Review of Studies on Incremental Validity of Assessment Measures Used in Psychological Assessment of Attention-Deficit Hyperactivity Disorder.

Few studies have summarized the literature relevant to the incremental validity of tools and procedures for the assessment of attention-deficit hyperactivity disorder (ADHD). The current project reviewed such studies published in the prior 18 years. Results from studies on the incremental validity of measures used in the assessment of ADHD were reviewed. Measures included symptom reports, clinical interviews, behavioral observation, continuous performance and other psychomotor tasks, intelligence tests, and measures of executive function. Twenty-nine published studies and two reviews were identified from 2004 to 2022. Incremental validity was determined using various statistics including R2, classification metrics, odds ratios, and post-test probabilities. Findings suggest that symptom reports from a collateral source and continuous performance test measures have incremental validity over self-reports and clinical interviews. Measures of intellectual and executive functioning did not show incremental validity in the diagnosis of ADHD. Findings are relevant to the practitioner, as they bear on the optimization of both the cost-effectiveness and the diagnostic accuracy of combined procedures in the assessment of ADHD.

The missing piece in block design tasks: Resolving performance differences elicited by designs with identical stimulus parameters.

Block design stimulus variables (perceptual cohesiveness, response uncertainty, partial components) have been previously shown to impact test performance. However, relevant studies suggest designs that "look" different should elicit similar performance, where these stimulus parameters are identical. The current study sought to explore other, previously unidentified parameters. To control for known parameters, designs with no perceptual cohesiveness and maximum uncertainty were presented-rotated in increments of 90° and with block edges either cued or uncued-to 65 university undergraduates. Even with cohesiveness and uncertainty constant, performance differences between designs that "look" different were elicited. Post hoc, we hypothesized two possible contributory parameters and coded the designs accordingly. Regression analysis suggested redundancy of adjacent blocks (i.e., coherent regions within the design) appeared to reduce the actual uncertainty of some designs. On the other hand, local and global symmetry, as defined by Palmer (1991, The Perception of Structure, pp. 23-39, The American Psychological Association), did not seem to predict block design performance above and beyond the effects of coherent regions. The advantages of a more complete understanding of stimulus contributions to test performance are discussed.

A pilot study examining the severity and outcome of the post-cardiac arrest syndrome: a comparative analysis of two geographically distinct hospitals.

BACKGROUND: Cardiac arrest occurs in >400 000 patients in the United States per year, and mortality rates vary across the country. Whether variations in cardiac arrest outcome are the result of differences in hospital or patient characteristics remains understudied. We tested whether hospital-independent factors would account for the difference in outcome between 2 geographically distinct hospitals. METHODS AND RESULTS: Consecutive adult (age >18 years) out-of-hospital cardiac arrests were considered for analysis. The primary outcome was in-hospital mortality. Predictor variables were classified according to whether they were hospital-independent or whether they could be related to the hospital's quality of care. Only hospital-independent variables were considered for the analysis. Sequential logistic modeling was used to assess outcome. A propensity score was derived and was used in subsequent multivariate logistic regression to predict hospital outcome. A total of 208 subjects were included. Overall mortality in the Detroit cohort was 87% in comparison with 61% in the Boston cohort (odds ratio: 4.4; 95% confidence interval: 2.2-8.8). After sequential adjustments for baseline covariates, out-of-hospital cardiac arrest score and propensity score, city was not significantly associated with mortality (odds ratio: 1.16; 95% confidence interval: 0.45-2.97). After propensity matching there was no significant difference in the odds ratio for death between the 2 cities (odds ratio: 1.15; 95% confidence interval: 0.51-2.61). CONCLUSIONS: In this pilot study, we found that pre- and intra-arrest conditions contribute substantially to the severity of the postarrest syndrome and on outcomes. Postarrest quality-of-care evaluations should include inherent differences in the presenting syndrome rather than a crude mortality rate.

Assessing the reliability of the Gambling Functional Assessment: Revised.

Dixon and Johnson (Anal Gambl Behav 1: 44-49, 2007) proposed the Gambling Functional Assessment as a tool to identify the consequences maintaining the respondent's gambling behavior, but subsequent studies on its psychometric properties suggested that it could use improvement. The present study investigated the internal consistency of the Gambling Functional Assessment--Revised using the responses of 1,060 undergraduate students. Temporal reliability was assessed by a second administration of the measure four (n = 87) or twelve (n = 98) weeks after the first administration. Temporal reliability was also compared to the South Oaks Gambling Screen (Lesieur and Blume in Am J Psychiatry 144: 1184-1188, 1987), which was also administered at both time points. Internal consistency measures were good to excellent, even when potential non-gamblers were excluded from the analyses. Temporal stability was also very good, with the possible exception of the consequence of "escape" at 12 weeks. The Gambling Functional Assessment--Revised represents a potentially useful tool for researchers and therapists interested in why respondents are gambling.

Testing the construct validity of the gambling functional assessment-revised.

