Cut-off scores for mild and moderate dementia on the Addenbrooke's Cognitive Examination-III and the Mini-Addenbrooke's Cognitive Examination compared with the Mini-Mental State Examination.

AIMS AND METHOD: We aimed to establish cut-off scores to stage dementia on the Addenbrooke's Cognitive Examination-III (ACE-III) and the Mini-Addenbrooke's Cognitive Examination (M-ACE) compared with scores traditionally used with the Mini-Mental State Examination (MMSE). Our cross-sectional study recruited 80 patients and carers from secondary care services in the UK. RESULTS: A score ≤76 on the ACE-III and ≤19 on the M-ACE correlated well with MMSE cut-offs for mild dementia, with a good fit on the receiver operating characteristic analysis for both the ACE-III and M-ACE. The cut-off for moderate dementia had lower sensitivity and specificity. There were low to moderate correlations between the cognitive scales and scales for everyday functioning and behaviour. CLINICAL IMPLICATIONS: Our findings allow an objective interpretation of scores on the ACE-III and the M-ACE relative to the MMSE, which may be helpful for clinical services and research trials.

Gender bias in autism screening: measurement invariance of different model frameworks of the Autism Spectrum Quotient.

BACKGROUND: The Autism Spectrum Quotient is a popular autism screening tool recommended for identifying potential cases of autism. However, many women with autism demonstrate a different presentation of traits to those currently captured by screening measures and assessment methods, such as the Autism Spectrum Quotient. AIMS: Different models of the Autism Spectrum Quotient have been proposed in the literature, utilising different items from the original 50-item scale. Within good-fitting models, the current study aimed to explore whether these items assess autistic traits similarly across men and women. METHOD: Seventeen Autism Spectrum Quotient models were identified from the literature. Using the responses of a large sample of adults from the UK general population (5246 women, 1830 men), confirmatory factor analysis was used to evaluate the fit of each model. Measurement invariance with respect to gender, adjusting for age, was explored in the 11 model frameworks that were found to have satisfactory fit to our data. RESULTS: It emerged that only two items were gender invariant (non-biased), whereas for the remaining items, the probability of endorsement was influenced by gender. In particular, women had a higher probability of endorsing items relating to social skills and communication. CONCLUSIONS: If the items of the Autism Spectrum Quotient indeed reflect autism-related traits, those items should be rephrased to ensure they do not present a gender-related bias. This is vital for ensuring more timely diagnoses and support for all people with autism.

Latent profiles identified from psychological test data for people convicted of sexual offences in the UK.

BACKGROUND: One size does not fit all in assessment and intervention for people with convictions for sexual offences. Crime scene indicators and risk-related variables have been used to identify distinct clusters of people with convictions for sexual offences, but there is a need for more robust typologies that identify clusters based on psychologically meaningful risk factors that can be targeted in treatment. AIMS: To use robust modelling techniques to identify latent profiles of people with convictions for sexual offences based on indicators of dynamic risk. METHOD: Adult male participants, who had been convicted for sexual offences and assessed for eligibility for the prison-based Core Sex Offender Treatment Programme delivered by His Majesty's Prison and Probation Service (UK), were randomly allocated to a test (n = 1577: 70.2%) or validation (n = 668: 29.8%) data-set. Exploratory factor analysis (EFA) was used to select measures of dynamic risk from psychological test data. EFA indicated four factors, from which six measures were selected for inclusion in latent profile analysis. RESULTS: Five latent profiles were identified in the test and validation data-sets. These were labelled low psychological impairment, impulsive, distorted thinker, rape preoccupied and child fantasist. Profiles varied in individual characteristics, offence histories, victim preferences and level of risk. CONCLUSIONS: Our findings should be used to guide assessment and intervention practices that are tailored to distinct psychological profiles consistent with principles of risk, need and responsivity.

Measuring Vulnerability in Grief: The Psychometric Properties of the Italian Adult Attitude to Grief Scale.

