, controls and hospitalized patients with disruptive behavior disorders. Each adolescent completed the Immediate and Delayed Memory Task and the Benton Visual Retention Test. Our main findings were that, even when controlling for IQ, the Immediate and Delayed Memory Task commission errors were associated with adverse Benton performance, but only in the patient group. These results may be explained by a shared association between processes of impulsivity and other deficits of executive control that may interfere with successful performance of the Benton.     

Validity of the Brief Psychiatric Rating Scale Within a Forensic Inpatient Hospital

Although the Brief Psychiatric Rating Scale(BPRS) has been utilized across several clinical settings, its potential utility within forensic psychiatric hospitals has not yet been investigated. Given the diversity of training and background among correctional mental health workers (i.e., psychiatrists, psychiatric nurses, occupational therapists, recreation therapists, psychologists, social workers,etc.) it is possible that the uniform use of the BPRS among the correctional staff would require extensive training and that substantial “refresher” training may be required to maintain the integrity of rater practices. The present study examined the ability of previously trained forensic mental health professionals to accurately assess psychopathology using the BPRS. Overall,experienced raters demonstrated relatively high concordance rates with “gold standard” ratings across three BPRS training videos (Case 1, Case2 and Case 3). No overall “rater drift” was apparent. However, raters were found to make significantly more errors when rating behavioral observation ratings than for ratings based on self-report patient statements. Findings suggest that ratings done by forensic mental health workers are relatively accurate when compared to “gold standard” ratings established for assessment of community and forensic psychiatric patients. This revised version was published online in July 2006 with corrections to the Cover Date.     

On the control of visual fixation durations in free viewing of complex images

The mechanisms for the substantial variation in the durations of visual fixations in scene perception are not yet well understood. During free viewing of paintings, gaze-contingent irrelevant distractors (Exp. 1) and non-gaze-related time-locked display changes (Exp. 2) were presented. We demonstrated that any visual change-its onset and offset-prolongs the ongoing fixation (i.e., delays the following saccade), strongly suggesting that fixation durations are under the direct control of the stimulus information. The strongest influence of distraction was observed for fixations preceded by saccades within the parafoveal range (<5° of visual angle). We assume that these fixations contribute to the focal in contrast to the ambient mode of attention (Pannasch & Velichkovsky, Visual Cognition, 17, 1109-1131, 2009; Velichkovsky, Memory, 10, 405-419, 2002). Recent findings about two distinct "subpopulations of fixations," one under the direct and another under the indirect control of stimulation (e.g., Henderson & Smith, Visual Cognition, 17, 1055-1082, 2009), are reconsidered in view of these results.     

Understanding Chest Pain: What Every Psychologist Should Know

Chest pain is one of the most frequent presenting complaints in Emergency Rooms and other medical settings. A considerable number of these patients do not have significant coronary artery disease. This led to plausible alternative explanations for these presenting symptoms and these patients tend to have unremarkable cardiac outcomes. Nevertheless, many studies have also documented that symptoms and related disability persist in the face of reassurances about benign cardiac status. Given the implied threat of chest pain (e.g., myocardial infarction) and the presence of chest pain symptoms in other noncardiac conditions (including anxiety and panic), it is not surprising that many of these patients present with considerable emotional distress. Consequently, chest pain symptoms represent diagnostic and treatment dilemmas for physicians and psychologists alike. The extent to which cardiac and noncardiac factors contribute to all forms of chest pain remains unknown. The function of this review is to provide mental health professionals with a primer on relevant clinical issues in chronic chest pain. We examine several common medical and psychiatric causes of chronic chest pain and selectively review (1) the relevant medical and psychiatric diagnostic and treatment considerations for chest pain and (2) the hypothetical biobehavioral mechanisms relevant to psychological intervention, (3) while expanding on existing conceptual models for understanding chest pain, and (4) offering some suggestions for future research.     

Clinical Geropsychology: Implications for Practice in Medical Settings

Older adults are a rapidly growing segment of the population, who have high rates of chronic illness and who utilize health care resources heavily. Psychologists must become better prepared to work with older patients in geriatric settings, including geriatric assessment units, memory disorders clinics, and nursing homes. In addition, all psychologists will increasingly encounter older patients in environments such as primary care clinics, rehabilitation settings, and disease management programs focusing on problems that are prevalent in older patients (e.g., cancer, diabetes). Suggestions are offered for adaptation of usual clinical practice to address the special needs of older patients and their families, and recommendations made for advancing and expanding the practice of clinical geropsychology.     

