Background: Cognitive fatigue (CF) is a human response to stimulation and stress and is a common comorbidity in many medical conditions that can result in serious consequences; however, studying CF under controlled conditions is difficult. Immersive virtual reality provides an experimental environment that enables the precise measurement of the response of an individual to complex stimuli in a controlled environment.
Objective: We aim to examine the development of an immersive virtual shopping experience to measure subjective and objective indicators of CF induced by instrumental activities of daily living.
Objective: Executive functioning encompasses interactive cognitive processes such as planning, organization, set-shifting, inhibition, self-monitoring, working memory, and initiating and sustaining motor and mental activity. Researchers therefore typically assess executive functioning with multiple tests, each yielding multiple scores. A single composite score of executive functioning, which summarizes deficits across a battery of tests, would be useful in research and clinical trials.
View Article and Find Full Text PDFObjective: Previous researchers have examined the frequency at which healthy participants obtain one or more low scores on neuropsychological test batteries, proposing five psychometric principles of multivariate base rates: (a) low scores are common, with their frequency contingent on (b) the low score cutoff used, (c) the number of tests administered/interpreted, and (d) the demographic characteristics and (e) intelligence of participants. The current study explored whether these principles applied to high scores as well, using the Delis-Kaplan Executive Function System (D-KEFS).
Method: Multivariate base rates of high scores (≥75th, ≥84th, ≥91st, ≥95th, and ≥98th percentiles) were derived for a three-test, four-test, and full D-KEFS battery, using the adult portion of the normative sample (aged 16-89 years; N = 1050) stratified by education and intelligence.
This study provides observed base rates of low executive functioning test scores among healthy children and adolescents, stratifies those base rates by narrow intellectual functioning and age groupings, and provides normative classification ranges to aid the interpretation of performances on the Delis-Kaplan Executive Function System (D-KEFS) in clinical practice and research. Participants included 875 children and adolescents between 8 and 19 years old from the D-KEFS normative sample (48% male; 52% female). Among these participants, 838 had complete data and were included in the current study.
View Article and Find Full Text PDFPurpose/objective: To compare and contrast how individuals with traumatic brain injury (TBI) are classified (positive or negative screen) by different cut-offs on two self-report measures of depressive symptoms: the PHQ-9, which assesses somatic symptoms, and the TBI-QOL Depression item bank, which does not. Research Method/Design: Three hundred eighty-five individuals with TBI were recruited from six rehabilitation hospitals in the U.S.
View Article and Find Full Text PDFPurpose/objective: Metrics to estimate premorbid cognitive ability, such as word reading tests, are important for clinical determination of cognitive changes following brain injury. In the present study, reading adjusted scores for the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) fluid tests were developed and validated with a sample of individuals with traumatic brain injury (TBI), to evaluate the clinical utility of reading-adjusted scores. Research Method/Design: The development sample included 843 adult participants, ages 20-85, from the NIHTB-CB standardization sample.
View Article and Find Full Text PDFPurpose/objective: To apply multivariate base rate analyses to the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) to facilitate the identification of cognitive impairment in individuals with traumatic brain injury (TBI). Research Method/Design: In a multisite cross-sectional design, 158 participants who sustained a complicated mild or moderate TBI (n = 74) or severe TBI (n = 84) at least 1 year earlier were administered the NIHTB-CB. The NIHTB-CB is comprised of 2 crystallized cognition tests (reflecting premorbid ability) and 5 fluid cognition tests, measuring processing speed, memory, and executive functioning.
View Article and Find Full Text PDFObjective: The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) measures reading, vocabulary, episodic memory, working memory, executive functioning, and processing speed. While previous research has validated the factor structure in healthy adults, the factor structure has not been examined in adults with neurological impairments. Thus, this study evaluated the NIHTB-CB factor structure in individuals with acquired brain injury.
View Article and Find Full Text PDFPurpose/objective: To compare the cognitive profiles of a well-characterized sample of adults with and without spinal cord injury (SCI) using the NIH Toolbox Cognition Battery NIHTB-CB. Research Method/Design: Participants were 156 community-dwelling individuals with SCI recruited from 3 academic medical centers, and 156 individuals without SCI selected from the NIHTB-CB normative database (N = 312). The main outcome measures were the demographically adjusted NIHTB-CB subtest and composite scores.
View Article and Find Full Text PDFPurpose/objective: The NIH Toolbox for the Assessment of Neurological Behavior and Function Cognition Battery (NIHTB-CB) is a common data element for use in individuals with traumatic brain injury (TBI). This study evaluates its sensitivity and specificity in distinguishing individuals with complicated mild, moderate, or severe TBI, and provides support for the construct validity of the NIHTB-CB in individuals with TBI.
Research Method: One hundred eighty-two individuals with TBI (n = 83 complicated mild/moderate; n = 99 severe) completed the NIHTB-CB and neuropsychological criterion measures.
Objective: Multivariate base rates allow for the simultaneous statistical interpretation of multiple test scores, quantifying the normal frequency of low scores on a test battery. This study provides multivariate base rates for the Delis-Kaplan Executive Function System (D-KEFS).
Method: The D-KEFS consists of 9 tests with 16 Total Achievement scores (i.
Objective: Executive function consists of multiple cognitive processes that operate as an interactive system to produce volitional goal-oriented behavior, governed in large part by frontal microstructural and physiological networks. Identification of deficits in executive function in those with neurological or psychiatric conditions can be difficult because the normal variation in executive function test scores, in healthy adults when multiple tests are used, is largely unknown. This study addresses that gap in the literature by examining the prevalence of low scores on a brief battery of executive function tests.
