Autonomic stress reactivity and executive functions in successful and unsuccessful criminal psychopaths from the community

A significant gap in the psychopathy literature is the lack of studies comparing "successful," nonconvicted psychopaths with "unsuccessful," convicted psychopaths. This study tested the hypothesis that successful psychopaths show increased autonomic stress reactivity and better neuropsychological function compared with unsuccessful psychopaths. A total of 26 controls, 16 unsuccessful psychopaths, and 13 successful psychopaths were assessed on psychophysiological measures recorded during an emotional manipulation, the Wisconsin Card Sorting Test (WCST), Wechsler Memory Scale--Revised subtests, and childhood stressors. Compared with controls, unsuccessful psychopaths showed reduced cardiovascular stress reactivity. In contrast, successful psychopaths showed heightened reactivity, better WCST performance, and more parental absence than unsuccessful psychopaths and controls. The implications of these findings and the generalizability of existing psychopathy research are discussed.     

SUPPORT FOR A NEUROPSYCHOLOGICAL MODEL OF SPIRITUALITY IN PERSONS WITH TRAUMATIC BRAIN INJURY

Recent research suggests that spiritual experiences are related to increased physiological activity of the frontal and temporal lobes and decreased activity of the right parietal lobe. The current study determined if similar relationships exist between self‐reported spirituality and neuropsychological abilities associated with those cerebral structures for persons with traumatic brain injury (TBI). Participants included 26 adults with TBI referred for neuropsychological assessment. Measures included the Core Index of Spirituality (INSPIRIT); neuropsychological indices of cerebral structures: temporal lobes (Wechsler Memory Scale‐III), right parietal lobe (Judgment of Line Orientation), and frontal lobes (Trail Making Test, Controlled Oral Word Association Test). As hypothesized, spirituality was significantly negatively correlated with a measure of right parietal lobe functioning and positively correlated (nonsignificantly) with measures of left temporal lobe functioning. Contrary to hypotheses, correlations between spirituality and measures of frontal lobe functioning were zero or negative (and nonsignificant). The data support a neuropsychological model that proposes that spiritual experiences are related to decreased activity of the right parietal lobe, which may be associated with decreased awareness of the self (transcendence) and increased activity of the left temporal lobe, which may be associated with the experience of specific religious archetypes (religious figures and symbols).     

Executive function tests in early‐onset psychosis: which one to choose?

People with schizophrenia exhibit executive functioning deficits, an area well investigated in the adult onset schizophrenia (AOS) group, but far less so in early-onset schizophrenia (EOS). Since EOS in general seems to exhibit poorer cognitive functions and is clinically more compromised than AOS, choice of efficient and sensitive assessment measures is not necessarily the same within the two groups. The MATRICS Consensus Cognitive Battery was developed for adults when studying treatment effects and uses Mazes (Neuropsychological Assessment Battery [NAB]) to assess executive functioning. We tested 31 adolescents with schizophrenia spectrum disorders and 66 healthy controls in order to examine how Mazes compares to two other commonly used tests to measure executive functioning, D-KEFS Color Word Interference Test (Stroop) and the Wisconsin Card Sorting Test (WCST). Significant discriminating power was found for all three measures. Patients performed 0.8-1.5 SD below controls with Stroop as the most sensitive measure, followed by Mazes and WCST. Mazes was selected by the MATRICS to assess treatment effects in AOS and is shown to be able. We find the instrument also able to separate adolescent patients from controls and thus, it appears a sensible choice in clinical settings. If a more elaborated neuropsychological evaluation of the executive functioning domain is needed, Stroop should be considered a complementary test.     

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.     

Wisconsin Card Sorting in adolescents: analysis of performance, response times and heart rate

Forty-nine adolescents performed the Wisconsin Card Sorting Test (WCST). A main PCA component of WCST performance was identified as 'efficiency of reasoning'. This factor was related to feedback processing. From the WCST, a perseveration score can be derived. Perseveration is the continued application of a rule, after it has been disconfirmed. We compared more and less perseverating subjects in relation to stimulus-response (SR) time, feedback inspection time and cardiac acceleration and deceleration. Less perseverating subjects responded faster, and had longer and more adaptive inspection times of error feedback. We examined the switch from rule application to rule search, and the difference between correct and error responses. A transient cardiac deceleration at the initiation of rule search was interpreted as a change in supervisory attention. An error-related deceleration to negative feedback was interpreted as a disturbance of higher control processing. Previous trial feedback influenced current processing time, feedback inspection time, and the cardiac acceleration and deceleration responses.     

