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.     

Confirmatory factor analysis of the wechsler memory scale-revised in a mixed clinical population

Abstract

Previous exploratory factor analyses (EFA) of the Wechsler Memory Scale-Revised (WMS-R) have yielded highly disparate factor structures, while the few reported confirmatory factor analyses (CFA) of this instrument have been more consistent. The present study employed a CFA approach to identify the factor structure of the WMS-R in a mixed clinical sample of 306 patients, the majority of whom had sustained mild, diffuse brain injury. Consistent with previous CFA studies, the present study found that a three-factor solution (attention/concentration, immediate memory, delayed recall) fit the data significantly better than competing models. The validity of separate verbal and visual memory indices was not supported, perhaps because of the heterogeneity of the sample.     

The behavior flexibility rating scale-revised (BFRS-R): factor analysis, internal consistency, inter-rater and intra-rater reliability, and convergent validity

We examined the psychometric properties of the behavior flexibility rating scale-revised (BFRS-R), a new scale intended for assessing behavioral flexibility in individuals with developmental disabilities. Seventy-six direct care staff members and 56 parents completed the BFRS-R for 70 children with developmental disabilities. Factor analysis revealed three factors (i.e., Flexibility towards objects, Flexibility towards the environment, and Flexibility towards persons) and results of several analyses indicated an excellent internal consistency and good intra-rater and inter-rater reliability of the total scale. These data suggest that the BFRS-R may provide a reliable rating of behavioral flexibility when used by direct-care staff and parents of children with developmental disabilities.     

Confirmatory factor analysis of the wechsler memory scale-revised in a sample of head-injured patients

Abstract

As part of a standard evaluation of neuropsychological sequelae, the Wechsler Memory Scale-Revised (WMS-R) was administered to 107 patients with a history of traumatic brain injury. Confirmatory factor analyses were conducted on the 12 subtests of the WMS-R to examine the fit of various hypothesized factor patterns, including patterns identified in previous exploratory factor analytic studies. Because part of the correlation between immediate and delayed recall trials of the same material is attributable to a common measurement procedure, this correlation due to measurement commonality was partialled out of the conceptual factor structure. The results suggested the presence of 3 distinct but highly correlated factors: attention/concentration, immediate memory, and delayed recall. Models that posited separate verbal and nonverbal memory processes failed to improve fit over more parsimonious models. Comparisons with previous factor analytic studies and implications for clinical assessment are discussed.     

An elaborated administration of the wechsler memory scale-revised

Abstract

The Wechsler Memory Scale-Revised (Wechsler, 1987) was elaborated by adding 20 recognition items for Logical Memory (LM) and by adding recognition, matching, and copy trials for Visual Reproductions (VR). Reliability was very good for VR copy (α = .77, interrater agreement, 100% within 1 point). Reliability was modest for LM recognition (α = .42) and for VR recognition (α = .58), but reasonable given the small number of items on each measure. The reliability coefficient was very weak for VR matching (a = .10), limited considerably by the ease of the task for this healthy sample and by the small number of items. After statistically correcting for imperfect reliability, validity coefficients (correlations with similar tests that are well standardized) were good for all of the new trials (r = .60 to r = 1.00). Age- and education-appropriate reference data are provided using 81 healthy adults. Further validation using theoretically and clinically meaningful patient groups would be very valuable. In the meantime, the new trials should serve the clinician well as screening tools.     

An exploratory analysis of correlates of recovery

OBJECTIVE: The concept of recovery has received increasing emphasis in the delivery of services to persons with schizophrenia. This study was an initial effort to develop an empirically based model of factors associated with a recovery orientation. METHODS: The authors reanalyzed data from 825 persons with schizophrenia who were assessed in the Schizophrenia Patient Outcomes Research Team (PORT) client survey. Multiple regression models were used to identify client and service use variables associated with each of four domains identified as important to a recovery orientation: life satisfaction, hope and optimism, knowledge about mental illness and services, and empowerment. RESULTS: In each regression model, the strongest relationship was observed between recovery orientation and lower severity of depressive symptoms. Both receipt of family psychoeducation and fewer side effects of medications were significantly and positively related to three of the four recovery domains. Psychotic symptoms were associated with less life satisfaction. Receipt of various services, including day treatment and legal services, was positively associated with knowledge about illness and services. CONCLUSIONS: Severity of psychiatric symptoms, a core feature of the biomedical perspective of mental illness, was negatively associated with a recovery orientation, and use of a variety of standard services were positively associated with a recovery orientation. Thus a polarized view of biomedical and recovery perspectives on mental illness may be unfounded, given that these perspectives appear to be mutually reinforcing.     

