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Biomedical subjects

J Donders

Publications and source records attributed to J Donders.

At least 19 recordsLinked to original sources
PubMed2001

Clinical utility of the Category Test as a multidimensional instrument.

The construct and criterion validities of the Category Test (CT) were evaluated in 162 participants who had sustained traumatic brain injury and had been screened carefully for confounding factors. Maximum likelihood factor analysis identified 2 latent constructs, consistent with previous research. However, only subtests associated with the Proportional Reasoning factor (Subtests V and VI) demonstrated consistent criterion validity in terms of sensitivity to injury severity. Performance of Subtest III, associated with the Spatial Positioning factor, was in the range of chance for more than a third of the sample, without any relationship to injury variables. It was concluded that the CT has construct validity as a multidimensional instrument but that only the Proportional Reasoning factor has criterion validity in the evaluation of sequelae of traumatic brain injury.

Adult↗
PubMed2001

Using a short form of the WISC-III: sinful or smart?

This article describes an example of making pediatric neuropsychological assessments more time-efficient. Empirical support, including new data, for the utilization of an eight-subtest short form of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler, 1991) is reviewed. It is concluded that this short form of the WISC-III is a valid substitute for the complete version under most clinical circumstances, allowing the practitioner to expand on interview, history or more specific neuropsychological tests without adding financial or time burdens to the evaluation.

Adolescent↗
PubMed2001

A survey of report writing by neuropsychologists, I: general characteristics and content.

A survey addressing professional practices regarding the content and format of reports on clinical neuropsychological assessments was sent to a randomly selected sample of 750 US members of Division 40 of the American Psychological Association. A total of 414 usable replies were received, yielding a response rate of 55%. Although there was widespread agreement between respondents with different clinical practices regarding the need to include in reports various specific variables (e.g., patient age and education, referral agent and question), there was considerable variability with regard to other items. Most notably, frequency of comments about prior financial compensation seeking varied with patient age group, diagnostic category, and reimbursement source, whereas patient age group and (to a lesser extent) psychologist's board certification were associated with different habits regarding specification of the utilized norms. It is concluded that, although there are many similarities among clinical documentations from different sources, the content of neuropsychological reports tends to vary with the specific practice parameters of the individual neuropsychologist.

Adolescent↗
PubMed2001

A survey of report writing by neuropsychologists, II: test data, report format, and document length.

Data are presented regarding current practices in the organization of neuropsychological reports, based on a representative sample of 414 US members of Division 40 of the American Psychological Association. The vast majority of the sample included some numeric test data in their reports, either within the text or as an addendum. The nature of the most predominant age groups and diagnostic categories served by neuropsychologists was of prominent influence on variables such as the frequency of utilization of age- and grade-equivalent scores, the inclusion of specific diagnostic codes, the provision of narrative recommendations, and the practice of deferring report distribution until after review with the patient or family. In addition, greater involvement with forensic evaluations in a medicolegal context through private practice tended to increase length of reports. It is concluded that, although there are many areas of consensus in the field with regard to the organization of neuropsychological reports, the final product needs to be shaped on the basis of consideration of the clinical presentation of the patient as well as the needs and knowledge base of the target audience.

Adolescent↗
PubMed2001

Subjective symptomatology after traumatic head injury.

BACKGROUND: Controversy persists regarding the reasons for persistent subjective complaints after mild traumatic head injury (THI). STATEMENT OF PURPOSE: To evaluate the influence of injury severity, psychological factors, and financial contingencies on symptomatology after THI. METHODS: Subjective complaints about cognitive, emotional, and somatic symptoms, as assessed by a standardized self-report inventory (Minnesota Multiphasic Personality Inventory-2; MMPI-2) were evaluated in 150 patients with THI. RESULTS: Individuals with mild THI demonstrated paradoxically greater symptomatology on the MMPI-2 than patients with moderate-to-severe THI. Furthermore, specific actuarial criteria for possible symptom magnification (Fake Bad Scale) were met about twice as often in patients with mild THI who were seeking financial compensation for alleged acquired dysfunction than in patients with mild THI without such external contingencies. CONCLUSION: The evaluation of persistent subjective complaints after THI should consider injury severity in concert with psychological and financial/motivational factors. Great caution should be taken in attributing persistent symptomatology after mild THI to cerebral dysfunction.

Adult↗
PubMed2001

Factor index score patterns in the WAIS-III standardization sample.