Although experiences of loss and the consequent grief are natural in human life, some individuals may have difficulty managing these events, to the point of developing significant impairment in their functioning in important life areas. Given this, the present research aimed to explore the psychometric properties of the Italian version of the Adult Attitude to Grief scale (AAG) to facilitate research on adult vulnerability to grief among Italian-speaking populations. A sample of 367 participants (Mage = 30.44, SD = 11.21; 78% females) participated in this research. A back-translation procedure was implemented to develop the Italian AAG. Then, participants completed the Italian AAG alongside a battery of other self-report psychometric scales in order to assess aspects of the construct validity of the AAG: the Forty-Item Defense Style Questionnaire, the Impact of Event Scale-Revised, and the Beck Depression Inventory-II. A bifactor structure was found to have the best fit to the data, supporting the possibility of using both the general factor (i.e., vulnerability) and three dimensions (i.e., overwhelmed, controlled, and resilient). Unlike the original version, the control dimension emerged as a "protective" factor in the Italian population, together with the resilient factor. Furthermore, results provided satisfactory indications of internal consistency and construct validity. In conclusion, the Italian AAG was shown to be a valid, reliable, quick, and easy-to-use scale that can be used both for research and clinical practice in the Italian context.

The Brain Medicine Clinic: two cases highlighting the advantages of integrative care.

BACKGROUND: Current assessment and management models often do not adequately address the many aspects of managing complex brain disorders involving disordered affect, behaviour and cognition (ABC). A more collaborative model of care, where several specialties can jointly assess and manage patients with complex brain disorders, is gaining attention. AIMS: In this case report, we present two cases that highlight the benefits of the 'brain medicine' clinical model. METHOD: The Brain Medicine Clinic employs an integrated clinical model in which psychiatrists and neurologists provide integrated interdisciplinary assessments of patients with complex brain disorders, leading to comprehensive assessment. We describe the clinical model and the trajectories of two patients with complex brain disorders seen in this clinic. In these case descriptions, we explain how the brain medicine clinical approach leads to an improved patient experience. RESULTS: The Brain Medicine Clinic assessments resulted in a neurobiopsychosocial formulation of symptoms and, consequently, holistic individualised treatment plans for two patients with complex brain disorders. This approach to patients' conditions emerges from the understanding that there are multifactorial causes of brain disorders at the social, cultural, psychological and biological level. CONCLUSIONS: Integrated interdisciplinary assessments allow for tailored treatment plans for individuals experiencing complex brain disorders, while creating efficiencies for the patient and the healthcare system.

Psychological and Neurophysiological Screening Investigation of the Collective and Personal Stress Resilience.

Methodological approaches to assess the human cognitive status are constantly evolving. At the same time, the creation of new assessment methods is accompanied by traditional research. This paper discusses the direction of research on the search for markers of stress resilience. The basis for the formation of the research algorithm was the assessment of activation factors of emotional states, including preceding stress-sensory (cognitive and informational) and psycho-emotional factors. This was determined using methodological techniques, stress factors, working conditions in professional teams, etc. For an express analysis (25-40 min) of diagnosing stress resistance, a research algorithm was justified, consisting of clinical and psychological testing, as well as EEG with traditional tests and analysis of indicators and spectra. Therefore, this research was aimed at the psychological and neurophysiological substantiation of approaches to express algorithms for assessing cognitive functions and resilience to stress under time deficit. A study on 102 healthy subjects and 38 outpatients of a neuropsychiatric clinic was performed. Basic outcomes: the integrative indicator SCL-90-R-"general index of severity" has a high statistical significance (p < 0.05) in both healthy subjects and neuropsychiatric outpatients. The effectiveness of the Mini-Mult test in conditions of time deficit is determined by the results of the scales of hypochondria, depression, hysteria, paranoia, psychasthenia, schizoid and hypomania (p < 0.05). Furthermore, we used a line of logical thinking techniques. A line of four logical methods is highly informative in assessing the mental status in conditions of time deficit. EEG power indices and spectra in theta, delta and alpha frequency ranges are an effective reflection of cognitive status. In this article, a testing algorithm as a variant for assessing neurocognitive status in screening studies of large groups is discussed.

