Influence of age, education, and blast exposure on the Test of Memory Malingering in an active-duty military sample.

Neuropsychologists use performance validity tests (PVT) to detect performance invalidity across various populations. Unexpected scores for normative and clinical populations on PVT performance could invalidate the assessment if the poor performance does not have a reasonable explanation. One of the most well-validated and frequently used PVT is the Test of Memory Malingering, whose usefulness has been analyzed in various populations, including the military. Studies on the influence of demographic variables and blast exposure on the performance of military samples have yielded inconclusive results. The current study investigates the influence of age, education, and blast exposure on the TOMM Trial 2 in a military sample that is representative of their demographics. The total sample size was 872 participants between 18-62 years of age (M = 26.35, SD = 6.63), divided into 832 males and 40 females. All participants were on active duty, and they had been deployed in war zones in Afghanistan and Iraq. They were referred to Carolina Psychological Health Services from the Naval Hospital of Camp LeJeune for psychological and/or neurological complaints, such as cognitive difficulties. The results show that age, education, and blast exposure variations do not affect TOMM performance. Further studies on the relationship between these variables should be pursued to elucidate how they are associated with the normative or clinical cognitive functioning of military populations.

An alternative approach to TOMM cutoff scores using a large sample of military personnel.

The accuracy of neuropsychological assessments relies on participants exhibiting their true abilities during administration. The Test of Memory Malingering (TOMM) is a popular performance validity test used to determine whether an individual is providing honest answers. While the TOMM has proven to be highly sensitive to those who are deliberately exaggerating their symptoms, there is a limited explanation regarding the significance of using 45 as a cutoff score. The present study aims to further investigate this question by examining TOMM scores obtained in a large sample of active-duty military personnel (N = 859, M = 26 years, SD = 6.14, 97.31% males, 72.44% white). Results indicated that no notable discrepancies existed between the frequency of participants who scored a 45 and those who scored slightly below a 45 on the TOMM. The sensitivity and specificity of the TOMM were derived using the forced-choice recognition (FCR) scores obtained by participants on the California Verbal Learning Test, Second Edition (CVLT-II). The sensitivity for each trial of the TOMM was 0.84, 0.55, and 0.63, respectively; the specificity for each trial of the TOMM was 0.69, 0.93, and 0.92, respectively. Because sensitivity and specificity rates are both of importance in this study, balanced accuracy scores were also reported. Results suggested that various alternative cutoff scores produced a more accurate classification compared to the traditional cutoff of 45. Further analyses using Fisher's exact test also indicated that there were no significant performance differences on the FCR of the CVLT-II between individuals who received a 44 and individuals who received a 45 on the TOMM. The current study provides evidence on why the traditional cutoff may not be the most effective score. Future research should consider employing alternative methods which do not rely on a single score.

Cross-Cultural Comparison of Rural Healthy Adults: Russian and American Groups.

OBJECTIVE: The Russian-speaking population is among the largest European-born in the U.S., yet Russian-American cross-cultural research is scarce. Two studies compared neuropsychological test performance in Russian and American urban adults. However, rural populations of the two nations have never been compared. Cross-cultural neuropsychological differences in rural populations might present differently than in urban dwellers. The present study provides a cross-sectional comparison of neuropsychological test performance in Russian and American rural adults. METHODS: Neuropsychological test performance of 51 American (67% female) and 52 Russian (60% female) healthy rural adults age 18-89 was compared using t-test with Bonferroni correction for education-adjusted z-scores for the following tests: Rey Complex Figure Test (RCFT), Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test A and B (TMT A&B), Stroop Neuropsychological Screening Test, Benton Judgment of Line Orientation Test (JLO), Brief Visuospatial Memory Test-Revised (BVMT-R), Color Trails Test 1 and 2 (CTT 1&2), WMS-IV Logical Memory Test (LMT), WAIS-IV Digit Span Forward (DSF) and Backward Test (DSB), and Symbol Digit Modalities Test (SDMT). RESULTS: Age and sex distribution did not differ in the two groups, but the Russian group was more highly educated. The American group outperformed the Russian group on TMT B, CTT 2, recognition trials of RCFT, BVMT-R, LMT, and on DSF. CONCLUSIONS: Cultural differences in attitudes to timed activities, experience with timed tests and multiple-choice format, attention to details, and length of digit-words that put differential demand on short-term memory in Russian and in English may mediate observed between-group differences.

