Cognitive outcomes in anti-LGI-1 encephalitis.

OBJECTIVE: Cognitive impairment is one of the most common symptoms of anti-leucine rich glioma inactivated 1 (anti-LGI-1) encephalitis, but little is known about the cognitive profile of these patients. This study characterized the cognitive profile of patients with anti-LGI-1 encephalitis and compared patterns of impairment to healthy controls and other patient groups with known temporal lobe/limbic involvement. METHODS: A retrospective analysis of adult patients with anti-LGI-1 encephalitis who underwent neuropsychological assessment was conducted. Performance patterns of anti-LGI-1 patients were compared to patients deemed cognitively healthy (HC), as well as patients with amnestic mild cognitive impairment (aMCI) and temporal lobe epilepsy (TLE). RESULTS: Among 10 anti-LGI encephalitis patients (60% male, median age 67.5 years) who underwent neuropsychological testing (median = 38.5 months from symptom onset), cognitive deficits were common, with 100% of patients showing impairment (≤1.5 SD below mean) on 1+ measures and 80% on 2+ measures. Patients with anti-LGI-1 encephalitis performed worse than controls on measures of basic attention, vigilance, psychomotor speed, complex figure copy, and aspects of learning/memory. Of measures which differed from controls, there were no differences between the anti-LGI-1 and TLE patients, while the anti-LGI-1 patients exhibited higher rates of impairment in basic attention and lower rates of delayed verbal memory impairment compared to the aMCI patients. CONCLUSIONS: Long-term cognitive deficits are common in patients with anti-LGI-1 encephalitis and involve multiple domains. Future research in larger samples is needed to confirm these findings.

The Relationship Between Religiousness/Spirituality and Psychometric Intelligence in the United States.

An inverse relationship between religiousness/spirituality (R/S) and psychometric intelligence (IQ) is well-documented in previous literature. However, the studies that have examined group differences on IQ regarding R/S have limited generalizability. The present study contributed to the literature by evaluating IQ among participants identifying as differentially religious/spiritual (i.e., religious only, spiritual only, both religious and spiritual, or neither religious nor spiritual) and among those classified as either Christian/Catholic, Atheist, or Agnostic. Four hundred and thirty-two participants (M age = 37.9; 36% men) participated online via Amazon's Mechanical Turk as part of a larger study and completed a brief measure of IQ, a scale of religiousness and spirituality, and a demographics questionnaire. Correlations between IQ and self-reported religiousness/spirituality were small and negative (Mean r = -0.17), consistent with previous literature. Multivariate analyses of covariance (MANCOVAs) controlling for age, gender, education, and socioeconomic status (operationalized by estimated annual household income) indicated that IQ scores tended to be lowest (p < 0.001) for "religious only" participants (estimated marginal mean [EMM] = 93.0) and highest for "neither religious nor spiritual" participants (EMM = 103.7). Furthermore, IQ scores were significantly lower (ps < 0.001) for Christian/Catholic participants (EMM = 96.7) compared to both Atheist (EMM = 104.9) and Agnostic participants (EMM = 107.5). Discussion of these findings, relationships to previous theoretical and empirical work, limitations of the present study, and directions for future inquiry are provided.

Five-Factor Model Personality Traits and Self-Classified Religiousness and Spirituality.

A review of the literature investigating the relationship between religion and spirituality and broad personality traits reveals methodological limitations. The present study sought to contribute to the present literature by investigating differences on personality traits among men and women who identified as either religious only (R), spiritual only (S), both spiritual and religious (B), or neither spiritual nor religious (N). One thousand thirty-seven (1037) adults (M age = 36.34, SD = 12.62) participated online via Amazon's Mechanical Turk as part of a larger study and completed the IPIP-NEO-120, Spiritual Transcendence Scale, Duke University Religion Index, and demographic information. Results revealed that men were more likely to identify as R and N than women, and women were more likely to identify as B than men. Women showed more significant differences among Big Five traits than men. Compared to other women, R-women reported the lowest levels of Openness, Agreeableness, and Neuroticism, and highest levels of Extraversion. N-women reported the highest levels of Neuroticism, while S-women reported highest Openness. Among men, R-men reported the lowest Openness, and S-men reported the highest Openness. B-men reported higher Extraversion than N-men. Additionally, Big Five traits appeared to account for significantly more variance in self-reported religiousness for women than men. Implications of these findings and recommendations for future research are provided and discussed.