Prevalence of post-traumatic stress disorder and validity of the Impact of Events Scale - Revised in primary care in Zimbabwe, a non-war-affected African country.

BACKGROUND: A critical step in research on the epidemiology of post-traumatic stress disorder (PTSD) in low-resource settings is the validation of brief self-reported psychometric tools available in the public domain, such as the Impact Event Scale - Revised (IES-R). AIMS: We aimed to investigate the validity of the IES-R in a primary healthcare setting in Harare, Zimbabwe. METHOD: We analysed data from a survey of 264 consecutively sampled adults (mean age 38 years; 78% female). We estimated the area under the receiver operating characteristic curve and sensitivity, specificity and likelihood ratios for different cut-off points of the IES-R, against a diagnosis of PTSD made using the Structured Clinical Interview for DSM-IV. We performed factor analysis to evaluate construct validity of the IES-R. RESULTS: The prevalence of PTSD was 23.9% (95% CI 18.9-29.5). The area under the curve for the IES-R was 0.90. At a cut-off of ≥47, the sensitivity of the IES-R to detect PTSD was 84.1 (95% CI 72.7-92.1) and specificity was 81.1 (95% CI 75.0-86.3). Positive and negative likelihood ratios were 4.45 and 0.20, respectively. Factor analysis revealed a two-factor solution, with both factors showing good internal consistency (Cronbach's factor-1 α = 0.95, factor-2 α = 0.76). In a post hoc analysis, we found the brief six-item IES-6 also performed well, with an area under the curve of 0.87 and optimal cut-off of 15. CONCLUSIONS: The IES-R and IES-6 had good psychometric properties and performed well for indicating possible PTSD, but at higher cut-off points than those recommended in the Global North.

20 anos da comissão consultiva em avaliação psicológica: desafios da ADI 3481 / 20 years of the advisory committee on psychological assessment: challenges of ADI 3481 / 20 años de la comisión consultiva en evaluación psicológica: desafíos de la ADI 3481

A Comissão Consultiva em Avaliação Psicológica (CCAP) do Conselho Federal de Psicologia (CFP), em seu 20º aniversário, vem discutir os possíveis efeitos, ainda efetivamente desconhecidos, da Ação Direta de Inconstitucionalidade (ADI) 3481, instruída no Supremo Tribunal Federal (STF), a qual desestruturou o modo como os testes psicológicos eram comercializados no Brasil. A livre comercialização de testes psicológicos coloca em risco a segurança de avaliações psicológicas e cabe à categoria profissional pensar estratégias de enfrentamento desses riscos. Neste artigo, são discutidos possíveis efeitos da ADI 3481 para a categoria profissional da psicologia, bem como para a sociedade em geral, e são também elencadas possíveis estratégias de enfrentamento desses riscos, sem desconsiderar aspectos éticos relacionados a eles. Dessa forma, busca-se neste manuscrito, além da problematização dos efeitos derivados da ADI 3481, pensar soluções ou alternativas que venham a redirecionar a trajetória da área da avaliação psicológica no Brasil. Com isso, abre-se um espaço de discussão e encaminhamentos que a categoria profissional precisará tomar nos próximos anos.(AU)

The Advisory Commission for Psychological Assessment of the Federal Council of Psychology discusses, on its 20th anniversary, the possible and still effectively unknown effects of the Direct Action of Unconstitutionality (DAU) 3481, following the Supreme Federal Court, which interrupted how psychological tests were marketed in Brazil. The free trade of psychological tests puts the safety of psychological assessments at risk, and this professional category must think of strategies to face these risks. This study discusses the possible effects of DAU 3481 for professional psychology and for society in general, listing possible strategies for coping with these risks without disregarding its ethical aspects. Thus, this study seeks to problematize the effects derived from DAU 3481 and think of solutions or alternatives that may redirect the trajectory of the field of psychological assessment in Brazil, thus opening a space for discussion and referrals professional psychology will require in the coming years.(AU)

