Showing papers in "Clinical Neuropsychologist in 1988"

Differentiation of amnesic and demented patients with the wechsler memory scale -revised

Abstract: The Wechsler Memory Scale-Revised (WMS-R) was administered to 16 amnesic patients, 20 patients with Alzheimer's Disease, 24 patients with Huntington's Disease and 28 normal control subjects. The findings for the five memory indices demonstrated that the amnesics' General and Delayed Memory Indices (69 and 56, respectively) were more accurate estimates of their severe anterograde memory problems than was the single MQ from the original WMS. It was also noted that amnesic patients could be distinguished from demented patients and control subjects on the basis of the differences between the Attention/Concentration and General Memory Indices (AC-GM) and between the General and Delayed Memory Indices (GM-DM). Savings scores calculated for the Logical Memory and Visual Reproduction tests showed that both the amnesic and Alzheimer patients forgot verbal and figural materials more quickly than did the Huntington's patients and normal control subjects. When the amnesic group was divided according to presu...

The syndrome of nonverbal learning disabilities: developmental manifestations in neurological disease, disorder, and dysfunction

Abstract: The syndrome of Nonverbal Learning Disabilities (NLD) is characterized by deficient performances in visual-spatial-organizational abilities, complex psychomotor and tactile-perceptual skills (both usually more marked on the left side of the body), and conceptual/problem-solving abilities. Over the course of development, above-average facility in single-word reading and spelling and below-average skills in mechanical arithmetic are evident. Extreme difficulties in dealing with novel and otherwise complex material are especially apparent. Automatic, rote language skills become increasingly well developed and socio-emotional disturbances of the internalized variety become increasingly more apparent with advancing years. These and other developmental manisfestations of the NLD syndrome are examined within the context of several types of neurological disease/developmental disabilities, including cranio-cerebral trauma, hydrocephalus, and autism, and are related to a developmental model (Rourke, 1987) ...

Three tests of attention and rapid information processing: An extension

Abstract: Descriptive data of three tests (Trail Making Test, Brown-Peterson Auditory Short- Term Memory Test, Paced Auditory Serial-Addition Test) are presented for three age groups (16-29, 30-49, 50-69 years). The use of Box Plots allows rapid visual analysis of response characteristics of the defined group on each task.

Rey auditory-verbal learning test: Development of norms for healthy young adults

Abstract: The Rey Auditory-Verbal Learning Test (AVLT) has been widely used in clinical neuropsychology because of the usefulness of its multiple measures of learning and memory and its ease of administration. Normative data has been reported for some patient populations but little normative data exists for healthy individuals. This study reports AVLT data for 222 job applicants, presently employed in a variety of occupations, who had previously passed basic-academic-skills tests and physical examinations and were motivated to perform well on AVLT testing. AVLT normative data are presented by WAIS-R FSIQ, Age, Education, and by Age and FSIQ combined. We also present a proposal for sharing and pooling data to expand the data matrix we present.

Modified wisconsin sorting test in elderly normal, depressed and demented patients

Abstract: Patients with major depression, and normal controls completed a modified version of the Wisconsin Card Sorting Test (WCST). DAT patients completed fewer categories and made more total and more perseverative errors than normal elderly patients. Moderate by severe DAT patients completed fewer categories than mild DAT and depressed patients. Mild DAT and depressed patients performed in a similar manner. The modified WCST may be particularly applicable for an elderly population. It simplifies the procedure and reduces ambiguity in conveying feedback so that fewer subjects may be unwilling or unable to complete the task. Further research is needed to establish the comparability of the modified WCST with the original test.

Factor structure of the wechsler memory scale-revised

Abstract: The factor structure of the Wechsler Memory Scale-Revised (WMS-R) was examined in a large (N = 434) sample of patients referred to the neuropsychology laboratories of two large medical centers. The subtests of the WMS-R were subjected to principal-components factor analysis. Some analyses included only the immediate-recall subtests, while other analyses included both immediate-and delayed-recall subtests. Additional analyses included VIQ and PIQ from the WAIS-R. Initial analyses of immediate-recall subtests indicated a two-factor solution similar to that reported in the standardization sample. Inclusion of IQ scores also revealed a two-factor solution with IQ scores and most memory subtests loading on separate factors. Inclusion in the analysis of delayed-recall subtests revealed three-factor solution with factors interpreted as representing verbal memory, nonverbal memory, and attention/IQ. These results are discussed in terms of factor-analytic studies of the earlier Wechsler Memory Scale, and ...