View Article and Find Full Text PDFArch Clin Neuropsychol
August 2017
Introduction: The National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function Cognition Battery is comprised of seven cognitive tests, including two tests measuring crystallized cognitive ability (i.e., vocabulary and reading) and five tests measuring fluid cognitive functioning (i.
View Article and Find Full Text PDFArch Clin Neuropsychol
December 2017
Objective: Neuropsychologists interpret a large number of scores in their assessments, including numerous retest scores to determine change over time. The rate at which healthy children and adolescents obtain reliably improved or declined memory scores when retested has yet to be explored. The purpose of this study was to illustrate the prevalence of reliable change scores on memory test batteries in healthy children and adolescents.
View Article and Find Full Text PDFObjectives: Performance on neurocognitive tasks develops with age, but it is still unknown whether this performance differs between children from different cultures. We compared cross-sectionally the development of neurocognitive functions in 3- to 15-year-old children from three countries: Finland, Italy, and the United States (N=2745).
Methods: Language, face memory, emotion recognition, theory of mind, and visuospatial processing subtests from the NEPSY-II standardizations in Finland, Italy, and the United States were used to evaluate if children and adolescents from different linguistic and cultural backgrounds differ in performance on these measures.
Arch Clin Neuropsychol
December 2016
Objective: The rate at which people obtain reliably improved or declined cognitive test scores when retested, in the absence of a change in clinical condition, is largely unknown. The purpose of this study was to illustrate the prevalence of statistically reliable change scores on memory test batteries in healthy adults and older adults.
Method: Participants included three adult and older adult test-retest samples from memory test batteries.
Cognitive impairment is a core clinical feature of traumatic brain injury (TBI). After TBI, cognition is a key determinant of post-injury productivity, outcome, and quality of life. As a final common pathway of diverse molecular and microstructural TBI mechanisms, cognition is an ideal endpoint in clinical trials involving many candidate drugs and nonpharmacological interventions.
View Article and Find Full Text PDFThe study purpose was to compare the diagnostic utility of the Brief Cognitive Status Exam (BCSE) to that of the Mini-Mental State Examination (MMSE) and to develop equated scores to facilitate comparisons. One hundred and eighty-two patients underwent cognitive evaluation and were placed into three groups: dementia (DEM), cognitive impairment, no dementia (CIND), and no cognitive impairment (NCI). One hundred and eighty-two healthy controls from the BCSE standardization sample served as a comparison group.
View Article and Find Full Text PDFExecutive functions are thought to be the latest functions to mature. However, this view has not been tested by assessing simultaneously memory, perception of emotions, visuospatial perception, and visuoconstructional skills. NEPSY II norm data from 1000 5- to 16-year-old U.
View Article and Find Full Text PDFThe Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test (TMT), a modification of the original TMT, was created to isolate set-shifting (Letter-Number Switching) from other component skills. This was accomplished by including four baseline conditions (Visual Scanning, Number Sequencing, Letter Sequencing, and Motor Speed) and by placing equal numbers of stimuli in the three sequencing conditions. Given that some studies with the original TMT demonstrated a significant effect of education and intellectual functioning on performance, we utilized the D-KEFS national standardization sample to examine the effects of education and vocabulary level-i.
View Article and Find Full Text PDFPrevious research using the Wechsler scales has identified areas of cognitive weaknesses in children, adolescents, and adults diagnosed with Autism or Asperger's syndrome. The current study evaluates cognitive functioning in adolescents and adults diagnosed with Autism or Asperger's syndrome using the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and the Social Perception subtest from the Advanced Clinical Solutions. Deficits in social perception, verbal comprehension, and processing speed were found in the Autism sample.
View Article and Find Full Text PDFThe Wechsler Adult Intelligence Scale-fourth edition (WAIS-IV) and the Wechsler Memory Scale-fourth edition (WMS-IV) were co-developed to be used individually or as a combined battery of tests. The independent factor structure of each of the tests has been identified; however, the combined factor structure has yet to be determined. Confirmatory factor analysis was applied to the WAIS-IV/WMS-IV Adult battery (i.
View Article and Find Full Text PDFClinicians can use the base rates of low scores in healthy people to reduce the likelihood of misdiagnosing cognitive impairment. In the present study, base rates were developed for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Memory Scale-Fourth Edition (WMS-IV) using 900 healthy adults and validated on 28 patients with moderate or severe traumatic brain injuries (TBIs). Results indicated that healthy people obtain some low scores on the WAIS-IV/WMS-IV, with prevalence rates increasing with fewer years of education and lower predicted intelligence.
View Article and Find Full Text PDFObjective: To assess the effect of atomoxetine on ADHD-related executive functions over a 6-month period using the Brown Attention-Deficit Disorder Scale (BADDS) for Adults, a normed, 40-item, self-report scale in a randomized, double-blind, placebo-controlled clinical trial.
Method: In a randomized, double-blind clinical trial, adults with ADHD received either atomoxetine 25 to 100 mg/day or placebo for 6 months. Patients completed the BADDS to report their current daily functioning in 5 clusters of ADHD-related impairments of executive functioning: (1) Organizing and Activating to Work; (2) Focusing for Tasks; (3) Regulating Alertness and Effort; (4) Modulating Emotions; and (5) Utilizing Working Memory.
Objective: Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS) that measures aspects of ADHD in adults.
Method: Psychometric properties of the AISRS total and AISRS subscales are analyzed and compared to the Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) and the Clinical Global Impression-ADHD-Severity Scale using data from a placebo-controlled 6-month clinical trial of once-daily atomoxetine.
Results: The AISRS has high internal consistency, good convergent, and discriminant validities; modest divergent validity; and small ceiling and floor effects (