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Biomedical subjects

Esther Strauss

Publications and source records attributed to Esther Strauss.

15 recordsLinked to original sources

Structure of four executive functioning tests in healthy older adults.

The authors examined the factor structure of 4 indicators of executive functioning derived from 2 new (i.e., Hayling and Brixton) and 2 traditional (i.e., Stroop and Color Trails) tests. Data were from a cross-sectional sample of 55- to 85-year-old healthy adults (N=427) from the Victoria Longitudinal Study. Confirmatory factor analysis (LISREL 8.52) tested both a 2-factor model of Inhibition (Hayling, Stroop) and Shifting (Brixton, Color Trails) and a single-factor model. The 2-factor model did not fit the data because the covariance matrix of the factors was not positive definite. The single-factor model fit the data well, chi(2)(2, N=427)=0.32, p=.85, root-mean-square error of approximation (RMSEA)=.00, comparative fit index (CFI)=1.00, goodness-of-fit index (GFI)=1.00. Moreover, the single-factor structure of executive functioning was invariant (configural and metric) across gender, and invariant (configural with limited metric) across age. Structural relations showed that poorer executive functioning performance was related to older age and lower fluid intelligence, chi(2)(11, N=418)=23.04, p=.02, RMSEA=.05, CFI=.97, GFI=.98.

Age Factors↗

Intraindividual variability as a marker of neurological dysfunction: a comparison of Alzheimer's disease and Parkinson's disease.

Individuals with certain neurological conditions may demonstrate greater inconsistency (i.e., intraindividual variability) on cognitive tasks compared to healthy controls. Several researchers have suggested that intraindividual variability may be a behavioral marker of compromised neurobiological mechanisms associated with aging, disease, or injury. The present study sought to investigate whether intraindividual variability is associated with general nervous system compromise, or rather, with certain types of neurological disturbances by comparing healthy adults, adults with Alzheimer's disease (AD), and Parkinson's disease (PD). Participants were assessed on four separate occasions using measures of reaction time and memory. Results indicated that inconsistency was correlated with indices of severity of impairment suggesting a dose-response relationship between cognitive disturbance and intraindividual variability: the more severe the cognitive disturbance, the greater the inconsistency. However, participants with AD were more inconsistent than those with PD, with both groups being more variable than the healthy group, even when controlling for group differences in overall severity of cognitive impairment or cognitive decline. Consequently, intraindividual variability may index both the severity of cognitive impairment and the nature of the neurological disturbance.

Aged↗

Aging and response inhibition: Normative data for the Victoria Stroop Test.

Increased difficulty with response inhibition occurs with age, although there is some controversy as to whether increased interference on Stroop tasks reflects difficulties with response inhibition or simply reflects generalized cognitive slowing. The Victoria Stroop Test (VST) is a brief, easily administered, psychometrically sound version of Stroop's original task. Performance on the VST by adults across a wide age span was examined to determine the association between age and various measures of interference. In addition, normative data for the VST were calculated. Participants were 272 healthy, community-dwelling adults age 18 to 94. Age and speed were negatively correlated on all trials of the VST. Importantly, however, interference scores that were corrected for baseline slowing remained highly correlated with age. Similarly, age and error scores on the interference trial were positively correlated, indicating decreased accuracy with age. These findings suggest that increased interference on Stroop tasks with age is not accounted for by simple cognitive slowing and more likely reflects other cognitive changes, such as decreased response inhibition. The VST has a number of administrative and psychometric strengths, and the provision of normative data should enhance its potential for clinical and research applications.

Adolescent↗

Cognitive functioning and everyday problem solving in older adults.

The relationship between cognitive functioning and a performance-based measure of everyday problem-solving, the Everyday Problems Test (EPT), thought to index instrumental activities of daily living (IADL), was examined in 291 community-dwelling non-demented older adults. Performance on the EPT was found to vary according to age, cognitive status, and education. Hierarchical regression analyses revealed that, after adjusting for demographic and health variables, measures of cognitive functioning accounted for 23.6% of the variance in EPT performance. In particular, measures of global cognitive status, cognitive decline, speed of processing, executive functioning, episodic memory, and verbal ability were significant predictors of EPT performance. These findings suggest that cognitive functioning along with demographic variables are important determinants of everyday problem-solving.

Activities of Daily Living↗

Performance on the Hayling and Brixton tests in older adults: norms and correlates.