Wms-r patterns among patients with unilateral brain lesions

Abstract: The effects of unilateral brain lesions on memory functioning were examined among a sample of 115 patients with well lateralized lesions using the new Wechsler Memory Scale-Revised (WMS-R). Multivariate analysis of the WMS-R age-corrected summary indexes for the patients with right-(n = 56) and left-(n = 59) hemisphere lesions was significant (p<.008), although subsequent univariate comparisons revealed that only the Verbal Memory Index was significant (p<.009). Multivariate analysis of the 13 individual WMS-R subtest scores was also significant (p<.03), with four univariate group comparisons being significant at p<.05. Because the WMS-R offers verbal and nonverbal analogs for five memory dimensions (span of memory, immediate and delayed recall of complex material, and immediate and delayed paired associate learning), it was possible to examine the subjects modality-specific performance patterns using a repeated measures MANOVA. The results yielded a significant multivariate interaction (p<.004),...

Using the wechsler memory scale-revised to detect and characterize memory deficits in multiple sclerosis

Abstract: The Wechsler Memory Scale-Revised (WMS-R) and measures of word-finding, vocabulary, and depression were administered to 45 patients with definite multiple sclerosis (MS) and to 25 age-, sex-, and education-matched normal controls. MS patients performed significantly more poorly as a group than did normal controls on all five WMS-R indexes, demonstrating the sensitivity of the WMS-R to memory impairment in MS. Three subgroups of MS patients with different levels and patterns of WMS-R performance were identified using cluster analysis. One subgroup (20%) exhibited marked global impairment in attention/short-term memory, learning, and long-term memory. Another subgroup (56%) had intact attention/short-term memory but displayed milder deficits in learning and long-term memory. Performance of the remaining 24% was intact. There was suggestive evidence that relapsing/progressive MS patients were more likely than others to be globally impaired, but extent of impairment was not related to other demograph...

Wechsler memory scale-revised and california verbal learning test: Convergence and divergence

Abstract: A preliminary correlational analysis of the Wechsler Memory Scale-Revised (WMS-R) and California Verbal Learning Test (CVLT) was conducted. Numerous strong correlations were found, suggesting a high degree of convergence between the two instruments. CVLT indices reflecting vulnerability to proactive and retroactive interference and types of recall errors, which are not formally measured by the WMS-R, tended not to correlate with WMS-R variables. The utility of these tests in clinical assessment is discussed.

Confirmatory analysis of the factor structure of the wechsler memory scale-revised

Abstract: Memory functions are known to be multifaceted. Models of the dimensionality of memory, as measured by the Wechsler Memory Scale-Revised (WMS-R), were investigated. Confirmatory factor analysis was used to explore one-, two-, and three-factor models for the first eight subtests of the WMS-R given to normal subjects in the standardization sample (N = 316) and a heterogeneous sample of clinical subjects (N = 343). The best fitting model was a two-factor model with general memory and attention/concentration dimensions.

NEPSY-An adaptation of Luria's investigation for young children

Abstract: The tasks in Luria's investigation cover over 30 areas of performance, corresponding to the components of complex cognitive functions. An extended psychometric version of this examination, in Finnish, has been elaborated for 4-to 8-year-old children. This method, called NEPSY, includes 36 equalized, homogeneous, and reliable subtests. The individual results are summarized in test profiles that demonstrate the strengths and weaknesses of the child's ability pattern. The test profile may also indicate the primary deficiencies underlying the overt disabilities. One illustrative case of language disorder is presented in which the primary deficiency was interpreted as being poor auditory-phonemic analysis of speech. The profile approach used in this method is also suitable for research aimed at identifying and explaining subgroups and types of language disorders, dyslexia, perceptual-motor disabilities, and other disturbances of complex functions.

Twenty-year follow-up of the prevailing opinion on the posttraumatic or postconcussional syndrome

Abstract: A replication of the 1967 Auerback et al. survey on postconcussional syndrome was conducted. The survey was mailed to 500 neurosurgeons and neuropsychologists. Several areas of changing neurosurgical opinion are identified. Differences in current neurosurgical and neuropsychological opinion are described. Finally, these results confirm the presence of some beliefs, widely held by professionals, but not supported by the current literature. By way of recommendation, it is suggested that the term post head injury syndrome be used in preference to postconcussional or posttraumatic syndrome. Suggestions for further research are presented.

Clinical neuropsychology: Prospects and problems

Abstract: The relationships between test performance, cognitive constructs, and underlying neurological status are examined. It is concluded that, while there are many tests that are sensitive to dysfunction in a given cortical area few are specific to such dysfunction. This is particularly true in the case of behavioral functions mediated by the frontal lobes. Modern clinical neuropsychology represents a fusion of experimental and correlational approaches in both research and practice. A serious time lag exists in the execution of seminal research and its application in clinical practice. The use of small collaborative data banks in reducing this time lag is discussed.

