Biomedical subjects

Rodney D Vanderploeg

Publications and source records attributed to Rodney D Vanderploeg.

10 recordsLinked to original sources

PubMed2003

Development of the Key Behaviors Change Inventory: a traumatic brain injury behavioral outcome assessment instrument.

OBJECTIVE: To describe the development and initial validation of a neurobehavioral outcome measure, the Key Behaviors Change Inventory (KBCI), for individuals with traumatic brain injury (TBI). DESIGN: Scale construction and development, and validity study. SETTING: Large state university and postal survey. PARTICIPANTS: Seventy-five volunteer undergraduate students and 25 volunteer collateral informants of individuals with TBI participated in the item-analysis phase. Thirty members of the Brain Injury Association and 20 members of the National Multiple Sclerosis Society rated both an identified patient and an age- and gender-equated control in the validation phase. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Content validity was examined through expert panel item sorts. Scale internal consistencies were examined with the Cronbach alpha. Construct validity was examined by comparing scale elevations between controls and 2 neurologic groups. RESULTS: Item-analysis procedures resulted in 8 scales of 8 items each: inattention, impulsivity, unawareness of problems, apathy, interpersonal difficulties, communication problems, somatic difficulties, and emotional adjustment. Internal consistency reliability coefficients ranged from.82 to.91. Multivariate analysis of variance revealed significant (P</=.001) differences in scale elevations among TBI, multiple sclerosis (MS), and control groups. The TBI and MS groups scored significantly higher than the control group on all scales; a subset of KBCI scales discriminated between the 2 neurologic groups. CONCLUSION: The KBCI was both sensitive and specific to typical behavioral changes after TBI, thus supporting its usefulness in rehabilitation settings. Cross-validation and development of a normative database are future steps necessary in its development.

Adaptation, Psychological↗

PubMed2003

Executive and nonexecutive neuropsychological functioning in antisocial personality disorder.

OBJECTIVE: To examine the relationships between antisocial personality disorder and executive abilities as well as antisocial personality disorder with other domains of cognitive functioning. BACKGROUND: Previous research has suggested that antisocial personality disorder is associated with impaired executive functioning. However, methodological limitations of past research have resulted in inconsistent findings. METHODS: Executive functioning and other cognitive abilities were compared in four demographically matched groups of middle-aged community dwelling male veterans (N = 336). The groups were: (A). those with active antisocial personality disorder psychopathology; (B). those with a lifetime prevalence of antisocial personality disorder but inactive antisocial personality disorder psychopathology; (C). a nonantisocial personality disorder psychiatrically matched control group; and (D). a normal control group. RESULTS: Multivariate analysis of variance revealed that the four groups were not statistically significantly different on measures of executive functioning or other cognitive abilities. CONCLUSIONS: Those with antisocial personality disorder perform at comparable levels to psychiatric and normal controls with respect to executive functioning and other domains of cognitive ability (i.e., language, memory, visuospatial, and motor abilities). An incidental finding was that, over time, the antisocial personality disorder groups improved more than control groups on a measure of general intellectual aptitude.

Adult↗

PubMed2002

Effects of alcohol and cigarette use on cognition in middle-aged adults.

In this retrospective cohort study we examined the independent and interactive effects of drinking and smoking on cognition in a sample of 3361 males, ages 31 to 49, with varying lifetime histories of alcohol and cigarette use. Dependent variables were neuropsychological measures of global and specific cognitive abilities. Comparison of the ability scores of seven groups, defined by their drinking and smoking histories, explained only 5.4% of the multivariate variance in cognitive ability and less than 2% in any individual cognitive measure. Regression analyses for current drinkers and smokers showed only a single significant, but negligible, effect of pack-years of smoking on a measure of global cognitive ability. Differences in cognitive function in groups defined by intensity of alcohol and cigarette use revealed no significant effect for drinking and a significant, but very small, effect for smoking.

Adult↗

PubMed2002

Effects of the use of alcohol and cigarettes on cognition in elderly adults.

