David Andrés González

Bacillus anthracis meningitis

Bacillus anthracis is an uncommon cause of meningitis. The characteristic hemorrhagic features in two patients who died despite antibiotic treatment are presented and discussed.

Psychometrics and latent structure of the IDS and QIDS with young adult students

BACKGROUND Students and young adults have high rates of suicide and depression, thus are a population of interest. To date, there is no normative psychometric information on the IDS and QIDS in these populations. Furthermore, there is equivocal evidence on the factor structure and subscales of the IDS. METHODS Two samples of young adult students (ns=475 and 1681) were given multiple measures to test the psychometrics and dimensionality of the IDS and QIDS. RESULTS The IDS, its subscales, and QIDS had acceptable internal consistencies (αs=.79-90) and favorable convergent and divergent validity correlations. A three-factor structure and two Rasch-derived subscales best fit the IDS. LIMITATIONS The samples were collected from one university, which may influence generalizability. CONCLUSIONS The IDS and QIDS are desirable measures of depressive symptoms when studying young adult students.

Cross-measure equivalence and communicability in the assessment of depression: a focus on factor-based scales.

All measures of depression yield a global summary scale indicating the severity of depressive symptoms, implicitly conceptualized as a homogeneous construct. However, depression is a heterogeneous construct, with different presentations, subtypes, correlates, and responses to interventions. In response, the National Institute of Mental Health (NIMH) has suggested changes in the way depression is assessed, moving the focus to specific factors, such as cognitive, somatic, or affective symptoms. Still, there is little factor overlap between measures, and shared factors are weighted differently. To help fulfill NIMH’s strategic plan, this study used canonical correlation analysis (CCA) to explore shared latent variables and redundancy across the measures. It also analyzed the psychometric properties of factor-based subscales in the Beck Depression Inventory–2nd edition (BDI-II), Center for Epidemiologic Studies Depression scale (CES-D), Inventory for Depression and Anxiety Symptoms (IDAS), and Inventory of Depressive Symptomatology (IDS). Using a diverse sample of 218 students who reported at least mild depressive symptoms, this study found that the IDAS was best aligned with NIMH’s strategic plan; it has complete DSM-IV/DSM-5 symptom coverage and content-valid, psychometrically sound subscales. The BDI-II, CES-D, and IDS did not have consistent subscales, nor had incomplete or incongruent coverage of DSM criteria. Furthermore, CCA revealed low redundancy across measures (23% to 41% shared variance). These results suggest that different measures of depression do not measure the same construct. As a partial solution, empirical conversion tables were provided for researchers and clinicians to empirically compare total scores from different measures.

The Dot Counting Test adds up: Validation and response pattern analysis in a mixed clinical veteran sample

ABSTRACT Objective: This study cross-validated the Dot Counting Test (DCT) as a performance validity test (PVT) among a mixed clinical veteran sample. Completion time and error patterns also were examined by validity group and cognitive impairment status. Method: This cross-sectional study included 77 veterans who completed the DCT during clinical evaluation. Seventy-four percent (N = 57) were classified as valid and 26% as noncredible (N = 20) via the Word Memory Test (WMT) and Test of Memory Malingering (TOMM). Among valid participants, 47% (N = 27) were cognitively impaired, and 53% (N = 30) were unimpaired. Results: DCT performance was not significantly associated with age, education, or bilingualism. Seventy-five percent of the overall sample committed at least one error across the 12 stimulus cards; however, valid participants had a 27% higher rate of 0 errors, while noncredible participants had a 35% higher rate of ≥4 errors. Overall, noncredible individuals had significantly longer completion times, more errors, and higher E-scores. Conversely, those with cognitive impairment had longer completion times, but comparable errors to their unimpaired counterparts. Finally, DCT E-scores significantly predicted group membership with 83.1% classification accuracy and an area under the curve of .87 for identifying invalid performance. The optimal cut-score of 15 was associated with 70% sensitivity and 88% specificity. Conclusion: The DCT demonstrated good classification accuracy and sensitivity/specificity for identifying noncredible performance in this mixed clinical veteran sample, suggesting utility as a non-memory-based PVT with this population. Moreover, cognitive impairment significantly contributed to slower completion times, but not reduced accuracy.

Corticobasal syndrome due to sporadic Creutzfeldt–Jakob disease: a review and neuropsychological case report

Abstract Objective: Creutzfeldt–Jakob disease (CJD) is a rare, rapidly progressive, and fatal neurodegenerative disease with neuropsychological sequelae. This study highlighted a rare presentation of CJD (e.g. corticobasal syndrome [CBS]), reviewed updated diagnostic criteria and procedures for CJD (e.g. diffusion weighted imaging [DWI], real-time quaking-induced conversion [RT-QuIC]), and discussed differential diagnoses. Method: Case report methodology focused on a 68-year-old, Hispanic, right-handed man with 11 years of education. He presented with a 1–2-month history of gait and motor difficulties (e.g. rigidity, myoclonus). Results: After evaluation, a ‘cortical ribboning’ pattern on DWI and positive RT-QuIC was integrated with performance on neurobehavioral exam (i.e. alien limb phenomenon, unilateral ideomotor apraxia) and neuropsychological testing (i.e. frontal-parietal dysfunction pattern) to reach a diagnosis of sCJD-CBS. The patient expired 3 months after onset of symptoms. Conclusions: This literature review and case report highlighted the importance of staying abreast of developments in neurological literature and the added value of neuropsychology, when integrated with newer procedures, for confirming and excluding diagnostic considerations.