An efficacy study of memory training for patients with closed-head injury

Abstract: Ten patients with histories of closed-head injury with persistent amnesia were given courses of memory training in list recall and face-name associations. The list-learning technique involved embedding words into high imagery stories, and the face-name association technique utilized an imagery technique in which physical features of faces were associated with names. In both cases, generalization of learning was encouraged by changing training materials over sessions. Subjects increased their ability to recall lengthy lists despite the fact that the list items were changed at each session during the last seven sessions of the 15-session training course. Learning efficiency was also increased on the face-naming procedure, as demonstrated by a significant reduction in trials needed to learn a series of eight face-name associations.

Comparison of normal controls and recently detoxified alcoholics on the wechsler memory scale-revised

Abstract: We examined the validity of the Wechsler Memory Scale-Revised (WMS-R) by contrasting scores of recently detoxified chronic alcoholics with age, sex, and education-matched controls. Associations between alcoholics' test scores and age, education, self-reported memory complaints, observed memory status, and alcohol consumption variables were also assessed. Alcoholics performed significantly more poorly than controls on all five WMS-R index scores and on five of 12 subtest scores. Differences between the groups were in terms of level of performance, not pattern of performance. Age was more highly associated with WMS-R scores for controls than for alcoholics. Observed memory status was associated with WMS-R scores, age, education, and years of drinking; self-ratings of memory functions were not. Finally, alcohol consumption variables and WMS-R scores were only weakly associated.

Residual neuropsychological deficits following head-injury on the wechsler memory scale-revised

Abstract: The Wechsler Memory Scale-Revised (WMS-R) was administered to 13 individuals with normal premorbid abilities who had experienced moderate to severe head injuries at least 1 year previously. Results were compared to performance on the Rey Auditory-Verbal Learning Test (RAVLT), the Rey-Osterrieth Complex Figure Test (ROCFT), and the Paced Auditory Serial-Addition Task (PASAT). The findings in the present sample of head-injured individuals indicated greater construct validity for the WMS-R Indexes of Verbal, Visual, and Delayed Memory than for the Attention Concentration Index. Further research is suggested to replicate and clarify these findings, and it is further recommended that additional measures of attention and concentration be used to supplement the WMS-R in clinical practice.

Abbreviated WAIS-R procedures: Use and limitations with head-injured patients

Abstract: The utility of the Satz-Mogel and Silverstein (two and four subtest) short forms of the WAIS-R was assessed on a group of 49 recently head-injured patients. The Satz-Mogel procedure yielded correct categorical classification of IQ in 92% of the cases and correlated highly with WAIS-R FSIQ (r = .97). Silverstein two-and four-subtest forms correlated highly with WAIS-R FSIQ (r = .82; r = .86) but resulted in a larger number of IQ classification errors. These data support the superiority of the Satz-Mogel procedure for abbreviating the WAIS-R with head-injured patients. Applications and limitations of short forms in the assessment of intelligence with head-injured patients are discussed.

Integration of neuropsychological theory, assessment, and application

Abstract: Theories of brain-behavior relationships have been proposed for more than a century, and they recently have progressed to a point of both heuristic and clinical value. Assessment procedures in clinical neuropsychology are quite variable among practioners. In this paper, criteria have been identified that should be met in clinical evaluation of brain-behavior relationships. Finally, there is a review of an approach to brain retraining that is integrated with both theory and clinical assessment, with assessment procedures stemming from theoretical considerations and also providing a basis for prescribing a brain retraining program.

Neuropsychological profile of an asperger's syndrome case with exceptional calculating ability

Abstract: Some mental retardates and Asperger's syndrome patients demonstrate a single exceptional talent, often musical or calculating ability, in the context of otherwise pervasive intellectual and social/interpersonal disability. Neuropsychological assessment of such individuals can shed light on the cognitive substrates for these unusual patterns of ability. This paper presents a neuropsychological case study of an Asperger's syndrome patient with remarkable mathematical abilities. Within a framework proposed by Rourke (1982), it is hypothesized that the social deficits associated with Asperger's syndrome may arise from longstanding difficulty with processing of information in novel situations, including decoding of visual information such as interpersonal cues and facial expressions. Relatively intact verbal skills may prevent these individuals from leading severely autistic lives and, in some cases, superior auditory verbal memory capacity may support development of extraordinary isolated “savant” sk...

Neuropsychological testimony: Some emerging concerns

Abstract: Recent court decisions may have a profound impact on the ways in which neuropsychological opinions are presented in court. Three such cases are described, with emphasis on a recent ruling establishing the competence of neuropsychological testimony but vesting judgement of the credibility of the testimony with the court. Psychologists seeking to offer neuropsychological opinion are charged to adhere to recognized standards and definitions in representing their skills to the courts and society at large.

