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Using Multivariate Statistics

Cognitive impairment creates significant challenges for patients, their families and friends, and clinicians who provide their health care Early recognition allows for diagnosis and appropriate treatment, education, psychosocial support, and engagement in shared decision-making regarding life planning, health care, involvement in research, and financial matters An IAGG-GARN consensus panel examined the importance of early recognition of impaired cognitive health Their major conclusion was that case-finding by physicians and health professionals is an important step toward enhancing brain health for aging populations throughout the world This conclusion is in keeping with the position of the United States' Centers for Medicare and Medicaid Services that reimburses for detection of cognitive impairment as part the of Medicare Annual Wellness Visit and with the international call for early detection of cognitive impairment as a patient's right The panel agreed on the following specific findings: (1) validated screening tests are available that take 3 to 7 minutes to administer; (2) a combination of patient- and informant-based screens is the most appropriate approach for identifying early cognitive impairment; (3) early cognitive impairment may have treatable components; and (4) emerging data support a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline

Brain health: the importance of recognizing cognitive impairment: an IAGG consensus conference

Assessment of Malingering

This study explored the role of intellectual humility (IH) in promoting attitude change and relationship closeness in the context of religious disagreement. Participants (N = 174) completed a preliminary survey that assessed their attitude on several contentious religious issues (e.g. gay marriage, abortion). Participants who disagreed about a contentious religious issue were then paired and engaged in a 10-min discussion. After the discussion, participants completed a series of questionnaires. The greatest degree of attitude change was seen in pairs with mutually high levels of IH, in which the participant self-reported high levels of IH and also perceived the discussion partner to have high levels of IH. Higher perceptions of the IH levels of the discussion partner predicted higher levels of closeness and trust. We discuss limitations, areas for future research, and practical implications.

Religious intellectual humility, attitude change, and closeness following religious disagreement

Abstract In psychological injury and related forensic evaluations, two types of tests are commonly used to assess Negative Response Bias (NRB): Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs). SVTs assess the credibility of self-reported symptoms, whereas PVTs assess the credibility of observed performance on cognitive tasks. Compared to the large and ever-growing number of published PVTs, there are still relatively few validated self-report SVTs available to professionals for assessing symptom validity. In addition, while several studies have examined how to combine and integrate the results of multiple independent PVTs, there are few studies to date that have addressed the combination and integration of information obtained from multiple self-report SVTs. The Special Issue of Psychological Injury and Law introduced in this article aims to help fill these gaps in the literature by providing readers with detailed information about the convergent and incremental validity, strengths and weaknesses, and applicability of a number of selected measures of NRB under different conditions and in different assessment contexts. Each of the articles in this Special Issue focuses on a particular self-report SVT or set of SVTs and summarizes their conditions of use, strengths, weaknesses, and possible cut scores and relative hit rates. Here, we review the psychometric properties of the 19 selected SVTs and discuss their advantages and disadvantages. In addition, we make tentative proposals for the field to consider regarding the number of SVTs to be used in an assessment, the number of SVT failures required to invalidate test results, and the issue of redundancy when selecting multiple SVTs for an assessment. 

/pdf/assessing-negative-response-bias-using-self-report-measures-6sh40w51.pdf

Assessing Negative Response Bias Using Self-Report Measures: New Articles, New Issues

Objective: Prior research has identified a variety of embedded performance validity indicators on the Conners’ Continuous Performance Test-II (CPT-II). The purpose of this study was to examine embe...

Examining embedded validity indicators in Conners continuous performance test-3 (CPT-3)

Objective To evaluate the relationships among performance validity, symptom validity, symptom self-report, and objective cognitive testing Method Combat Veterans (N = 338) completed a neurocognitive assessment battery and several self-report symptom measures assessing depression, posttraumatic stress disorder (PTSD) symptoms, sleep quality, pain interference, and neurobehavioral complaints All participants also completed two performance validity tests (PVTs) and one stand-alone symptom validity test (SVT) along with two embedded SVTs Results Results of an exploratory factor analysis revealed a three-factor solution: performance validity, cognitive performance, and symptom report (SVTs loaded on the third factor) Results of t tests demonstrated that participants who failed PVTs displayed significantly more severe symptoms and significantly worse performance on most measures of neurocognitive functioning compared to those who passed Participants who failed a stand-alone SVT also reported significantly more severe symptomatology on all symptom report measures, but the pattern of cognitive performance differed based on the selected SVT cutoff Multiple linear regressions revealed that both SVT and PVT failure explained unique variance in symptom report, but only PVT failure significantly predicted cognitive performance Conclusions Performance and symptom validity tests measure distinct but related constructs SVTs and PVTs are significantly related to both cognitive performance and symptom report; however, the relationship between symptom validity and symptom report is strongest SVTs are also differentially related to cognitive performance and symptom report based on the utilized cutoff score (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Performance validity and symptom validity tests: Are they measuring different constructs?