COVID-19: psychological effects on a COVID-19 quarantined population in Bangladesh.

BACKGROUND: It had been seven months since the first confirmed case (8th March, 2020) of COVID-19 in Bangladesh and people have now got a more complete picture of the extent of the pandemic. Therefore, it is time to evaluate the effects of COVID-19 on mental health. The current population-based study aimed to assess the prevalence of depression and PTSD of the quarantined people in Bangladesh during COVID-19 outbreak. METHODS: A total of 5792 individuals comprised the population of this study. Subjects were respondents to an online questionnaire that was administered through social media. The questionnaire included questions on personal information, quarantine related knowledge, items of the Impact of Event Scale-Revised (IES-R) and the Center for Epidemiologic Studies-Depression (CES-D) scale. Data were collected and analyzed by regression utilizing a using IBM SPSS-22 (Statistical Package for Social Science, Chicago, IL, USA). RESULTS: The most post-traumatic stress disorder (PTSD) symptoms had on the male (n = 1392, 75.7%) who had institutional quarantine. The most depression symptoms were on the female (n = 920, 72.8%) whose income was more than 75000 takas in Bangladeshi currency. 81.8% of respondents had PTSD and their scores ≥24 in the IES-R scale. On the other hand, the respondent's income was 40000-74999 takas in Bangladesh currency had more PTSD symptoms and the odd ratio 19.3 (95% CI: 12.5-27.3), adjusted odds ratio 22.9 (95% CI: 15.6-32.4), after adjusting all personal variables. 85.9% respondents scored 16 ≤ in the CES-D scale, meaning they were depressed. The respondents whose education level grade 10 were most depressed and the odd ratio of 3.8 (95% CI: 3.1-4.65), adjusted odds ratio of 13.19 (95% CI: 9.88-17.62) after adjusting all personal variables. CONCLUSIONS: The prevalence of depression and PTSD of the quarantined people higher than that of the affected group during the outbreak of COVID-19 in Bangladesh. If the administration and health care workers become conscious of such results, actions and policies can be taken to improve the consequential sufferings.

InterOrganizational practice committee recommendations/guidance for teleneuropsychology (TeleNP) in response to the COVID-19 pandemic.

Objective: The Inter Organizational Practice Committee (IOPC) convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic.Method: A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature, collated federal, regional and state regulations and information from insurers, and surveyed practitioners to identify best practices.Results: Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and "tips" for TeleNP procedures are provided.Conclusion: This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at OPC.online.

Inter Organizational Practice Committee Recommendations/Guidance for Teleneuropsychology in Response to the COVID-19 Pandemic†.

OBJECTIVE: The Inter Organizational Practice Committee convened a workgroup to provide rapid guidance about teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. METHOD: A collaborative panel of experts from major professional organizations developed provisional guidance for neuropsychological practice during the pandemic. The stakeholders included the American Academy of Clinical Neuropsychology/American Board of Clinical Neuropsychology, the National Academy of Neuropsychology, Division 40 of the American Psychological Association, the American Board of Professional Neuropsychology, and the American Psychological Association Services, Inc. The group reviewed literature; collated federal, regional, and state regulations and information from insurers; and surveyed practitioners to identify best practices. RESULTS: Literature indicates that TeleNP may offer reliable and valid assessments, but clinicians need to consider limitations, develop new informed consent procedures, report modifications of standard procedures, and state limitations to diagnostic conclusions and recommendations. Specific limitations affect TeleNP assessments of older adults, younger children, individuals with limited access to technology, and individuals with other individual, cultural, and/or linguistic differences. TeleNP may be contraindicated or infeasible given specific patient characteristics, circumstances, and referral questions. Considerations for billing TeleNP services are offered with reservations that clinicians must verify procedures independently. Guidance about technical issues and "tips" for TeleNP procedures are provided. CONCLUSION: This document provides provisional guidance with links to resources and established guidelines for telepsychology. Specific recommendations extend these practices to TeleNP. These recommendations may be revised as circumstances evolve, with updates posted continuously at IOPC.online.

