Who is exaggerating cognitive impairment and who is not?

This chart review examined the effects of effort on neuropsychological assessment and test performance patterns among genuine and exaggerating patients, with and without neurological findings, as aids to diagnosing symptom exaggeration. The sample consisted of 561 consecutive patients involved in compensation claims. With a flexible neuropsychological test (NPT) battery, the claims were assessed over 2 days. The sample included 303 patients evaluated for traumatic brain injury, 55 patients with neurological disease, and 203 patients assessed for other conditions (eg, depression or chronic pain). An average of 38 ability measures per patient were used to generate an overall NPT domain score. Composite scores were also computed for symptom validity tests, self-report measures of psychiatric symptoms, and memory complaint inventory. Seven NPT cognitive subdomain scores were multiply regressed onto the symptom validity test composite, accounting for 45% of its total variance. Patients were also assigned to Genuine or Exaggerator groups based on symptom validity test performance. The NPT for Exaggerating patients averaged 1.43 standard deviations below that of Genuine patients, suggesting that NPT scores for most Exaggerating patients are underestimates of their true ability. Factor analysis results differed between these groups. As a result, clinicians might avoid falsely identifying genuine patients as exaggerating by incorporating their self-reports of psychiatric symptoms and memory complaints into the diagnostic process.     

Psychiatric patient- and informant-reported personality: predicting concurrent and future behavior

The authors investigated the criterion and incremental validity of personality reports from psychiatric patients and knowledgeable informants in predicting patient substance use, social and risky behaviors, and psychological distress. Patient and informant reports of patient personality and behavior were collected from an adult psychiatric sample (N = 94). Hierarchical regressions indicated that patient reports of personality accounted for significant variance in both concurrent (17%-42%) and future behavior assessed 1 year later (17%-40%). Informant reports contributed significantly to the prediction of several behaviors and most strongly to social behaviors. Behaviors were predicted equally well by self-reports and informant reports in prospective as in concurrent regressions. Thus, both patient and informant reports of personality contribute importantly to prediction of behavior, and predictive ability is stable across time.     

Age-related differences and the role of augmented visual feedback in learning a bimanual coordination pattern

The purpose of this study was to investigate the effects of aging and the role of augmented visual information in the acquisition of a new bimanual coordination pattern, namely a 90° relative phase pattern. In a pilot study, younger and older adults received augmented visual feedback in the form of a real-time orthogonal display of both limb movements after every fifth trial. Younger adults acquired this task over three days of practice and retained the task well over periods of one week and one month of no practice while the older adults showed no improvement at all on the task. It was hypothesized that the amount of augmented information was not sufficient for the older adults to overcome the strong tendency to perform natural, intrinsically stable coordination patterns, which consequently prevented them from learning the task. The present study evaluated the age-related role of augmented visual feedback for learning the new pattern. Participants were randomly assigned within age groups to receive either concurrent or terminal visual feedback after every trial in acquisition. In contrast to the pilot study, all of the older adults learned the pattern, although not to the same level as the younger adults. Both younger and older adults benefitted from concurrent visual feedback, but the older adults gained more from the concurrent feedback than the younger adults, relative to terminal feedback conditions. The results suggest that when learning bimanual coordination patterns, older adults are more sensitive to the structure of the practice conditions, particularly the availability of concurrent visual information. This greater sensitivity to the learning environment may reflect a diminished capacity for inhibitory control and a decreased ability to focus attention on the salient aspects of learning the task.     

Multidimensional latent-construct analysis of children's social information processing patterns: correlations with aggressive behavior problems

Social information processing (SIP) patterns were conceptualized in orthogonal domains of process and context and measured through responses to hypothetical vignettes in a stratified sample of 387 children (50% boys; 49% minority) from 4 geographical sites followed from kindergarten through 3rd grade. Multidimensional, latent-construct, confirmatory factor analyses supported the within-construct internal consistency, cross-construct discrimination, and multidimensionality of SIP patterns. Contrasts among nested structural equation models indicated that SIP constructs significantly predicted children's aggressive behavior problems as measured by later teacher reports. The findings support the multidimensional construct validity of children's social cognitive patterns and the relevance of SIP patterns in children's aggressive behavior problems.     

Outcomes of hemisphericity questionnaires correlate with unilateral dichotic deafness

Using the Dichotic Deafness Test, 145 university workers were separated into dichotic deafness and hearing groups based on minor ear responses to dichotic consonant-vowel stimuli. They were also separated into putative right and left brain-oriented groups by Zenhausern's Preference Questionnaire. Interestingly, members of the dichotically hearing group chose mainly right brain-oriented answers and vice versa. A correlation coefficient twice that obtained for Zenhausern's Preference Questionnaire resulted when subject groups separated by the novel Polarity Questionnaire were compared to Dichotic Deafness Test groups. Only 30% of Preference Questionnaire items, versus 90% of Polarity Questionnaire items, were significantly correlated with Dichotic Deafness Test groups. This is the first report of hemisphericity-type questionnaires showing significant correlations with a biophysical measure of brain laterality.     

Background beliefs in Bayesian inference

We report five experiments in which the role of background beliefs in social judgments of posterior probability was investigated. From a Bayesian perspective, people should combine prior probabilities (or base rates) and diagnostic evidence with equal weighting, although previous research shows that base rates are often underweighted. These experiments were designed so that either piece of information was supplied either by personal beliefs or by presented statistics, and regression analyses were performed on individual participants to assess the relative influence of information. We found that both prior probabilities and diagnostic information significantly influenced judgments, whether supplied by beliefs or by statistical information, but that belief-based information tended to dominate the judgments made.     

Change in cognitive functioning associated with apoE genotype in a community sample of older adults

The influence of a genetic risk factor, apolipoprotein E (apoE) epsilon4 variant, was assessed in older adults aged 70 to 94 on 3 occasions over 7 years. The results of latent growth curve analyses are reported for individuals genotyped for apoE at the 2nd measurement occasion (n = 601) and for a subsample of individuals without probable or definite dementia during the 1st or 2nd occasion (n = 434). ApoE-epsilon4 status was a significant predictor of level and change in memory performance and change in speed performance in the full sample, and of initial level and change in memory performance in the nondemented subsample. These results support previous findings that apoE-epsilon4 is associated with accelerated memory deterioration in individuals without clinical dementia.     

Orthographic neighborhood effects in lexical decision: the effects of nonword orthographic neighborhood size

The effects of large neighborhoods (neighborhood size) and of higher frequency neighbors (neighborhood frequency) were examined as a function of nonword neighborhood size in lexical decision tasks. According to the multiple read-out model (J. Grainger & A. M. Jacobs, 1996), neighborhood size and neighborhood frequency effects should vary systematically as a function of nonword neighborhood size. In these experiments, the nonword context was more extensively manipulated than in previous studies, providing a more complete test of the model's predictions. In addition, simulations were conducted examining the model's ability to account for the facilitatory neighborhood size and neighborhood frequency effects observed in these experiments. The results suggest that the model overestimates the role of inhibition in the orthographic processing of English words.