Alternate form reliability and concurrent validity of the PPVT-R for referred rehabilitation agency adults

This study investigated the relationships among the Peabody Picture Vocabulary Test-Revised (PPVT-R) alternate forms and, also, the relationship of each PPVT-R form with the Wechsler Adult Intelligence Scale-Revised (WAIS-R) for a referred sample of 60 adult clients of the California State Department of Rehabilitation. Clients ranged in age from 18-3 to 37-7 (M = 25-7, SD = 5-9). PPVT-R alternate forms r = .88 was significant at p less than .001. Correlations with the WAIS-R VIQ were .82 for L, .78 for M; with PIQ, .46 for L, .38 for M; with FSIQ, .77 for L, .67 for M. All correlations with both forms of the PPVT-R were significant. PPVT-R mean scores did underestimate significantly all WAIS-R mean scores. Implications are discussed.     

The role of imagery in the rehabilitation of neglect in severely disabled brain-injured adults.

Two single case studies are presented examining the effects of imagined limb activation in participants with unilateral visual neglect and severe physical disabilities. The first study employed a standard ABBABBA design where the participant was asked to imagine making movements with his left arm during the intervention conditions. Neglect was systematically assessed at each stage on the following measures: line bisection, star cancellation, and a scanning task. Performance during intervention conditions was compared to baseline conditions. The results suggest that imagined activation of the left arm may significantly reduce the severity of left neglect. The second study used an ACCABBACCABBA design. The participant was asked to imagine making movements with his left arm during the intervention conditions and with his right arm during the control conditions. The measures used in this study were line bisection, star cancellation, and letter cancellation. The results showed that there was no reduction in neglect symptoms associated with imagined left arm movements, but there was an increase associated with imagined right arm movements. This was thought to represent either a specific difficulty imagining left arm movements or a difficulty in combining left arm imagined arm movement with task completion. Overall, the results support the hypothesis that imagined movement can affect the presentation of neglect, and that the effects are specific to the arm that is used. This technique may prove useful to the clinical practitioner working with severely disabled brain-injured adults with neglect for whom conventional intervention techniques are inappropriate.     

The PPVT-R as a measure of psycholinguistic functioning: a caution

The present investigation was undertaken to evaluate the use of the PPVT-R as a measure of psycholinguistic functioning. The sample included 75 school-aged children referred for evaluation. The mean PPVT-R standard score (94.59, SD = 15.85) was not significantly different (p less than .01) than the WISC-R Full Scale IQ (95.36, SD = 16.29), Verbal IQ (94.36, SD = 16.17), or Performance IQ (97.75, SD = 15.61), or the mean ITPA PLQ. The PPVT-R correlated positively and significantly with the WISC-R Full Scale IQ (.77), Verbal IQ (.71) and Performance IQ (.74) and the WISC-R subtests, with coefficients that ranged from .42 (object assembly) to .69 (vocabulary). In addition, the PPVT-R correlated positively and significantly with the ITPA Psycho-Linguistic Quotient (PLQ) (.72) and the ITPA) subtests, with coefficients that ranged from .38 (auditory sequential memory) to .72 (grammatic closure). Regression analyses determined that the ITPA PLQ and the PPVT-R standard score were not predictive of one another. The data are interpreted to suggest that the PPVT-R is not more appropriately used as a measure of receptive language ability than as a screen for intellectual functioning.     

Patterns of sleep quality during and after postacute rehabilitation in older adults: a latent class analysis approach

Sleep quality is related to emotional, physical, psychological and cognitive functioning and functional independence in later life. After acute health events, older adults are likely to utilize postacute rehabilitation services to improve functioning and facilitate return to independent living. Patterns of how sleep changes with postacute rehabilitation, and predictors of such patterns, are unknown. The current investigation employed latent class analysis (LCA) methods to classify older adults (n = 233) into groups based on patterns of self‐reported sleep quality pre‐illness, during postacute rehabilitation and up to 1 year following postacute rehabilitation. Using LCA, older adults were grouped into (1) consistently good sleepers (46%), (2) good sleepers who transitioned into poor sleepers (34%), (3) consistently poor sleepers (14%) and (4) poor sleepers who transitioned into good sleepers (6%). In three planned analyses, pain was an independent predictor of membership in classes 1 or 2 (good pre‐illness sleep quality) versus classes 3 or 4 (poor pre‐illness sleep quality), and of membership in class 1 (consistently good sleep) versus class 2 (good sleep that transitioned to poor sleep). A lower Mini‐Mental State Examination score was a predictor of membership in class 1 versus class 2. There were no statistically significant predictors of membership in class 3 versus class 4. Demographics, comorbidities and depressive symptoms were not significant predictors of class membership. These findings have implications for identification of older adults at risk for developing poor sleep associated with changes in health and postacute rehabilitation. The findings also suggest that pain symptoms should be targeted to improve sleep during postacute rehabilitation.     