La Comisión Consultiva en Evaluación Psicológica (CCEP) del Consejo Federal de Psicología (CFP), en su 20.º aniversario, propone discutir los posibles efectos aún efectivamente desconocidos de la Acción Directa de Inconstitucionalidad (ADI) 3481, determinada por el Supremo Tribunal Federal (STF), por la cual trastornó la forma de comercializar las pruebas psicológicas en Brasil. La comercialización sin restricciones de las pruebas psicológicas pone en riesgo la seguridad de las evaluaciones psicológicas, y le corresponde a la categoría profesional pensar estrategias para enfrentar estos riesgos. En este artículo se discuten los posibles efectos de la ADI 3481 para la categoría profesional de la Psicología, así como para la sociedad en general, pero también se enumeran posibles estrategias para el enfrentamiento de estos riesgos, sin descuidar los aspectos éticos relacionados con ellos. Así, este manuscrito busca, además de problematizar los efectos derivados de la ADI 3481, pensar en soluciones o alternativas que puedan reconducir la trayectoria del campo de la evaluación psicológica en Brasil. Esto abre un espacio de discusión y derivaciones que la categoría profesional deberá tomar en los próximos años.(AU)

Cognitive Interview in the Search for Validity Evidence Based on Response Processes / Entrevistas Cognitivas na Busca de Evidências de Validade Baseadas no Processo de Resposta / Entrevistas Cognitivas en la Búsqueda de Evidencia de Validez Basada en el Proceso de Respuesta

Abstract Cognitive interviews can provide validity evidence for instruments based on item response processes; however, use of focus groups still prevails in Brazilian literature. Moreover, semantic analysis has only been considered when searching for validity evidence based on test content. This paper presents a proposal for qualitative data analysis based on cognitive interviewing, thus providing researchers with a protocol that enables best practices in carrying out this technique, and consolidating it in the Brazilian literature as an option to search for validity evidence based on item response processes. To conclude, we present some criticisms regarding current procedures for validity evidence based on test content and discuss some possibilities.

Resumo As entrevistas cognitivas podem fornecer evidências de validade para os instrumentos com base no processo de resposta aos itens. Na literatura brasileira, entretanto, o uso de grupos focais ainda prevalece. Além disso, a análise semântica tem sido considerada apenas na busca de evidências de validade baseada no conteúdo do teste. Esse manuscrito apresenta uma proposta para análise de dados qualitativos de entrevistas cognitivas. O objetivo é fornecer aos pesquisadores um protocolo que viabiliza as melhores práticas na realização desta técnica, consolidando-a na literatura brasileira como uma opção para busca de evidência de validade baseada no processo de resposta dos itens. Por fim, são apresentadas algumas críticas em relação aos atuais procedimentos de busca de evidências de validade baseadas no conteúdo e possibilidades são discutidas.

Resumen Las entrevistas cognitivas pueden proporcionar evidencia de validez para los instrumentos basados en el proceso de respuesta al ítem. En la literatura brasileña, sin embargo, aún prevalece el uso de grupos focales; además, el análisis semántico solo se ha considerado en la búsqueda de evidencias de validez basadas en el contenido de la prueba. Este manuscrito presenta una propuesta para el análisis de datos cualitativos de entrevistas cognitivas. El objetivo es proporcionar a los investigadores un protocolo que posibilite las mejores prácticas en la realización de esta técnica, consolidándola en la literatura brasileña como una opción para la búsqueda de evidencias de validez a partir del proceso de respuesta a los ítems. Finalmente, se presentan algunas críticas en relación a los procedimientos actuales de búsqueda de evidencias de validez en base al contenido y se discuten posibilidades.

