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Biomedical subjects

M D van den Broek

Publications and source records attributed to M D van den Broek.

11 recordsLinked to original sources
PubMed2005

Ecological validity of measures of executive functioning.

OBJECTIVES: This study aimed to ascertain the ecological validity of the Hayling and Brixton tests of executive functioning, by investigating whether cognitive 'impairment' detected by these measures was associated with assessment of 'disability' and 'handicap'. DESIGN AND METHOD: A correlational design was employed to evaluate the degree of association between the executive test results, and behavioural and community integration measures. Participants were 53 people with brain injuries participants who were selected from neuropsychology patient lists and their 'significant other'. The brain-injured participant was given the executive tests, together with behavioural and community integration questionnaires, while their 'significant other' was given an equivalent behavioural questionnaire and structured interview. RESULTS: There were moderate relationships between scores on the tests and measures of everyday functioning, suggesting that the tests have modest ecological validity. CONCLUSIONS: The tests contribute to understanding the impact of executive impairment on everyday functioning, but they should be interpreted in combination with other measures of executive functioning.

Adult↗
PubMed2005

The detection of malingering in memory performance: the sensitivity and specificity of four measures in a UK population.

OBJECTIVES: To investigate the validity of a clinical neuropsychological battery for the detection of malingering on tests of memory. METHODS: A simulated scenario design was developed to investigate the effectiveness of a battery of four neuropsychological tests in the detection of malingering; the Coin in the Hand Test (CIH), Autobiographical Memory Index (AMI), Rey I 5-Item Test (RIT),and the Wechsler Mental Control Test (MCT). The performances of patients with an acquired brain injury (N = 40) were compared with two groups of controls instructed either to simulate a head injury performance (N = 40) or do their best (N = 40). RESULTS: The CIH and MCT demonstrated good validity and displayed high sensitivity and specificity. The RIT and the AMI was relatively poor in distinguishing between simulators and patients. CONCLUSIONS: The sensitivity and specificity of all four tests to the detection of malingering has been assessed. Two of the tests the CIH and MCT would be useful as a quick and accurate screening tool for detecting malingering.

Adult↗
PubMed2000

Evaluation of an electronic memory aid in the neuropsychological rehabilitation of prospective memory deficits.

Five subjects with acquired memory impairment were trained to use a new electronic memory aid, the Voice Organizer, to manage prospective memory errors. Performance was assessed on two measures analogous to everyday memory tasks; a Message-Passing task requiring prospective recall after a delay of 9 hours, and a Domestic Task measure which involved the recall of household chores following a delay of 1-6 days. All subjects benefited from the introduction of the aid on the Message-Passing task and all but one improved their prospective recall on the Domestic Task measure. These results suggest that the Voice Organizer may be a useful aid in the neuropsychological rehabilitation of prospective memory impairment.

Adult↗
PubMed1998

A new performance-curve method for the detection of simulated cognitive impairment.

OBJECTIVE: To evaluate a new performance-curve method for detecting simulated cognitive impairment. DESIGN: The method was based on quantitative analysis of choice reaction times in a series of eight matching-to-sample tasks of graded complexity, in which participants were required to identify which of two comparison stimuli was identical to a simultaneously presented sample stimulus. The stimuli consisted of arrays of letters, the number of letters ranging from 1 to 10 in the eight tasks. METHODS: Mean reaction times of a standardization group of 20 healthy young adults were used to construct regression equations to describe the behaviour of three test groups: 20 healthy individuals instructed to perform to the best of their ability (non-simulators), 20 healthy individuals instructed to simulate cognitive impairment incurred as a result of a head injury (simulators), and 25 patients with a history of closed head injury (patients). RESULTS: There was a linear relationship between individual participants' latencies and the mean latencies of the standardization sample; the patient group showed steeper slopes, and the simulators higher intercepts, than the non-simulator group. A univariate measure of performance, based on the proportionate increase in latency corresponding to a standard increase in the standardization group's latency was able to identify 14/20 simulators while misclassifying 2/20 non-simulators and 2/25 patients. Other measures, including the number of errors made in the choice reaction time task and in recognition memory tasks, and a performance-curve measure based on Raven's Standard Progressive Matrices, were less successful in identifying simulators. CONCLUSIONS: This new performance-curve method may prove to be a useful addition to tests currently used to diagnose simulated cognitive impairment in clinical and medicolegal settings.

