A brief report: The National Adult Reading Test (NART) is a stable assessment of premorbid intelligence across disease severity in obstructive sleep apnea (OSA).

Obstructive sleep apnea (OSA) is a widely prevalent disorder that can affect cognitive function. The relationship between cognitive function and OSA is known to be affected by an individual's premorbid cognitive ability. Tools to measure premorbid intelligence across OSA disease severity have not been validated. This brief report aims to establish if the National Adult Reading Test (NART) provides a stable estimate of premorbid intelligence across levels of OSA disease severity. We examined if NART scores varied systematically across levels of untreated OSA severity (defined according to the apnea-hypopnea index [AHI]) and mean oxygen saturation in sleep clinic (n = 121) and community samples (n = 398) using regression analysis. Simple linear regression was used to predict NART scores based on the AHI. NART-estimated premorbid IQ scores without demographics did not vary systematically with AHI (F < 1; ß = 0.01) or mean SpO2 (F < 1; ß = 0.12). NART-estimated premorbid IQ scores with added demographic information also did not vary systematically with AHI (F < 1; ß = -0.01) or mean SpO2 (F < 1; ß = 0.15). This preliminary examination shows that the NART provides a stable estimate of premorbid intelligence across untreated OSA disease severity, as demarcated by AHI or mean nocturnal SpO2 .

Residential neighborhood greenery and children's cognitive development.

Children who grow up in neighborhoods with more green vegetation show enhanced cognitive development in specific domains over short timespans. However, it is unknown if neighborhood greenery per se is uniquely predictive of children's overall cognitive development measured across many years. The E-Risk Longitudinal Study, a nationally representative 1994-5 birth-cohort of children in Britain (n = 1658 urban and suburban-dwelling participants), was used to test whether residential neighborhood greenery uniquely predicts children's cognitive development across childhood and adolescence. Greenery exposure was assessed from ages 5 to 18 using the satellite imagery-based normalized difference vegetation index (NDVI) in 1-mile buffers around the home. Fluid and crystalized intellectual performance was assessed in the home at ages 5, 12, and 18 using the Wechsler Intelligence Scale, and executive function, working memory, and attention ability were assessed in the home at age 18 using the Cambridge Neuropsychological Test Automated Battery. Children living in residences surrounded by more neighborhood greenery scored significantly higher, on average, on IQ measures at all ages. However, the association between greenery and cognitive measures did not hold after accounting for family or neighborhood socioeconomic status. After adjustment for study covariates, child greenery exposure was not a significant predictor of longitudinal increases in IQ across childhood and adolescence or of executive function, working memory, or attention ability at age 18. Children raised in greener neighborhoods exhibit better overall cognitive ability, but the association is likely accounted for by family and neighborhood socioeconomic factors.

When is neuropsychological testing medically necessary for children on medicaid in New Mexico?

Healthcare for poor children, also known as Medicaid, is disproportionately relied upon by citizens of poor states such as New Mexico, where (a) there are more unintended pregnancies, (b) domestic violence during and after pregnancies occurs with regularity, (c) youth substance use is much more common, (d) crime rates are some of the worst in the country, (e) many never graduate from high school, and (f) incarceration is often inevitable. Yet, there is a dearth of research into the neuropsychological health of these children. Meanwhile, nonneuropsychologists working for managed care organizations routinely deny authorization for neuropsychological testing based on a lack of medical necessity. The present article addresses the question of neuropsychological medical necessity using community-based neuropsychological data from New Mexico collected on Medicaid and non-Medicaid youth via retroactive chart review. Downstream fiscal implications that are related to the eventual cost of mental illness and crime among those with poor neuropsychological health are discussed.

Recurrent unintended pregnancies among young unmarried women serving in the Israeli military.