Análise da estrutura disponibilizada ao ensino de avaliação psicológica / Analysis of the structure provided for teaching psychological assessment / Análisis de la estructura proporcionada para la enseñanza de la evaluación psicológica

O objetivo do presente estudo foi analisar as condições estruturais disponibilizadas para o ensino das disciplinas de Avaliação Psicológica nos cursos de Psicologia das Instituições de Ensino Superior (IES) do Ceará. Obteve-se autorização de oito instituições para realizar a pesquisa e, tendo como base um roteiro de observação, foram analisados aspectos de material e equipamento, infraestrutura e Serviço de Psicologia. Os principais resultados indicaram que as instituições possuíam uma variedade mínima de 20 testes psicológicos, os alunos assinavam um termo para alugar os testes e as IES desenvolviam atividades para a comunidade. Entretanto, também foi observado a inexistência da testagem informatizada, poucas instituições contavam com testotecas e os funcionários responsáveis pelo serviço e material da avaliação psicológica, em sua maioria, não eram formados em Psicologia. Pode-se concluir que o panorama das instituições cearenses observadas é promissor, mas deve-se continuar em busca de melhorias

The aim of the present study was to analyze the structural conditions made available for the teaching of Psychological Assessment disciplines in the Psychology courses of Higher Education Institutions in Ceará. Authorization was obtained from eight institutions to carry out the research and, based on an observation script, were analyzed aspects of material and equipment, infrastructure and Psychology Service. The main results indicated that the institutions had a minimum range of 20 psychological tests, students signed a term to rent the tests and the institutions developed activities for the community. However, it was also observed that there was no computerized testing, few institutions had "testotecas" and the employees responsible for the service and psychological assessment material were mostly not graduate in Psychology. It can be concluded that the scenario of the institutions in Ceará observed is promising, but one must continue to seek improvements

El objetivo del presente estudio fue analizar las condiciones estructurales disponibles para la enseñanza de asignaturas de Evaluación Psicológica en los cursos de Psicología de las Instituciones de Educación Superior en Ceará. Se obtuvo autorización de ocho instituciones para llevar a cabo la investigación y, en base a un guion de observación, se analizaron aspectos de material y equipo, infraestructura y Servicio de Psicologia. Los principales resultados indicaron que las instituciones tenían un rango mínimo de 20 tests psicológicos, los estudiantes firmaron un plazo para alquilar el tests y las IES desarrollaron actividades para la comunidad. Sin embargo, también se observó que no había tests computarizados, pocas instituciones tenían "testotecas" y los empleados responsables del servicio y el material de evaluación psicológica en su mayoría no estaban graduado en psicología. Se puede concluir que el escenario de las instituciones observadas en Ceará es prometedor, pero hay que seguir buscando mejoras

Avaliação psicológica no estado do Maranhão: cenário atual e direções futuras / Psychological assessment in the state of Maranhão: current scenario and future directions / Evaluación psicológica en el estado de Maranhão: escenario actual y direcciones futuras

As últimas duas décadas trouxeram mudanças para o campo da Avaliação Psicológica (AP) no Brasil. Considerando que historicamente o desenvolvimento da Psicologia foi desigual entre as regiões do país, este estudo teve como objetivo investigar as práticas, a formação e o conhecimento de psicólogos maranhenses sobre avaliação psicológica. Participaram 124 psicólogos com registro ativo no Conselho Regional de Psicologia do Maranhão, que responderam a um roteiro estruturado de entrevista elaborado para este estudo. Os resultados mostraram que a maioria afirma realizar AP na sua prática profissional, que entrevista é a técnica mais usada e considerada mais importante para o processo, que há indícios de avanço na formação em AP no estado do Maranhão, mas que permanecem dificuldades em relação à compreensão de conceitos psicométricos e na inserção das práticas de AP no dia a dia do trabalho dos psicólogos. (AU)