The occurrence of different intrusive errors in patients with Alzheimer's disease, multiple cerebral infarctions, and major depression.

Recent evidence suggests that specific types of intrusive errors may occur more often in the protocols of Alzheimer's disease (AD) patients than in those of patients diagnosed with other types of dementia. Using the FULD Object Memory Evaluation, we documented the occurrence of five qualitatively different types of intrusive errors for mildly and moderately impaired patients with AD and multiple cerebral infarctions (MCI). Depressed and normal elderly controls were also studied. Despite an equivalent degree of impairment on a broad array of neuropsychological measures, mildly impaired AD patients evidenced greater deficits on a measure tapping retrieval from semantic memory and demonstrated a higher occurrence of specific types of intrusive errors relative to their mildly impaired MCI counterparts. Further, both of these measures were highly correlated, suggesting that these indices may be particularly sensitive to semantic dysfunction associated with early AD.     

The clinical utility of the Rey Auditory-Verbal Learning Test in medical rehabilitation

Recent research has reported the Rey Auditory-Verbal Learning Test Trial V (RAVLT-V) score to be a sensitive indicator of global cognitive functioning, not merely verbal learning skills. The concurrent validity of the RAVLT-V relative to other neuropsychological measures frequently utilized in medical rehabilitation was investigated in a sample of 64 outpatients diagnosed with traumatic brain injury (TBI). The sample was predominantly male (77%), white (97%), youthful (31.4±11.5 years), high school educated, and an average of 53 months postinjury. Using stepwise multiple regression analysis, a three-variable model consisting of gender, Wechsler Memory Scale-Revised Delayed Memory Index, and Trailmaking Part B (time) accounted for 61% of the variance in RAVLT-V scores. These findings suggest that in TBI patients, the RAVLT taps not only specific verbal learning and memory, but also global cognitive functions. Sensitivity to diffuse neuropsychological changes and ease/speed of administration make the RAVLT a valuable tool in medical rehabilitation settings.     

Relations between source amnesia and frontal lobe functioning in older adults

A study is reported in which the relations among normal aging, source amnesia, and frontal lobe functioning were explored. Twenty-four older adults (aged 60-84 years) were tested on their ability to remember where they had acquired new factual information; they were also given the Wisconsin Card Sorting Test (WCST), a test of verbal fluency, and other psychometric tests. The degree of source amnesia in this normal sample correlated with age, verbal fluency, and some measures from the WCST. Source amnesia was not related to Performance IQ, however, or to a measure of fact recall. The implications for the relations among aging, memory, and frontal lobe functions are discussed.     

Using the TOMM for evaluating children's effort to perform optimally on neuropsychological measures.

Suboptimal effort is a threat to the validity of neuropsychological evaluations. Numerous papers have been devoted to this subject and a large number of measures have been developed in an attempt to detect suboptimal effort. To date, however, the clinical literature has focused almost exclusively on identifying suboptimal effort in adults, whereas suboptimal effort among children has not been addressed thoroughly in the clinical neuropsychological literature. The present study investigated whether or not already established effort measures could be used with children. The Test of Memory Malingering (TOMM) and the Rey-15-item test were administered to 128 children in two sites, the USA and Cyprus. The results indicated that the TOMM has the potential to be used as a measure for identifying children who do not put forth maximal effort during neuropsychological evaluations. In contrast, the Rey-15-item test does not appear to be a promising measure of effort for use with children, especially younger children.     

Measuring impulsivity in adolescents with serious substance and conduct problems

Adolescents with substance use and conduct disorders have high rates of aggression and attention deficit hyperactivity disorder (ADHD), all of which have been characterized in part by impulsivity. Developing measures that capture impulsivity behaviorally and correlate with self-reported impulsivity has been difficult. One promising behavioral measure, however, is a variant of the continuous performance test, the Immediate Memory Test/Delayed Memory Test (IMT/DMT). The authors showed significant group differences between adolescents in treatment for serious substance and conduct problems and community controls on impulsivity measures, both behavioral and self-report, as well as on aggression and problem behavior measures. Furthermore, the IMT/DMT correlated significantly with self-reported impulsivity. In summary, the IMT/DMT may be an effective behavioral measure of impulsivity in adolescents.     