Examining the relationship between neuroticism and post-concussion syndrome in mild traumatic brain injury.

Objective: We sought to examine the relationship between personality traits and post-concussion symptom reporting in individuals with and without a self-reported history of concussion. Methods: Data were collected via a cross-sectional electronic survey from 619 individuals via Amazon Mechanical Turk (mTurk). Participants completed a background demographic questionnaire, as well as both the Post-Concussion Symptom Scale (PCSS) and IPIP-NEO-120 personality inventory. Results: Significant relationships were seen between concussion symptom reporting and personality traits of neuroticism, extraversion, agreeableness, and conscientiousness, but not openness, among both groups. The positive concussion group reported more severe symptoms across nearly all PCSS items, despite being, on average, multiple years removed from their injury. Furthermore, broad personality traits did not differ between concussion groups. Discussion: The positive concussion group reported persisting symptoms many years post-injury, suggesting a small subset of individuals may not become fully asymptomatic following a concussion. While differences among personality traits, including neuroticism, were not seen, psychiatric distress, namely symptoms of depression, accounted for a significant degree of variance in symptom reporting and is likely a strong influencer in recovery trajectory. As such, an increased emphasis on psychotherapeutic treatment following a concussion, especially in cases with prolonged recovery, may be warranted.

Confirming the Tripartite Structure of the Duke University Religion Index: A Methodological Approach.

The present study provided a methodological critique regarding psychometric investigations of the Duke University Religion Index (DUREL) and its variants. Nine hundred seventeen (630 females and 287 males) university students (M age = 19.24) completed the DUREL, the Personal Religious Inventory, and the Daily Spiritual Experiences Scale online. Confirmatory factor analyses were performed to assess a three-factor (organizational religious activity; non-organizational religious activity; and intrinsic religiosity) and a unidimensional model of the DUREL. Chi-square difference tests were performed, and Akaike information criterion values and Bayesian information criterion values were compared between the models, each of which supported the three-factor model for the DUREL over the unidimensional model. Convergent validity for the three factors of the DUREL emerged through Spearman's rho correlations with measures of personal prayer, ritual religious attendance, religious integration, Closeness to the Divine. This study concluded that the DUREL is a multidimensional measurement of religion for use in English-speaking university students, and it provided a broad methodological note regarding future investigations of measures of religion or spirituality that possess an existing theoretical model.

Religious Integration and Psychological Distress: Different Patterns in Emerging Adult Males and Females.

This study examined differences between male and female emerging adults on low, moderate, and high levels of religious integration in relation to psychological distress. Participants were recruited from undergraduate courses at a religiously affiliated, Midwestern university and completed the integration scale of the Personal Religious Inventory and the Langner Symptom Survey. Due to significantly higher reports of religious integration in female participants, the sample was separated by sex. A significant, negative correlation between religious integration and psychological distress was found only for females. Similarly, females in the low religious integration group reported significantly higher levels of psychological distress than females high in religious integration, while no differences were found among males. This study corroborates previous research suggesting a general link between religion and mental health, but further suggests religious integration and psychological distress are uniquely related for males and females. Possible reasons and future areas of study are noted.

Differential Effects of Family Structure on Religion and Spirituality of Emerging Adult Males and Females.

This study examined measures of religion and spirituality in a sample of male and female emerging adult college students whose parents were either divorced or intact using the Personal Religious Inventory, the Duke University Religion Index, the Daily Spiritual Experiences Scale, the Spiritual Transcendence Scale, and the Spiritual Involvement and Beliefs Scale. Data were collected online, and 66% of participants received extra credit for participating. A main effect of sex was found, as females reported significantly higher scores than men on all but one measure of religion and spirituality, and the dataset was separated by sex. No differences were found between males from divorced and intact families. However, females from intact families scored significantly higher on all religion and spirituality measures than females from divorced families. This study suggests that females may respond differently than males to their parents' divorce in the context of religion and spirituality, and discusses possible reasons.

Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis.

Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.

Associations Between Cognitive Impairment and Neuroimaging in Patients with Multiple Sclerosis.

OBJECTIVE: Multiple sclerosis (MS) is a debilitating inflammatory and neurodegenerative disease which commonly involves cognitive dysfunction. Magnetic resonance imaging (MRI) studies have shown that patients with MS (pwMS) have diffuse patterns of brain atrophy, however, the relationship between the presentation of cognitive dysfunction and brain tissue loss remains understudied. Given the integral function of thalamus as a central nervous system relay center and its involvement in various brain circuits, thalamic atrophy may play a key role in the development and progression of cognitive dysfunction. The purpose of this study is to examine the relationship between cognitive impairment in pwMS and thalamic atrophy. METHODS: A total of 121 pwMS who had neuropsychological testing and quantitative MRI within 1 year of each were retrospectively identified. Grouped LASSO linear regression with 10-fold cross validation was used to estimate each neuropsychological test score with thalamic volume as the focal predictor and all other demographic and MRI metrics as covariates. RESULTS: Rates of impairment ranged from 19% to 44%. Results showed notable associations between thalamic volume and Symbol Digit Modalities Test (ß = 0.11), Brief Visuospatial Memory Test, delayed (ß = 0.12), California Verbal Learning Test, delayed and total (ß = 0.24 and ß = 0.15 respectively), and Trail Making Test Part A (ß = -0.01), after adjusting for covariates. CONCLUSIONS: These findings demonstrate an independent association between thalamic volumes and processing speed and memory performance, after accounting for demographic, clinical, and other MRI variables, among pwMS.

Considerations regarding noncredible performance in the neuropsychological assessment of patients with multiple sclerosis: A case series.

Determining the validity of data during clinical neuropsychological assessment is crucial for proper interpretation, and extensive literature has emphasized myriad methods of doing so in diverse samples. However, little research has considered noncredible presentation in persons with multiple sclerosis (pwMS). PwMS often experience one or more factors known to impact validity of data, including major neurocognitive impairment, psychological distress/psychogenic interference, and secondary gain. This case series aimed to illustrate the potential relationships between these factors and performance validity testing in pwMS. Six cases from an IRB-approved database containing pwMS referred for neuropsychological assessment at a large, academic medical center involving at least one of the above-stated factors were identified. Backgrounds, neuropsychological test data, and clinical considerations for each were reviewed. Interestingly, no pwMS diagnosed with major neurocognitive impairment was found to have noncredible performance, nor was any patient with noncredible performance in the absence of notable psychological distress. Given the variability of noncredible performance and multiplicity of factors affecting performance validity in pwMS, clinicians are strongly encouraged to consider psychometrically appropriate methods for evaluating validity of cognitive data in pwMS. Additional research aiming to elucidate base rates of, mechanisms begetting, and methods for assessing noncredible performance in pwMS is imperative.

"It's on the tip of my tongue!" exploring confrontation naming difficulties in patients with multiple sclerosis.

BACKGROUND: Naming difficulty is commonly reported by patients with multiple sclerosis (pwMS). Though many cognitive batteries recommended for pwMS include fluency tasks, they do not include naming tasks. The aim of this study was to examine the prevalence of naming impairment in pwMS by using a measure of confrontation naming and to identify correlates with neuroimaging. METHODS: One-hundred-eighty-five pwMS (Mage = 48.75 ± 11.23) completed neuropsychological testing and fifty had brain MRI scans within one year of neuropsychological testing. Controlling for demographic variables, partial correlations and hierarchical regressions with language tests as the outcome variables and neuroimaging variables as predictors were performed. RESULTS: Performance on language tasks ranged within low average to average, with impairment most frequently found on a measure of confrontation naming (Boston Naming Test [BNT];27.6%), followed by a measure of phonemic fluency (Controlled Oral Word Association Test [COWAT]; 24.3%) and semantic fluency (animals [AF]; 18.3%). In the subset of patients with neuroimaging, thalamic volume had the strongest relationship with language variables, followed by white matter volume and T2 lesion volume. Language variables had no association with fractional gray matter volume. Of the language measures, BNT demonstrated the strongest relationship with MRI variables, followed by AF. There were no significant associations between neuroimaging variables and COWAT. Regression results revealed that fractional thalamic volume significantly contributed to BNT scores after adjusting for demographics, while T2 lesion volume predicted AF and no neuroimaging variables emerged as predictors for COWAT after controlling for demographics. CONCLUSIONS: Objective naming impairment is common in pwMS and are more strongly associated with neuroimaging of MS brain pathology than verbal fluency tasks that are commonly used in cognitive batteries for pwMS. Continued research on language (especially naming) deficits and neuroimaging correlates (particularly thalamic involvement) in pwMS is needed.