Validity of the verbal IQ as a short form of the Wechsler adult intelligence scale-revised

Assessed the validity of the Verbal IQ as a short form of the WAIS-R. Ss were 104 psychiatric patients with means for age, education, and Full Scale IQ of 36.22 (SD = 9.04), 12.46 (SD = 1.98), and 93.94 (SD = 12.19), respectively. A correlation of 0.93 (p < 0.001) between the Verbal and Full Scale IQs was found. The average Verbal IQ exceeded the average Full Scale IQ by a small (i. e., 1.65 IQ points) but statistically significant amount (p < 0.001). Thirty-three (32%) Ss showed changes in their intelligence categories when the Verbal IQ was compared to the Full Scale IQ. However, when the Verbal IQ was banded by the standard error of measurement (SE_M = ± 3) and the precision range was compared to the Full Scale IQ, results indicated 88% agreement. If clinicians must rely on the Verbal IQ as an estimate of the Full Scale, reporting the score in conjunction with a precision range will increase its accuracy.     

The effect of gaze direction on sound localization in brain-injured and normal adults

This study examined the effects of eye position on sound localization in normal and brain lesion subjects. On the assumption that cerebral lesions may disrupt the representation of or attention to auditory space in the contralesional hemispace, we predicted that subjects with brain lesions would be less accurate in localizing sounds in the contralesional hemispace. In Experiment 1 we showed that gazing to the midline subjects with brain lesions were indeed impaired in localizing sounds in the contralesional hemispace. On the assumption that spatial attention is deployed at the site to which gaze is directed, we predicted that sound localization would be better on the side to which subjects directed their gaze. In Experiment 2, brain lesion subjects performed significantly better in the contralesional hemispace when they directed gaze to that hemispace. This improvement was accompanied by deterioration of performance in the ipsilesional hemispace. When subjects directed gaze to the ipsilesional hemispace, performance in the contralesional hemispace was further impaired. The effect of gaze was also observed in normal subjects in Experiments 2 and 3, independently of response mode (verbal versus pointing responses). These findings are consistent with the hypothesis that sound location may be mapped in eye-centered coordinates and that directing gaze to one hemispace reduces attentional allocation to the other hemispace.     

Validity of the Wonderlic Personnel Test as a brief measure of intelligence in individuals referred for evaluation of head injury.

Some have argued that the Wonderlic Personnel Test (WPT) may represent a brief and efficient measure of intellectual functioning (e.g., Dodrill, 1980). The present study investigated the validity of the WPT as such a measure, in individuals with head injury. The findings suggested that, although the WPT showed relatively high agreement with the Wechsler Adult Intelligence Scale-Revised (WAIS-R) in the whole group, it did not have good agreement with WAIS-R scores on an individual case basis. Since clinical practice typically seeks to evaluate individual performance, it is suggested that the WPT is not a suitable tool for psychological assessment of individuals with known or suspected head injury.     

Multidimensional health locus of control in a rehabilitation setting

In an attempt to replicate a recent report of the factorial structure of the Multidimensional Health Locus of Control Scale, a sample of rehabilitation patients (N = 107) were studied. Analyses in the present study failed to validate the previously reported three-dimensional structure, which indicates a need for careful interpretation of this scale when used with certain populations. An alternative factor structure and possible future directions are proposed.     

Validity of a screening test for school learning problems in a pediatric clinical setting.

Children brought to pediatric outpatient clinics with the primary complaint of developmental difficulty often arrive with little or no information as to the nature of their problem. This study sought to determine if a brief screening test could facilitate the referral process by predicting the primary diagnosis subsequently given to the child based on a comprehensive interdisciplinary evaluation. Subjects for the study were 176 English-speaking children between the ages of 5 and 11 who had been evaluated at the child development center of a large urban medical school. Of the children later diagnosed as learning handicapped, 89% failed the routing test, while 78% with other primary diagnoses passed it. The results of this preliminary study suggest that a brief screening test can be used effectively to form initial hypotheses about the problems (learning vs. nonlearning) experienced by students referred to pediatric clinics for developmental difficulties. Suggestions for further research are offered.     