A SURVEY OF EXECUTIVE COACHING PRACTICES

Despite the ubiquity of executive coaching interventions in business organizations, there is little uniformity in the practices (e.g., assessment tools, scientific or philosophical approaches, activities, goals, and outcome evaluation methods) of executive coaches. Addressing the ongoing debate about the role of psychology in executive coaching, we compare the practices of psychologist and nonpsychologist coaches, as well as the practices of coaches from various psychological disciplines (e.g., counseling, clinical, and industrial/organizational). Results of surveys completed by 428 coaches (256 nonpsychologists, 172 psychologists) revealed as many differences between psychologists of differing disciplines as were found between psychologist and nonpsychologist coaches. Moreover, differences between psychologists and nonpsychologists were generally small (average d = .26). Our survey also revealed some differences in the key competencies identified by psychologist and nonpsychologist coaches.     

The effects of Wechsler Intelligence Scale for Children-Fourth Edition cognitive abilities on math achievement

This study used structural equation modeling to examine the effect of Stratum III (i.e., general intelligence) and Stratum II (i.e., Comprehension-Knowledge, Fluid Reasoning, Short-Term Memory, Processing Speed, and Visual Processing) factors of the Cattell-Horn-Carroll (CHC) cognitive abilities, as operationalized by the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV; Wechsler, 2003a) subtests, on Quantitative Knowledge, as operationalized by the Wechsler Individual Achievement Test, Second Edition (WIAT-II; Wechsler, 2002) subtests. Participants came from the WISC-IV/WIAT-II linking sample (n=550). We compared models that predicted Quantitative Knowledge using only Stratum III factors, only Stratum II factors, and both Stratum III and Stratum II factors. Results indicated that the model with only the Stratum III factor predicting Quantitative Knowledge best fit the data.     

Memory deficits for non-amnestic mild cognitive impairment

Non-amnestic mild cognitive impairment (naMCI) is one of the clinical subtypes of mild cognitive impairment (MCI). However, the characteristics of memory deficits in naMCI as assessed by clinical neuropsychological evaluations are not clear. In this study, a battery of neuropsychological tests was administered to 122 cognitively normal controls (NC), 133 amnestic mild cognitive impairment (aMCI) patients, and 72 naMCI patients. The results showed that in individuals with naMCI, episodic memory, and other cognitive domains were impaired. The Prospective Memory Test (PMT) event-based prospective memory (EBPM), the Symbol Digit Modalities Test (SDMT) Accidental Memory, Stick test (ST) visuoconstructional memory, and ST Working Memory were impaired, yet did not reach the level of aMCI. Semantic memory was affected to a degree comparable with aMCI. Some functions like Auditory Verbal Learning Test (AVLT) recognition, and Judgment of Confidence (JOC) were maintained, as well as PMT Time-Based Prospective Memory (TBPM). This study verified that memory impairment among individuals with naMCI was mainly in memory functions mediated by the frontotemporal cortex.     

The Relationship Between Performance on the Gordon Diagnostic System and Other Measures of Attention

Tests purporting to measure attention were administered to college students to examine their relationship to three relatively new tests of attention from the Gordon Diagnostic System (GDS). All subjects received the Standard Delay, Vigilance, and Distractibility Tests of the GDS. In addition, 69 of 136 subjects received the Digit Span, Arithmetic, and Digit Symbol subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R), and Kagan's Matching Familiar Figures Test. After the GDS, the other 67 subjects received the Visual Span subtest of the Wechsler Memory Scale-Revised (WMS-R), and the Stroop. Replication (across two studies) and gender influences were not evident on GDS performance. Performance data on this test for these 136 college students, collapsed across replication and gender, are presented. Although within-test correlations were strong, correlations between tests were weak. A ceiling effect on the Vigilance task may have effected its correlations with other tests. Results suggest that the GDS tasks are not substitutes for commonly used tests of attention, but may be useful as an additional source of information in the assessment of attention.     

A biopsychosocial approach to liver transplant evaluation in two patients with Wilson's disease

Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation.     

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.     