BACKGROUND: Unintended pregnancy is a major public health problem with known risk factors, however, little is known about the prevalence of variables associated with recurrent unintended pregnancy (RUP) among young, unmarried women. METHODS: A retrospective cohort study of unmarried women aged 18-21 serving in the Israeli military between 2013 and 2015. Multivariable logistic regression analysis was used to examine associations between RUP and women's education, IQ, immigration status, country of origin, socioeconomic status and history of psychiatric illness. RESULTS: Of 129,638 women drafted by the Israeli military during the study period, 1720 women with unintended pregnancies had a follow up period of at least a year. Three hundred and eighty-nine of them had RUP (22.6%). Multivariable models comparing women with no unintended pregnancies and women with RUP revealed that RUP was more common among (adjusted relative risk; 95% confidence interval) women who had not graduated from high school (6.9; 4.99-9.55), who had low (90-99) IQ scores (3.9; 2.88-5.39) those reporting Africa as the country of origin (2.5; 1.37-4.59) and those from a lower socioeconomic neighborhood (1.6; 1.18-2.05). Multivariate regression modeling comparing women with single unintended pregnancies and women with RUPs showed that recurrent unintended pregnancy was more common among women who had not graduated from high school (3.2; 2.04-4.84) and those who had a low (90-99) IQ score (1.9; 1.32-2.61). CONCLUSION: Rate of RUP is high among women serving in the Israeli military. These women have unique epidemiological characteristics. This may serve in identifying populations at high risk and thus may enable policy maker to offer at least to this population Long-Acting Reversible Contraception (LARC) methods. We encourage policy makers to consider the provision of LARC methods to all servicewomen who had an unintended pregnancy.

Cognitive status and profile validity on the Personality Assessment Inventory (PAI) in offenders with serious mental illness.

Cognitive impairment among seriously mentally ill offenders has implications for legal matters (e.g., competency to stand trial), as well as clinical treatment and care. Thus, being able to identify potential cognitive concerns early in the adjudication process can be important when deciding on further interventions. In this study, we examined the validity scales of the Personality Assessment Inventory (PAI), scores on the Wechsler Adult Intelligence Scale-IV (WAIS-IV), and competency findings in male inmates (n=61) diagnosed with a serious mental illness. Lower scores on the WAIS-IV significantly (p=0.001) predicted invalid, versus valid, PAI profiles, with working memory impairment being the most significant (p=0.004) predictor of an invalid profile. Ancillary analyses on a smaller sample (n=18) indicate that those with invalid PAI profiles were more likely to be deemed legally incompetent (p=0.03). These findings suggest that the PAI validity scales may be informative in detecting cognitive concerns and help clinicians make determinations about competency restoration and treatment.

On the validity of self-report assessment of cognitive abilities: Attentional control scale associations with cognitive performance, emotional adjustment, and personality.

Individual differences in attentional control involve the ability to voluntarily direct, shift, and sustain attention. In studies of the role of attentional control in emotional adjustment, social relationships, and vulnerability to the effects of stress, self-report questionnaires are commonly used to measure this construct. Yet, convincing evidence of the association between self-report scales and actual cognitive performance has not been demonstrated. Across 2 independent samples, we examined associations between self-reported attentional control (Attentional Control Scale; ACS), self-reported emotional adjustment, Five-Factor Model personality traits (NEO Personality Inventory-Revised) and performance measures of attentional control. Study 1 examined behavioral performance on the Attention Network Test (ANT; Fan, McCandliss, Sommer, Raz, & Posner, 2002) and the Modified Switching Task (MST; Suchy & Kosson, 2006) in a large sample (n = 315) of healthy young adults. Study 2 (n = 78) examined behavioral performance on standardized neuropsychological tests of attention, including Conner's Continuous Performance Test-II and subtests from the Wechsler Adult Intelligence Scales, Third Edition (WAIS-III; Psychological Corporation, 1997) and Delis-Kaplan Executive Function System (D-KEFS; Delis, Kaplan, & Kramer, 2001). Results indicated that the ACS was largely unrelated to behavioral performance measures of attentional control but was significantly associated with emotional adjustment, neuroticism, and conscientiousness. These findings suggest that although self-reported attentional control may be a useful construct, researchers using the ACS should exercise caution in interpreting it as a proxy for actual cognitive ability or performance. (PsycINFO Database Record

Short form of Spanish version of the WISC-IV for intelligence assessment in elementary school children.