The objective of this study was to examine the independent and interactive effects of lifetime patterns of drinking and smoking on cognitive performance in the elderly. A sample of 395 individuals with varying histories of alcohol and cigarette use was drawn from the Charlotte County Healthy Aging Study, a community-based, cross-sectional study of randomly selected older adults of age 60 to 84. Dependent variables were the results of a neuropsychological battery that provided measures of general cognitive ability, executive function, and memory. Specifically, we examined (1) differences in performance among groups of abstainers, drinkers, and smokers, (2) the effects of lifetime drinking and smoking dose on cognition within the group of users, and (3) the effects of intensity of drinking and smoking on cognition. Potential methodological confounds, such as age, education, and medical history, were controlled by means of sampling and covariance procedures. Analyses failed to provide evidence for a beneficial J-curve or threshold effect for drinking, but did not reveal any detrimental effect. No detrimental effect of smoking was found in any analysis; nor was there any evidence of an interaction between alcohol and cigarette use on any cognitive measure.

Aged↗

PubMed2002

The Key Behaviors Change Inventory and executive functioning in an elderly clinic sample.

The Key Behaviors Change Inventory (KBCI) was developed to assess executive, behavioral, and emotional functioning following brain insults and to track the course of recovery. The purpose of this study was to investigate, in an elderly memory disorder clinic sample, the convergent and discriminant validity of the KBCI by examining the relationships between various measures of executive functioning and the KBCI scales that theoretically relate to executive functions. The KBCI was administered to the caregivers of 97 consecutive patients who came to a memory disorders clinic seeking services. The KBCI scales of Inattention, Apathy, Unawareness of Problems, and Communication Problems were significantly correlated with cognitive measures of executive functioning but not with measures of memory, visuospatial abilities or global cognitive functioning. In contrast, KBCI scales of Interpersonal Difficulties, Somatic Difficulties, and Emotional Adjustment were not related to any cognitive measures, either executive or nonexecutive. Contrary to predicted findings, the Impulsivity Scale was not associated with cognitive measures of executive functioning. This lack of relationship most likely reflects the failure to include executive measures of orbitofrontal functioning in this study. Results provide convergent and discriminant validity support for the KBCI. The KBCI may be a useful tool for assessing and tracking the executive, behavioral, and emotional sequelae of neurologic disorders.

Adaptation, Psychological↗

PubMed2002

Neuropsychological findings in combat-related posttraumatic stress disorder.

Previous research investigating whether combat-related Posttraumatic Stress Disorder (PTSD) is associated with impaired neuropsychological functioning has yielded inconsistent findings. The present study addressed many methodological limitations of previous research. Neuropsychological measures of intellectual ability, learning, memory, attention, visuospatial ability, executive functioning, language, and psychomotor speed were compared in four groups of early middle-aged community dwelling veterans. The four demographically comparable groups were: (a) those with current PTSD symptoms (n=80); (b) those with a prior history of PTSD but not currently experiencing active PTSD symptoms (n=80); (c) a non-PTSD psychiatrically matched control group (n=80); and (d) a normal control group (n=80). Results indicated that the four groups did not statistically differ on the neuropsychological measures and that veterans with PTSD perform similarly to demographically matched controls. Results further suggested that the cognitive difficulties previously linked to PTSD may actually have been secondary to preexisting individual differences or other clinical conditions coexisting with PTSD.

Adult↗

PubMed2002

Validity indicators within the Wisconsin Card Sorting Test: application of new and previously researched multivariate procedures in multiple traumatic brain injury samples.