Janet Rogers Matthews (1944-2019).

Presents an obituary for Janet Rogers Matthews (1944-2019). Janet was a tenured psychology faculty at Creighton University before joining the Department of Psychology of Loyola University New Orleans. She remained on their faculty for 30 years, until 2014, when she became professor emerita. Janet described herself as "an APA junky." She served on the Board of Directors of the American Psychological Association (APA); the APA's Council of Representatives; and approximately 50 different boards, committees, and task forces of the association. She was a Fellow of nine divisions of APA (Divisions 1, 2, 12, 29, 31, 35, 40, 32, and 52), as well as president of Divisions 2 and 31. In addition, she served on the American Board of Assessment Psychology. She was very active in the Southwestern Psychological Association, where she also served as its president. Janet's legacy is as a mentor and teacher. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Gerald "Jerry" Goldstein (1931-2017).

Presents an obituary of Gerald "Jerry" Goldstein (1931-2017). Jerry passed away at his home in Pittsburgh, Pennsylvania, on April 8, 2017. Goldstein was famous for his contributions to the establishment of clinical neuropsychology as a science and professional specialty. In addition to his extraordinary service to the specialty, he made important contributions to the neuropsychology of alcoholism and schizophrenia, as well as to neuropsychological rehabilitation. (PsycINFO Database Record

Neuropsychological Measures in the Arab World: A Systematic Review.

Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.

Cognitive Screening Tests Versus Comprehensive Neuropsychological Test Batteries: A National Academy of Neuropsychology Education Paper†.

The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations. Screening tests are generally brief and narrow in scope, they can be administered during a routine clinical visit, and they can be helpful for identifying individuals in need of more comprehensive assessment. Some screening tests can also be helpful for monitoring treatment outcomes. Comprehensive neuropsychological assessments are multidimensional in nature and used for purposes such as identifying primary and secondary diagnoses, determining the nature  and severity of a person's cognitive difficulties, determining functional limitations, and planning treatment and rehabilitation. Cognitive screening tests are expected to play an increasingly important role in identifying individuals with cognitive impairment and in determining which individuals should be referred for further neuropsychological assessment. However, limitations of existing cognitive screening tests are present and cognitive screening tests should not be used as a replacement for comprehensive neuropsychological testing.

Diagnostic mistakes of culturally diverse individuals when using North American neuropsychological tests.

Although the role of culture has increasingly gained acceptance in clinical neuropsychology, relatively minimal research exists regarding the actual impact on clinical activities. In this study, we assess how using North American neuropsychological tests affects diagnostic accuracy in cognitive disorders of culturally diverse individuals. To address this question, participants from Colombia, Morocco, and Spain were administered five commonly used neuropsychological tests and the test results were used to determine whether they would be classified as having the DSM-5 diagnostic criteria for Mild Cognitive and Major Cognitive Disorder. Results reveal that diagnostic error occurred up to 20% of the time, and that the frequency of misdiagnosis differed by nationality. These results provide evidence that using tests from one culture to assess individuals from other cultures produces significant false positives. Findings are discussed in terms of the foundations of neuropsychological assessment and its relationship to cultural variables.

Neuropsychological analysis of an idiot savant: A case study.