The field of Psychological Assessment (PA) in Brazil faced changes in the last two decades. Since the development of Psychology has been historically uneven between the regions of the country, this study aimed to assess the practices, academic training, and knowledge of psychologists from the state of Maranhão on psychological assessment. 124 psychologists with active registration in the Regional Council of Psychology of Maranhão participated responding to a structured interview script prepared for this study. The results show that most claim to perform PA in their professional practice; that interview is the most used technique and it is considered the most important for the process; that there are indications of progress in PA training in the state of Maranhão, but some difficulties remain regarding the comprehension of psychometric concepts and the insertion of PA practices in the daily work of psychologists. (AU)

Las ultimas dos décadas trajeron cambios para el campo de la Evaluación Psicológica (EP) en Brasil. Considerando que históricamente el desarrollo de la Psicología fue desigual entre las regiones del país, este estudio tuvo como objetivo investigar las prácticas, la formación y el conocimiento de psicólogos del estado de Maranhão sobre evaluación psicológica. Participaron 124 psicólogos con matrícula activa en el Consejo Regional de Psicología de Maranhão, que respondieron a un guión estructurado de entrevista elaborado para este estudio. Los resultados mostraron que: la mayoría afirma realizar EP en su práctica professional; la entrevista es la técnica mas usada y considerada mas importante para el processo; hay indicios de avances en la formación en EP en el estado de Maranhão, pero permanecen dificultades en relación a la comprensión de conceptos psicométricos y en la inserción de las prácticas de EP en el día a día del trabajo de los psicólogos. (AU)

The Development of Psychological Assessment in Brazil and Current and Future Challenges / O Desenvolvimento da Avaliação Psicológica no Brasil e os Desafios Atuais e Futuros

Abstract Brazilian psychological assessment possesses several indicators that prove its quality, although by the early 1990s, the use of psychological tests in evaluative processes had fallen into disrepute in society. The present article recounts the history of Brazilian psychological assessment, told through the lens of the creation of a working group (WG) of the Associação Nacional de Pesquisa e Pós-graduação em Psicologia (ANPEPP, National Association for Research and Graduate Studies in Psychology) and its subsequent achievements. The construction of the Sistema de Avaliação dos Testes Psicológicos (SATEPSI, Psychological Testing Assessment System) and its deployment, collectively, by the profession's regulating agency with the collaboration of scientific associations as well as of the WG and ANPEPP are also mentioned. Many initiatives were reunited, rehabilitating the credibility of the practice of assessment. The authors stress the advances that still need to be made, such as widening research with minority groups and including new statistical analyses and technologies that will impact the development of psychological assessment.

Resumo A área de avaliação psicológica brasileira possui qualidade comprovada por vários indicadores, embora até o início da década de 1990, o uso de testes psicológicos em processos avaliativos tenha caído no descrédito da sociedade. O presente artigo explicita a história da avaliação psicológica brasileira, narrada à luz da criação de um grupo de trabalho da Associação Nacional de Pesquisa e Pós-graduação em Psicologia e das conquistas subsequentes. A construção do Sistema de Avaliação dos Testes Psicológicos (SATEPSI) e seus desdobramentos, coletivamente, pelo órgão de classe, com a colaboração das associações científicas e do GT da ANPEPP, também são mencionados. Diversas iniciativas foram reunidas, trazendo de volta a credibilidade da prática de avaliação. As autoras destacam os avanços que ainda se fazem necessários, como a ampliação de pesquisas com grupos minoritários, a inclusão de novas análises estatísticas e de tecnologias, que seguramente, impactarão no desenvolvimento da avaliação psicológica.

Does folic acid supplementation have a positive effect on improving memory? A systematic review and meta-analysis of randomized controlled trials.