The use of Luria's method for the neurobehavioral assessment of encephalopathy in an adolescent: application in a rehabilitation setting.

Standardized neuropsychological test batteries demonstrate their greatest reliability and validity in patients with focal, well-defined neurologic disease. In these patients, the test profiles typically highlight focal areas of strengths and weaknesses in the brain. However, the clinical utility of standard test batteries and their reliance on scaled score differences is limited when evaluating patients with severe or diffuse neurobehavioral disorders. In the present case study, we applied the qualitative approach of Alexander Luria to the neuropsychological evaluation of a severely impaired adolescent, unable to complete psychometric tests. Luria's investigative method was able to assist in the localization of the brain dysfunction and the neurologic diagnosis of a young patient with an unusual neurologic presentation secondary to serious multisystem disease. The initial neuropsychological diagnostic impressions were later confirmed by diagnostic testing. The test results were also used to provide recommendations for ongoing neurorehabilitation of the patient.     

Validity of verbal autopsy method to determine causes of death among adults in the urban setting of Ethiopia

ABSTRACT: BACKGROUND: Verbal autopsy has been widely used to estimate causes of death in settings with inadequate vital registries, but little is known about its validity. This analysis was part of Addis Ababa Mortality Surveillance Program to examine the validity of verbal autopsy for determining causes of death compared with hospital medical records among adults in the urban setting of Ethiopia. METHODS: This validation study consisted of comparison of verbal autopsy final diagnosis with hospital diagnosis taken as a "gold standard". In public and private hospitals of Addis Ababa, 20,152 adult deaths (15 years and above) were recorded between 2007 and 2010. With the same period, a verbal autopsy was conducted for 4,776 adult deaths of which, 1,356 were deceased in any of Addis Ababa hospitals. Then, verbal autopsy and hospital data sets were merged using the variables; full name of the deceased, sex, address, age, place and date of death. We calculated sensitivity, specificity and positive predictive values with 95% confidence interval. RESULTS: After merging, a total of 335 adult deaths were captured. For communicable diseases, the values of sensitivity, specificity and positive predictive values of verbal autopsy diagnosis were 79%, 78% and 68% respectively. For non-communicable diseases, sensitivity of the verbal autopsy diagnoses was 69%, specificity 78% and positive predictive value 79%. Regarding injury, sensitivity of the verbal autopsy diagnoses was 70%, specificity 98% and positive predictive value 83%. Higher sensitivity was achieved for HIV/AIDS and tuberculosis, but lower specificity with relatively more false positives. CONCLUSION: These findings may indicate the potential of verbal autopsy to provide cost-effective information to guide policy on communicable and non communicable diseases double burden among adults in Ethiopia. Thus, a well structured verbal autopsy method, followed by qualified physician reviews could be capable of providing reasonable cause specific mortality estimates in Ethiopia. However, the limited generalizability of this study due to the fact that matched verbal autopsy deaths were all in-hospital deaths in an urban center, thus results may not be generalizable to rural home deaths. Such application and refinement of existing verbal autopsy methods holds out the possibility of obtaining replicable, sustainable and internationally comparable mortality statistics of known quality. Similar validation studies need to be undertaken considering the limitation of medical records as "gold standard" since records may not be confirmed using laboratory investigations or medical technologies. The validation studies need to address child and maternal causes of death and possibly all underlying causes of death.     

The relationship between psychometric intelligence and the five-factor model of personality in a rehabilitation sample

WAIS-R and NEO Personality Inventory (NEO-PI) scores obtained from 85 rehabilitation clients of the Evaluation and Development Center of Southern Illinois University's Rehabilitation Institute were utilized to examine the relationship between psychometric intelligence and personality. Correlational analyses revealed that the NEO-PI Openness domain and its six facets significantly correlated with WAIS-R FSIQ, VIQ, PIQ, and 9 of the 11 subtests. Multiple regression analyses showed that the five NEO-PI domains accounted for significant proportions of WAIS-R, FSIQ, VIQ, and PIQ score variance. The NEO-PI Openness domain was found to be the best predictor of WAIS-R FSIQ, VIQ, and PIQ scores. The study concludes with a discussion of the meaning and implications of the findings and suggestions for future research.     

Symptom Validity Testing of remote memory in a criminal forensic setting.

Symptom Validity Testing (SVT) has been used effectively with sensory perception and short-term memory. The procedure was recently adapted to assess remote memory for specific events. Memory for remote events is particularly important to the criminal justice system, and courts are beginning to draw on neuropsychology to assist in the assessment of claimed remote memory loss. This report discusses the importance of this objective technique to neuropsychologists involved with criminal courts and presents its use in three cases from the criminal forensic arena. Normative results for the three case study tests are presented and suggest the procedure is a robust version of SVT. Implications of these results are discussed.     