Nonmemory Composite Embedded Performance Validity Formulas in Patients with Multiple Sclerosis.

OBJECTIVE: Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited work has examined embedded PVTs in this population. As previous investigations indicated that nonmemory-based embedded PVTs provide clinical utility in other populations, this study sought to determine if a logistic regression-derived PVT formula can be identified from selected nonmemory variables in a sample of patients with MS. METHOD: A total of 184 patients (M age = 48.45; 76.6% female) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 146) or "noncredible" (n = 38) groups according to performance on standalone PVT. Missing data were imputed with HOTDECK. RESULTS: Classification statistics for a variety of embedded PVTs were examined, with none appearing psychometrically appropriate in isolation (areas under the curve [AUCs] = .48-.64). Four exponentiated equations were created via logistic regression. Six, five, and three predictor equations yielded acceptable discriminability (AUC = .71-.74) with modest sensitivity (.34-.39) while maintaining good specificity (≥.90). The two predictor equation appeared unacceptable (AUC = .67). CONCLUSIONS: Results suggest that multivariate combinations of embedded PVTs may provide some clinical utility while minimizing test burden in determining performance validity in patients with MS. Nonetheless, the authors recommend routine inclusion of several PVTs and utilization of comprehensive clinical judgment to maximize signal detection of noncredible performance and avoid incorrect conclusions. Clinical implications, limitations, and avenues for future research are discussed.

Methodological considerations of assessing meaningful/reliable change in computerized neurocognitive testing following sport-related concussion.

OBJECTIVE: Traditional reliable change index (RCI) methods may be psychometrically limited due to their inability to account for particularly high or low baseline performance and regression to the mean following serial testing. The current study sought to examine differences between RCI and standardized regression-based (RBz) methods in a cohort of adolescent athletes engaged in sport-related concussion recovery. METHODS: Consultation records and results of computerized testing data via the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery were retrospectively reviewed among 240 adolescent athletes involved in return-to-play protocols following a sport-related concussion. RESULTS: High concordance rates were found between RCI and RBz metrics across ImPACT composites, consistent with previous literature. However, especially for those with lower baseline performance, RBz scores tended to suggest cognitive performance not meeting or exceeding baseline scores despite RCI metrics being appropriate across speed-based ImPACT composites. In contrast, results revealed high rates of RCI scores suggesting continued cognitive difficulties despite RBz metrics being within normal limits, especially for adolescents with higher baseline performance. CONCLUSIONS: Results suggest value in interpreting RBz values in addition to RCI values as these allow for clinical interpretation more sensitive to statistical confounds, including baseline performance and regression to the mean.

Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia.

Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (M age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.

The utility of the Wisconsin card sorting test, 64-card version to detect noncredible attention-deficit/hyperactivity disorder.

