Craig Uchiyama

Alternate forms of the auditory-verbal learning test: issues of test comparability, longitudinal reliability, and moderating demographic variables☆

The present investigation examines the alternate-form and longitudinal reliability of two versions of the Auditory-Verbal Learning Test (AVLT) on a large, multiregional, healthy male sample. Subjects included 2,059 bisexual and homosexual HIV-seronegative males recruited from the Multicenter AIDS Cohort Study from centers in Baltimore, Chicago, Los Angeles, and Pittsburgh. The findings revealed no significant differences between forms upon initial or 1-year longitudinal administration, supporting the equivalence of the two versions. However, significant practice effects were noted longitudinally, arguing for the need of appropriate retest normative data. Furthermore, as age, ethnicity, and education were found to significantly affect test performance, it is recommended that normative data be interpreted according to these variables. In addition to providing normative and longitudinal data, this investigation presents information concerning the use and limitations of the alternate forms of the AVLT.

Heterogeneity of cognitive profiles in normal aging: implications for early manifestations of Alzheimer's disease

This study explores the presence of homogeneous subgroups among 156 normal elderly subjects based on their performance on a battery of neuropsychological tests. Subjects ranged in age between 57 and 85 years and included 62 males and 94 females with a mean age 70.7 years, mean education 14.1 years, and mean Full Scale IQ of 117.2. Six clusters were extracted, three of which are likely to represent preclinical stages of the dementing process with distinct patterns of cognitive deficits. The results are discussed in light of different models of cognitive deterioration in DAT.

Personality Change in Head Trauma: A Validity Study of the Neuropsychology Behavior and Affect Profile

This study represents the first attempt to cross validate and report on the Neuropsychology Behavior and Affect Profile (NBAP) using closed head injury (CHI) participants. The NBAP is designed to measure emotional functioning before and following a brain event. Two CHI samples, differing primarily by method of ascertainment, were compared to a group of normal controls. Results provided support for concurrent and predictive validity of the NBAP across both CHI samples. Significantly higher levels of postinjury emotional functioning in clinic-referred CHI patients compared to CHI individuals not seeking treatment (strictly research participants) was demonstrated. A surprising finding was that pre-injury emotional levels of clinic-referred subjects were rated as less severe than that of controls. Based on this finding, the possibility of a gradient effect was discussed in which raters appeared to place selectively greater weight on current condition, while simultaneously making premorbid levels less severe than they really were. Results were discussed in the context of study limitations and directions for further research.

Performance on motor tasks as an indication of increased behavioral asymmetry with advancing age.

Age-related asymmetrical functional decline was tested on a sample of 64 right-handed volunteers between 60 and 64 years of age who were free from neurological illnesses and physical handicaps. Increase in functional asymmetry was explored by examining performance indexes for each hand and superiority of the dominant hand on motor tasks of different complexities: the Finger Tapping Test, the Grooved Pegboard Test, and the Pin Test. Our study revealed an increase in superiority of the right hand with age on a highly demanding task (Pin Test). This finding is discussed in light of the hypothesis of a decline in callosal functioning with age and the alternative hypothesis of a greater vulnerability of the right hemisphere in the elderly.

The pattern of deficit in different memory components in normal aging and dementia of alzheimer's type

The study explored differential patterns of deficits in different memory components as a function of dementia severity. Three groups of 58 subjects each were used: (1) highly functioning elderly who are free of neurological or psychiatric symptoms; (2) individuals with early signs of memory disturbance, whose MMSE scores were > or = 24; and (3) individuals with MMSE scores below 24, who meet criteria for DAT. Performance on the tests that assess different memory components was compared for the three groups. Results suggest pronounced change in acquisition component of memory at the onset of dementia, whereas retrieval from remote memory discriminates well between the mild and the more advanced phases of the disease. Retrieval from recent memory deteriorates more gradually. Based on these results, efficiency of different memory mechanisms was discussed.

Subtlety of the MMPI-2 depression scale : A subject laid to rest ?

This study was designed to examine the relative validity of the Wiener-Harmon Depression-Obvious (D-O) and Depression-Subtle (D-S) subscales of the Minnesota Multiphasic Personality Inventory-2. With samples of psychiatric outpatients classified as depressed (n = 31) and nondepressed (n = 44 ) on the basis of extensive diagnostic interviews, criterion validity was supported for overall Scale 2 scores, as well as those based on the D-O subscale. Concurrent validity was upheld when Scale 2 and the D-O subscale were compared with a standard criterion indicator ofdepression. Results failed to support the validity of the D-S subscale as a measure of depression in psychiatric outpatients.

Direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in normal geriatric persons: a structural equation model.

The direct and indirect effects of demographic, medical, and psychological variables on neuropsychological performance in elderly individuals were examined using a LISREL structural equation model. One-hundred fifty-six geriatric subjects were individually administered a comprehensive neuropsychological battery, an extensive medical history and demographics questionnaire, and the Neuropsychology Behavior and Affect Profile (a psychological assessment instrument). The model assessed the effects of five independent latent variables (medical history, psychological functioning, global mental status, education, and gender-related functioning) on two dependent latent variables (nonverbal and verbal neuropsychological functioning). The best fitting model revealed that three latent variables (medical history, global mental status, and gender-related functioning) had direct effects on neuropsychological functioning and that all five independent variables exhibited indirect effects. These findings suggest that the influence of demographic variables on neuropsychological functioning for geriatric persons is complex and that certain variables should not be interpreted independently of each other due to their significant moderating influences.

Development and Evaluation of Validity Scales for the Neuropsychology Behavior and Affect Profile: A Dissembling Study.

The Neuropsychology Behavior and Affect Profile (NBAP) is a peer-rated inventory of behavioral and affective changes in brain injured individuals and consists of five Clinical Scales that have demonstrated strong external validity. A potential confound is the NBAPs susceptibility to rater bias. In the present investigation, four validity scales were developed and external validity and psychometric properties were examined through a dissembling paradigm. Study I describes item selection and construction of the validity scales. Study 2 demonstrates that various combinations of both the clinical and validity scales effectively differentiated dissemblers from informants of two groups of traumatic brain injury patients. Although results differed somewhat when dissemblers were grouped according to their level of neuropsychological training, highly trained dissemblers (licensed clinical neuropsychologists) could be detected.