Biomedical subjects

A M Paolo

Publications and source records attributed to A M Paolo.

At least 19 recordsLinked to original sources

PubMed2001

Exploratory factor analysis of the WAIS-III in a mixed patient sample.

The Wechsler Adult Intelligence Scale-III (WAIS-III) was administered to 152 patients at a VA Medical Center. Means for age, education, and Full Scale IQ were 51.49 years (SD = 13.00), 12.43 years (SD = 2.00), and 92.61 (SD = 14.06), respectively. Of the 152 patients, 69 had substance abuse disorders, 39 had medical/neurological conditions, 27 had both substance abuse and psychiatric disorders, and 17 had psychiatric conditions. The 13 WAIS-III subtests were subjected to a principal-axis factor analysis with oblimin rotation. Four factors were specified to be retained. The Verbal Comprehension, Perceptual Organization, and Processing Speed factors were identical to those in the standardization sample. However, Arithmetic could not be allocated to any factor within the patient sample. The Working Memory factor consisted only of the Digit Span and Letter-Number Sequencing subtests. &copy 2000 National Academy of Neuropsychology. Published by Elsevier Science Ltd

Journal Article↗

PubMed2000

Response rate comparisons of e-mail- and mail-distributed student evaluations.

BACKGROUND: The proliferation of electronic information delivery systems has led to increasing use of e-mail as a rapid method of gathering information. Little research has been conducted on the use of e-mail for collecting curriculum evaluations. PURPOSE: To compare e-mailed and mailed educational evaluations for 4th-year medical students. METHODS: Curriculum evaluations were sent to 4th-year medical students who were randomly assigned to receive the survey either by mail or e-mail. RESULTS: Mailed evaluations yielded a higher return rate, fewer number of students omitting items, and shorter responses to an open-ended question than evaluations completed via e-mail. CONCLUSIONS: Although the findings have limited generalizability because of low response rates and small sample sizes, the results suggest caution when using e-mail to collect curriculum evaluations from 4th-year medical students.

Clinical Clerkship↗

PubMed1999

Action (verb naming) fluency as an executive function measure: convergent and divergent evidence of validity.

Numerous studies have demonstrated dissociable neuroanatomic underpinnings for the retrieval of grammatical classes of words such as nouns and verbs. Whereas retrieval of common and proper nouns is primarily mediated by posterior and anterior temporal regions, respectively, verb retrieval is primarily mediated by frontal regions. The majority of studies evaluating verb production have utilized tasks requiring subjects to name a graphically depicted action (i.e. action naming), leaving tests of verb generation in the absence of prompting stimuli (i.e. action fluency) largely unexamined. In a recent study, Piatt, Fields, Paolo, Koller and Tröster (in press) found that an action fluency task discriminated demented Parkinson's disease (PD) patients from non-demented PD patients and healthy control subjects, whereas lexical and categorical fluency tasks did not. These authors suggested that action fluency was sensitive to the fronto-striatal pathophysiology associated with PD dementia, and thus, that action fluency might serve as an indicator of executive functioning. This study was undertaken to evaluate the construct validity of action fluency as an executive function measure in a group of healthy elderly control subjects. Findings revealed modest to moderate relationships between action fluency and several putative executive measures. Action fluency was unrelated to indices of semantic and episodic memory. Results support the construct validity of action fluency as an executive function measure and suggest that this task may provide some unique information not tapped by traditional executive function tasks.

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PubMed1999

Lexical, semantic, and action verbal fluency in Parkinson's disease with and without dementia.

Previous research suggests that lexical and semantic verbal fluency are differentially sensitive to the effects of cortical and subcortical dementias, but little is known about action fluency performance in dementias. The present study compared lexical, semantic, and action fluency in groups of patients with Parkinson's disease (PD) with and without dementia and an elderly control group. Findings revealed an interaction between fluency type and subject group. Although the demented PD (PDD) group performed significantly more poorly than their non-demented counterparts and normal controls on all three fluency tasks, a disproportionate disparity in scores was noted on the action fluency task. The findings suggest that action fluency may be particularly sensitive to PD-associated dementia and may be an early indicator of the conversion from PD to PDD. As reported elsewhere, PD without dementia was not associated with significant impairment on any of the fluency tasks.

