Psychometric Evaluation of the Life Orientation Test—Revised in Treated Opiate Dependent Individuals

We examined internal consistency and test-retest reliability of a measure of dispositional optimism, the Life Orientation Test — Revised, in 121 opiate-dependent patients seeking methadone treatment. Internal consistency was adequate at baseline (α = .69) and follow-up (α = .72). Low socioeconomic status and being on disability were significantly associated with reduced internal consistency; ethnic and educational differences approached significance. Test-retest reliability was good (ICC = .72), varying across gender, race, ethnicity, education, employment and income (ICC Range = .24 –.85). Criterion validity was strong; the LOT-R was significantly negatively correlated with hopelessness (r = -.65, p < .001) and depression (r = -.60, p < .001). Findings support the use of this measure of optimism and pessimism to assess positive cognitive and emotional attributes and improve treatment strategies for opiate-dependent individuals. Future research should address the measurement and significance of optimism in minority, low socioeconomic status and poorly-educated individuals.     

Use of the Multiple Errands Test – Simplified Version in the assessment of suboptimal effort

Most measures of suboptimal effort focus on short-term learning; fewer studies have considered non-memory feigned cognitive impairment. This study investigated the utility of the Multiple Errands Test – Simplified Version (MET-SV) in the detection of feigned executive functioning impairment. Performance of simulating malingerers (N?=?47) was compared to acquired brain injury (N?=?46) and neurologically healthy control groups (N?=?50). Although simulating malingerers were successful at feigning a realistic level of impairment compared to the brain injury group, there were significant differences regarding pattern of performance. A logistic regression model successfully classified 84% of simulating malingerers and 74.5% of brain injured individuals. Receiver Operating Characteristic (ROC) analysis supported the discriminatory power of the model. The current study is unique in yielding some understanding of the real-life observation of suspected malingerers compared to individuals with genuine cognitive difficulties. Results suggest the MET-SV can contribute to the clinical assessment of individuals suspected of suboptimal effort in the domain of executive functioning. Further research is needed to establish whether the MET-SV can be reliably used in medico-legal settings.     

The development of the Chinese version of Impact of Event Scale – Revised (CIES-R)

Background: This is an exploratory study on the psychometric properties and normative data of the Chinese translation of the Impact of Event Scale – Revised (CIES-R). Methods: The original Impact of Event Scale – Revised was translated into Chinese and the comparability of content was verified through back-translation procedures. The study consisted of a sample of 116 patients from the Accident and Emergency Department. Results: The reliability of the Chinese version was verified. The validity of the Chinese version as a measure of psychological distress was supported by the positive correlations between the various subscale scores of CIES-R (i. e., Intrusion, Avoidance, and Hyperarousal) and General Health Questionnaire-20. However, the independence of the three subscales was not supported. Conclusions: The present result suggests that normative information for different age groups and clinical samples might be different. Further study with clinical sample and investigation of the relationship between CIES-R and other diagnostic measures of PTSD are discussed. Received: 22 August 2002 / Accepted: 13 September 2002 Correspondence to Kitty K. Wu     

Test Your Memory (TYM) as a screening instrument in clinical practice – the Polish validation study

Objectives: The Test Your Memory (TYM) test is a short, self-administered screening cognitive instrument designed for the detection of Alzheimer's disease (AD). The study was aimed to examine the Polish version of TYM as a screening instrument in Polish clinical practice.

Method: In this study 199 patients were assessed whereas 131 patients with AD and mild cognitive impairments (MCI) and 94 healthy control subjects took part in the final analysis. The sensitivity and specificity of the TYM test were evaluated among the AD group and healthy control group. The TYM test was compared to other neuropsychological tests, such as Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), DemTect and Verbal Fluency Test (FAS).