Assessment of ADHD: differences across psychology specialty areas

Child psychologists are frequently involved in the assessment of ADHD symptoms among school-aged youth. There is limited information regarding the extent to which psychologists adhere to recommended assessment practices and whether differences exist in assessment strategies among psychologists from different specialty areas (clinical, counseling, and school) and/or who practice in different settings (university, school, or outpatient clinic). A 3 (specialty area) x 3 (employment setting) between-groups design is used wherein 230 child psychologists completed surveys regarding diagnostic practice. Psychologists differ in adherence with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) diagnostic criteria, use of clinical interviews, and type of behavior observation. Only 15% of psychologists report using multiple methods consistent with recommended standards of best practice. Differences between groups of psychologists indicate that the diagnosis of ADHD in children is influenced by the type of psychologist conducting the evaluation and the setting in which the evaluation is conducted.     

VISUO-PERCEPTIVE AND VISUO-MOTOR PERFORMANCE OF CHILDREN WITH READING DISABILITIES

N ielsen , H. H. & R inge , K. Visuo-perceptive and visuo-motor performance of children with reading disabilities. Scand. J. Psychol ., 1969, 10 , 225–231.—Twenty 9–10-year-old children with reading disability were compared with twenty normal readers on Frostig Test of Visual Perception, Bender Visual Motor Gestalt Test and Goodenough Draw-a-Person Test. Contrary to prediction, the results showed more similarity than difference in performance level between the two groups, only the Bender Test discriminating significantly ( p<0.05 ). It was concluded that impaired visual perception and visuo-motor dysfunction did not seem important correlates of reading disability.     

Sustained attention and visual processing speed in children and adolescents with bipolar disorder and other psychiatric disorders

To investigate the cognitive functioning of children and adolescents with bipolar illness, 112 child and adolescent psychiatric inpatients and day-hospital patients at a state psychiatric hospital were administered the Wechsler Intelligence Scale for Children-III (WISC-III) as part of an admission psychological assessment. There were 22 patients with Bipolar Disorder and 90 with other psychiatric disorders; all were between 8 and 17 years of age. The patients with Bipolar Disorder had a mean age of 14 yr., a mean Verbal IQ of 78, a mean Performance IQ of 76, and a mean Full Scale IQ of 75. When their WISC-III scores were compared with those who had Schizophrenia Spectrum disorders (Schizophrenia and Schizoaffective Disorder), Psychosis Not Otherwise Specified, Attention Deficit Hyperactivity Disorder, and Conduct Disorder and Oppositional Defiant Disorder, there were no significant between-group mean differences for Verbal IQ, but patients with Bipolar Disorder had a significantly lower mean Performance IQ than those with ADHD and those with Conduct Disorder and Oppositional Defiant Disorder. Contrary to the expectation that the patients with Bipolar Disorder might have better sustained attention (higher Digit Span scores) than those with Schizophrenia Spectrum disorders and worse visual processing speed (lower Coding scores) than the other diagnostic groups, the bipolar patients' Digit Span and Coding scores did not differ significantly from those of the other groups. The patients with Psychosis, Not Otherwise Specified had significantly lower mean Performance IQ, Full Scale IQ, and Coding than the ADHD and the Conduct Disorder and Oppositional Disorder groups.     

WAIS-IV subtest covariance structure: conceptual and statistical considerations

D. Wechsler (2008b) reported confirmatory factor analyses (CFAs) with standardization data (ages 16-69 years) for 10 core and 5 supplemental subtests from the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Analyses of the 15 subtests supported 4 hypothesized oblique factors (Verbal Comprehension, Working Memory, Perceptual Reasoning, and Processing Speed) but also revealed unexplained covariance between Block Design and Visual Puzzles (Perceptual Reasoning subtests). That covariance was not included in the final models. Instead, a path was added from Working Memory to Figure Weights (Perceptual Reasoning subtest) to improve fit and achieve a desired factor pattern. The present research with the same data (N = 1,800) showed that the path from Working Memory to Figure Weights increases the association between Working Memory and Matrix Reasoning. Specifying both paths improves model fit and largely eliminates unexplained covariance between Block Design and Visual Puzzles but with the undesirable consequence that Figure Weights and Matrix Reasoning are equally determined by Perceptual Reasoning and Working Memory. An alternative 4-factor model was proposed that explained theory-implied covariance between Block Design and Visual Puzzles and between Arithmetic and Figure Weights while maintaining compatibility with WAIS-IV Index structure. The proposed model compared favorably with a 5-factor model based on Cattell-Horn-Carroll theory. The present findings emphasize that covariance model comparisons should involve considerations of conceptual coherence and theoretical adherence in addition to statistical fit.