In educational settings, quick assessments of intelligence are often required to screen children with potential special needs. The WISC-IV is administered individually and takes between one and two hours to complete. Given its widespread use in Spain, a short-form of the Spanish version is likely to be of use to professionals. The goal of this research was to develop a short form of the WISC-IV that can be performed in approximately half an hour. Data obtained in 100 elementary school children were analyzed following the criteria of Resnick and Entin (1971) . The results showed that the most accurate estimation of intelligence was achieved with a combination of the Vocabulary, Block Design, Letter-Number Sequencing, and Coding subtests.

Discovery of previously undetected intellectual disability by psychological assessment: a study of consecutively referred child and adolescent psychiatric inpatients.

Intellectual disability is associated with an increased risk of behavioral disturbances and also complicates their treatment. Despite increases in the sophistication of medical detection of early risk for intellectual disability, there is remarkably little data about the detection of intellectual disability in cases referred for psychiatric treatment. In this study, we used a 10-year sample of 23,629 consecutive child and adolescent admissions (ages between 6 and 17) to inpatient psychiatric treatment. Eleven percent (n=2621) of these cases were referred for psychological assessment and were examined with a general measure of intellectual functioning (i.e., WISC-IV). Of these cases, 16% had Full Scale IQs below 70. Of the cases whose therapists then referred them for formal assessment of their adaptive functioning (i.e., ABAS-II) 81% were found to have composite scores below 70 as well. Only one of the cases whose Full Scale IQ was less than 70 had a referral diagnosis of intellectual disability. Cases with previously undetected intellectual disability were found to be significantly more likely to have a diagnosis of a psychotic disorder and less likely to have a diagnosis of mood disorder than cases with IQs over 70. Disruptive behavior disorder diagnoses did not differ as a function of intellectual performance. These data suggest a high rate of undetected intellectual disability in cases with a psychiatric condition serious enough to require hospitalization and this raises the possibility that many such cases may be misdiagnosed, the basis of their problems may be misconceptualized, and they may be receiving treatments that do not take into account their intellectual level.

Whose IQ is it?--Assessor bias variance in high-stakes psychological assessment.

Assessor bias variance exists for a psychological measure when some appreciable portion of the score variation that is assumed to reflect examinees' individual differences (i.e., the relevant phenomena in most psychological assessments) instead reflects differences among the examiners who perform the assessment. Ordinary test reliability estimates and standard errors of measurement do not inherently encompass assessor bias variance. This article reports on the application of multilevel linear modeling to examine the presence and extent of assessor bias in the administration of the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) for a sample of 2,783 children evaluated by 448 regional school psychologists for high-stakes special education classification purposes. It was found that nearly all WISC-IV scores conveyed significant and nontrivial amounts of variation that had nothing to do with children's actual individual differences and that the Full Scale IQ and Verbal Comprehension Index scores evidenced quite substantial assessor bias. Implications are explored.

[Diagnostic of ADHD in childhood and adolescence with the K-SADS-PL]. / Diagnostik der ADHS im Kindes- und Jugendalter mit dem K-SADS-PL.

Attention Deficit-/Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence, often accompanied by comorbid disorders. A high standard of diagnostic assessment combined with a demand for valid diagnostic instruments is necessary. The K-SADS-PL is an established semi-structured interview, focusing on the categorical assessment of psychiatric disorders. The aim of the following study was to examine specific characteristics of ADHD symptomatology including functional and behavioral assessment. Therefore correlations between the result in a diagnostic interview (K-SADS-PL) and different ADHD-specific instruments were performed. Groups were formed (exposed vs. unexposed), based on the diagnostic finding in the K-SADS-PL. Group-specific test score differences were calculated and compared by multivariate analyses of covariance. Children with ADHD showed a significantly higher impact of conduct and emotional problems than the unexposed group. Health related quality of life was more impaired in children and families suffering from ADHD which refers to the relevance of family-oriented psychotherapy.