Results: The average TYM score in healthy control group: 45.4, 40.9 in the MCI patients and 23.4 in AD patients. The Polish version of the TYM test showed good correlation with other neuropsychological instruments among AD patients. Participants aged ≥75 and those with primary education performed significantly worse in TYM. The TYM achieved the best differentiation between AD and the healthy control group for ≤39 cut-off with a sensitivity and specificity of 91% and 90%, respectively.

Conclusion: The Polish version of the TYM test is a useful instrument and may be seen as an alternative to the MMSE screening test in clinical practice in patients with dementia. However, the normative data suggested that the age and the level of education of the respondents should be considered as important factors affecting the interpretation of the final score.     

Factor structure and item level psychometrics of the Social Problem Solving Inventory – Revised: Short Form in traumatic brain injury

Social problem-solving deficits characterise individuals with traumatic brain injury (TBI), and poor social problem solving interferes with daily functioning and productive lifestyles. Therefore, it is of vital importance to use the appropriate instrument to identify deficits in social problem solving for individuals with TBI. This study investigates factor structure and item-level psychometrics of the Social Problem Solving Inventory – Revised: Short Form (SPSI-R:S), for adults with moderate and severe TBI. Secondary analysis of 90 adults with moderate and severe TBI who completed the SPSI-R:S was performed. An exploratory factor analysis (EFA), principal components analysis (PCA) and Rasch analysis examined the factor structure and item-level psychometrics of the SPSI-R:S. The EFA showed three dominant factors, with positively worded items represented as the most definite factor. The other two factors are negative problem-solving orientation and skills; and negative problem-solving emotion. Rasch analyses confirmed the three factors are each unidimensional constructs. It was concluded that the total score interpretability of the SPSI-R:S may be challenging due to the multidimensional structure of the total measure. Instead, we propose using three separate SPSI-R:S subscores to measure social problem solving for the TBI population.     

New Error type and Recall Consistency Indices for the Brief Visuospatial Memory Test – Revised: Performance in Healthy Adults and Multiple Sclerosis Patients

The Brief Visuospatial Memory Test –?Revised (BVMT-R) is a reliable and well-validated test of visual-spatial memory with six equivalent, alternate forms. While the BVMT-R is commonly used in the evaluation of patients with craniocerebral trauma, schizophrenia, and multiple sclerosis (MS), the range of variables is limited. In this study, we developed new BVMT-R error and recall consistency indices. Inter-rater reliability and validity for the new indices were examined in 70 MS patients and 72 healthy volunteers. In addition to poorer general performance, MS patients made more intrusions and qualitative errors, and showed a trend toward poorer BVMT-R recall consistency. Findings suggest these error types and inconsistent learning contribute to poorer recall of visual material in MS.     

Evaluation of the Mississippi PTSD Scale—Revised Using Rasch Measurement

This study used Rasch measurement theory to examine the Mississippi Scale--Revised for its utility in the development of an interval measure of posttraumatic stress disorder (PTSD). Rasch is a probability-based theory that provides both a measure of the person responding to the instrument and the location of each item calibration on one common construct or dimension. The study used a largely male sample of 153 veterans to evaluate the quality of the items defining PTSD, to describe how the items represent the symptom range of the disorder, and to assess the functioning of items in evaluating PTSD with and without comorbid MDD. Sixteen items were found to fit the measurement model. These items may be used to develop an interval scale of the PTSD construct that is generalizable across diverse populations and that can be used for individualized comparable assessments.     

Is the Halstead Category Test a multidimensional instrument?

Factor structure of the Halstead Category Test was evaluated in patients with schizophrenia, heterogeneous forms of brain damage, and patient controls using confirmatory factor analysis. Analyses were performed including and excluding subtests 1 and 2. In the first analysis, a three-factor model was optimal, with subtests 1 and 2 loading on one factor (Counting), 3, 4, and 7 loading on a second factor (Spatial Positional Reasoning), and subtests 5 and 6 loading on a third factor (Proportional Reasoning). Excluding subtests 1 and 2, a two-factor solution was optimal consisting of the Spatial Positional (subtests 3 and 4) and Proportional Reasoning (subtests 5 and 6) factors, with subtest 7 loading on both factors. Optimal factor structures for the three groups were identical. Correlations between factor scores were similar among groups. Factor scores also correlated significantly (p <.01 ) with all of the other cognitive measures. It was concluded that the Category Test is a multidimensional procedure with factors associated in a general way with other cognitive abilities.     