Clinicians who evaluate patients with concerns related to attention-deficit/hyperactivity disorder (ADHD) are encouraged to include validity indicators throughout clinical assessment procedures. To date, no known previous literature has examined the Wisconsin Card Sorting Test (WCST) specifically to address noncredible ADHD, and none has attempted to identify an embedded PVT within the 64-card version. The present study sought to address these gaps in the literature with a simulation study. Sixty-seven undergraduate participants (M age = 19.30) were grouped as credible (combining healthy controls and individuals with ADHD) or noncredible (combining coached and uncoached participants simulating ADHD-related impairment) and administered a battery of neuropsychological tests. Results revealed the noncredible group performed significantly worse on several WCST-64 variables, including failure to maintain set, number of trials to first category, and total categories. Raw scores from these variables were entered as predictors as one set in a logistic regression (LR) with group membership as the outcome variable. An exponentiated equation (EE) derived from LR results yielded acceptable discriminability (area under receiver operating characteristic curve = .73) with modest sensitivity (.38) while maintaining ideal specificity (.91), generally commensurate with a standalone forced-choice memory PVT and better than an embedded attention-based PVT. These findings suggested the WCST-64 may be sensitive to noncredible performance in the context of ADHD and reiterates the importance of considering tests of various cognitive abilities in the evaluation of performance validity. Implications of these findings, limitations of the present study, and directions for future inquiry, including cross-validation in clinical samples, were discussed.

Examination of five- and four-subtest short form IQ estimations for the Wechsler Intelligence Scale for Children-Fifth edition (WISC-V) in a mixed clinical sample.

Evaluating general cognitive ability (i.e., intelligence) is common in neuropsychological practice, and identifying abbreviated assessments of intelligence is often advantageous. Despite the Wechsler Intelligence Scale for Children, Fifth Edition's (WISC-V) widespread contemporary use, limited research has identified clinically useful short form (SF) full scale IQ (FSIQ) estimations in clinical samples. This study sought to address this gap in the literature. Two hundred sixty-eight pediatric participants (M age = 9.79; 69% male; 88% Caucasian/White) who underwent psychological/neuropsychological evaluation were included. Mean scores for WISC-V scores fell in the low average-to-average ranges, consistent with the clinical nature of this sample (e.g., M FSIQ = 85.3). Ten unique SF combinations with five (pentad) and four (tetrad) subtests, each intentionally selected to represent a breadth of domains subsumed by WISC-V FSIQ, were described by summing subtest age-corrected scaled scores. Regression-based and prorated FSIQ estimates were calculated, and mean differences suggested some prorated estimates should be arithmetically adjusted. Both regression-based and prorated/adjusted methods provided FSIQ estimates that were accurate within five Standard Score points of true FSIQ for approximately 81-92% (pentad) and 65-76% (tetrads) of participants. Prorated/adjusted estimates appeared to provide somewhat better accuracy than regression-based estimates. Relationships between SFs and true FSIQ did not appear to be moderated by participant age, gender, nor how many WISC-V subtests were administered to participants within this archival sample (i.e., 7 vs. 10). Implications of these findings, including benefits, detriments, and other considerations of each SF combination, in addition to limitations of this study, are discussed in detail.

Detecting feigned symptoms of depression, anxiety, and ADHD, in college students with the structured inventory of malingered symptomatology.

OBJECTIVE: Research consistently shows how easily students can feign symptoms of ADHD on self-report checklists to determine eligibility for curricular and standardized testing accommodations. However, it is unclear how easily students can feign psychological symptoms to accesses academic accommodations, making the assessment of symptom validity important in both populations. METHOD: Using a between-subjects design, 75 college students were randomly assigned to one of three groups: (1) coached feigning of ADHD, (2) coached feigning of depression and anxiety (DA), and (3) honest responding (HR). Participants completed the Depression, Anxiety, and Stress Scale (DASS-21) and the Structured Inventory of Malingered Symptomatology (SIMS). RESULTS: The SIMS showed 100% specificity, but low sensitivity (36-52%) for detecting feigned symptoms with different cutoffs. Differences on SIMS subtests were apparent by group with elevated scores for the DA group on the Affective Disorders subscale and elevation for the ADHD group on the Low Intelligence and Amnestic subscales. Participants identified as feigning by the SIMS typically reported more severe symptoms than participants not identified on the DASS-21. CONCLUSIONS: The SIMS equally classified the feigned ADHD and DA participants for both cutoff scores utilized. Potential reasons for low sensitivity rates are discussed and future research recommendations are made.

The dimensionality of the Behavior Rating Inventory of Executive Function, Second Edition in a clinical sample.

