The figure copy and recall test of the Adult Memory and Information Processing Battery: inter-rater reliability.

OBJECTIVE: Examined inter-rater reliability of the scoring of the Figure Copy and Recall subtest of the Adult Memory and Information Processing Battery (AMIPB; Coughlan & Hollows, 1985). METHOD: Figure Copy and Recall tests of 56 individuals referred for neuropsychological assessment were independently scored by three experienced neuropsychologists and the scores correlated. Detailed analysis of reasons for scoring discrepancies was carried out. RESULTS: Raters scores were highly correlated in relation to both forms of the tests. The major source of discrepancy was errors in accuracy. CONCLUSIONS: Results indicate that the AMIPB manual instructions are sufficiently detailed to obtain good inter-rater reliability when the raters are experienced clinicians. Further research using trainees or assistant psychologists is suggested.

Posttraumatic stress disorder explains reduced quality of life in subarachnoid hemorrhage patients in both the short and long term.

OBJECTIVE: A subarachnoid hemorrhage reduces patients' quality of life (QoL) in both the short and long term. Neurological problems alone cannot explain this reduction. We examined whether posttraumatic stress disorder (PTSD) and fatigue provide an explanation. METHODS: We prospectively studied a representative sample of 105 subarachnoid hemorrhage patients. Patients were examined at approximately 3 and 13 months postictus. Examinations included assessments of PTSD, fatigue, sleep, cognitive and physical outcomes, and QoL. Patients' coping skills were also assessed. Regression analyses identified predictors for QoL and PTSD. RESULTS: Thirty-seven percent met the diagnostic criteria for PTSD at both assessment points. This is a fourfold increase compared with the rate of PTSD in the general population. Fatigue in patients was also consistently elevated, higher, in fact, than the notoriously high fatigue level reported for cancer patients undergoing chemotherapy. PTSD was the best predictor for mental QoL, the domain most persistently impaired. It also helped predict physical QoL. Moreover, PTSD was linked to increased sleep problems and may, therefore, have led to fatigue in both the acute and later stages of recovery. To establish the cause of PTSD, a logistic regression was performed. This showed that maladaptive coping was the best predictor of PTSD. CONCLUSION: PTSD explains why some subarachnoid hemorrhage patients, despite relatively good clinical outcomes, continue to experience a reduced QoL. Given that maladaptive coping skills seem the main cause of PTSD, teaching patients better coping skills early on might prevent PTSD and QoL reduction.

NART prediction and impairment in neurological patients.

Crawford, Allan, Cochrane, and Parker (1990) used demographic variables in a multiple regression equation to predict NART error scores in a general population sample. The present study examined the applicability of Crawford's equation to neurological patients. Using this equation and the authors' suggestion that NART performance can be impaired in neurological patients, the data were also examined in participants with diffuse cortical damage. Participants (n = 175) were patients referred for clinical neuropsychological evaluation in north-east England. The findings confirmed the usefulness of Crawford's equation: Participants showing significantly higher obtained than predicted NART error scores (identified using Crawford's equation), were categorised as NART-impaired. Analyses of NART-impaired and NART-unimpaired patient subgroups showing diffuse cortical damage indicated the former had a significantly higher mean NART error score and mean discrepancy between NART-predicted and observed IQs. However, a significantly lower mean verbal (VIQ) IQ score was also noted in the NART-impaired participants, suggesting that the risk of an impaired NART performance is greater in a diffusely damaged patient with a lower premorbid VIQ.