Strategy Use on the Ruff Figural Fluency Test☆

Although the popularity of including figural fluency tests in cognitive and neuropsychological test batteries has increased in recent years, the spontaneous use of strategies on these measures remains poorly understood. This study addressed three questions pertaining to strategy use on the Ruff Figural Fluency Test (RFFT): (i) how common is strategy use, (ii) what information does strategy use convey, and (iii) can examinees learn to use strategies. Findings revealed that nearly seven out of 10 healthy college students used a strategy at least once while taking the RFFT. The number of strategies used and the number of figures produced using a strategy had modest correlations with select executive function measures (D-KEFS Tower Test, Sorting, and Letter & Category Verbal Fluency) in hypothesized directions. When strategies were demonstrated for subjects who did not spontaneously use them, those subjects were able to subsequently use strategies. These findings suggest that although common, failure to spontaneously use a strategy is not unusual. Further, strategy use may reflect a cognitive asset, particularly regarding planning, reasoning, and cognitive flexibility.     

Flibanserin – the female Viagra?

This article provides a clinically relevant review of the first medication approved by the US Food and Drug Administration for hypoactive sexual desire disorder (HSDD) in premenopausal women. In this short piece, the human sexual response cycle and its relevance to HSDD will be described as well as the pharmacological mechanism of action of flibanserin. Finally, efficacy and safety data of this new medication will be summarised.     

Crossing the line – Learning psychiatry at the movies

Special Study Modules (SSMs) have developed in response to the General Medical Council's recommendations. St George's, University of London runs a ‘Psychiatry and Film’ SSM for medical students on the 5-year MBBS course. Many films have plots or characters that have a mental illness. Psychiatry & filmmaking share certain skills. Both seek to understand character, motivation and behaviour. Cinema therefore has the potential to be a useful tool for medical educational purposes. Specific to psychiatry, themes such as the accuracy of portrayals of different mental illness, the psychiatrist/patient relationship and living with a mental illness can be explored. General issues such as the role of the psychiatrist in society, medical ethics, professionalism and stigma can also be usefully highlighted for consideration and debate. This may encourage medical students to consider psychiatry as a potential career specialty and help reduce negative attitudes to mental illness.     

Embedded Effort Indicators on the California Verbal Learning Test – Second Edition (CVLT–II): An Attempted Cross-Validation

This study determined whether the logistic regression method that was recently developed by Wolfe and colleagues (2010) for the detection of invalid effort on the California Verbal Learning Test – Second Edition (CVLT–II) could be cross-validated in an independent sample of 100 consecutively referred patients with traumatic brain injury. Although the CVLT–II logistic regression formula demonstrated a statistically significant level of agreement with results from the Word Memory Test, it was associated with an unacceptably high proportion of false positives. The component variables of the logistic regression were sensitive to length of coma but did not covary with psychosocial complicating factors (e.g., unresolved prior psychiatric history) that were associated with a higher relative risk of failure of WMT validity criteria. It is concluded that the Wolfe et al. logistic regression should be used only with great caution in the context of clinical neuropsychological evaluations.     

What About Inhibition in the Wisconsin Card Sorting Test?

The commercially available Wisconsin Card Sorting Test (WCST) is one of the most commonly used tests for assessing executive functions within clinical settings. Importantly, however, it remains relatively unclear exactly what processes are assessed by the test. Conceptually, increased perseverative errors in sorting cards are usually related to deficient inhibition processes. Empirically, evidence supporting this conclusion is limited. In a sample of 38 healthy adults we addressed the question to what extent inhibition mechanisms assessed by the go/no-go and the stop-signal paradigm are related to WCST performances. Inhibition-related scores were found to predict non-perseverative errors better than perseverative errors. Consequently we conclude that the non-perseverative errors score reflects processes that are partly dependent on inhibition functions.     