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PubMed1998

Utility of the seven subtest WAIS-R short form in a female sample with brain damage.

We examined the accuracy of the WAIS-R seven subtest short form (Ward, 1990) for predicting IQs of 130 females with brain damage or dysfunction. Means for age, education, and FSIQ were 44.37 years (SD = 18.46), 12.74 years (SD = 2.42), and 87.64 (SD = 13.62). Results indicated that 93%, 84%, and 93% of short form estimated VIQs, PIQs, and FSIQs were within +/-5 points of their actual WAIS-R scores. In terms of Wechsler's (1981) seven category intelligence classification, levels of agreement were 83%, 72%, and 82% for the Verbal, Performance, and Full scales, respectively. These findings support the use of the seven subtest short form with brain-damaged women when time is at a premium and only a general estimate of intellectual functioning is required.

Adult↗

PubMed1998

Continuous Visual Memory Test performance in healthy persons 60 to 94 years of age.

Performance of elderly subjects on the Continuous Visual Memory Test (CVMT) was examined in a sample of neurologically normal adults (74 males and 103 females). Means for age and education were 71.20 years (SD = 6.02) and 14.77 years (SD = 2.48). Results revealed that the recommended impairment cut-off scores provided in the CVMT manual did not generalize to the current sample with 8% to 50% of healthy elderly persons falling within the impaired range. Therefore, the current sample was used to provide updated preliminary elderly normative data for the CVMT.

Journal Article↗

PubMed1998

Test-retest stability of the Continuous Visual Memory Test in elderly persons.

Ninety-two normal elderly persons were administered the Continuous Visual Memory Test (CVMT) on two occasions an average of 1.1 years apart. Means for age and education were 69.02 years (SD = 5.79) and 14.80 years (SD = 2.64), respectively. Stability coefficients were.49 on the Total score,.44 on d-prime, and.48 on Delayed Recognition. D-Prime and Delayed Recognition scores demonstrated significant change on retest. To assist clinicians in the process of detecting meaningful change on retest, standard error of difference values and 90% cut-off scores were provided.

Journal Article↗

PubMed1997

Estimating premorbid WAIS-R intelligence in the elderly: an extension and cross validation of new regression equations.

Recently developed equations that combine WAIS-R subtests and demographic information to estimate premorbid intelligence were evaluated in persons 75 years and older. The equations underestimated the obtained IQs of elderly persons. Therefore, new equations were developed using the old age WAIS-R standardization sample. The new equations cross-validated well and demonstrated adequate ability to detect possible intellectual deterioration in a brain damaged sample. The demographic formulas of Barona, Reynolds, and Chastain worked as well as the new equations in suggesting possible deterioration in a sample of elderly persons with chronic and diffuse cognitive impairment.

Aged↗

PubMed1997

Comparison of NART and Barona demographic equation premorbid IQ estimates in Alzheimer's disease.

Two methods of estimating premorbid WAIS-R intelligence were compared in matched samples of normal and AD persons. The NART and Barona 1984 demographic equations accurately predicted the IQs of the normal group and overestimated the IQs of the AD subjects. When the AD group was divided into mild and moderately impaired subgroups, the more severely demented subjects displayed lower WAIS-R IQs and NART estimated IQs, revealing that NART performance is sensitive to dementia severity. However, the NART estimated IQs for the mild and moderately impaired AD subgroups were larger than the WAIS-R IQs, suggesting that while the NART is sensitive to dementia severity, it may still provide relevant clinical information.

Aged↗

PubMed1997

Test-retest stability of the California verbal learning test in older persons.

