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Reliable Digit Span: Does it Adequately Measure Suboptimal Effort in an Adult Epilepsy Population?
Maiman, Moshe; Del Bene, Victor A; MacAllister, William S; Sheldon, Sloane; Farrell, Eileen; Arce Rentería, Miguel; Slugh, Mitchell; Nadkarni, Siddhartha S; Barr, William B.
Affiliation
  • Maiman M; Department of Neurology, NYU-Langone Comprehensive Epilepsy Center, NYU-Langone Health, NYU School of Medicine, New York, NY, USA.
  • Del Bene VA; Department of Psychology, Drexel University, Philadelphia, PA, USA.
  • MacAllister WS; Department of Neurology, NYU-Langone Comprehensive Epilepsy Center, NYU-Langone Health, NYU School of Medicine, New York, NY, USA.
  • Sheldon S; Ferkauf Graduate School of Psychology, Clinical Health Psychology Program, Yeshiva University, Bronx, NY, USA.
  • Farrell E; Department of Neurology, NYU-Langone Comprehensive Epilepsy Center, NYU-Langone Health, NYU School of Medicine, New York, NY, USA.
  • Arce Rentería M; Department of Neurology, NYU-Langone Comprehensive Epilepsy Center, NYU-Langone Health, NYU School of Medicine, New York, NY, USA.
  • Slugh M; Ferkauf Graduate School of Psychology, Clinical Health Psychology Program, Yeshiva University, Bronx, NY, USA.
  • Nadkarni SS; Institute of Neurology and Neurosurgery, Saint Barnabas, Livingston, NJ, USA.
  • Barr WB; Department of Neurology, NYU-Langone Comprehensive Epilepsy Center, NYU-Langone Health, NYU School of Medicine, New York, NY, USA.
Arch Clin Neuropsychol ; 34(2): 259-267, 2019 Mar 01.
Article in En | MEDLINE | ID: mdl-29659666
ABSTRACT

OBJECTIVE:

Assessment of performance validity is a necessary component of any neuropsychological evaluation. Prior research has shown that cutoff scores of ≤6 or ≤7 on Reliable Digit Span (RDS) can detect suboptimal effort across numerous adult clinical populations; however, these scores have not been validated for that purpose in an adult epilepsy population. This investigation aims to determine whether these previously established RDS cutoff scores could detect suboptimal effort in adults with epilepsy.

METHOD:

Sixty-three clinically referred adults with a diagnosis of epilepsy or suspected seizures were administered the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS-III or WAIS-IV). Most participants (98%) passed Trial 2 of the Test of Memory Malingering (TOMM), achieving a score of ≥45.

RESULTS:

Previously established cutoff scores of ≤6 and ≤7 on RDS yielded a specificity rate of 85% and 77% respectively. Findings also revealed that RDS scores were positively related to attention and intellectual functioning. Given the less than ideal specificity rate associated with each of these cutoff scores, together with their strong association to cognitive factors, secondary analyses were conducted to identify more optimal cutoff scores. Preliminary results suggest that an RDS cutoff score of ≤4 may be more appropriate in a clinically referred adult epilepsy population with a low average IQ or lower.

CONCLUSIONS:

Preliminary findings indicate that cutoff scores of ≤6 and ≤7 on RDS are not appropriate in adults with epilepsy, especially in individuals with low average IQ or below.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Epilepsy / Malingering / Memory Disorders Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Arch Clin Neuropsychol Journal subject: NEUROLOGIA / PSICOLOGIA Year: 2019 Document type: Article Affiliation country: Estados Unidos

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Epilepsy / Malingering / Memory Disorders Type of study: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Arch Clin Neuropsychol Journal subject: NEUROLOGIA / PSICOLOGIA Year: 2019 Document type: Article Affiliation country: Estados Unidos