Representative profile subtypes, based on factor index scores, were examined in the standardization sample of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). Two-stage cluster analysis identified five reliable subtypes. Three clusters were differentiated primarily by level of performance across all factor index scores (ranging from below average, to average, to above average). The other two clusters were characterized by distinct patterns of performance, with relative efficacy on the Processing Speed index being the most prominent distinction (ranging from a relative weakness to a relative strength). The clusters did not differ significantly in age, but ethnicity and income covaried directly with level of WAIS-III performance, whereas gender affected differential patterns of performance. Furthermore, education and memory were associated primarily with level and, to a relatively minor degree, pattern of WAIS-III performance. Implications for clinical practice are discussed.

Chi-Square Distribution↗
PubMed2001

Criterion validity of new WAIS-II subtest scores after traumatic brain injury.

The criterion validity of the new subtests from the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III; Wechsler, 1997) was evaluated in a sample of 100 patients with traumatic brain injury (TBI). Letter-Number Sequencing and Symbol Search, but not Matrix Reasoning, yielded statistically significant differences in performance between patients with moderate-severe TBI, patients with mild TBI, and demographically matched controls. Level of education accounted for a statistically significant amount of variance in the performance of patients with TBI, in addition to that explained by injury severity variables. It is concluded that Letter-Number Sequencing and Symbol Search have satisfactory criterion validity, but that they need to be supplemented with other measures in the context of neuropsychological evaluations. Matrix Reasoning, on the other hand, is not sensitive to the sequelae of TBI and more studies are needed to determine how it can be used for neuropsychological assessment purposes.

Adult↗
PubMed2000

Influence of demographic variables on neuropsychological test performance after traumatic brain injury.

The validity of correcting for demographic variables when considering neuropsychological test scores was evaluated in a sample of 136 patients with traumatic brain injury (TBI) who had been screened carefully for premorbid or comorbid confounding factors. When considered in concert with neurological variables, age and education accounted for a significant proportion of the variance in raw scores on the Category Test and the Trail Making Test in the complete sample. Gender did not affect level of test performance. Correcting neuropsychological test scores for demographic variables did not significantly alter their success in identifying patients with severe TBI, but did lead to greater accuracy when classifying individuals with mild-moderate TBI. This investigation concluded that norms that consider the demographic background of the individual are likely to reflect more accurately the neuropsychological status of patients with TBI than interpretations that are based exclusively on raw data.

Adult↗
PubMed2000

Neurobehavioral recovery after pediatric head trauma: injury, pre-injury, and post-injury issues.

This article reviews the most significant demographic, neurological, and psychosocial factors affecting the occurrence of and recovery from traumatic head injury (THI) in children and adolescents. Review of the available literature suggests that, as with adults, there is no compelling evidence for persistent neurobehavioral deficits after mild THI in children. In contrast, neurobehavioral deficits are common in children who have sustained moderate to severe THI. This article emphasizes that a long-term developmental perspective that considers in concert injury, pre-injury, and post-injury variables is needed for a proper appreciation of possible sequelae of pediatric THI. Specific pitfalls in forensic assessments of these children are reviewed. Empirical findings are presented to support the position that neuropsychological evaluations of children with THI that do not consider pre-injury status are likely to lead to misattribution errors. Clinical implications are illustrated with a case example.

Adolescent↗
PubMed2000

Predictors of parental distress after congenital disabilities.

This study investigated the relationship between child functional independence, family dynamics, psychosocial factors, and level of distress in parents of children with congenital disabilities. The Vineland Adaptive Behavior Scales, the Family Assessment Device (FAD), and the Brief Symptom Inventory (BSI) were administered to 60 parents of children with cerebral palsy, 34 parents of children with spina bifida, and 27 parents of children with limb deficiencies. Stepwise multiple regression analyses indicated that the Roles scale from the FAD and the presence of a significant new psychosocial stressor within the previous 6 months were statistically significant predictors of the level of parental distress as assessed by the BSI. Exploration of the extent to which families have adaptive distributions of responsibilities for dealing with domestic tasks, as well as with unrelated life stressors, may be helpful in identifying those parents of children with congenital disabilities who are at risk for distress.

Activities of Daily Living↗
PubMed2000

Assessment of incomplete effort with the California Verbal Learning Test.

The false-positive rates of 2 formulas for the detection of incomplete effort on the California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober, 1987) were evaluated in a sample of 134 patients with traumatic head injury (THI) who had been carefully screened to eliminate any individuals who might be expected to have financial incentives for poor performance. One formula incorrectly identified only 7.46% of the sample as providing incomplete effort, confirming its potential usefulness in clinical settings. The other formula fared much worse, misidentifying an unacceptably high 18.66% of the sample. Lower levels of education were found to increase the likelihood of false-positive results with that formula. It is concluded that the CVLT holds promise for the evaluation of incomplete effort after THI but only within the context of a more comprehensive neuropsychological evaluation.