Impact of neonatal growth on IQ and behavior at early school age.

OBJECTIVES: The objective was to examine associations of neonatal weight gain (NWG) and head circumference gain (HCG) with IQ scores and behavior at early school age. METHODS: We used data from the Promotion of Breastfeeding Intervention Trial, involving Belarusian infants born full term and weighing ≥2500 g. NWG and HCG were measured as the percentage gain in weight and head circumference over the first 4 weeks relative to birth size. IQ and behavior were measured at 6.5 years of age by using the Wechsler Abbreviated Scales of Intelligence and the Strengths and Difficulties Questionnaire (SDQ), respectively, with SDQ collected from parents and teachers. The associations between the exposures (NWG, HCG) and children's IQ and SDQ were examined by using mixed models to account for clustering of measurements, and adjustment for potentially confounding perinatal and socioeconomic factors. RESULTS: Mean NWG was 26% (SD 10%) of birth weight. In fully adjusted models, infants in the highest versus lowest quartile of NWG had 1.5-point (95% confidence interval [CI] 0.8 to 2.2) higher IQ scores (n = 13 840). A weak negative (protective) association between NWG and SDQ total difficulties scores was observed for the teacher-reported (ß = -0.39, 95% CI -0.71 to -0.08, n = 12 016), but not the parent-reported (ß = -0.12, 95% CI -0.39 to 0.15, n = 13 815), SDQ. Similar associations were observed with HCG and IQ and behavior. CONCLUSIONS: Faster gains in weight or head circumference in the 4 weeks after birth may contribute to children's IQ, but reverse causality (brain function affects neonatal growth) cannot be excluded.

Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects?

BACKGROUND: We compared differences in intelligence and memory function between normal elderly Japanese subjects with more years of education and those with fewer years of education. We also investigated clinical and neuropsychological factors that are strongly correlated with memory function. METHODS: There were 118 normal elderly subjects who underwent the Mini-Mental State Examination, Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III), and Wechsler Memory Scale Revised. Subjects with at least 13 years of education were categorized as the H group, and those with 12 years of education or less were categorized as the L group. RESULTS: Age and Mini-Mental State Examination scores were not significantly different between the two groups. On the WAIS-III, there were significant differences between the two groups in Verbal IQ and Full Scale IQ. On the Wechsler Memory Scale Revised, there were significant differences between the two groups in Visual Memory, General Memory, and Delayed Recall. Correlation coefficients between memory function and the other factors demonstrated significant but weak correlations between years of education and General Memory (R = 0.22) and between years of education and Delayed Recall (R = 0.20). Strong correlations were found between Verbal IQ and Verbal Memory (R = 0.45), between Verbal IQ and General Memory (R = 0.49), between Full Scale IQ and General Memory (R = 0.50) and between Full Scale IQ and Delayed Recall (R = 0.48). CONCLUSIONS: In normal elderly Japanese subjects, years of education weakly correlated with memory function while Verbal IQ, Full Scale IQ and Verbal Comprehension on WAIS-III had stronger correlations with memory function. Verbal IQ and Verbal Comprehension on WAIS-III were found to be insusceptible to the cognitive decline characteristic of Alzheimer's disease or amnestic mild cognitive impairment. Therefore, verbal intelligence, as measured by Verbal IQ and Verbal Comprehension, may be the most useful factor for inferring premorbid memory function in Alzheimer's disease or amnestic mild cognitive impairment patients.

[The assessment of cognitive abilities in psychiatric patients: are widely used psychological tests still up-to-date?]. / Wie zeitgemäß sind die in der deutschsprachigen Erwachsenenpsychiatrie verwendeten psychologischen Leistungstests?

