Jacqueline Remondet Wall

Expectancy of impaired neuropsychological test scores in a non-clinical sample.

Two methods were addressed to evaluate the incidence of false positive impairment on tests in neuropsychological evaluation. One method used a mathematical model based on the binomial theory () to offer predictions based on probability. The model sets boundaries to determine when score variations would occur by chance and is therefore useful for identifying when cases exceed established boundaries. In addition, the present study examined test performance in a non-clinical sample of 94 college students via the Halstead Reitan Neuropsychological Test Battery. Results found that 15% of the sample had impairments suggested by the Halstead Impairment Index, using criteria established by . In addition, one-half of the sample obtained impaired scores on one or two tests. These results are consistent with what the binomial model predicted. The model would therefore serve as a useful resource for clinicians when considering the probability of impaired test performance.

Marital satisfaction and psychophysiological responsiveness in spouses of patients with chronic pain

The primary purpose of this study was to investigate the relationship between spouse marital satisfaction and spouse solicitousness to their physiological responsiveness during marital interactions about pain. Twenty-six couples engaged in a series of structured marital interactions about neutral and pain-related topics while monitored for skin conductance (SC) and heart rate (HR). There was strong support for the role of spouses’ marital satisfaction in predicting their physiological responsiveness. The more satisfied a spouse, the more physiologically reactive the spouses were when listening to the patient describe pain, and the less reactive when responding to it. Dissatisfied spouses demonstrated the opposite pattern. They autonomically deactivated when hearing about the pain and became reactive when responding to it. Solicitousness was not a significant predictor of the spouses’ physiological responsiveness. Block’s (1981) proposed physiological mechanism for the origin of solicitousness in spouses did not receive support. It appears that responding in any fashion may lessen the magnitude of arousal in maritally satisfied spouses, whereas dealing with pain-related topics produces unpleasant arousal in dissatisfied spouses.

Derivation and Clinical Validation of Consistency Indices on the Test of Memory Malingering

Response consistency (CNS) is considered in free-standing performance validity measures like the Medical Symptom Validity Test (MSVT). This study examined the utility of CNS scores on the Test of Memory Malingering (TOMM). CNS indices were derived in a non-clinical undergraduate sample randomized to control (n = 73), naïve simulator (n = 73), and coached simulator (n = 73) groups. Two of the three TOMM CNS measures showed higher classification rates identifying naïve simulators than the standard TOMM criteria; CNS measures classified coached simulators better than the standard TOMM criteria. Coached simulators outperformed naïve simulators on the standard TOMM scores, but not on CNS measures, suggesting their resilience to coaching. In a separate clinical sample of veterans (N = 92), TOMM CNS scores exhibited comparable classification rates with the standard TOMM scoring using the MSVT as the performance validity criterion. Overall, findings support TOMM CNS scores, especially in settings in which examinee coaching is likely.

Accountability in Child Welfare Services: Developing a Statewide Outcome Evaluation Program

Questions are often raised regarding the effectiveness and value of treatment programs for children and families. Recently, programs have been increasingly held accountable for services offered. In response, the member agencies of IARCCA have developed a comprehensive outcome measurement program. This article describes the project, focusing on the conditions that led to its inception and how the measurement plan was developed. In addition, the article includes information on the selection of personnel, measurement instruments, and methods and on the process of data collection. Summary results are provided, including how these results are utilized to improve services. Finally, the continued expansion and future directions of the Outcome Project are discussed.

Use of the Binomial Distribution to Predict Impairment: Application in a Nonclinical Sample

A mathematical model based on the binomial theory was developed to illustrate when abnormal score variations occur by chance in a multitest battery (Ingraham & Aiken, 1996). It has been successfully used as a comparison for obtained test scores in clinical samples, but not in nonclinical samples. In the current study, this model has been applied to demographically corrected scores on the Halstead-Reitan Neuropsychological Test Battery, obtained from a sample of 94 nonclinical college students. Results found that 15% of the sample had impairments suggested by the Halstead Impairment Index, using criteria established by Reitan and Wolfson (1993). In addition, one-half of the sample obtained impaired scores on one or two tests. These results were compared to that predicted by the binomial model and found to be consistent. The model therefore serves as a useful resource for clinicians considering the probability of impaired test performance.

Examining Verbal Memory on the Word Memory Test and California Verbal Learning Test-Second Edition

This study compared the Word Memory Test (WMT) and California Verbal Learning Test-Second Edition (CVLT-II) in a sample (N = 76) of outpatient physiatry referrals who passed WMT validity indices. WMT and CVLT-II raw scores showed moderate to strong correlations. WMT scores were more likely to be below expectation than CVLT-II scores using norms from the respective test manuals. With impaired scores defined as 2 SDs below normative mean, the WMT and CVLT-II showed 67% overall agreement and kappa of 0.34. Forty percent of participants who scored within normal limits on the CVLT-II demonstrated an impaired score on the WMT. Despite evidence of utility, WMT memory subtests appear limited by current normative data.

Using grip strength force curves to detect simulation: a preliminary investigation.

Analysis of grip strength force curves has successfully detected suboptimal effort in industrial rehabilitation research. This study examined force curve analysis as an effort measure when grip strength was administered according to standardized neuropsychological procedures in a sample without reported neurologic and upper extremity injury. Eighty-two undergraduates were randomized to control (n = 26), naïve simulator (n = 28), and coached simulator (n = 28) conditions. Outcome measures included grip strength in kilograms, variables calculated from grip strength force curves, and the Word Memory Test (WMT). While average force in kilograms was not significantly different between groups, significant differences were found on the average to peak force ratio as calculated from grip strength force curves. The classification accuracy of average to peak force ratio was lower than the WMT, but comparable to other effort measures. Force curve analysis may warrant further study in a clinical sample.