Although biological etiologies and diffuse anatomical changes have been provided as plausible explanations for the unusual behaviors observed in idiot savants, no neuropsychological case studies or explanations for these behaviors are found in the literature. We present a case in which the "diagnosis" of idiot savant was based on historical, clinical, and test data. To assess his calendar abilities, this individual was subsequently tested over a period of six months on his ability to determine the day of the week across approximately 1,000 years. For a period of approximately 100 years he was 100% accurate. The neuropsychological tests revealed marked deficits in all areas with performance generally in the lower 1-5th percentile of the population (e.g., Full Scale Intelligence Quotient [FSIQ] = 54). Tests of attention yielded the best scores although still deficient. General learning, coding, and executive function tests proved to be challenging. In contrast, tests of visuo-motor abilities were only of moderate difficulty for the individual. These findings are considered within the theoretical framework of Rimland (autism) and Squyres (memory).

Clinical significance of neuropsychological improvement after supplementation with omega-3 in 8-12 years old malnourished Mexican children: a randomized, double-blind, placebo and treatment clinical trial.

It has been shown that supplementation with omega-3 improves cognitive performance, especially in infants and toddlers, but it is unknown whether these results are effective in older malnourished children. The aims of this study, therefore, were to investigate the omega-3 supplementation effects in 8- to 12-year-old children and to know which neuropsychological functions improve after three months of intervention in a sample of Mexican children with mild to moderate malnutrition. This study was a randomized, double-blind, treatment and placebo study of 59 children aged 8-12 years who were individually allocated to 2 groups. The duration of the intervention lasted 3 months. Neuropsychological performance was measured at baseline and at 3 months. Results show that more than 50% of children in the treatment group had greater improvement in 11 of the 18 neuropsychological variables studied. Processing speed, visual-motor coordination, perceptual integration, attention and executive function showed improvement in more than 70% of the omega-3 supplemented children. This trial was registered at clinicaltrials.gov as NCT01199120.

Is the color trails culture free?

Increasingly clinical neuropsychology has been addressing the effects of culture on neuropsychological functioning. However, that focus has been on comparing performance on standardized tests across two or more groups, often Hispanic. In this study, Arabic children were tested in Morocco using a "culture-free test," Children's Color Trails. Children of different ages and living in rural and urban centers were tested. The results suggest that the Color Trails Test scores from Arab children differed from U.S. norms available. Furthermore, the location of testing and the age of the child were of significance. The role of culture-specific tests was considered.

Neuropsychological test performance of Spanish speakers: is performance different across different Spanish-speaking subgroups?

Even though theories and research have pointed out the importance of variables such as age, gender, or education on neuropsychological assessment, much less emphasis has been placed on language and culture. With the increasing population of Spanish speakers in North America and the limited amount of clinical and scholarly information currently available, neuropsychological assessment of this group has similarly become of increasing importance. Though several studies have been published over the last two decades, an assumption exists that all Spanish speakers, holding education and age constant, would perform similarly regardless of their origin. To address this assumption, a sample of 126 participants was tested from four different countries (Chile, Dominican Republic, Puerto Rico, and Spain). Participants were compared on the following commonly used neuropsychological tests: Verbal Serial Learning Curve, Rey- Osterrieth Complex Figure Test, Verbal Phonemic Fluency Test, the Stroop Color and Word Test, and the Trail Making Test. Analyses revealed significant differences across the groups in two of the five tests administered. Significant differences were observed in the delayed recall of the Serial Learning Test and in the Verbal Fluency Test. The findings highlight the importance of within-group differences between Spanish speakers.

A novel collaborative practice model for treatment of mental illness in indigent and uninsured patients.