OBJECTIVE: Evaluation of widely used tests for the assessment of cognitive abilities of adult psychiatric patients in German speaking countries by current psychometric standards. METHODS: The German Wechsler Adult Intelligence Scales (HAWIE, HAWIE-R, WIE), the Multiple Choice Vocabulary Test (MWT-B), the German adaption and revision of the Benton Visual Retention Test (BT; 10-Item version, 20-Item version), and the d2 Test of attention (Test d2, d2-C, d2-R) were evaluated. A systematic search for relevant psychometric test publications in German language journals and textbooks was carried out. Three evaluation criteri a were considered: 1) theoretical foundation, 2) availability of actual test norms, 3) usual psychometric test validity and reliability criteria. RESULTS: The theoretical foundation of all of the psychological tests under review was found to be very weak. The norm values of some of the tests are outdated. Most of the psychological tests do not fulfill high quality standards of psychometric testing. CONCLUSIONS: The examined psychological tests for the assessment of cognitive abilities of psychiatric patients only partly conform to current standards of psychological testing. It is likely that the test results are of limited value. Misleading or even incorrect clinical evaluations might be a frequent outcome.

Sex differences in the association between physical exercise and IQ.

Previous research suggests that physical exercise may have beneficial effects on cognitive performance in children and the elderly, but little research has yet examined these associations in healthy adults. It was hypothesized that self-reported frequency and duration of physical exercise would correlate positively with measured intelligence on the Wechsler Abbreviated Scale of Intelligence in healthy young to middle aged adults (25 men, 28 women). Although there was a modest positive association between physical exercise and intelligence (IQ) for the group as a whole, when examined separately by sex, greater physical activity was associated with higher intelligence scores for women, whereas exercise level was essentially unrelated to intelligence among men. These associations remained consistent even after controlling for demographic and socioeconomic factors. The association between exercise and IQ appears to be moderated by sex in healthy adults, possibly through its effects on glucoregulation, insulin sensitivity, or other factors that differ between men and women.

[Application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment].

OBJECTIVE: Study on the application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment. METHODS: Mental impairment assessment cases between July 2009 and March 2011 in judicial appraisal institute of Taizhou University were collected. Assessment results obtained with the WAIS-RC short forms and adult intelligence disability scale were compared with the experts assessing conclusions and analyzed using SPSS 11.5 software. RESULTS: Assessment results with the two scales did not fully comply with the expert's conclusions, with reliability coefficient were 0.785 and 0.940 respectively, correlation coefficient were 0.850 and 0.922 respectively. CONCLUSION: The intelligence assessment was influenced by many factors. When the appraised individuals had nerve dysfunction and mild intelligence disability or mental disorders, the two scales should be used together. When the appraised individuals had moderate intelligence disability or mental disorders, adult intelligence disability scale had advantage.

A correction for recruitment bias in norms derived from meta-analysis.

Normative comparisons are an integral component of neuropsychological test interpretation and provide the basis for an inference of abnormal function and impairment. In order to remedy a deficit of normative standards for a large number of neuropsychology tests, Mitrushina, Boone, Razani, and D'Elia (2005) used the meta-analysis of studies that incorporated normal volunteers to create a type of normative standard for many tests in neuropsychology that were not adequately normed in the past. The present study examined this method by contrasting meta-analysis norms of the Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1981) with its published quota norms. The study examined 12 experimental studies of the WAIS-R that included normal, control volunteers (N = 2,147). These were combined by meta-analysis, and the summary scores were compared. The meta-analysis revealed a significant sampling bias with studies recruiting more White and higher educated respondents than indicated by the U.S. Census. This bias was successfully corrected using Monte Carlo simulation and adjustments for quota sampling. The corrections could be applied to all meta-analysis norms currently in use and bring them in line with the U.S. Census demographics.

Low-level environmental lead exposure in childhood and adult intellectual function: a follow-up study.

