Demographically-adjusted norms for the WAIS-R Block Design and Arithmetic subtests: Results from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) project.

OBJECTIVE: Wechsler Adult Intelligence Scale (WAIS) Block Design and Arithmetic subtests are frequently used as measures of visuospatial construction and verbal working memory, respectively. As part of a larger test adaptation and norming effort for this population, we generated and investigated demographically-adjusted interpretive norms for WAIS-R Block Design and Arithmetic in Spanish-speaking adults living in the US-Mexico border region. METHOD: Participants included 183 community-dwelling adults ages 20-55 (education range: 0-20 years; 58% women) from the NeuroPsychological-Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project. They completed the WAIS-R Block Design and Arithmetic subtests in Spanish. Demographically-adjusted T-scores were calculated for these subtests using fractional polynomial equations adjusting for linear and non-linear effects of age, education (continuous), and sex. We compared our rates of impairment (i.e. T < 40) against rates calculated using published English-speaking WAIS-R standardization sample norms adjusted for age, education, and sex. RESULTS: Education was positively associated with performance on Block Design and Arithmetic subtests, and men outperformed women on both subtests. The present Spanish-speaker norms for these subtests yielded expected rates of "impairment" (i.e. 15-16% impaired, a 1 SD cutoff), while existing norms for English-speakers underestimated impairment (i.e. 5-6% impaired) when applied to our Spanish-speaking sample. CONCLUSIONS: Regional normative data will improve interpretation of test performance on Block Design and Arithmetic subtests for Spanish-speakers living in the US-Mexico border region and may aid in bolstering the overall analysis of neuropsychological profile patterns in this population. Cross-validation with Spanish-speakers in other regions and/or with other national origins is needed.

Inhibitory Control, Task/Rule Switching, and Cognitive Planning in Vascular Dementia: Are There Any Differences From Vascular Aging?

Recent studies have shown that patients diagnosed with Vascular Dementia (VaD) exhibit deficits in executive functions. According to "vascular hypothesis of cognitive aging," community-dwelling older adults having risk factors for vascular disease development (RVD) may suffer from cognitive decline of the same type. The aim of the study was to assess the level of specific executive functions (EF) that have been revealed as most affected by vascular abnormalities, in older adults with incipient VaD and RVD. Subsequently specific ways of EF measuring could be suggested for more accurate diagnosis of early stage VaD. The study compared three adult groups (N = 60): (a) patients diagnosed with incipient VaD, according to DSM-5 criteria (n = 20); (b) community-dwelling older adults presenting cardiovascular risk factors (RVD; n = 20); (c) healthy young adult controls (n = 20). Three types of executive functions were examined: inhibitory control, cognitive flexibility as rule/task switching, and planning. The following D-KEFS subtests were administered for their evaluation: The 'Color-Word Interference Test,' the 'Verbal Fluency Test,' and the 'Tower Test.' Mixed-measures ANOVA, MANOVA, and one-way ANOVA as well as Scheffe post hoc test were applied to the data of the scores in each condition of each test. The results showed that VaD patients had significantly lower performance in test conditions requiring switching and planning, compared to RVD group and young controls. The specific deficits of VaD patients, compared to older adults presenting RVD according to multiple-group path analyses were: more uncorrected errors in inhibition, the use of semantic knowledge primarily instead of switching ability to switch between semantic categories, as well as a lower level of movement precision in planning.

Postoperative executive function in adult moyamoya disease: a preliminary study of its functional anatomy and behavioral correlates.