Psychometric properties and reference data for Danish versions of Free and Cued Selective Reminding Test,Category Cued Memory Test and Logical Memory

Memory assessment is a key element in neuropsychological testing. Gold standard evaluation is based on updated normative data, but in many small countries (e.g. in Scandinavia) such data are sparse. In Denmark, reference data exist for non‐verbal memory tests and list‐learning tests but there is no normative data for memory tests which capture narrative recall and cued recall. In a nation‐wide study, Free and Cued Selective Reminding Test (FCSRT ), WMS ‐III Logical Memory (LM ) and a newly developed test Category Cued Memory Test (CCMT ‐48) were applied in 131 cognitively intact persons (aged 60–96 years). Regression‐based reference data for Danish versions of FCSRT , CCMT ‐48 and LM adjusted for age, education and gender are provided. Gender and age‐group had a significant impact on the expected scores, whereas the effect of education had a limited effect on expected scores. Test performances were significantly correlated in the range 0.21–0.51. Based on these findings and previous results it may be relevant to assess both free recall, cued recall and recognition to tap the earliest changes associated with neurodegeneration, and this study therefore provides an important supplement to existing Danish normative data. Future studies should investigate the discriminative validity of the tests and the clinical utility of the presented reference data.     

On the historical and conceptual background of the Wisconsin Card Sorting Test

In this paper, we describe the development of the Wisconsin Card Sorting Test (WCST). We trace the history of sorting tasks from the studies of Narziss Ach on the psychology of thinking, via the work of Kurt Goldstein and Adhémar Gelb on brain lesioned patients around 1920 and subsequent developments, up to the actual design of the WCST by Harry Harlow, David Grant, and their student Esther Berg. The WCST thus seems to originate from the psychology of thinking ('Denkpsychologie'), but the test, as it is used in clinical neuropsychological practice, was designed by experimenters working within the behaviorist tradition. We also note recent developments suggesting that, contrary to the general impression, implicit learning may play a role in WCST-like discrimination learning tasks.     

Wisconsin card sorting test and Halstead Category Test performances of children and adolescents who exhibit the syndrome of nonverbal learning disabilities

Abstract

Wisconsin Card Sorting Test (WCST) and Halstead Category Test (HCT) performances of 15 children/adolescents (age range 9 to 17 years) diagnosed with the syndrome of nonverbal learning disabilities (NLD) and 15 age-, gender-, and FSIQ-matched verbal learning-disabled (VLD) controls were examined. The VLD group made significantly fewer errors on the HCT than did the NLD group. In addition, the VLD controls significantly outperformed the NLD participants on seven of the nine WCST index scores (all except failure to maintain set and learning to learn scores). Consistent with the adult literature, the common variance between the HCT and WCST was modest, indicating that these two neuropsychological measures gauge different domains of functioning. It is suggested that the HCT assesses conceptualization/higher order reasoning abilities, whereas the WCST taps dimensions of executive functioning.     

Examining the Test Of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as screening tools for insufficient effort

Assessing effort level during neuropsychological evaluations is critical to support the accuracy of cognitive test scores. Many instruments are designed to measure effort, yet they are not routinely administered in neuropsychological assessments. The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are commonly administered symptom validity tests with sound psychometric properties. This study examines the use of the TOMM Trial 1 and the WMT Immediate Recognition (IR) trial scores as brief screening tools for insufficient effort through an archival analysis of a combined sample of mild head-injury litigants ( N = 105) who were assessed in forensic private practices. Results show that both demonstrate impressive diagnostic accuracy and calculations of positive and negative predictive power are presented for a range of base rates. These results support the utility of Trial 1 of the TOMM and the WMT IR trial as screening methods for the assessment of insufficient effort in neuropsychological assessments.     

Measurement of test anxiety among selected black adolescents: Appropriateness of four anxiety scales

In an effort to determine the appropriateness of three already available anxiety measures and one newly developed measure for use with low-achieving minority- group adolescents, this study explored the reliability and validity for four self- report anxiety scales. The Test Anxiety Scale for Children (TASC), the Alpert-Haber Achievement Anxiety Scale for Children (AASC), the State-Trait Anxiety Inventory for Children (STAIC), and a newly developed Reading Anxiety Scale (RAS), in which was embedded the Lie Scale for Children (LSC), were administered to 60 seventh- grade black students. Internal consistency reliability estimates are moderate to moderately high. Significant intercorrelations (p<.05) were found among the scales except for the A-State (state anxiety) subscale of the STAIC, which correlated significantly only with the RAS. No scale was found to be redundant with any other scale. The scales differentiated anxiety levels but did not operate differentially on the basis of gender. Conclusions are drawn regarding the appropriateness of using these scales with some minority-group adolescents.     

