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Biomedical subjects

Michael N Lopez

Publications and source records attributed to Michael N Lopez.

10 recordsLinked to original sources

New scores for the Category Test: measures of interference for subtests 5 and 6.

The Category Test is a well-known neuropsychological instrument used to assess concept formation and higher executive abilities. The present study investigated the utility of additional scores for the Category Test. We used principles developed in cognitive psychology to create several new measures for subtests 5 and 6 of this test. These scores were primarily designed to be sensitive to interference effects of learning decision rules from subtest 2, subtest 3, and subtest 4. The new scores as well as the total error scores from subtests 5 and 6 were used to discriminate subjects with documented brain injury from subjects who were neurologically normal based on neuroimaging and neurologic evaluation. The Category Test was given following Reitan's (1979) instructions, with the exception that no additional prompting was given to participants who struggled early with the test in order to reduce the "executive" guidance of the examiner. Because any "interference" from earlier subtests on performance of subtest 5 and subtest 6 should be related to mastery of these earlier subtests, the normal group was matched to the brain-impaired group on which subtest(s) they learned. This resulted in four learning groups: (a) learned subtests 3 and 4; (b) learned subtest 4 but not 3; (c) learned subtest 3 but not 4; and (d) failed to learn either subtest. ANOVA analyses revealed that the three measures of interference were significantly greater in the brain-damaged group than in the normal controls. Also, specific interference measures were related to specific prior subtest mastery, thus providing support for a proactive interference effect. In addition, we have evidence that our new measures may be selectively sensitive to frontal system dysfunction.

Adult↗

Psychometric properties of the Folstein Mini-Mental State Examination.

Criterion-referenced (Livingston) and norm-referenced (Gilmer-Feldt) techniques were used to measure the internal consistency reliability of Folstein's Mini-Mental State Examination (MMSE) on a large sample (N = 418) of elderly medical patients. Two administration and scoring variants of the MMSE Attention and Calculation section (Serial 7s only and WORLD only) were investigated. Livingston reliability coefficients (rs) were calculated for a wide range of cutoff scores. As necessary for the calculation of the Gilmer-Feldt r, a factor analysis showed that the MMSE measures three cognitive domains. Livingston's r for the most widely used MMSE cutoff score of 24 was .803 for Serial 7s and .795 for WORLD. The Gilmer-Feldt internal consistency reliability coefficient was .764 for Serial 7s and .747 for WORLD. Item analysis showed that nearly all of the MMSE items were good discriminators, but 12 were too easy. True score confidence intervals should be applied when interpreting MMSE test scores.

Aged↗

Psychometric properties of the benton visual form discrimination test.

Coefficient alpha and an item analysis were calculated for the 16-item Benton Visual Form Discrimination Test (VFDT) using a heterogeneous sample (N = 293) of mostly elderly medical patients who were suspected of having cognitive impairment. The total score reliability was .74. An item analysis found that 15 of the items were within established criteria for item difficulty, however, 5 items were found to be poor discriminators. Through the use of confidence intervals around observed scores, it was shown that the current classification criterion for the VFDT demands a higher reliability coefficient than what was found. Also, evidence for the test's insufficient level of difficulty is presented. It is difficult to recommend this test for clinical use.

Adult↗

A qualitative analysis of inaccurate responses on the Hooper Visual Organization Test.

The present study investigated the types of inaccurate responses, i.e., Don't Know, Semantic, Visual (nonlinguistic), Phonological, Circumlocutory, and Perseverative, made on the Hooper Visual Organization Test by a heterogeneous sample of 68 brain-damaged and 63 substance abuse patients. The mean age of the brain-damaged and substance abuse groups were 46.0 (SD=13.5) and 43.7 (SD=12.9) yr., respectively. Analysis showed that the brain-damaged group made significantly more visual and perseverative responses than the substance abuse group. There was significantly more variance in the Visual responses than the Semantic responses for the brain-damaged group. The authors conclude that visuospatial ability is the primary factor for successful performance on this test.

Adult↗

MMPI-2: Confidence intervals for random responding to the F, F Back, and VRIN scales.

Several studies have investigated random responding to the F, F Back, and VRIN scales. Only one study attempted to provide practical cutoff scores for these scales, but was unable to reach definitive cutoffs. This study uses the normal approximation to the binomial distribution and provides confidence interval bounds for random responding at the 95, 90, and 85% levels for the F, F Back, and VRIN scales. The possibility that humans asked to respond randomly produce F, F Back, and VRIN scores different from computer-generated random scores was investigated. The results show nonsignificant differences between human and computer responses for the F and F Back scales and mixed results for the VRIN scale.

Computer Simulation↗

Psychometric properties of the Hooper Visual Organization Test.

The psychometric properties of the Hooper Vsual Organization Test (VOT) have not been well investigated Here the authors present internal consistency and interrater reliability coefficients, and an item analysis, using data from a sample (N = 281) of "cognitively impaired" and "cognitively intact" patients, and patients with undetermined cognitive status. Coefficient alpha for the VOT total sample was .882. An item analysis found that 26 of the 30 items were good at discriminating among patients. Also, the interrater reliabilities for three raters (.992), two raters (.988), and one rater (.977) were excellent. Therefore, the judgmental scoring of the VOT does not interfere significantly with its clinical utility. The authors conclude that the VOT is a psychometrically sound test.

Cognition Disorders↗

Boston Naming Test: problems with administration and scoring.

The poorly written administration and scoring instructions for the Boston Naming Test allow too wide a range of interpretations. Three different, seemingly correct interpretations of the scoring methods were compared. The results show that these methods can produce large differences in the total score.

Female↗

Note on Knight's analysis of the WAIS-III instruction effect on the Matrix Reasoning subtest.

Knight's 2003 analysis of the effect of the WAIS-III instructions on the Matrix Reasoning subtest was based on multiple t tests, which is a violation of conventional statistical procedures. Using this procedure significant differences were found between the group who know the subtest was untimed versus the group which did not know if the subtest was timed or untimed. Reanalysis of the data used three statistical alternatives: (a) Bonferroni correction for all possible t tests, (b) one-way analysis of variance, and (c) selected t tests with the Bonferroni correction. All three analyses yielded nonsignificant differences between means, thereby changing the conclusions of Knight's study.

Decision Making↗

Millon Clinical Multiaxial Inventory (MCMI-III): the inability of the validity conditions to detect random responders.

The effectiveness of the MCMI-III Validity scale, Scale X, and the Clinical Personality Pattern scales to detect random responding is put to the test. The binomial expansion and Monte Carlo techniques were used. If the examiner is willing to interpret tests of questionable validity, then 50% of the random responders will not be detected. Scale X and the Clinical Personality Pattern scales were useless in detecting random responders.

Adult↗