Adult↗
PubMed2000

Novel learning abilities after traumatic head injury in children.

The cognitive abilities of 69 children with traumatic head injury (THI) were evaluated with the California Verbal Learning Test-Children's Version (CVLT-C; Delis, Kramer, Kaplan, & Ober, 1994), the Children's Category Test (CCT; Boll, 1993), and the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler, 1991). Compared to children with mild to moderate injuries, children with severe THI demonstrated statistically significant impairments on the CVLT-C Total T-score as well as the WISC-III Processing Speed index, but findings for the CCT were less robust. Longer length of coma and male gender were associated with relatively poorer performance on the CVLT-C. Children with severe THI demonstrated difficulties with both capacity and speed of information processing, which could not be accounted for by attentional or general verbal knowledge factors. It is concluded that the combination of the CVLT-C and the WISC-III is useful in the evaluation of cognitive sequelae of THI but that findings from the CCT must be considered with some caution in this population.

Journal Article↗
PubMed1999

Psychometric intelligence in patients with traumatic brain injury: utility of a new screening measure.

OBJECTIVE: To evaluate the validity of the General Ability Measure for Adults (GAMA) in a sample of patients with traumatic brain injury (TBI). DESIGN: Comparison with criterion standards of Wechsler Adult Intelligence Scale-Revised (WAIS-R) and measures of injury severity. SETTING: Regional rehabilitation center. PARTICIPANTS: One-year prospective series of consecutive rehabilitation referrals, including 42 adult patients with TBI. MAIN OUTCOME MEASURES: GAMA and WAIS-R IQ scores were obtained within 1 year after injury and compared with each other and with measures of injury severity. RESULTS: The GAMA demonstrated statistically significant covariance with the WAIS-R and was able to discriminate severe TBI from mild/moderate TBI. The correlation between the GAMA and length of coma fell just short of statistical significance. CONCLUSIONS: The GAMA is sufficiently sensitive to the presence or absence of severe TBI but may not be sufficiently sensitive to the exact degree of injury severity.

Adolescent↗
PubMed1999

Performance discrepancies on the California Verbal Learning Test-Children's Version in the standardization sample.

The standardization data for the California Verbal Learning Test-Children's Version (CVLT-C) were used to evaluate statistically significant discrepancies between key quantitative variables of this instrument, as well as the base rate of specific discrepancies. The results indicated that apparently large discrepancies between the respective standard scores were actually fairly common. However, for 3 of the 4 contrasts, discrepancies that equaled or exceeded 1.5 z-score points in the hypothesized direction were sufficiently unusual to be considered clinically significant. For a 4th contrast, discrepancies that equaled or exceeded 1 z-score point in the hypothesized direction appeared to meet this criterion. It is suggested that the interpretation of clinically obtained CVLT-C profiles should focus primarily on specific quantitative variables, with inclusion of consideration of the presented base rates of discrepancies between the respective z scores.

Adolescent↗
PubMed1999

Latent structure of the Wisconsin Card Sorting Test after pediatric traumatic head injury.

The performance of 80 pediatric patients with traumatic head injury (THI) on the Wisconsin Card Sorting Test (WCST; Heaton, Chelune, Talley, Kay, & Curtiss, 1993) was examined to determine the underlying latent structure. Exploratory factor analysis with oblique rotation identified three factors: response accuracy, failure to self-monitor, and learning. The response accuracy factor was directly affected by both age and length of coma. Level of performance on this factor also covaried with post-injury psychometric intelligence. It is concluded that interpretation of the WCST results of children with THI should consider the multifactorial nature of the instrument in combination with injury severity characteristics and demographic variables.

Adolescent↗
PubMed1999

Performance on the California Verbal Learning Test after traumatic brain injury.

The California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober, 1987) data of 150 patients with traumatic brain injury (TBI) were evaluated to determine the latent underlying constructs as well as the possibility of performance subtypes with criterion validity. Confirmatory factor analysis of eight competing latent variable models suggested that a four-factor model (composed of Attention Span, Learning Efficiency, Delayed Recall, and Inaccurate Recall) fit the data relatively well. Two-stage cluster analysis of marker variables of each of these four factors suggested the presence of four reliable subtypes. Level of performance differences between these clusters were related to injury severity parameters. It is concluded that the CVLT is a sensitive and mulitfactorial measure of learning and memory after TBI. Specific recommendations for interpretation of clinically obtained CVLT profiles are provided.

Adolescent↗