Introduction: The results of randomized controlled trials (RCTs) on the effect of folic acid supplementation on memory status due to various heterogeneity, dosage, duration, and cognitive function assessments were inconclusive. Therefore, we have performed a systematic review and meta-analysis to investigate the effect of folic acid supplementation on memory in RCTs. Method: Comprehensive computerized systematic searches were conducted throughout Scopus, PubMed/Medline, and Google Scholar from inception until February 2022 to investigate the effect of folic acid supplementation memory levels in RCTs. The standardized mean difference (SMD) and 95% confidence interval (CIs) were used to estimate the overall effect size using random-effects meta-analyses. Results: The overall results of nine trials with 641 participants, revealed that folic acid supplementation did not significantly change memory score compared to placebo (SMD: 0.12; 95% CI: -0.17, 0.40, p = 0.418; I 2 = 62.6%). However, subgroup analyses showed that supplementation with folic acid had favorable effects on memory levels considering the following conditions: (1) doses lower than 1 mg/day, (2) treatment lasting more than 6 months, (3) conducted in eastern countries, and (4) in participants equal to or older than 70 years old. The dose-response analysis suggested a significant favorable effect on memory status at doses of 6-11 mg/d and a significant decline at doses of 17-20 mg/d. Discussion: Although we did not find a significant effect of folic acid supplementation on memory, there were some suggestions of beneficial effects in the subgroup analyses.

Blots and brains. A note on the centenary of Hermann Rorschach's death.

This historical note is a commemorial of Rorschach, the person, and Rorschach the test. Hermann Rorschach died 100 years ago, not quite a year after the publication of his book containing the 10 inkblots. These have reached an iconic status, but the "Rorschach Test" as used in psychiatry, legal organizations and aptitude assessments is not quite what Hermann Rorschach designed it for in the first line. A first section of this article introduces Hermann Rorschach as a man with very broad interests and an inclination to ask cognitive science questions that are still challenging today. A second section provides a critical summary of the fate of the ten inkblots after Rorschach's death - how they conquered the whole world in a time with a pronouced "psychometric attitude", and also how they failed in some attempts to measure personality traits in special populations. A final section focuses on recent research on one particular aspect of a testee's associations to the inkblots: "movement responses", i.e. the perception of implied motion. Here, neural and behavioral correlates have been demonstrated by modern neuroimaging techniques. One study, which set out to validate both the Rorschach as a personality test and the view that the two cerebral hemispheres correspond to divergent "personalities" is also summarized. The viewpoint concludes by suggesting that future work with inkblots should consider Rorschach's original intention to use inkblots to uncover basic laws of perception. Modern applications of computer-generated pseudorandom stimuli (random dot arrays or stochastic noise) would have been embraced by Hermann Rorschach as he appreciated the impact of visual noise for the study of vision and visual cognition.

Psychological Testing in Forensic Contexts Conducted Remotely.

The use of videoconferencing technology to conduct forensic psychiatric and forensic psychological evaluations remotely has grown considerably in the last decade. This commentary addresses a number of points made by Recupero regarding the use of remote technology to conduct forensic psychiatric evaluations. These points include the research supporting telepsychiatry and its generalizability to forensic assessment, the error rate associated with remote forensic assessment, and its general acceptance in the field. The commentary also considers the inclusion of psychological testing and specialized forensic measures in forensic assessment and describes criteria for considering tests and measures that can reasonably be included in a remotely conducted forensic assessment.

The diagnostic and predictive potential of personality traits and coping styles in major depressive disorder.

BACKGROUND: Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals. METHODS: Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals. RESULTS: Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD. CONCLUSIONS: Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.

Implementation of Mobile Psychological Testing on Smart Devices: Evaluation of a ResearchKit-Based Design Approach for the Implicit Association Test.

