Using supplemental memory measures to refine interpretation of the repeatable battery for the assessment of neuropsychological status.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used as a cognitive screening measure or as part of a comprehensive neuropsychological battery. Augmenting the current memory subtests of the RBANS to reflect clinically meaningful distinctions in memory performance may improve its clinical utility, allowing users to generate additional hypotheses and refine clinical interpretations. We pilot four supplementary memory measures to use with the RBANS, adapted from paradigms commonly used by other neuropsychological tests. We also provide several new theoretically derived memory indices to supplement the standard Delayed Memory Index. The new subtests correlated significantly with the standard memory measures, and the new indices demonstrated good reliability and diagnostic accuracy. This study provides preliminary support for supplementing the RBANS to allow for more nuanced interpretations of memory performance.

The Savage Organizational Scoring System for the Rey-Osterrieth Complex Figure Test: Norms and New Data From Veterans in a Traumatic Brain Injury Clinic.

The Rey-Osterrieth Complex Figure Test (RCFT) permits quantifying diverse cognitive abilities, including executive function (EF). We evaluated the psychometric properties of a scoring procedure for the RCFT, the Savage Organizational Scoring System (SOSS), that awards points for drawing the largest structural elements of the figures as continuous wholes. This was a two-phase study: first, we conducted a systematic literature search for studies using the SOSS, and aggregated previously published data for healthy controls to create a normative database; second, we observed performances from veterans evaluated for traumatic brain injury (TBI), examining the reliability of their SOSS scores, the SOSS correlations with two EF measures and the participants' self-reported cognitive functioning, and then compared their mean scores to normative expectations. Across our literature-derived normative database, the aggregated mean SOSS score was 4.12 (SD = 1.72), which was marginally higher than that of our veteran participants evaluated for TBI, 3.72 (SD = 1.79). The SOSS had modest internal consistency (α = .59). Unlike the criterion EF measures, the SOSS was not significantly related to self-reported cognitive functioning. The SOSS shared a small, significant correlation with Trails B and Shipley Abstraction; but RCFT Copy scores were more strongly related to these tests, and the SOSS added no significant incremental predictive value beyond the RCFT Copy score. However, SOSS scores did predict RCFT Recall beyond RCFT Copy scores. We conclude that the SOSS has modest reliability and is predictive of RCFT Recall scores, but it is not strongly correlated with other EF measures, and it is only minimally affected by mild TBI.

Everyday Executive Function and Self-Awareness in Agenesis of the Corpus Callosum.

OBJECTIVE: Agenesis of the corpus callosum (AgCC) is associated with a range of cognitive deficits, including mild to moderate problems in higher order executive functions evident in neuropsychological assessments. Previous research has also suggested a lack of self-awareness in persons with AgCC. METHOD: We investigated daily executive functioning and self-awareness in 36 individuals with AgCC by analyzing self-ratings on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), as well as ratings on the same instrument from close relatives. Discrepancies between self- and informant-ratings were compared to the normative sample and exploratory analyses examined possible moderating effects of participant and informant characteristics. RESULTS: Significant deficiencies were found in the Behavioral Regulation and Metacognitive indices for both the self and informant results, with elevated frequency of metacognition scores in the borderline to clinical range. Informants also endorsed elevated frequency of borderline to clinically significant behavioral regulation scores. The proportion of AgCC participants whose self-ratings indicated less metacognitive impairment than informant-ratings was greater than in the normative sample. Self-ratings of behavioral regulation impairment decreased with age and informant-ratings of metacognition were higher in males than females. CONCLUSIONS: These findings provide evidence that individuals with AgCC experience mild to moderate executive functioning problems in everyday behavior which are observed by others. Results also suggest a lack of self-understanding or insight into the severity of these problems in the individuals with AgCC, particularly with respect to their metacognitive functioning.

Validating the usefulness of the NSI validity-10 with the MMPI-2-RF.

Purpose/Aim of the Study: The Neurobehavioral Symptom Inventory (NSI) is a 22-item self-report measure created to quantify the somatosensory, cognitive, and affective symptoms of Post-concussive Syndrome. Developers of the NSI used a subset of 10 items, the Validty-10, to measure symptom overreporting. We compared the Validity-10 versus the remaining NSI items (i.e., the Remaining-12) for how accurately they detect symptom exaggeration on the Minnesota Multiphasic Personality Inventory Second Edition - Restructured Form (MMPI-2-RF).Materials and Methods: We used a sample of 45 veterans evaluated in a Polytrauma/TBI Clinic of a Midwest VA Healthcare System who completed the NSI and MMPI-2-RF.Results: The Vaidity-10, Remaining-12, and Total Score all strongly correlated with mean of the MMPI-2-RF validity scales (r = .65, .67, and .70, respectively), illustrating equivalency among the various NSI scores. Groups were created based on significant T score elevation on any MMPI-2-RF validity scale (i.e. F-r > 119, or Fp-r, F-s, FBS, or RBS > 99). ROC analyses demonstrated that areas under the curve were equivalent for NSI Total Score (.84), Validity-10 (.81), and Remaining-12 (.81) in detecting overreporting.Conclusions: These findings do not support the notion that the Validity-10 has unique utility as an embedded symptom validity scale and highlights the likelihood that NSI Total Score can also serve this function.

Awareness of consequences in agenesis of the corpus callosum: Semantic analysis of responses.

OBJECTIVE: Agenesis of the corpus callosum (AgCC) in individuals with general intelligence within the normal range results in a syndrome of mild to moderate deficiencies in cognitive, emotional, and social functioning that are still being explored. Anecdotal accounts from families suggest that these cognitive and psychosocial deficiencies affect the ability of these individuals to anticipate the consequences of their decisions and behaviors. This research was designed to clarify the nature of social and emotional cognition in AgCC with respect to imagination of the consequences of decisions by assessing responses from the Awareness of Consequences Scale (AOCS). METHOD: Verbal AOCS responses from persons with AgCC and age and IQ-matched neurotypical controls were scored in the normal manner, and also subjected to semantic analyses using both latent semantic analysis and Linguistic Inquiry and Word Count. RESULTS: It was found that, relative to neurotypical controls, individuals with AgCC scored significantly lower on the typical scoring of the AOCS, had nontypical semantic content in their responses, and used fewer emotion and cognitive content (insight) words. These results were apparent in responses to the three most complex of the AOCS scenarios. CONCLUSIONS: Results were consistent with the hypothesis that persons with AgCC are deficient in the capacity to imagine the emotional and cognitive consequences of potential actions on others. particularly in the face of greater situational and social complexity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).