An ethological analysis of depression: comparison between ethological recording and Hamilton rating of five endogenously depressed patients

Five patients who had all been diagnosed as endogenously depressed at admission were rated twice a week and observed ethologically for 4 h/week during the entire hospitalization (4-11 weeks). Observations were carried out in the actual social environment of the ward. Data were analysed based on the parameters of behaviour diversity, behaviour activity, and marker elements. Depression was scored as low values of diversity and activity; improvement corresponded to higher values of these parameters. As possible markers of improvement, 8 behavioural elements have been singled out. One patient constituted a special case: at discharge she was rated as completely recovered; however, the ethological data indicated a serious aggravation. The day after discharge the patient attempted to commit suicide. It is concluded that ethological psychiatric research may be able to supplement traditional psychiatry with decisive information in the areas of diagnosis and treatment assessment.     

Defining remission on the Montgomery-Asberg depression rating scale

OBJECTIVE: In antidepressant efficacy trials, it is common to define treatment remission as a score below a cutoff on symptom severity measures. No consensus has emerged regarding an appropriate cutoff for defining remission on the Montgomery-Asberg Depression Rating Scale (MADRS). The goal of the present study was to establish an empirically based cutoff on the MADRS for defining remission. METHOD: 303 psychiatric outpatients being treated for a DSM-IV major depressive episode were rated on the Standardized Clinical Outcome Rating for Depression, an index of DSM-IV remission status; the MADRS; and the Global Assessment of Functioning (GAF) scale. We examined the sensitivity, specificity, and overall classification rate of the MADRS for identifying a broad and narrow interpretation of the DSM-IV definition of remission, as well as the association between the breadth of the definition of remission and psychosocial functioning. RESULTS: On the basis of a narrow definition of remission, which requires a complete absence of clinically significant symptoms of depression, the optimal MADRS cutoff was < or = 4. On the basis of a broader definition, the optimal cutoff was < or = 9. Compared with patients scoring 5 through 9 on the MADRS, those who met the narrow definition of remission were rated higher, indicating better functioning, on the GAF and reported significantly less psychosocial impairment (p <.05). CONCLUSION: Our results support the use of a low cutoff on the MADRS to define remission. Because the choice of cutoff will impact the percentage of patients who are considered to be in remission and thus impact conclusions about treatment effectiveness, more empirical study should be directed toward this issue.     

An exploratory study: The psychoeducational group treatment of drug-refractory unipolar depression

The present study is a clinical evaluation or pilot study aimed at evaluating the practicality of implementing a psychoeducational group treatment for outpatients with unipolar depression who have not responded to antidepressant medication. The treatment was designed to teach skills related to improved mood, including: (1) relaxation, (2) increasing pleasant activities, (3) cognitive strategies, and (4) social skills. Of the 10 patients who participated, one dropped out, four were no longer depressed, two showed some improvement, and three were still depressed after treatment. Improvements were maintained at 1-month and 9-month follow-ups.     

Factor analysis of the wechsler memory scale-revised and the halstead-reitan neuropsychological battery

A principal components factor analysis of the 12 subtests of the WMS-R, WAIS Verbal and Performance IQ scores, and measures of a modified Halstead-Reitan Neuropsychological Battery was performed on a sample of 135 patients. The Visual Reproduction subtests I and II factored with other spatial measures and Performance IQ while Logical Memory I and II and Verbal Paired Associates I and II emerged as separate verbal memory factors. Additionally, two attention/concentration factors were found, one primarily verbal and one primarily visual. Further study in the interpretation of the Verbal and Visual Memory Indexes was advised.     

Pathways from maternal depression to young adult offspring depression: an exploratory longitudinal mediation analysis

Maternal depression in the peri‐natal period is associated with increased risk for young adult depression in offspring. This study explored mediation of these links via trajectories of child conduct and emotional problems (Strengths and Difficulties Questionnaire) from ages 4–16 years old in data from the Avon Longitudinal Study of Parents and Children cohort (n = 13373). Through gender‐specific structural equation models, a composite measure of exposure to early maternal depression (Edinburgh Postnatal Depression Scale), predicted young adult depression at age 18 (Revised Clinical Interview Schedule – distal outcome). Mediational effects were then estimated by testing which parts of joint piecewise latent trajectory models for child/adolescent conduct and emotional problems were associated with both exposure and distal outcome. For girls, only conduct problems in early childhood were consistently indicated to mediate effects of early maternal depression on risk of young adulthood depression. Some evidence for a pathway via changing levels of childhood and adolescent emotional difficulties was also suggested. For boys, by contrast, the differing models gave less consistent findings providing some evidence for a small time‐specific indirect effect via early childhood conduct problems. In addition to its practice implications the current methodological application offers considerable potential in exploratory longitudinal developmental mediation studies. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd     

Diagnosing major depression in cocaine abusers: the use of depression rating scales

This study compared the sensitivity and specificity of three rating scales in detecting major depression in 149 hospitalized cocaine abusers. Patients were administered the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression, and the Symptom Checklist-90 at admission and at 2 weeks and 4 weeks of hospitalization. The admission BDI score offered the best combination of sensitivity and specificity. However, the low specificity of all the scales and the low prevalence rate of major depression in this population made the positive predictive power of the instruments weak. The results support some limited use of the BDI as an initial screening instrument in cocaine abusers.     