The parent-report Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is a widely used pediatric neuropsychological measure. Unfortunately, despite meaningful changes from its predecessor, few studies have examined its internal factor structure (now with Behavioral Regulation [BRI], Emotion Regulation [ERI], and Cognitive Regulation [CRI]), and no available literature has investigated higher order models for the BRIEF-2. This study sought to address this shortcoming in the literature by investigating and reporting on the dimensionality of the parent-report BRIEF-2 in a clinical sample. Two hundred and two (202) pediatric neuropsychology examinees (M age = 9.90; 68% males) with complete data for the parent-report BRIEF-2 were included. Descriptive results revealed generally elevated scores across BRIEF-2 scales (Global Executive Composite M T = 70.16). Exploratory factor analyses suggested two factors (CRI and BRI/ERI) should be extracted, and that higher order models should be considered. Confirmatory factor analyses suggested that a direct hierarchical/bifactor two-factor structure (which was more parsimonious than the theoretical three-factor model) provided the best fit, with a bulk of the variance explained by the general GEC factor. The BRIEF-2 may be best interpreted at the overall level, with relatively less weight given to the index variables, particularly within clinical samples with high levels of reported executive functioning difficulties. Implications of these findings, limitations of the present study, and appropriate directions for future inquiry were discussed.

Examining the Clinical Utility of Selected Memory-Based Embedded Performance Validity Tests in Neuropsychological Assessment of Patients with Multiple Sclerosis.

Within the neuropsychological assessment, clinicians are responsible for ensuring the validity of obtained cognitive data. As such, increased attention is being paid to performance validity in patients with multiple sclerosis (pwMS). Experts have proposed batteries of neuropsychological tests for use in this population, though none contain recommendations for standalone performance validity tests (PVTs). The California Verbal Learning Test, Second Edition (CVLT-II) and Brief Visuospatial Memory Test, Revised (BVMT-R)-both of which are included in the aforementioned recommended neuropsychological batteries-include previously validated embedded PVTs (which offer some advantages, including expedience and reduced costs), with no prior work exploring their utility in pwMS. The purpose of the present study was to determine the potential clinical utility of embedded PVTs to detect the signal of non-credibility as operationally defined by below criterion standalone PVT performance. One hundred thirty-three (133) patients (M age = 48.28; 76.7% women; 85.0% White) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 100) or "noncredible" (n = 33) groups based on a standalone PVT criterion. Classification statistics for four CVLT-II and BVMT-R PVTs of interest in isolation were poor (AUCs = 0.58-0.62). Several arithmetic and logistic regression-derived multivariate formulas were calculated, all of which similarly demonstrated poor discriminability (AUCs = 0.61-0.64). Although embedded PVTs may arguably maximize efficiency and minimize test burden in pwMS, common ones in the CVLT-II and BVMT-R may not be psychometrically appropriate, sufficiently sensitive, nor substitutable for standalone PVTs in this population. Clinical neuropsychologists who evaluate such patients are encouraged to include standalone PVTs in their assessment batteries to ensure that clinical care conclusions drawn from neuropsychological data are valid.

Verbal Short-Form FSIQ Estimations for Possible Use With Individuals With Motor and Visual Impairment or in Virtual Environments.

OBJECTIVE: Abbreviated and virtual neuropsychological assessment practices are growing in popularity and viable alternatives to traditional testing methods are needed, especially in the face of global health concerns. This study generated and examined short form (SF) full-scale IQ (FSIQ) estimations, which lend themselves to virtual test administration. METHODS: Archival data were procured from 318 concurrent cognitive evaluations at a university clinic. Twenty-six unique SF combinations, including dyads, triads, tetrads, and pentads, were created from Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) subtests within verbal comprehension and working memory indices due to these tests' ability to be administered without visual stimuli or psychomotor involvement. RESULTS: Stepwise regression analyses revealed 9 SF combinations (i.e., 1 pentad, 3 tetrads, 2 triads, and 3 dyads) that significantly accounted for unique variance in FSIQ scores and provided good accuracy estimating FSIQ. CONCLUSION: Results suggest the potential viability of verbal WAIS-IV SF FSIQ estimations for clinical use when assessing patients with motor or visual impairments, as well as performing tele-neuropsychological services.