OBJECTIVE Chronic frontal hemodynamic disturbances are associated with executive dysfunction in adult patients with moyamoya disease (MMD). However, the impact of surgical revascularization on executive dysfunction and its underlying mechanism remains unclear. The aim of the present study was to examine the postoperative radiological correlates of cognitive improvement and thereby explore its underlying mechanism. METHODS Fourteen patients who met the inclusion criteria were identified at Huashan Hospital, were operated on, and were successfully followed up for 6 months. Postoperative changes in cortical perfusion and regional amplitude of low-frequency fluctuations (ALFF) were examined by SPECT and resting-state functional MRI, respectively. Executive function was evaluated by 2 tests (Trail Making Test Part B and the summation of executive subtests of Memory and Executive Screening [MES-EX]). Follow-up neuropsychological outcomes were then correlated with radiological changes to identify nodes functioning as leading contributors to postoperative executive outcomes. RESULTS All patients underwent successful unilateral bypass procedures, with some operations performed on the left side and some on the right side. At the 6-month follow-up, the baseline and follow-up test scores for the different sides did not differ significantly. The group with good collaterals (Matsushima Grade A, 9 patients) exhibited significantly increased postoperative perfusion (change in [△] hemodynamics) in bilateral frontal (left, p = 0.009; right, p = 0.003) and left parietal lobe (p = 0.014). The Spearman's correlation test suggested that only the right frontal lobe exhibited significant positive postoperative radiological correlates with cognitive performance (△MES-EX vs △hemodynamics, r = 0.620, p = 0.018; △MES-EX vs △ALFF, r = 0.676, p = 0.008; △hemodynamics vs △ALFF, r = 0.547, p = 0.043). Subsequent regional ALFF analysis revealed that the right dorsolateral prefrontal cortex (DLPFC) was the only node in the responsible hemisphere to exhibit significant postoperative changes. CONCLUSIONS The results not only advance our understanding of pathological interactions of postoperative executive performance in adult MMD, but also indicate that the right DLPFC amplitude might be a quantitative predictor of postoperative executive control improvement.

Reflexões teóricas e práticas sobre a interpretação da Escala de Inteligência Wechsler para Adultos / Reflexiones teóricas y prácticas sobre la interpretación de la Escala de Inteligencia Wechsler para Adultos / Theoretical and practical reflections on the interpretation of the Wechsler Adult Intelligence Scale

O uso das Escalas Wechsler de Inteligência está voltado para contextos clínicos, psicoeducacionais e de pesquisa, possibilitando a avaliação minuciosa das capacidades cognitivas de crianças, adolescentes e adultos. A inteligência geral deve ser considerada como uma manifestação da personalidade como um todo. As habilidades intelectuais são medidas através de instrumentos psicométricos. Para esta pesquisa, com foco na Escala de Inteligência Wechsler para Adultos (WAIS-III), buscou-se abordar as principais características e utilizações da escala para a população adulta, bem como se explorou a importância das informações deste instrumento e suas aplicações, principalmente no que se refere à interpretação clínica qualitativa. Trata-se de uma revisão da literatura dos autores mais clássicos sobre o tema. Os autores recorreram a uma revisão crítica de aspectos essenciais que tangenciam a testagem psicológica e neuropsicológica, abordando os constructos de inteligência cristalizada, fluída e suas integrações com o estudo da personalidade. Finalmente, os autores discutem a importância dos índices fatoriais e suas implicações na interpretação clínica.

El uso de la Escala de Inteligencia de Wechsler se enfrenta al ámbito clínico, psicopedagógico y de investigación, lo que permite la evaluación a fondo de las capacidades cognitivas de los niños, adolescentes y adultos. La inteligencia general debe considerarse como una manifestación de la personalidad como un todo. Las habilidades intelectuales se miden a través de instrumentos psicométricos. Esta investigación, cuyo objeto de estudio es la Escala de Inteligencia Wechsler para Adultos (WAIS-III), trata de responder a las características y usos de dicha escala para la población adulta. Así mismo, analiza la importancia de la información sobre este instrumento y sus aplicaciones, especialmente en lo referente a la interpretación clínica cualitativa. Se trata de una revisión bibliográfica de los autores más clásicos sobre el tema. Los autores llevaron a cabo una revisión crítica de los aspectos clave relacionados con las pruebas psicológicas y neuropsicológicas, abordando los constructos de la inteligencia cristalizada, la inteligencia fluída, y su integración con el estudio de la personalidad. Por último, los autores discuten la importancia de los índices factoriales y sus implicaciones para la interpretación clínica.

