Neuropsychological testing: evolution and emerging trends

Neuropsychological (NP) test batteries have evolved as an amalgam of intelligence tests, various individual measures of "biological" cognition, and sensory and motor testing. The early emphasis of NP testing was to identify "organicity" and central nervous system lesion localization. More recent approaches have emphasized the profiling of performance across individual neurocognitive domains (eg, attention, memory, and language) to facilitate diagnosis and treatment planning. However, the field is still hampered by the use of many tests that are antiquated, excessively long, or of dubious psychometric quality. Some of these problems may have contributed to the current under-utilization of NP testing in diagnostic workups of neuropsychiatric disorders. This paper reviews some of the recent changes in the field that hold promise for substantially shortening assessments, improving diagnostic reliability, and making NP testing more cost-effective and practical.     

Thomas Wolfe: Study of a Wanderer

Thomas Wolfe was an American novelist who in his short and tragic life (1900-1939) was preoccupied with themes of lost youth, memory, transience and an insatiable wandering. Wolfe was preoccupied with what I have seen, felt and thought. He was a wanderer who in his brief life made seven voyages to Europe and compulsively explored that continent. He would never own a home or a piece of land. He rarely lived in an apartment for more than a year and more commonly for just a few months. The purpose of this paper is to explore the meaning of Wolfe's tormented wandering and his endless searching. It will be my thesis that Wolfe demonstrated an inability to mourn. His writings are an attempt to recapture his past and to restore a lost world. Emphasis will be placed on themes of loss and mourning, insatiable hunger and desire, preoccupation with transience and death, and a search for that which was lost.     

Integrated versus segregated accounting and the magnitude effect in temporal discounting

Temporal discounting rates in humans generally decrease as the amount of reward increases, a phenomenon known as themagnitude effect. In the present study, we examined whether temporal discounting and the magnitude effect are related to segregation of choices in terms of gains or losses for waiting for or expediting receipt of a reward. Subjects (N = 24) responded to a series of hypothetical choices about amounts of money available either immediately or after a delay. The immediate and delayed amounts either were presented as integrated amounts in the baseline condition or were segregated as differential gains or losses for choosing delayed or expedited consumption (delay and speedup conditions, respectively). Temporal discounting rates decreased in the segregated conditions, in accord with the standard discounted utility model but contrary to the hypothesis that the subjects were choosing on the basis of reward differentials in the baseline condition. The size of the magnitude effect was comparable in the baseline and the delay conditions but decreased in the speed-up condition. These results challenge explanations of the magnitude effect in terms of an increasing proportional sensitivity property of the utility function (Loewenstein & Prelec, 1992) and the hypothesis that subjects choose on the basis of differentials even when the rewards are presented as integrated amounts.     

Utility of the trauma symptom inventory's atypical response scale in detecting malingered post-traumatic stress disorder

The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.     

A replication of the MMPI-A PSY-5 scales and development of facet subscales

McNulty, Harkness, Ben-Porath and Williams recently developed Personality Psychopathology Five (PSY-5) scales for the Minnesota Multiphasic Personality Inventory-A (MMPI-A). This study examined these new scales in a sample of 545 adolescents receiving inpatient psychiatric treatment. Item-level principal components analyses were employed to determine the internal structure of each PSY-5 scale and to aid in the creation of facet subscales for each PSY-5 scale. Results suggest that the MMPI-A PSY-5 scales display adequate internal consistency and our findings generally replicate the original work of McNulty et al. but also extend this work by showing that several of the PSY-5 scales may also be subdivided into meaningful lower level dimensions. These facet subscales for each of the MMPI-A PSY-5 scales are offered for further study.     

An examination and replication of the psychometric properties of the Massachusetts Youth Screening Instrument--second edition (MAYSI-2) among adolescents in detention settings

There is a high prevalence of psychological disorders among adolescents in detention facilities. The need for a simple, effective screening tool led to the development of the Massachusetts Youth Screening Instrument (MAYSI) and its successor, the MAYSI-2. This study evaluated the MAYSI-2 psychometric properties based on the records of 704 youths evaluated at intake to detention facilities. In addition to factor structure, the study evaluated test-retest reliability and concurrent external validity. Results were generally encouraging in terms of the use of MAYSI-2 in detention facilities, and directions for future research are discussed.     

Neural synergy between kinetic vision and touch

Ambiguous visual information often produces unstable visual perception. In four psychophysical experiments, we found that unambiguous tactile information about the direction of rotation of a globe whose three-dimensional structure is ambiguous significantly influences visual perception of the globe. This disambiguation of vision by touch occurs only when the two modalities are stimulated concurrently, however. Using functional magnetic resonance imaging, we discovered that touching the rotating globe, even when not looking at it, reliably activates the middle temporal visual area (MT+), a brain region commonly thought to be crucially involved in registering structure from motion. Considered together, our results show that the brain draws on somatosensory information to resolve visual conflict.