One hundred fifty-one healthy older persons were administered the California Verbal Learning Test (CVLT) on 2 occasions, an average of 1.30 years apart. Means for age and education were 69.63 years (SD = 6.46) and 14.91 years (SD = 2.54), respectively. Stability coefficients ranged from .24 on number of perseverations to .76 for both List A total recall and long-delay free recall. Only 5 CVLT scores demonstrated a significant change on retest, and the overall magnitude of improvement was small. To assist clinicians in the process of detecting significant change on retest, the authors provide standard error of difference values and 90% confidence intervals for 22 CVLT scores.

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PubMed1997

California Verbal Learning Test: normative data for the elderly.

Overlapping age tables were developed, separately for males and females, to provide additional normative information for the California Verbal Learning Test (CVLT) and extend the normative data to persons older than 80 years of age. Participants were 92 males and 120 females with means for age and education of 70.58 years (SD = 6.98) and 14.92 years (SD = 2.56), respectively. Normative information was also provided for additional measures of retention rate and proportion of perseverations and intrusions. The clinical utility of these norms strongly depends on how closely a person matches the demographic characteristics of the normative group.

Aged↗

PubMed1997

Exploratory factor analysis of the Wechsler Adult Intelligence Scale-Revised in a sample of brain-damaged women.

The first exploratory factor analysis of the WAIS-R using an exclusively female sample (N = 152) of brain-damaged patients was conducted. Means for age, education, and Full Scale IQ were 43.51 years(SD = 18.22), 12.60 years(SD = 2.47), and 86.34(SD = 13.32). Results indicated that either a two- or three-factor model was plausible for this sample. The two-factor solution supported Wechsler's (1981) Verbal and Performance IQ designations, while the three-factor model revealed Verbal-Comprehension (i.e., Information, Comprehension, Vocabulary, and Similarities), Perceptual-Organization (i.e., all Performance subtests), and Freedom From Distractibility (i.e., Digit Span) factors. Comparison of the factor structures for the present sample with those of normal women and brain-damaged men suggested factorial equivalency across groups.

Journal Article↗

PubMed1996

Utility of the Barona demographic equations to estimate premorbid intelligence: information from the WAIS-R standardization sample.

The WAIS-R (Wechsler, 1981) and elderly WAIS-R standardization samples (Ryan, Paolo, & Brungardt, 1990) were combined to evaluate the utility of the Barona demographic regression equations (Barona, Reynolds, & Chastain, 1984) to estimate premorbid intelligence. The equations underestimated ability for persons with IQs less than 80 and overestimated ability of subjects with IQs greater than 119. The equations also overestimated the IQs of 247 persons with confirmed brain dysfunction. Because this overestimation occurred for impaired persons with IQs less than 90, it is difficult to determine whether the difference reflects true intellectual deterioration or statistical artifact. Abnormal cut-off scores at the 10% and 5% levels are provided to allow clinicians to detect abnormal discrepancies between the estimated and obtained IQs.

Adolescent↗

PubMed1996

Self-reported disability due to headache: a comparison of clinic patients and controls.

OBJECTIVE: To compare the self-reported disability of headache sufferers who seek medical assistance with those who do not seek such help and determine possible relationships between perceived disability and psychological factors. METHOD: Subjects were 51 headache patients and 53 persons without medical assistance for their headache within the past 2 years. All subjects completed a structured interview that gathered headache data, a headache disability scale, and the Minnesota Multiphasic Personality Inventory-Revised (MMPI-2). DESIGN: A 2 x 2 ANCOVA design was employed. Subject group (patient vs control) was the first factor and headache type (migraine vs mixed) was the second. Covariates were headache intensity and five subscales of the MMPI-2. Dependent variables were the seven subscales of the headache disability scale. Stepwise discriminant analysis was conducted to determine which factors best classified subjects as patients or controls. SETTING: University Medical Center headache clinic. RESULTS: Clinic patients reported significantly greater disability on their occupation than controls--a difference emerging after controlling for level of headache pain and personality variables. Patients differed from controls, although not significantly, in the rank order of life activities most affected by headache. Discriminant analysis revealed that self-reported disability for occupation and the Hysteria scale from the MMPI-2 best differentiated the groups.