BACKGROUND: Early life lead exposure might be a risk factor for neurocognitive impairment in adulthood. OBJECTIVES: We sought to assess the relationship between early life environmental lead exposure and intellectual function in adulthood. We also attempted to identify which time period blood-lead concentrations are most predictive of adult outcome. METHODS: We recruited adults in the Boston area who had participated as newborns and young children in a prospective cohort study that examined the relationship between lead exposure and childhood intellectual function. IQ was measured using the Wechsler Abbreviated Scale of Intelligence (WASI). The association between lead concentrations and IQ scores was examined using linear regression. RESULTS: Forty-three adults participated in neuropsychological testing. Childhood blood-lead concentration (mean of the blood-lead concentrations at ages 4 and 10 years) had the strongest relationship with Full-Scale IQ (ß = -1.89 ± 0.70, p = 0.01). Full-scale IQ was also significantly related to blood-lead concentration at age 6 months (ß = -1.66 ± 0.75, p = 0.03), 4 years (ß = -0.90 ± 0.41, p = 0.03) and 10 years (ß = -1.95 ± 0.80, p = 0.02). Adjusting for maternal IQ altered the significance of the regression coefficient. CONCLUSIONS: Our study suggests that lead exposure in childhood predicts intellectual functioning in young adulthood. Our results also suggest that school-age lead exposure may represent a period of increased susceptibility. Given the small sample size, however, the potentially confounding effects of maternal IQ cannot be excluded and should be evaluated in a larger study.

Measurement invariance in the assessment of people with an intellectual disability.

Intellectual assessment is central to the process of diagnosing an intellectual disability and the assessment process needs to be valid and reliable. One fundamental aspect of validity is that of measurement invariance, i.e. that the assessment measures the same thing in different populations. There are reasons to believe that measurement invariance of the Wechsler scales may not hold for people with an intellectual disability. Many of the issues which may influence factorial invariance are common to all versions of the scales. The present study, therefore, explored the factorial validity of the WAIS-III as used with people with an intellectual disability. Confirmatory factor analysis was used to assess goodness of fit of the proposed four factor model using 13 and 11 subtests. None of the indices used suggested a good fit for the model, indicating a lack of factorial validity and suggesting a lack of measurement invariance of the assessment with people with an intellectual disability. Several explanations for this and implications for other intellectual assessments were discussed.

Investigation of the factor structure of the Wechsler Adult Intelligence Scale--Fourth Edition (WAIS-IV): exploratory and higher order factor analyses.

The present study examined the factor structure of the Wechsler Adult Intelligence Scale--Fourth Edition (WAIS-IV; D. Wechsler, 2008a) standardization sample using exploratory factor analysis, multiple factor extraction criteria, and higher order exploratory factor analysis (J. Schmid & J. M. Leiman, 1957) not included in the WAIS-IV Technical and Interpretation Manual (D. Wechsler, 2008b). Results indicated that the WAIS-IV subtests were properly associated with the theoretically proposed first-order factors, but all but one factor-extraction criterion recommended extraction of one or two factors. Hierarchical exploratory analyses with the Schmid and Leiman procedure found that the second-order g factor accounted for large portions of total and common variance, whereas the four first-order factors accounted for small portions of total and common variance. It was concluded that the WAIS-IV provides strong measurement of general intelligence, and clinical interpretation should be primarily at that level.

IQ variations across time, race, and nationality: an artifact of differences in literacy skills.

A body of data on IQ collected over 50 years has revealed that average population IQ varies across time, race, and nationality. An explanation for these differences may be that intelligence test performance requires literacy skills not present in all people to the same extent. In eight analyses, population mean full scale IQ and literacy scores yielded correlations ranging from .79 to .99. In cohort studies, significantly larger improvements in IQ occurred in the lower half of the IQ distribution, affecting the distribution variance and skewness in the predicted manner. In addition, three Verbal subscales on the WAIS show the largest Flynn effect sizes and all four Verbal subscales are among those showing the highest racial IQ differences. This pattern of findings supports the hypothesis that both secular and racial differences in intelligence test scores have an environmental explanation: secular and racial differences in IQ are an artifact of variation in literacy skills. These findings suggest that racial IQ distributions will converge if opportunities are equalized for different population groups to achieve the same high level of literacy skills. Social justice requires more effective implementation of policies and programs designed to eliminate inequities in IQ and literacy.