Associations between Symptom Validity Test failure and scores on the MMPI-2-RF validity and substantive scales

This study examined the association between Symptom Validity Test (SVT) failure and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008), in the Forensic Disability Claimant samples described in the MMPI-2-RF Technical Manual (Tellegen & Ben-Porath, 2008 a, 2008b). SVTs used included the Word Memory Test (Green, 2003), the Computerized Assessment of Response Bias (Allen, Conder, Green, & Cox, 1997), the Medical Symptom Validity Test (Green, 2004), and the Test of Memory Malingering (Tombaugh, 1996). SVT failure was associated with significant elevations throughout the MMPI-2-RF overreporting validity scales and substantive scales. Pairwise contrasts between groups failing 0 and 3 SVTs revealed predominantly large effect sizes for the overreporting validity scales (d = 0.78-1.11), and many of the substantive scales, including the Cognitive Complaints (COG) scale. Results of this study demonstrate an association between SVT performance and elevated scores on the MMPI-2-RF. These results suggest that exaggeration of cognitive symptoms as demonstrated by SVT failure is also associated with overreported emotional, somatic, and neurocognitive complaints on the MMPI-2-RF.     

Development and validation of a Response Bias Scale (RBS) for the MMPI-2

This study describes the development of a Minnesota Multiphasic Personality Inventory (MMPI-2) scale designed to detect negative response bias in forensic neuropsychological or disability assessment settings. The Response Bias Scale (RBS) consists of 28 MMPI-2 items that discriminated between persons who passed or failed the Word Memory Test (WMT), Computerized Assessment of Response Bias (CARB), and/or Test of Memory Malingering (TOMM) in a sample of 1,212 nonhead-injury disability claimants. Incremental validity of the RBS was evaluated by comparing its ability to detect poor performance on four separate symptom validity tests with that of the F and F(P) scales and the Fake Bad Scale (FBS). The RBS consistently outperformed F, F(P), and FBS. Study results suggest that the RBS may be a useful addition to existing MMPI-2 validity scales and indices in detecting symptom complaints predominantly associated with cognitive response bias and overreporting in forensic neuropsychological and disability assessment settings.     

Developmental Patterns and Use of the Wisconsin Card Sorting Test for Children and Adolescents with Learning Disabilities

This study examined the Wisconsin Card Sorting Test (WCST) by testing 129 children and adolescents with learning disabilities (LD) who were between 7 and 13 years of age. Developmental trends were examined across age groups using scores from the WCST. Several scales yielded developmental patterns, supported by statistically significant main effects for age. Additionally, multiple regression analyses were run examining the relationship of the WCST with other measures. The models yielded were in predicted directions. The results of this study support the clinical utility of the WCST in children and adolescents with LD.     

Construction and validation of an ecological version of the Wisconsin Card Sorting Test applied to an elderly population

ABSTRACT

The goal of this project was to construct and validate an ecological version of the Wisconsin Card Sorting Test (WCST) aimed at the elderly. This was accomplished by replacing the geometric stimuli of the traditional version with stimuli belonging to the semantic category of transport vehicles, and by elimination of the color yellow. The results showed the ecological WCST version was preferred over the traditional version and older people felt less tired during test performance. In the two independent normal elderly groups, all pairs of scores that can be derived from the WCST correlated significantly with each other. Six of 11 outcome measures of the traditional WCST-128 (long) version were significantly influenced by age. By contrast, in the WCST-64 (short) version and in the ecological WCST-54 version only one measure was affected by the age variable. No significant effect of education level or gender emerged from the results in any WCST version. Again, the subjects with cognitive deterioration had lower performance in the ecological WCST-54 version than in the two traditional WCST versions. It seems reasonable to assume that the ecological version of WCST is more discriminating and has more advantages than the traditional versions. Further research on individual differences in the performance on this task will increase understanding of the components of the test, and of the variety of factors and possible deficits that could lead to an impaired performance of the test.