The use of the Wechsler Intelligence Scales has entered clinical, psycho-educational and research settings, thus enabling a full assessment of cognitive abilities of children, adolescents and adults. The general intelligence should be considered as a manifestation of personality as a whole. Intellectual skills are measured by psychometric instruments. This research, which focuses on the Wechsler Intelligence Scale for Adults (WAIS-III), addresses the key features and uses of the scale for the adult population and explores the importance of information about this instrument and its applications, especially with regard to qualitative clinical interpretation. It consists of a literature review about the more classical authors on the subject. The authors draw on a critical review of key aspects related to psychological and neuropsychological testing, addressing the constructs of crystallized intelligence, fluid intelligence and their integration with the study of personality. Finally, the authors discuss the importance of factor indices and their implications for clinical interpretation.

Subtestes semelhanças, vocabulário e compreensão do WISC-III: pontuação objetiva ou subjetiva? / WISC-III subtests of similarities, vocabulary and comprehension: objective or subjective scoring?

Este trabalho visou analisar a pontuação dos subtestes Semelhanças, Vocabulário e Compreensão do WISC-III, tendo em vista que podem envolver maior subjetividade do avaliador. Participaram do estudo 42 psicólogos de diferentes Estados do Brasil, os quais corrigiram as respostas de 6 protocolos do teste selecionados aleatoriamente da amostra de padronização ao contexto brasileiro. Tomando-se como referência os escores totais, o subteste Vocabulário apresentou maior variabilidade nas pontuações, seguido por Compreensão. Considerando-se o total de itens analisados em cada subteste, Semelhanças apresentou a maior concordância entre os avaliadores. Entretanto, os resultados evidenciaram que os três subtestes envolvem a subjetividade do avaliador na pontuação das respostas.

In all psychological tests, scoring should be of concern for examiners because the accuracy of results depends, at some extent, on the quality of the correction. This work aims to examine the correction, by different psychologists, of the scores for the Wechsler Intelligence Scale for Children (WISC-III) subtests of Similarities, Vocabulary and Comprehension since these are the subtests where examiner's subjectivity seemingly most influences scoring. Forty two psychologists from different states in Brazil participated in this study. They corrected the answers of six test protocols randomly selected from a standardization sample for the Brazilian context. Taking as reference the total scores, the Vocabulary subtest showed greater variability in score, followed by the Comprehension one. Considering the total number of items tested in each subtest, Similarities had the highest agreement among raters. The results showed that all the three subtests involve subjectivity on behalf of the examiner to score the answers. Continuing in this study, we also aim to determine test reliability based on interrater agreement.

Viabilidade da estimativa de QI a partir dos subtestes Vocabulário e Cubos da WAIS-III / Viability of IQ estimates based on Vocabulary and Block Design WAIS III subtests

Objetivou-se avaliar a viabilidade de estimar o Quociente de Inteligência (QI) de adultos por meio de duas estratégias que utilizam uma forma curta constituída pelos subtestes Vocabulário e Cubos da Escala Wechsler de Inteligência para Adultos (WAIS-III). Participaram do estudo 77 homens e mulheres, com idade média de 39,1 anos (dp=13,4). Foi aplicada a WAIS-III e questionários para cumprir os critérios de inclusão dos participantes sem prejuízos neurológicos e psiquiátricos. Para avaliar a concordância entre as duas estratégias de estimar o QI, utilizou-se o método estatístico proposto por Bland e Altman. Como resultado, encontrou-se que as estimativas de QI geradas pelas duas estratégias apresentam concordância com a medida do QI realizada pela aplicação da escala completa apenas em alguns dos casos avaliados. Sugere-se cautela na utilização dessas estratégias para estimar o QI de adultos.

The aim of this study was to evaluate the feasibility of estimating the Intelligence Quotient (IQ) in adults based on two strategies that use Vocabulary and Block Design subtests of Wechsler Adult Intelligence Scale (WAIS-III). Seventy-seven men and women participated of the study, with mean age of 39.1 (sd=13.4). WAIS-III subtests were administered and questionnaires were used to verify inclusion criteria for participants without neurological or psychiatric impairments. A statistical method proposed by Bland and Altman was used to evaluate the agreement between both strategies to estimate IQ. Results suggest that IQ estimates derived from both strategies only agree with the IQ derived from the full battery in a few cases of the sample. Considering these findings, caution is suggested when using these strategies to estimate adults' IQ.