An attempt was made to modify the Gambling Functional Assessment (GFA), which was proposed to identify four possible contingencies maintaining the respondent's gambling behavior. However, previous research found that it only identified two contingencies (i.e., positive vs. negative reinforcement), with some items cross-loading on both contingencies and one not loading at all. A total of 1,060 undergraduate students completed a revised version of the GFA containing 22 items. Exploratory factor analyses conducted on a random selection of half of the participants led to a two-factor solution (positive and negative reinforcement) for 16 of the items that strongly loaded on the two factors. Confirmatory factor analyses conducted using structural equation modeling on the data from the other half of the sample confirmed the two-factor model. The GFA-Revised consists of 16 items, 8 each measuring positive and negative reinforcement contingencies. Although this revised measure cleanly parses the two contingencies, the data indicate that gambling maintained by positive reinforcement is more frequent than gambling maintained by negative reinforcement. This outcome will make directly comparing the two contingencies difficult, especially given that evidence suggests that gambling maintained by negative reinforcement is more strongly associated with pathology than gambling maintained by positive reinforcement.

Learning effects in the block design task: a stimulus parameter-based approach.

Learning effects were assessed for the block design (BD) task, on the basis of variation in 2 stimulus parameters: perceptual cohesiveness (PC) and set size uncertainty (U). Thirty-one nonclinical undergraduate students (19 female) each completed 3 designs for each of 4 varied sets of the stimulus parameters (high-PC/high-U, high-PC/low-U, low-PC/high-U, and low-PC/low-U), ordered randomly within a larger set of designs with mixed stimulus characteristics. Regression analyses revealed significant, although modest, learning effects in all conditions. Negative-logarithmic learning slopes (growth factors) were greatest for high-U/high-PC designs and smallest for low-U/low-PC designs. Comparison of these slopes with known Wechsler Adult Intelligence Scale (3rd ed.; D. Wechsler, 1997; and 4th ed.; D. Wechsler, 2008) BD subtest gain scores demonstrated that presenting novel test items matched on stimulus parameters in multiple administrations reduced learning effects compared with the repeated use of the same test items. The results suggest that repeated administration of novel test items of the BD subtest, matched for PC and U, would result in more accurate assessments of changes in examinees' abilities over time than would the use of the same items. Difficulties inherent in implementing this method are also discussed.

Assessing the reliability of the Gambling Functional Assessment.

Dixon and Johnson (Analysis of Gambling Behavior 2007, 1:44-49) introduced the Gambling Functional Assessment (GFA), which attempts to identify the consequences that may be maintaining a person's gambling behavior. The present study had 949 introductory psychology students complete the GFA, with 124 of them completing the measure a second time 12 weeks later. Measures of internal consistency were quite good regardless of whether "non-gamblers" were included or excluded. Test-retest reliability was somewhat mixed, with Escape scores yielding substandard coefficients, especially among females. Both internal and test-retest reliability were typically poorer for female respondents. In general, the GFA performed within the limits of acceptable reliability, and coefficients compared favorably with similar measures. Future investigations will need to determine the reliability and validity of the instrument, especially as it pertains to its intended population, pathological gamblers.

Testing the construct validity of Dixon and Johnson's (2007) Gambling Functional Assessment.

The Gambling Functional Assessment (GFA; Dixon & Johnson, 2007) is a 20-item self-report inventory identifying four potential consequences maintaining gambling behavior. Exploratory and confirmatory factor analyses are performed for two large, nonclinical samples of university undergraduates. For the exploratory analysis, the optimal model yields two factors: Positive Reinforcement (correlated with GFA Sensory, Attention, and Tangible scores) and Negative Reinforcement (correlated with GFA Escape scores). One GFA item fails to load on either factor adequately. Factor loadings are confirmed using structural equation modeling for the second sample. The resulting model yields a mix of adequate and suboptimal fit indicators. Although the 2-factor model of the GFA has great theoretical utility and shows significant promise, confirmation within clinical samples of gamblers will be necessary to further validate the model. GFA Escape scores are uniquely distributed in the two samples and may represent functions most likely to maintain pathological gambling.

Retention of high tactile acuity throughout the life span in blindness.

Previous studies of tactile acuity on the fingertip, using passive touch, have demonstrated an age-related decline in spatial resolution for both sighted and blind subjects. We have reexamined this age dependence with two newly designed tactile-acuity charts that require active exploration of the test symbols. One chart used dot patterns similar to braille, and the other used embossed Landolt rings. Groups of blind braille readers and sighted subjects ranging from 12 to 85 years old were tested in two experiments. We replicated previous findings for sighted subjects by showing an age-related decrease in tactile acuity by nearly 1% per year. Surprisingly, the blind subjects retained high acuity into old age, showing no age-related decline. For the blind subjects, tactile acuity did not correlate with braille reading speed, the amount of daily reading, or the age at which braille was learned. We conclude that when measured with active touch, blind subjects retain high tactile acuity into old age, unlike their aging sighted peers. We propose that blind people's use of active touch in daily activities, not specifically braille reading, results in preservation of tactile acuity across the life span.

Relationship of stimulus and examinee variables to performance on analogous visual and tactile block construction tasks.

Nonverbal/spatial tests are unavailable for persons with visual impairments, despite decades of documented need and developmental effort. Because past tactile analogs of block design (BD) tests have not been widely accepted, known BD test parameters were compared across visual and tactile designs to assess the applicability of the test across modalities. Contrary to expectations, edge-cueing of designs with no perceptual cohesiveness (PC) improved tactile and visual performance. The expected PC by cueing and field independence (FI) by PC interactions were found for visual, but not tactile, BD. Uncued tactile designs elicited more errors, tending to occur closer to the center of the designs. These data suggest that visual and tactile BD performance cannot be interpreted similarly. Differences may be due to to modality-specific demand for various encoding and recoding abilities. The standing model is expanded to account for cross-modality differences in BD performance by including both rotation and block segregation.