Adult↗

PubMed1996

Utility of a Wisconsin Card Sorting Test short form in persons with Alzheimer's and Parkinson's disease.

The utility of administering only the first deck of 64 cards from the Wisconsin Card Sorting Test (WCST-64) in persons with Alzheimer's (AD) and Parkinson's disease (PD) was evaluated. There were 35 elderly subjects matched for gender, age, and education in each of four groups: controls, PD without dementia (PDN), PD with dementia (PDD), and AD. Additionally, the control and PDN subjects were matched for level of cognitive functioning as were the PDD and AD groups. Results revealed that demented persons performed significantly worse than nondemented subjects. The WCST-64 was also sensitive to the subtle executive deficits demonstrated by persons with PD without dementia. The findings support the use of the WCST-64 in elderly persons with AD and PD.

Aged↗

PubMed1996

Stability of WAIS-R scatter indices in the elderly.

The test-retest reliability and clinical stability of WAIS-R VIQ-PIQ differences, inter, and intrasubtest scatter were investigated in a sample of 61 normal persons 75 years and older. The test-retest coefficient was.76 for VIQ-PIQ discrepancy, ranged from.05 to.56 for the intersubtest scatter range, and from.08 to.43 for intrasubtest scatter. In terms of clinical stability, 56% of subjects maintained a similar magnitude and direction of meaningful VIQ-PIQ differences from test to retest. Classification of subtest strengths and weakness from test to retest was generally poor with an average disagreement of 52% from the first to the second assessment. Intrasubtest scatter also displayed poor clinical stability with 25-50% of subjects demonstrating meaningful changes on retest.

Journal Article↗

PubMed1996

WAIS-R verbal-performance IQ discrepancies in persons with lateralized lesions: utility of a seven subtest short form.

WAIS-R Verbal-Performance IQ difference scores for Ward's (1990) seven subtest short form and the complete WAIS-R were examined in patients with lateralized and diffuse lesions. For both versions, the expected Performance > Verbal pattern was observed in the right hemisphere lesion group, while no summary score differences were seen in the left hemisphere group. Verbal-Performance IQ discrepancies for the short form fell within +/- 5 points of the WAIS-R discrepancy scores in about 75%of the cases, regardless of lesion location. Statistically reliable IQ differences between the complete and abbreviated WAIS-R attained 66%, 91%, and 89% agreement for the left, right, and diffuse groups, respectively. The results support the clinical utility of the seven subtest short form.

Journal Article↗

PubMed1995

Headache symptoms and psychological profile of headache-prone individuals. A comparison of clinic patients and controls.

OBJECTIVE: To compare the psychological characteristics of headache sufferers who seek medical assistance with those who do not. SUBJECTS: Fifty-one patients seeking medical help for their headache and 53 controls who had not sought medical assistance for their headache within the past 2 years. All subjects completed a structured interview that gathered headache data according to the International Headache Society classification criteria and the Minnesota Multiphasic Personality Inventory-Revised (MMPI-2). DESIGN: A 2 x 2 design was employed. Subject group (patient vs control) was the first factor and headache type (migraine vs mixed) was the second. SETTING: University medical center outpatient headache clinic. RESULTS: Patient and control groups did not differ in age, education, gender, or number of individuals with migraine. The only headache characteristic distinguishing the groups was that clinic patients rated their "most severe headache" as more intense than did controls. On the MMPI-2, the clinic group scored significantly higher on the Hypochondriasis, Depression, Hysteria, Psychasthenia, and Social Introversion scales than did controls. Severity of headache was not responsible for this difference, since it was used as a covariate in the analysis. There were no significant differences on the MMPI-2 for headache type, nor were there any significant interactions. CONCLUSIONS: These results were discussed in light of previous studies. It was concluded that psychological characteristics are important factors in the decision to seek medical help for headache.

Adult↗