The effect of perceptual reasoning abilities on confrontation naming performance: An examination of three naming tests

ABSTRACT Introduction: Confrontation naming tests are a common neuropsychological method of assessing language and a critical diagnostic tool in identifying certain neurodegenerative diseases; however, there is limited literature examining the visual–perceptual demands of these tasks. This study investigated the effect of perceptual reasoning abilities on three confrontation naming tests, the Boston Naming Test (BNT), Neuropsychological Assessment Battery (NAB) Naming Test, and Visual Naming Test (VNT) to elucidate the diverse cognitive functions underlying these tasks to assist with test selection procedures and increase diagnostic accuracy. Method: A mixed clinical sample of 121 veterans were administered the BNT, NAB, VNT, and Wechsler Adult Intelligence Scale–4th Edition (WAIS–IV) Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) as part of a comprehensive neuropsychological evaluation. Results: Multiple regression indicated that PRI accounted for 23%, 13%, and 15% of the variance in BNT, VNT, and NAB scores, respectively, but dropped out as a significant predictor once VCI was added. Follow-up bootstrap mediation analyses revealed that PRI had a significant indirect effect on naming performance after controlling education, primary language, and severity of cognitive impairment, as well as the mediating effect of general verbal abilities for the BNT (B = 0.13; 95% confidence interval, CI [.07, .20]), VNT (B = 0.01; 95% CI [.002, .03]), and NAB (B = 0.03; 95% CI [.01, .06]). Conclusions: Findings revealed a complex relationship between perceptual reasoning abilities and confrontation naming that is mediated by general verbal abilities. However, when verbal abilities were statistically controlled, perceptual reasoning abilities were found to have a significant indirect effect on performance across all three confrontation naming measures with the largest effect noted with the BNT relative to the VNT and NAB Naming Test.

Adaptation of the BDI-II in Mexico

The number of Spanish-speaking individuals and immigrants in the United States has risen dramatically and is projected to continue to rise. The availability of appropriately translated and validated measurement instruments, such as the Beck Depression Inventory, is a priority for researchers and clinicians in the U.S. and Mexico, where the first edition of the BDI is still prominently used. The purpose of this study was to pilot a Mexican adaptation of the BDI-II and report initial psychometric characteristics. Two samples were used: students from across Mexico and community adults from Mexico City. Results indicated that the translation was easily understood by most individuals, had adequate internal consistency, and a three-factor structure (negative attitude, performance difficulties, and somatic elements) had the best fit. Implications for use with Mexican-origin Spanish speakers are discussed.

Validating the Structure of the Depression and Somatic Symptoms Scale

BACKGROUND Depressed primary care patients may present with somatic symptoms first, complicating differential diagnosis. Clinicians have few instruments for assessing this comorbidity. OBJECTIVE To evaluate the psychometrics of the translated Chinese Depression and Somatic Symptoms Scale (DSSS) in Americans. PROCEDURES A total of 491 nonclinical but symptomatic ethnically-diverse individuals completed the DSSS and Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS Factor analysis yielded 2 distinct factors: depression and somatic symptoms. DSSS and subscales showed internal consistency, reliability, and convergent validity with CES-D and subscales. CONCLUSIONS These results support DSSSs trustworthiness for US populations. Using DSSS for patient assessment may assist diagnosis and inform interventions.

An Evaluation of the Texas Functional Living Scale's Latent Structure and Subscales

Objective Performance-based functional assessment is a critical component of neuropsychological practice. The Texas Functional Living Scale (TFLS) has promise given its brevity, nationally representative norms, and co-norming with Wechsler scales. However, its subscale structure has not been evaluated. The purpose of this study was to evaluate the TFLS in a mixed clinical sample (n = 197). Method Reliability and convergent and discriminant validity coefficients were calculated with neurocognitive testing and collateral reports and factor analysis was performed. Results The Money and Calculation subscale had the best psychometric properties of the subscales. The evidence did not support solitary interpretation of the Time subscale. A three-factor latent structure emerged representing memory and semantic retrieval, performance and visual scanning, and financial calculation. Conclusions This study added psychometric support for interpretation of the TFLS total score and some of its subscales. Study limitations included sample characteristics (e.g., gender ratio) and low power for collateral report analyses.

Adaptation of the BDI–II in Mexico. (Adaptación del IDB-II en México)

The number of Spanish-speaking individuals and immigrants in the United States has risen dramatically and is projected to continue to rise. The availability of appropriately translated and validated measurement instruments, such as the Beck Depression Inventory, is a priority for researchers and clinicians in the U.S. and Mexico, where the first edition of the BDI is still prominently used. The purpose of this study was to pilot a Mexican adaptation of the BDI-II and report initial psychometric characteristics. Two samples were used: students from across Mexico and community adults from Mexico City. Results indicated that the translation was easily understood by most individuals, had adequate internal consistency, and a three-factor structure (negative attitude, performance difficulties, and somatic elements) had the best fit. Implications for use with Mexican-origin Spanish speakers are discussed.