PURPOSE: The implementation and evaluation of a collaborative practice model (CPM) of mental health care at a free clinic are described. SUMMARY: Since 2004, the mental health clinic of the Cape Fear Clinic in Wilmington, NC, has provided pharmacotherapy and psychotherapy services to a mostly female population of poor and uninsured patients (average age, about 45 years) under a CPM that includes a state-licensed Clinical Pharmacist Practitioner with prescribing privileges. Spanish is the primary language of about 28% of the clinic's patients. At patient intake and (when possible) six months later, three measures of physical and mental health are administered: the Short-Form Health Survey (SF-12), the physical and mental component summaries of the Patient Health Questionnaire for depression (PHQ-9), and the Alcohol Use Disorders Identification Test (AUDIT); psychological counseling, psychotropic medications, and laboratory monitoring are provided as appropriate. In 2009, the clinic's volunteer health care providers served 56 patients (a total of 316 office visits), providing about 165 hours of free clinical services valued at more than $15,000 and free prescription medications valued at about $123,000. Although the clinic's experience has demonstrated the feasibility of CPM-based mental health care for the indigent and uninsured, a comparison of pretest and posttest data on a sample of clinic patients did not show significant changes from mean baseline SF-12, PHQ-9, and AUDIT scores, possibly due in large part to sampling challenges resulting from the loss of many clinic patients to follow-up. CONCLUSION: A CPM that includes a pharmacist with prescribing authority and psychologists was implemented to provide care for a low-income, uninsured, partly Spanish-speaking patient population.

Measuring effort in neuropsychological evaluations of forensic cases of Spanish speakers.

Changing demographics indicate a dramatic growth in Spanish speakers in the USA. There is an increasing need to provide valid neuropsychological evaluations to these individuals as well as interest in providing the same in Latin American countries. This is especially the case with symptom validity testing, in general, and those involved with litigation in particular. To address this situation, the Dot Counting Test, the Rey 15-Item Test, and the Test of Memory Malingering were administered to clinical controls as well as individuals involved in litigation-forensic non-capital and forensic capital murder cases. The results represent a first step toward the determination of the utility of those tests to address effort in Spanish speakers in the USA.

The use of psychometrists in clinical neuropsychology: history, current status, and future directions.

In recent years, the National Academy of Neuropsychology and other professional neuropsychological organizations have published a number of articles and position papers regarding the use, education, and training of psychometrists ("technicians"). Although these documents provide guidelines for the suggested qualifications and training procedures of psychometrists, none make any mention of the need for a standardized credentialing process, which is commonly required of technicians in similar fields, especially in medical settings. Given the recent changes in current procedural Terminology codes used to bill for neuropsychological services and the interpretation of legislation disallowing the use of psychometrists in New York, the need for a standard credential for psychometrists is apparent. This article will review the history and current use of psychometrists in clinical neuropsychology and highlight the need and rationale for the credentialing of psychometrists.

Psychology as a health care profession.

This article reviews the concept that professional psychology is synonymous with mental health. The acceptance of this concept results in limiting the potential impact that psychology has for both individuals and society. Historical antecedents of both psychology and professional psychology are considered as laying a foundation for a necessary paradigm shift from primarily mental health to health. Clinical neuropsychology, health psychology, and prescriptive authority are considered as three examples that may assist in guiding professional psychology toward inclusiveness into a broader health care arena. Limitations of the proposed paradigm and directions for its future are considered. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

The culture of time in neuropsychological assessment: exploring the effects of culture-specific time attitudes on timed test performance in Russian and American samples.

Cultural differences in time attitudes and their effect on timed neuropsychological test performance were examined in matched non-clinical samples of 100 Russian and American adult volunteers using 8 tests that were previously reported to be relatively free of cultural bias: Color Trails Test (CTT); Ruff Figural Fluency Test (RFFT); Symbol Digit Modalities Test (SDMT); and Tower of London-Drexel Edition (ToL(Dx)). A measure of time attitudes, the Culture of Time Inventory (COTI-33) was used to assess time attitudes potentially affecting time-limited testing. Americans significantly outscored Russians on CTT, SDMT, and ToL(Dx) (p,.05) while differences in RFFT scores only approached statistical significance. Group differences also emerged in COTI-33 factor scores, which partially mediated differences in performance on CTT-1, SDMT, and ToL(Dx) initiation time, but did not account for the effect of culture on CTT-2. Significant effect of culture was revealed in ratings of familiarity with testing procedures that was negatively related to CTT, ToL(Dx), and SDMT scores. Current findings indicated that attitudes toward time may influence results of time limited testing and suggested that individuals who lack familiarity with timed testing procedures tend to obtain lower scores on timed tests.