Objective: To determine whether a framework-based approach for mobile apps is appropriate for the implementation of psychological testing, and equivalent to established methods. Methods: Apple's ResearchKit was used for implementing native implicit association test methods (IAT), and an exemplary app was developed to examine users' implicit attitudes toward overweight or thin individuals. For comparison, a web-based IAT app, based on code provided by Project Implicit, was used. Adult volunteers were asked to test both versions on an iPad with touch as well as keyboard input (altogether four tests per participant, random order). Latency values were recorded and used to calculate parameters relevant to the implicit setting. Measurements were analyzed with respect to app type and input method, as well as test order (ANOVA and χ2 tests). Results: Fifty-one datasets were acquired (female, n = 21; male, n = 30, average age 35 ± 4.66 years). Test order and combination of app type and input method influenced the latency values significantly (both P<0.001). This was not mirrored for the D scores or average number of errors vs. app type combined with input method (D scores: P = 0.66; number of errors: P = 0.733) or test order (D scores: P = 0.096; number of errors: P = 0.85). Post-hoc power analysis of the linear ANOVA showed 0.8 by f 2=0.25, with α = 0.05 and 4 predictors. Conclusions: The results suggest that a native mobile implementation of the IAT may be comparable to established implementations. The validity of the acquired measurements seems to depend on the properties of the chosen test rather than the specifics of the chosen platform or input method.

The diagnostic process from primary care to child and adolescent mental healthcare services: the incremental value of information conveyed through referral letters, screening questionnaires and structured multi-informant assessment.

BACKGROUND: A variety of information sources are used in the best-evidence diagnostic procedure in child and adolescent mental healthcare, including evaluation by referrers and structured assessment questionnaires for parents. However, the incremental value of these information sources is still poorly examined. AIMS: To quantify the added and unique predictive value of referral letters, screening, multi-informant assessment and clinicians' remote evaluations in predicting mental health disorders. METHOD: Routine medical record data on 1259 referred children and adolescents were retrospectively extracted. Their referral letters, responses to the Strengths and Difficulties Questionnaire (SDQ), results on closed-ended questions from the Development and Well-Being Assessment (DAWBA) and its clinician-rated version were linked to classifications made after face-to-face intake in psychiatry. Following multiple imputations of missing data, logistic regression analyses were performed with the above four nodes of assessment as predictors and the five childhood disorders common in mental healthcare (anxiety, depression, autism spectrum disorders, attention-deficit hyperactivity disorder, behavioural disorders) as outcomes. Likelihood ratio tests and diagnostic odds ratios were computed. RESULTS: Each assessment tool significantly predicted the classified outcome. Successive addition of the assessment instruments improved the prediction models, with the exception of behavioural disorder prediction by the clinician-rated DAWBA. With the exception of the SDQ for depressive and behavioural disorders, all instruments showed unique predictive value. CONCLUSIONS: Structured acquisition and integrated use of diverse sources of information supports evidence-based diagnosis in clinical practice. The clinical value of structured assessment at the primary-secondary care interface should now be quantified in prospective studies.

Diagnostic Difficulties in Discriminating Autism Spectrum Disorder in an Adult With Periodic Psychosis Versus Schizophrenia Spectrum Condition: An Insight From Psychological Testing.

It has long been recognized that the biological underpinnings of autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD) may share a common basis; however, the two conditions remain separate in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) due to a few distinguishing characteristics. Both disorders are characterized by cognitive and social deficits and have been presumed to be linked to multiple genes. We describe a 46-year-old male who presented atypically with three previous and one current episode of schizoaffective-like symptoms. We describe his previous inpatient admissions, current inpatient course, psychological test results, and treatment. The patient initially presented with schizoaffective disorder, but with a thorough interview, collateral information review, and psychological evaluation, it was determined that he instead was presenting with a previously undiagnosed case of ASD with brief psychosis when under stress. This case serves as an example of an atypical presentation of ASD which can be mistaken for schizoaffective disorder. It is important to establish the correct diagnosis, as the subsequent treatment and management of the patient's problems will depend on it. In such a patient, a low dose of atypical antipsychotic medication with serotonergic properties and psychotherapy would be the treatment of choice.