The individualized nature of the aging process underlines the need to have neuropsychological tests that are sensitive enough to distinguish normal changes associated with aging from those that are pathological. However, these measures are only useful if adequate normative data are available. Normative data are presented for two new executive functioning tasks, the Hayling and Brixton tests, which were administered as part of a neuropsychological battery to 457 typically aging older adults (53-90 years). Advancing age was associated with poorer performance on both the Hayling and Brixton tests. Results showed that fluid intelligence accounts for some but not all of the age-related variance on these tasks.

Aged↗

Memory span on the Wechsler Scales.

This study had two goals. One was to assess whether the WMS-III Spatial Span subtest operates as a visual analogue of Digit Span while the second was to determine whether backward span is a more sensitive measure of working memory than the forward span condition. Analyses based on the WAIS-III-WMS-III standardization and clinical group data revealed some important distinctions between Digit and Spatial Span. The two tasks exhibited differences in patterns of performance on the forward versus backward conditions, in their relationships with age, and in their methodology. Moreover, the backward conditions of both Digit and Spatial Span did not appear more affected by risk factors such as aging or pathology than the forward scores. This runs contrary to the widespread notion that backward span provides differential sensitivity regarding working memory processing.

Adolescent↗

Reexamining the effects of epilepsy surgery on IQ in children: use of regression-based change scores.

Prior studies have found no adverse effects of pediatric epilepsy surgery on IQ. However, empirical techniques such as regression models, designed to account for confounding factors such as practice effects and test-retest reliability and able to provide a standardized method for evaluating outcome, have not been used in studying change after pediatric epilepsy. The goal of this study was to demonstrate the regression technique while empirically measuring the effect of epilepsy surgery on IQ in a group of pediatric patients. Predictors of retest IQ (e.g., baseline IQ, retest interval, demographics, epilepsy severity) were evaluated in a control group with intractable seizures (N = 23) assessed twice with the WISC-III. The resulting equation was used to evaluate IQ changes in a second group of children who underwent epilepsy surgery (N = 22). In controls, baseline IQ was a strong predictor of retest IQ. Number of AEDs was inversely related to retest IQ. Based on the control regression, four children (18%) in the surgical sample obtained significantly higher than expected postsurgical IQ scores and one child (5%) obtained a lower than expected IQ score. This study demonstrates that regression-based techniques yield informative estimates on outcome and may be an improvement over prior methods of measuring change after pediatric epilepsy surgery.

Adolescent↗

Confirmatory factor analysis of the WMS-III in patients with temporal lobe epilepsy.

Five competing models specifying the factor structure underlying the Wechsler Memory Scale-Third Edition (D. Wechsler, 1997b) primary subtest scores were evaluated in a sample of patients with intractable temporal lobe epilepsy (N = 254). Models specifying separate immediate and delayed constructs resulted in inadmissible parameter estimates and model specification error. There were negligible goodness-of-fit differences between a 3-factor model of working memory, auditory memory, and visual memory and a nested--more parsimonious--2-factor model of working memory and general memory. The results suggest that specifying a separate visual memory factor provides little advantage for this sample--an unexpected finding in a population with lateralized dysfunction, for which one might have predicted separate auditory and visual memory dimensions.

Adult↗

Victoria Symptom Validity Test scores of patients with profound memory impairment: nonlitigants case studies.

Victoria Symptom Validity Test (VSVT) scores from six nonlitigants with neurological illness accompanied by dense anterograde amnesia or severe memory impairment are presented. All of these patients obtained perfect or near perfect scores on the VSVT. These data add to the literature suggesting that the VSVT is insensitive to genuine neurologically-based memory impairment and provide an additional floor-level clinical benchmark against which to compare the performance of litigants.

Adult↗

Age-related slowing of digit symbol substitution revisited: what do longitudinal age changes reflect?

A previous investigation reported that cross-sectional age differences in Digit Symbol Substitution (DSS) test performance reflect declines in perceptual processing speed. Support for the tenability of the processing speed hypothesis requires examining whether longitudinal age-related change in DSS performance is largely mediated by changes in speed. The present study used data from the Victoria Longitudinal Study to examine patterns and predictors of longitudinal change in DSS for 512 older adults (M(age) = 68.37 years, SD = 7.43). On the basis of multilevel modeling, baseline DSS performance was poorer for older participants and men, with longitudinal declines more pronounced with increasing age and decreasing speed. In contrast to the present cross-sectional findings, statistical control of change trajectories in perceptual speed using the same data did not substantially attenuate age changes. These discrepancies suggest different sources of variance may underlie cross-sectional age differences and longitudinal age changes for DSS.

