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Kenneth M Adams

Publications and source records attributed to Kenneth M Adams.

10 recordsLinked to original sources

Psychological disturbance, incomplete effort, and compensation-seeking status as predictors of neuropsychological test performance in head injury.

Indices from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) representing cognitive and emotional disturbance as well as incomplete effort on the Recognition Memory Test (RMT; Warrington, 1984) were examined as predictors of performance on the Halstead-Reitan Neuropsychological Test Battery (HRB; Reitan & Wolfson, 1993). In the current study, which included a large sample (N = 369) of patients referred for neuropsychological (NP) evaluation after presumptive head injury, MMPI-2 measures of psychological disturbance accounted for as much as 25% of the variance in HRB test scores, resulting in a moderate overall effect size (median Adj. R(2) = .16; R = .40). When demographic variables, head injury severity, and compensation-seeking status were entered in previous steps, incomplete effort as defined by chance performance on the RMT accounted for between 2% and 13% of the variance in HRB test scores, with modest overall effect size (median R(2) Delta = .07; R = .26) in multiple regression equations. Additionally, when MMPI-2 indices of psychological disturbance were included in the last step, they accounted for 2% to 11% of additional variance, retaining a modest overall effect (median R(2) Delta = .03; R = .17). Compensation-seeking status and injury severity as measured by duration of post-traumatic amnesia were, at best, modestly related to NP test performance. Findings confirm the reliable relationship between test performance and psychological disturbance as well as incomplete effort when assessing dysfunction following head injury. In contrast to previous studies, incomplete effort was unrelated to compensation-seeking status.

Adult↗

Detecting insufficient effort using the Seashore Rhythm and Speech-Sounds Perception Tests in head injury.

This study examined the capacity of the Seashore Rhythm Test (SRT) and the Speech-Sounds Perception Test (SSPT) to detect insufficient effort in a clinical sample. Forty-six participants with financially compensable mild head injury who obtained scores indicative of insufficient effort on multiple measures were compared to 49 participants with brain injury who were not involved in litigation. Receiver operating characteristic (ROC) curve analysis indicated that both the SRT (AUC = .84) and SSPT (AUC = .80) were significant (p < .001) predictors of insufficient effort. Maximizing sensitivity and specificity, the optimal cutoff scores were 8 errors on the SRT and 10 errors on the SSPT. Combining both variables into a logistic regression function increased the diagnostic efficiency.

Acoustic Stimulation↗

Poor response inhibition as a predictor of problem drinking and illicit drug use in adolescents at risk for alcoholism and other substance use disorders.

OBJECTIVE: To evaluate the predictive power of executive functions, in particular, response inhibition, in relation to alcohol-related problems and illicit drug use in adolescence. METHOD: A total of 498 children from 275 families from a longitudinal high-risk study completed executive function measures in early and late adolescence and lifetime drinking and drug-related ratings at multiple time points including late adolescence (ages 15-17). Multi-informant measures of attention-deficit/hyperactivity disorder and conduct disorder were obtained in early childhood (ages 3-5), middle childhood, and adolescence. RESULTS: In multilevel models, poor response inhibition predicted aggregate alcohol-related problems, the number of illicit drugs used, and comorbid alcohol and drug use (but not the number of drug-related problems), independently of IQ, parental alcoholism and antisocial personality disorder, child attention-deficit/hyperactivity disorder and conduct symptoms, or age. Multivariate models explained 8% to 20% of residual variance in outcome scores. The incremental predictive power of response inhibition was modest, explaining about 1% of the variance in most outcomes, but more than 9% of the residual variance in problem outcomes within the highest risk families. Other measured executive functions did not independently predict substance use onset. CONCLUSION: Models of alcoholism and other drug risks that invoke executive functions may benefit from specifying response inhibition as an incremental component.

Adolescent↗

Smoking is associated with neurocognitive deficits in alcoholism.