PPVT IQ validity in adults: a measure of vocabulary, not of intelligence

Used partial correlation and multiple regression procedures to test the hypothesis that the PPVT IQ assesses more than vocabulary in adults. Ss were 84 inpatients from psychiatry and neurology wards. The relationships between the PPVT IQ and other measures of vocabulary, intelligence, memory, visual-motor speed and education were examined in the statistical analyses. Although these variables have significant simple correlations with the PPVT IQ, the multivariate analyses show that the Vocabulary Subtest of the WAIS-R is the only important variable. No other variable or variable combinations are able to account for further PPVT IQ variance after the effect of the Vocabulary Subtest is removed. The results support the use of the PPVT as a test of adult vocabulary, but not adult intelligence, and suggest that the PPVT may be useful as part of language assessment in patients with expressive language disorders.     

Goal setting as a health behavior change strategy in overweight and obese adults: a systematic literature review examining intervention components

Objective

This paper describes goal setting components used for behavior change specific to diet and physical activity in community-based interventions targeting overweight and obese adults.

Methods

A systematic literature review was conducted. Studies were evaluated using the S.T.A.R.T. (Specificity, Timing, Acquisition, Rewards and feedback, and Tools) criteria which were developed for the purposes of this paper in order to elucidate which intervention features elicit optimal health behavior outcomes.

Results

Eighteen studies were included. Based on the S.T.A.R.T. criteria, it was determined that developing specific goals that are in close proximity, involve the participant in acquisition, and incorporate regular feedback, are common features in this context.

Conclusion

Goal setting can be useful for effecting health behavior changes in this population. However, as different intervention components were often implemented concurrently (e.g., education sessions, self-monitoring records), it was not possible to ascertain which were responsible for positive changes independently.

Practice implications

Goal setting shows promise as a tool that can be incorporated into weight reduction programs by health care professionals and researchers. Studies are warranted to identify the specific mechanisms through which individuals with overweight or obesity can apply the S.T.A.R.T. criteria with respect to goal setting for the purposes of weight loss.     

The structure of intelligence in children and adults with high functioning autism

Confirmatory factor analyses of the commonly used 11 subtests of the Wechsler child and adult intelligence scales were accomplished for 137 children and 117 adults with high functioning autism (HFA) and for comparable age groups from the standardization samples contained in the Wechsler manuals. The objectives were to determine whether the structure of intelligence in HFA groups was similar to that found in the normative samples, and whether a separate "social context" factor would emerge that was unique to HFA. Four-factor models incorporating a Social Context factor provided the best fit in both the autism and normative samples, but the subtest intercorrelations were generally lower in the autism samples. Findings suggest similar organization of cognitive abilities in HFA, but with the possibility of underconnectivity or reduced communication among brain regions in autism.     

The dynamics of illness perceptions: Testing assumptions of Leventhal's common‐sense model in a pulmonary rehabilitation setting

Objectives . Although Leventhal's common‐sense model (CSM) is proposed to represent a dynamic system, limited research has been conducted to investigate whether and how illness perceptions change. This study tested two hypotheses from the CSM about the dynamics of illness perceptions of patients with chronic obstructive pulmonary disease (COPD) in a pulmonary rehabilitation setting. Design and methods . The study employed a longitudinal design. Patients with COPD (N=87) who took part in a pulmonary rehabilitation programme filled out the Illness Perception Questionnaire – Revised (IPQ‐R) before and after treatment and rated the degree to which the rehabilitation had led to the achievement of desired outcomes. Clinical variables and quality of life (Chronic Respiratory Disease Questionnaire) data were obtained from medical records. Results . In line with expectations, results showed that, at baseline, longer time since diagnosis was associated to perceptions corresponding with a chronic illness model (longer illness duration, more experienced consequences, less perceived personal controllability), after correction for clinical variables. After completion of the rehabilitation programme, patients who were more convinced that their participation had led to the achievement of desired outcomes were less concerned about the negative consequences of COPD, had stronger perceptions about the variability in symptoms (cyclical timeline) and had stronger perceptions of personal controllability Conclusions . We conclude that, in accordance with Leventhal et al.'s CSM, coping with an illness is a continuous process and the achievement of desired outcomes during treatment is likely to enable patients to adopt a more positive representation of their illness.