Is the Boston Naming Test Still Fit For Purpose?

The Boston Naming Test (BNT) (Kaplan, Goodglass, & Weintraub, 1983 Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea & Fibiger. [Google Scholar]) is the most commonly used test of confrontation naming in neuropsychology (Rabin, Barr, & Burton, 2005 Rabin, L., Barr, W., & Burton, L. (2005). Assessment practices of clinical neuropsychologists in the United States and Canada: A survey of INS, NAN, and APA Division 40 members. Archives of Clinical Neuropsychology, 20, 33–65. doi:10.1016/j.acn.2004.02.005.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). However, there are significant criticisms of the BNT which suggest that it might not be the assessment measure of choice. These criticisms are that the BNT has poor psychometric properties, is not adequately standardized, and has inadequate norms. It is further suggested that when considered in the context of contemporary conceptualizations of the neuropsychology of naming, the BNT does not adequately capture the processes known to be required for successful naming, and does not sample widely enough from the content domain of “naming”. These criticisms suggest that the BNT is flawed as a measure of naming, and are discussed in detail in this review. Other stand-alone visual confrontation naming tasks are reviewed to evaluate whether any might be viable substitutes for the BNT in clinical neuropsychology. The Naming Test from the Neuropsychological Assessment Battery (Stern & White, 2009 Stern, R., & White, T. (2009). NAB Naming Test: Professional manual. Lutz, FL: Psychological Assessment Resources. [Google Scholar]) was identified as a possible alternative to the BNT, however, neither of these tests was designed with reference to models of the neuropsychology of naming, and development of a new test of naming is indicated.     

Goal-Directed Fantasy and the Performance of Hypnotic Test Suggestions†

Rejection sensitivity has been found to confer risk for depression. The process through which this occurs remains unclear. This risk factor also has been associated with negative behavioral tendencies and interpersonal difficulties. Drawing on these different lines of research, the current investigation aimed to evaluate stress generation, the tendency for depression-prone individuals to experience higher rates of life stressors that are at least in part influenced by their own behavior, as a potential mechanism mediating the link between rejection sensitivity and subsequent depressive symptoms. Sixty-six adults with a history of depression were followed over a 4-month interval and completed assessments of rejection sensitivity and depressive symptoms at baseline, and depressive symptoms, a diagnostic interview for depression, and a contextual threat life stress interview at 4-month follow-up. Consistent with the stress generation hypothesis, rejection sensitivity predicted higher rates of dependent stressors, but not independent ones, over the 4-month prospective follow-up period. Furthermore, prospectively occurring dependent stressors mediated the relationship between baseline rejection sensitivity and depressive symptoms at follow-up. The finding that stress generation may operate as a mediating mechanism underlying the pathway between rejection sensitivity and depression lends preliminary support for the importance of targeting maladaptive behavioral tendencies in rejection-sensitive individuals in clinical settings.     

What about inhibition in the Wisconsin Card Sorting Test?

The commercially available Wisconsin Card Sorting Test (WCST) is one of the most commonly used tests for assessing executive functions within clinical settings. Importantly, however, it remains relatively unclear exactly what processes are assessed by the test. Conceptually, increased perseverative errors in sorting cards are usually related to deficient inhibition processes. Empirically, evidence supporting this conclusion is limited. In a sample of 38 healthy adults we addressed the question to what extent inhibition mechanisms assessed by the go/no-go and the stop-signal paradigm are related to WCST performances. Inhibition-related scores were found to predict non-perseverative errors better than perseverative errors. Consequently we conclude that the non-perseverative errors score reflects processes that are partly dependent on inhibition functions.