The Wisconsin Card Sorting Test (WCST) is a popular neuropsychological measure of executive dysfunction that has been researched with regard to invalid performances, a subset of which in a forensic context could be associated with malingering. In the first of three studies, WCST multivariate approaches identified in prior research (Bernard, McGrath, & Houston, 1996; Suhr & Boyer, 1999), as well as newly created variables, were used to differentiate 33 chronic traumatic brain injury (TBI) patients with good effort and 27 patients with probable insufficient effort (IE). Newly created variables that were derived logically based upon hypotheses regarding strategies that might be employed by malingerers were not effective in differentiating TBI and IE groups. Application of previously researched validity indicators based upon commonly used WCST variables, individually, and within new logistic regression findings were reasonably effective in differentiating TBI and IE groups. In order to determine whether results would vary in different TBI samples, these validity indicators were examined in Study 2 with 75 moderate and severe, acute TBI rehabilitation patients whose posttraumatic amnesia had just resolved. Statistically significant differences were present between the IE group of Study 1 and the rehabilitation patient group of Study 2 on failures to maintain set, number of trials to achieve first correct category, and number of categories completed. All these measures were performed more poorly by the IE group. However, previously used multivariate approaches and the logistic regression analysis developed in Study 1 ranged widely in the degree to which Study 2's more acute rehabilitation patients were correctly classified. Specifically, the discriminant function of Bernard and colleagues correctly classified 73% and the Suhr and Boyer logistic regression correctly classified 75% of the Study 2 participants. The Study 1 logistic regression classified 97% of the Study 2 participants correctly. In Study 3, 130 mild to severe TBI patients in the VA system were studied. The Study 1 IE group performed significantly worse than the more acute and more severe VA TBI group on all 10 common WCST variables of interest. Application of the three multivariate procedures resulted in good to excellent classification rates: Suhr and Boyer logistic regression 85%, Bernard et al. discriminant function 85%, and Study 1 logistic regression 99%. The aggregate discussion of the three studies focuses on apparent differences in samples associated with varying degrees of success in identifying TBI patients. Application of these validity indicators in forensic situations should consider that some of these multivariate approaches possess possible classification limitations associated with chronicity and severity of the reported TBI. Only the Study 1 logistic regression demonstrated improved classification rates with the more acute and severe patients of Study 2 and Study 3. As with all validity indicators, use of any WCST IE criteria in isolation would not be appropriate.

Adult↗

PubMed2002

Differences in executive functioning between Alzheimer's disease and subcortical ischemic vascular dementia.

The present study examined the performance of 114 individuals (62 males, 52 females) on a variety of tests purported to measure executive abilities. Participants were diagnosed with possible or probable Alzheimer's disease (AD), subcortical ischemic vascular dementia (SVaD), or were normal controls (NoDx). Groups were matched for age and education, and clinical groups were matched for severity of dementia. Multivariate and univariate analyses of variance were performed which indicated that the AD and SVaD patients differed from the NoDx on all measures of executive functioning. Further, the AD group made significantly more episodic memory errors than the SVaD group. On the other hand, consistent with previous research, the SVaD group performed significantly better than the AD group on recognition memory, but not on free recall measures. Present findings suggest that AD patients have more executive self-monitoring problems than SVaD patients do, but SVaD patients have more retrieval problems (executive memory search), suggesting a fractionation of executive abilities. Thus, differences between dementia groups depend on the nature of the executive function assessed.

Aged↗

PubMed2002

Identifying retrieval problems using the California Verbal Learning Test.

Wilde, Boake, and Sherer (1995) examined the discrepancy between Long Delayed Free Recall (LDFR) and Recognition Discriminability (RD)--the California Verbal Learning Test (CVLT) index thought to indicate the presence of memory retrieval problems--and found little evidence to recommend its use in traumatic brain injury (TBI). The present investigation re-examined this index from the perspective of a continuum of retrieval deficit severity. CVLT performance was examined in 122 TBI patients, and 2 retrieval deficit indicators of varying severity were evaluated. Memory-impaired control groups were matched with retrieval deficit groups on initial acquisition and demographic characteristics. Individuals with a LDFR/RD discrepancy did not show predicted differences on other CVLT indices of retrieval problems, similar to the findings of Wilde et al. (1995). In contrast, individuals with a consistent discrepancy between free recall and semantic cued recall (Short and Long Delay) had greater improvement with recognition cueing and made fewer intrusive errors than controls. Individuals who benefited from semantic cues (where retrieval of the target word is still required) also benefited from recognition cues (where retrieval demands are minimal). Evidence supported the existence of a continuum of retrieval deficit severity. An LDFR/RD discrepancy without performance improvement from semantic cueing appears to indicate a more severe retrieval deficit, whereas performance improvement from both recognition and semantic cueing indicates less severe retrieval deficits.

Adult↗

PubMedDate not supplied

Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

OBJECTIVE: To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. DESIGN: Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. PARTICIPANTS: Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. MAIN OUTCOME MEASURES: Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. RESULTS: Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. CONCLUSIONS: These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.

Adult↗