BACKGROUND: Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits. OBJECTIVE: Determine whether smoking contributes to neurocognitive deficits associated with alcoholism. DESIGN: Neurocognitive function was examined in a community-recruited (n=172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance). RESULTS: Both alcoholism and smoking were negatively correlated with neurocognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ. CONCLUSIONS: Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Future studies are necessary to more fully understand the effects of smoking on neurocognitive function in alcoholism.

Adult↗

Normative Symbol Digit Modalities Test performance in a community-based sample.

The Symbol Digit Modalities Test is a substitution task that is the inverse of the Digit Symbol Test. The familiar task of filling numbers in boxes, and the availability of an oral administration, make this a popular screening instrument for brain impairment. Normative data were previously reported for a variety of clinical groups, but complete information on non-clinical samples across age, education, gender, and socioeconomic status is limited. The present study examines the performance of a community-dwelling control sample across age, education, gender, and income groupings. In a multivariate model, these four variables did not impact test performance. These results support the utilization of the SDMT as a robust screening test for adult neuropsychological impairment.

Adult↗

Neuropsychological executive functioning in children at elevated risk for alcoholism: findings in early adolescence.

One component of individual risk for alcoholism may involve cognitive vulnerabilities prodromal to alcoholism onset. This prospective study of 198 boys followed between 3 and 14 years of age evaluated neurocognitive functioning across three groups who varied in familial risk for future alcoholism. Measures of intelligence, reward-response, and a battery of neuropsychological executive and cognitive inhibitory measures were used. Executive functioning weaknesses were greater in families with alcoholism but no antisocial comorbidity. IQ and reward-response weaknesses were associated with familial antisocial alcoholism. Executive function effects were clearest for response inhibition, response speed, and symbol-digit modalities. Results suggest that executive deficits are not part of the highest risk, antisocial pathway to alcoholism but that some executive function weaknesses may contribute to a secondary risk pathway.

Adolescent↗

MMPI-2 indices of psychological disturbance and attention and memory test performance in head injury.

A number of studies have investigated the relationship between psychological disturbance and neuropsychological (NP) test performance. The current study is a replication and extension of who found that MMPI-2 indices of psychological disturbance are related to performance on NP tests of attention and memory in psychiatric and head-injured patients. In a large sample (N=381) referred for evaluation after sustaining presumed head injury, we examined the relationship between MMPI-2 indices of psychological disturbance and measures of attention and memory from the Wechsler Memory Scale-Revised (WMS-R), Wechsler Adult Intelligence Scale-Revised (WAIS-R), California Verbal Learning Test (CVLT), and the Memory Assessment Scales (MAS). Although related to other domains, MMPI-2 variables were most consistently related to measures of attention and List Learning. Even when demographic variables, injury severity, and litigation status were controlled, MMPI-2 indices significantly predicted performance on six out of eight tests. However, the correspondence between similar indices on the WMS-R and MAS were relatively low, especially for Verbal Memory and Visual Reproduction. Further, litigation was significant in predicting only 2 of 8 attention and memory indices.

Adult↗

Relationship between neuropsychological and emotional functioning in severe chronic alcoholism.

Previous studies of patients with severe chronic alcoholism have shown a high prevalence of emotional distress such as anxiety and depression, and neuropsychological impairments such as executive deficits, but few have examined the relationship between these disorders. We addressed this issue in 51 abstinent patients with histories of severe chronic alcoholism utilizing the Minnesota Multiphasic Personality Inventory (MMPI) and the Halstead-Reitan Neuropsychological Test Battery (HRNTB). Applying factor analysis to the MMPI clinical and validity scales, we derived four dimensions accounting for 78% of the available variance. We found that Factor 1, which loaded on most clinical scales of the MMPI, was significantly correlated (p <.01) with performance on the Halstead Category Test (HCT), a measure of executive functioning. Further, group analysis with MANOVA using HCT (impaired and nonimpaired) as the independent variable revealed a significant main effect for Factor 1 (p <.004), which was maintained and strengthened when age and education were controlled as covariates (p <.001). The results suggest a relationship between emotional distress and executive functioning as measured by the HCT, reflecting differing facets of frontal lobe dysfunction common to cognitive and affective domains in patients with severe chronic alcoholism.

Adult↗