Stress-Related Growth: Building a More Resilient Brain

OBJECTIVE We evaluated the contribution of blast-pressure severity to cognitive functioning beyond posttraumatic stress disorder (PTSD) severity and traumatic brain injury (TBI). METHOD Post-9/11 veterans (N = 254, 86.22% male) completed the Wechsler Adult Intelligence Scale (WAIS-IV) and Trail Making Test (TMT). The Clinician-Administered PTSD Scale (CAPS-5), Mid-Atlantic MIRECC Assessment of TBI, and the Salisbury Blast Interview evaluated PTSD diagnosis/severity, deployment TBI history/severity, and blast-exposure history/severity, respectively. RESULTS Veterans with mild deployment TBI had overall significantly lower T scores on the WAIS-IV Verbal Comprehension Index (d = .13), Working Memory Index (d = .30), and Processing Speed Index (d = .25); the Trail Making Test A (TMT-A; d = .50); and the Trail Making Test B (TMT-B; d = .37). Mild deployment TBI was significantly associated with TMT-A (ΔR² = .05, p < .001) and TMT-B (ΔR² = .03, p = .001) performance. Blast-pressure severity moderated the association between mild deployment TBI and TMT-A (ΔR² = .02, p = .039, B = -2.01). CONCLUSION Blast-pressure severity exacerbated the effects of mild TBI on a simple attention task, such that participants with TBI had gradual decrements in attention as blast severity increased. Veterans who incur a TBI and are exposed to blasts during deployment may experience persisting difficulties with cognitive functioning as a result of alterations in basic attention abilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Influence of blast exposure on cognitive functioning in combat veterans.

Objective: Mild traumatic brain injury (TBI) that occurs in a deployment environment is characteristically different from mild TBI that occurs outside of deployment. This study evaluated differential and interaction effects of deployment and nondeployment mild TBI on cognitive and behavioral health outcomes. Research Method: Combat veterans (N = 293) who passed performance-validity measures completed the Mid-Atlantic MIRECC Assessment of TBI (MMA-TBI), Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS-5), a neuropsychological assessment battery, and self-report questionnaires. A 2 × 2 × 2 analysis of variance (ANOVA) was conducted to evaluate the main and interaction effects across mild TBI groups and PTSD diagnosis. Results: Deployment TBI was associated with poorer outcomes on several cognitive tests: Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV); Working Memory Index (WMI; p = .018); Trail Making Test A (TMT-A; p < .001); and Trail Making Test B (TMT-B; p = .002). Deployment TBI and PTSD were also associated with increased PTSD, depressive, and neurobehavioral symptoms; pain interference; and poorer sleep quality. Nondeployment TBI had no effect on cognitive performance and was associated only with poorer sleep quality. PTSD had the strongest associations with symptom measures and deployment TBI with cognitive outcomes. There were no significant interaction effects after adjusting for multiple comparisons. Conclusions: Remote outcomes associated with mild deployment TBI are different from those associated with nondeployment mild TBI and are robust beyond PTSD. This suggests that the environment surrounding a TBI event influences cognitive and symptom sequelae. Veterans who experience mild TBI during deployment may report changes in cognition, but most will continue to function within the expected range. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Anna S Ord

Papers

Examining embedded validity indicators in Conners continuous performance test-3 (CPT-3)

Performance validity and symptom validity tests: Are they measuring different constructs?

Stress-Related Growth: Building a More Resilient Brain

Influence of blast exposure on cognitive functioning in combat veterans.

Differential effects of deployment and nondeployment mild TBI on neuropsychological outcomes.