Language, grip strength, sensory-perceptual, and receptive skills in a normal elderly sample

Abstract: A representative sample of 85 normal subjects (aged 65–75) were administered tests of language, motor, sensory-perceptual, and receptive abilities selected from the Halstead-Reitan Neuropsychological Battery. The results of this descriptive study provide useful normative standards for these tests when used with elderly patients. Self-reported history of chronic systemic disease or current medication usage did not, in general, have a negative effect on performance on these tests.

Development of the Wechsler Memory Scale--Revised.

Abstract: The 1945 Wechsler Memory Scale has been revised in terms of content, structure, scoring procedures, and norms. The changes and additions were guided in part by limitations of the original scale. This paper describes this process.

Wechsler memory scale-revised: Deficits in performance associated with neurotoxic solvent exposure

Abstract: Twenty industrial painters with a history of solvent-exposure and evidence of memory impairment on neuropsychological examination were administered the Wechsler Memory Scale-Revised (WMS-R). Although the more educated had better WMS-R performance than the others, all educational groups performed at an impaired level relative to WMS-R education-adjusted norms. Employed individuals scored consistently higher on the WMS-R than those who were unemployed and these differences were not accounted for by age or education. The results of this study support the construct and criterion validity of the WMS-R for assessment of chronic solvent encephalopathy. Further research using the WMS-R was suggested to assess its concurrent validity and test-retest reliability for individuals with a history of neurotoxic solvent exposure.

Entry into clinical neuropsychology: Graduate, undergraduate, and beyond

Abstract: Psychologists at all levels of training have become interested in entering the field of clinical neuropsychology. The issues and obstacles pertaining to entry at various professional levels are discussed. Training and credentialing issues surrounding the question of minimal levels of competence have direct bearing on the protection of the discipline of neuropsychology and the population who receive neuropsychological services.

Neuropsychological test performances with chronic low-level formaldehyde exposure

Abstract: Thirteen persons with chronic low-level formaldehyde exposure in domestic environments were administered a comprehensive battery of neuropsychological tests after removal from the environments for several months. The formaldehyde exposure group was group-matched by sex, age, and education with control and mild head-injury groups, and test results compared using one-way ANOVA and MANOVA (n = 13 for each group). Results indicate that the formaldehyde-exposed group is significantly different from the mild head-injury group and similar to the control group on the neuropsychological measures. Comparisons between the groups on the Minnesota Multiphasic Personality Inventory indicate emotional reactions and somatic concerns for both the formaldehyde and the head-injured groups. There is a need for further research with larger groups and with assessment at intervals during various time periods including the exposure phase.

Older adult norms for the Southern California Figure-Ground Visual Perception Test.

Abstract: Older adult norms for men are provided for the Southern California Figure-Ground Visual Perception Test (FG; Ayres, 1966), based on the performance of 117 patients from a geriatric medicine and rehabilitation facility ranging in age from 40 to 77 years. Reasons are presented for administering the entire test rather than using the traditional cutoff. When comparing FG performance to norms of younger adults (Bieliauskas, Newberry, & Gerstenberger, 1988), results indicate that figure-ground discrimination is poorer in older individuals. The norms provided here serve to complement the previous study employing FG, and it is hoped that they will encourage its wider use.

Selected psychometric and clinical review of neurodevelopmental infant tests

Abstract: A paradigm shift has occurred in the assessment of normal and high-risk infants because recognition memory infant tests have demonstrated greater predictive validity than traditional sensorimotor infant tests for predicting later childhood cognitive outcomes. Previous psychometric research on selected neurodevelopmental tests is examined, and the clinical and theoretical implications of these findings are discussed.

Neuropsychological sequelae of carbon monoxide toxicity at eleven-year follow-up

Abstract: This is a case study of a man who experienced accidental carbon monoxide (CO) poisoning and who developed neurological sequelae which led to his psychiatric hospitalization 4 years later. Skull x-rays, EEG, brain scan, and CT scan were all within normal limits at the time of hospitalization, but the patient demonstrated moderate intellectual impairment, including marked visual/spatial deficits, as well as other neuropsychological difficulties. A follow-up evaluation 11 years after the poisoning indicated moderate improvement, however, the visual/spatial deficits were relatively unimproved. The authors concluded that it is important to evaluate the cognitive impairment of CO victims over time: that the apparent diffuse neurological impairment of these patients may, in reality, be a stable and discrete pattern of neurological impairment; and that CO victims who appear to have “totally recovered”; may, to the contrary, have lingering neurological impairments which are not immediately obvious without...