Aged↗

Intraindividual variability in cognitive performance in three groups of older adults: cross-domain links to physical status and self-perceived affect and beliefs.

Intraindividual variability of physical status and affect/beliefs as well as their relations with cognition were examined in 3 groups of older adults: healthy elderly, individuals with a nonneurological health-related disturbance (arthritis) and people with neurological compromise (dementia). The findings showed that greater inconsistency in physical performance was observed in groups characterized by central nervous system dysfunction. By contrast, fluctuations in affect appeared to reflect other more transient sources, such as pain. In general, increased inconsistency in non-cognitive domains was associated with poorer cognitive function. There were cross-domain links between inconsistency in physical functioning and fluctuations in cognitive performance, although the nature of the links depended largely upon the neurological status of the individuals. Considered together, the result indicated that measures of cognitive as well as physical variability are important behavioral markers of neurological integrity.

Affect↗

Intraindividual variability in physical and emotional functioning: comparison of adults with traumatic brain injuries and healthy adults.

Recent research has shown that individuals with certain neurological conditions demonstrate greater intraindividual variability on cognitive tasks compared to healthy controls. The present study investigated intraindividual variability in the domains of physical functioning and affect/stress in three groups: adults with mild head injuries, adults with moderate/severe head injuries, and healthy adults. Participants were assessed on 10 occasions and results indicated that (a) individuals with head injuries demonstrated greater variability in dominant finger dexterity and right grip strength than the healthy controls; (b) increased variability tended to be associated with poorer performance/report both within and across tasks; and (c) increased variability on one task was associated with increased variability on other tasks. The findings suggest that increased variability in physical function, as well as cognitive function, represents an indicator of neurological compromise.

Adolescent↗

Functional equivalence of WAIS-III/WMS-III digit and spatial span under forward and backward recall conditions.

The purpose of the current study was to examine the performance characteristics of the Wechsler Spatial Span subtest in a mixed clinical sample. Contrary to expectation, differential patterns of performance were obtained on the Digit and Spatial Span tasks. Forward Digit Span scores were significantly higher than backward recall scores, but this was not the case for Spatial Span. There were no differences between forward and backward raw Spatial Span scores at the mean level. Further, about one third of the sample showed better performance on backward compared to forward Spatial Span. In addition, performance on the Spatial Span backward task correlated unexpectedly with that of the WMS-III Immediate and Delayed Auditory Index scores. Overall, the findings suggest that clinicians should be hesitant when interpreting the Spatial Span task, and the backward condition in particular, as a measure of working memory. Finally, methodological concerns with the Spatial Span task are noted, raising additional concerns regarding the meaning of this task.

Humans↗

How'd they do it? Malingering strategies on symptom validity tests.

Twenty-five undergraduate students were instructed to feign believable impairment following a brain injury from a car accident and 27 students were told to perform like they had recovered from such an injury. Three forced-choice tests, the Test of Memory Malingering (TOMM), Victoria Symptom Validity Test (VSVT), and Word Memory Test (WMT) were given. Test-taking strategies were evaluated by means of a questionnaire given at the end of the test session. The results revealed that all the tasks differentiated between groups. Using conventional cut-scores, the WMT proved most efficient while the VSVT captured the most participants in the definitive below-chance category. Individuals instructed to feign injury were more likely to prepare prior to the experiment, with feigning of memory loss as the most frequently reported strategy. Regardless, preparation effort did not translate into believable performance on the tests.

Adult↗

Intraindividual variability as an indicator of malingering in head injury.

The utility of various measures of malingering was evaluated using an analog design in which half the participants (composed of three groups: naive healthy people, professionals working with head-injured people, individuals who suffered a head injury but not currently in litigation) were asked to try their best and the remainder was asked to feign believable injury. Participants were assessed with the Reliable Digit Span (RDS) task, the Victoria Symptom Validity Test (VSVT), and the Computerized Dot Counting Test (CDCT) on three separate occasions in order to determine whether repeat administration of tests improves prediction. The results indicated that regardless of an individual's experience, consideration of both level of performance (particularly on forced-choice symptom validity tasks) and intraindividual variability holds considerable promise for the detection of malingering.

Journal Article↗