Derivation of a definition of remission on the Montgomery-Asberg depression rating scale corresponding to the definition of remission on the Hamilton rating scale for depression

During the past decade the Montgomery–Asberg Depression Rating Scale (MADRS) has been used with increasing frequency to measure outcome in antidepressant efficacy trials (AETs). In characterizing treatment outcome in AETs it is common to define treatment remission as a score below a predetermined cutoff score on the scale. Various cutoffs have been used to define remission on the MADRS. The goal of the present paper is to determine the cutoff on the MADRS that most closely corresponds to the cutoff most frequently used on the Hamilton Rating Scale for Depression to define remission. Three hundred and three psychiatric outpatients who were being treated for a DSM-IV major depressive episode were rated on the HRSD and the MADRS. A linear regression equation was computed to estimate MADRS scores from HRSD scores. After deriving the regression equation, we computed the MADRS score corresponding to an HRSD score of 7. We also examined the sensitivity, specificity and overall classification rate of the MADRS for identifying remission on the HRSD. Based on the equation from a linear regression analysis for the entire sample, a MADRS score of 11 would correspond to a score of 7 on the HRSD. We repeated the analysis after excluding the more severely depressed patients who currently met criteria for MDD, and based on the equation from this regression analysis a MADRS score of 10 would correspond to a score of 7 on the HRSD. In a complementary analysis, we examined the sensitivity, specificity and overall classification rate of the MADRS at different cutoff points for identifying remission, and found that a cutoff of 10 maximized the level of agreement with the HRSD definition of remission. In conclusion, the regression equation relating HRSD and MADRS scores is dependent, in part, on the range and severity of scores in the sample. To facilitate comparisons of studies using the HRSD and MADRS our results suggest that a cutoff of 10 on the MADRS is equivalent to the HRSD cutoff of 7.     

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 the implications of the current data for research and clinical practice.     

An exploratory factor analysis of the Tail Suspension Test in 12 inbred strains of mice and an F2 intercross

To explore the genetic dimensions of the stress response in rodents, we tested 12 inbred strains of mice and an F2 intercross (n=745) on the Tail Suspension Test (TST) and the Tail Suspension-Induced Hyperthermia (TSIH) paradigm. These selected 12 strains provide a representative sampling of the genetic heterogeneity of mousedom. An F2 intercross was derived from NMRI and 129S6 strains, which differ in their responses on the TST. Both inbred strains and F2 mice underwent a standardized protocol of automated TST with two sessions: (1) baseline and (2) imipramine TST. The duration of immobility and the body temperature after TST were recorded. The inbred strains were also tested in the Light-Dark Transition (LDT) test and in the Open Field Test (OFT), measuring the distance traveled, vertical movements, and center time as independent variables. The F2 mice were measured for core temperature after TST (TSIH). High intercorrelations among strain means were found for the LDT and OFT measures. Principal components analysis extracted four factors: "exploratory fear," body weight, imipramine response on immobility, and "stress reactivity." These dimensions were largely confirmed in the F2 population with one additional factor: imipramine response on TSIH. The results support a distinction between "stress reactivity" as measured by the TST and "exploratory fear" behavior as measured by the LDT and OFT.     

Validation of HARD (Hamilton depression rating scale) a diagram of the evaluation of depression by MADRS (Montgomery-Asberg depression rating scale) Multicentric study of mianserin

A national multicentric trial has included 402 depressed patients (DSM III Criteria) and has validated diagram HARD by MADRS. A constant and similar decrease in the total of the two rating scales has been shown at several times of assessment, Day 0, 10, 20, 60, and 90. High coefficents of correlation are found between HARD and MADRS. The sensitivity to change under treatment (mianserin 60 mg) is equal for the two rating scales.     

Dimensions of schizophrenic positive symptoms: an exploratory factor analysis investigation

Current psychopathology classifies schizophrenic positive symptoms into four groups: delusions, hallucinations, formal thought disorder, and catatonic symptoms. The present study explores the factor structure of different positive symptoms to refine this classification. The 35 positive symptoms of 429 psychiatric patients, consecutively admitted to any of 95 mental hospitals, with diagnosis of the ICD-10 F20 schizophrenia, were studied. After excluding those items with a base rate of 10% or less, factor analysis yielded six factors. The first factor was loaded by most of Schneider’s first-rank symptoms and two specific auditory hallucinations; the second by all the catatonic symptoms and incoherence; the third by bodily delusions/hallucinations; the fourth by delusions of persecution and reference; the fifth by grandiose and religious delusions; and the sixth by visual and miscellaneous hallucinations. The finding that schizophrenic positive symptoms may have more than four dimensions suggests the need for reclassification of schizophrenic symptoms and for reconsideration of evidence-based diagnostic criteria for the disorder. Received: 26 January 1996 / Accepted: 12 December 1998     

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.