Adolescent↗
PubMed1994

Detection of acquired deficits in general intelligence using the National Adult Reading Test and Raven's Standard Progressive Matrices.

A multiple regression equation for estimating premorbid Raven's Standard Progressive Matrices (RSPM) scores on the basis of age and the National Adult Reading Test (NART) was derived. A sample of patients with confirmed cerebral lesions was examined to determine the proportion of patients with significant discrepancies between their predicted and obtained RSPM performance. The sensitivity of the procedure was modest (52 per cent), although a comparison with discrepancies between premorbid and current performance on the Wechsler scales indicated that the RSPM was more sensitive to neuropathology. These findings suggest that when NART-intelligence test comparisons are used to diagnose cerebral impairment, the likelihood of a false-negative diagnosis is high.

Adult↗
PubMed1993

Utility of the Modified Wisconsin Card Sorting Test in neuropsychological assessment.

Nelson's (1976) Modified Wisconsin Card Sorting Test (MCST) was evaluated and the utility of the conventional criterion and new threshold scores for identifying patients with frontal lobe disorder assessed. Measures of perseveration and other indices of performance on the MCST were not found to discriminate between patients with frontal and non-frontal lobe lesions, using either the conventional criterion or new threshold scores. In addition there were no significant differences between left- and right-sided lesioned patients. However, the task was found to have high specificity (98.7 per cent) and good sensitivity (45.6 per cent) to lesions irrespective of site indicating that it may be a useful screening test. The present findings are consistent with recent research with the original Wisconsin Test, that suggests that card-sorting performance may not be as differentially sensitive to frontal lobe disorder as has been thought hitherto.

Adult↗
PubMed1988

Failure to replicate evidence for phobic schemata in agoraphobic patients.

Two experiments incorporating methodological refinements were conducted to replicate previous findings that agoraphobics selectively recall phobic material compared with normal subjects. In addition, patients with anxiety states but no phobic symptomatology were studied to assess whether selective recall is specific to agoraphobia or a feature of anxious patients generally. The results of both studies failed to replicate previous findings and fail to offer support for recent theorizing regarding the presence of cognitive differences between agoraphobics and normals.

Adult↗
PubMed1987

Performance of normal adults on the Matching Familiar Figures Test.

Seventy-seven subjects underwent the Matching Familiar Figures Test (MFFT) and the Wechsler Adult Intelligence Scale. Mean latency to the first response (L) and square-root-transformed error score (T) on the MFFT were normally distributed in the sample. T was correlated positively with age and negatively with IQ; L was not significantly correlated with either. Orthogonal 'impulsiveness' (I) and 'efficiency' (E) indices were derived from the standard scores for L (zL) and T (zT) using the formulae I = zT - zE, and E = -(zT + zL). The interpretation of I and E, and the potential usefulness of the MFFT as a neuropsychological test, are discussed.

Adult↗
PubMed1984

The effects of a psychological "stressor" and raised ambient temperature on the pharmacological responsiveness of human eccrine sweat glands: implications for sweat gland hyper-responsiveness in anxiety states.

The responsiveness of eccrine sweat glands to local intradermal injections of carbachol was studied in six male healthy volunteers using a plastic paint impression method. A psychological "stressor" (performance of a mental arithmetic task) resulted in an increase in the sizes of the responses evoked by carbachol, this being reflected in a higher value of Emax obtained under the "stress" than under the "non-stress" condition. A rise in ambient temperature from 20 degrees C to 35 degrees C resulted in qualitatively similar effects on the dose-response curve. These results are discussed in the context of recent observations on the pharmacological responsiveness of sweat glands in patients suffering from anxiety neurosis.

Adult↗
PubMedDate not supplied

Why does neurorehabilitation fail?

Following neurorehabilitation, many patients show limited benefit, generalization, or maintenance of gains over time. Some of the reasons that account for modest outcomes are discussed with particular reference to the differences between patients' needs and aspirations, the nature of patient-clinician interactions, and patients' rehabilitation readiness. The role of a more client-centered approach is reviewed, as well as the importance of facilitating patients' capacity to identify problems, develop goals, consider options, and make choices. It is proposed that effective outcomes depend on the clinicians' success in harnessing patients' intrinsic motivation to change.

Attitude to Health↗