Jeffrey D. Gfeller

Relationship between social desirability and self-report in chronic pain patients

Objective:To examine the relationship between social desirability and self- report in data collected from chronic pain patients. Setting:A multidisciplinary pain management center located in a major university medical center. Patients:Two hundred persons presenting with chronic pain, including low back, head/neck, and extremity pain. Measures:Marlowe-Crowne Social Desirability Scale, Beck Depression Inventory—Short Form, Spielberger Trait Anxiety Inventory, Psychosomatic Symptom Checklist, McGill Pain Questionnaire, Pain Disability Index, Quality of Life Scale, Pain Drawing. Results and Conclusions:Correlations showed that patients with greater social desirability response bias reported less depression and anxiety but higher levels of pain severity. When depression effects were controlled in a regression analysis, social desirability correlated positively with self-reported disability. These results show systematic response patterns associated with social desirability, suggesting that social desirability response biases should be considered in both research and clinical assessments of chronic pain patients.

The Immediate Post-Concussion Assessment and Cognitive Testing battery and traditional neuropsychological measures: A construct and concurrent validity study

Primary objective: This study examined the construct and concurrent validity of ImPACT, a computerized neuropsychological test battery used for evaluating sports-related concussion. Research design: Approximately 100 neurologically intact undergraduates completed ImPACT and a battery of traditional neuropsychological tests utilized by the National Football League (NFL). Methods and procedures: Participants completed the two batteries in a counterbalanced order. Factor analyses examined the component structure of ImPACT and the NFL batterys factor structure. Correlational analyses assessed relationships among variables within and across the two batteries. Main results: A four-factor solution explaining 70% of variance was found with the NFL battery, including general memory, mental processing speed, verbal memory and processing speed and auditory and verbal working memory. A five-factor solution explaining 69% of variance was found with the ImPACT battery, with components assessing forced choice efficiency, verbal and visual memory, inhibitory cognitive abilities, visual processing abilities with a memory component and a factor with a single loading from Colour Match Total Commissions. Correlations revealed a range of significant and non-significant correlations between the two batteries. Conclusions: While both batteries overlap regarding their assessed constructs (e.g. memory, inhibitory cognitive abilities) notable differences in their factor structures were present as well.

The relationship between perfectionism and self-efficacy

Abstract The hypothesis that individuals scoring high vs low on measured perfectionism would differ significantly on a measure of self-efficacy was tested. The Burns Perfectionism Scale (BPS), the Multidimensional Perfectionism Scale (MPS), and the Generalized Self-Efficacy Scale (SES) were administered to 271 college students. It was found that while the BPS and MPS total scores were not able to discriminate high and low perfectionism scorers on self-efficacy, the three subscales of the MPS did. In this case, higher levels of Self-Oriented and Other-Oriented Perfectionism were associated with low self-efficacy, while higher levels of Socially-Prescribed Perfectionism were associated with high self-efficacy. The results not only have important implications for the conceptualization of perfectionism as an important factor in self-efficacy, but have important assessment implications, as well. Possible interpretations are offered.

The East Boston Memory Test : A clinical screening measure for memory impairment in the elderly

Comparisons between the East Boston Memory Test (EBMT), a brief verbal memory measure used in epidemiological studies with dementia, selected Wechsler Memory Scale-Revised (WMS-R) subtests, and the Mini-Mental State Examination (MMSE) were investigated with 23 geriatric patients diagnosed with dementia. Significant correlations between the EBMT and WMS-R verbal subtests were predicted and occurred (r = .42 to .64). A five minute EBMT recall correlated most highly with the WMS-R Logical Memory subtests. The sensitivity of the EBMT in detecting cognitive impairment was investigated and compared with the sensitivity of the MMSE. The EBMT correctly classified 78% of subjects, compared to a 70% correct classification rate with the MMSE. Implications of these findings and suggestions for future research directions are discussed.

Complexity Analysis of Resting State Magnetoencephalography Activity in Traumatic Brain Injury Patients

Diagnosis of mild traumatic brain injuries (TBIs) has been difficult because of the absence of obvious focal brain lesions, using conventional computed tomography (CT) or magnetic resonance imaging (MRI) scans, in a large percentage of TBIs. One useful measure that can characterize potential tissue and neural network damage objectively is Lempel-Ziv complexity (LZC) applied to magnetoencephalography (MEG) signals. LZC is a model-independent estimator of system complexity that estimates the number of different patterns in a sequence. We hypothesized that because of the potential network damage, TBIs would show a reduced level of complexity in regions that are impaired. We included 18 healthy controls and 18 military veterans with TBI in the study. Resting state MEG data were acquired, and the LZCs were analyzed across the whole brain. Our results indicated reduced complexity in multiple brain areas in TBI patients relative to the healthy controls. In addition, we detected several neuropsychological measures associated with motor responses, visual perception, and memory, correlated with LZC, which likely explains some of the cognitive deficits in TBI patients.

Cluster analysis of child sexual offenders: A validation with roman catholic priests and brothers

Abstract The present study was designed to replicate cluster analytic techniques previously used to identify subgroups among child sexual offenders with a more restricted population of Roman Catholic priests and brothers who have sexually abused children. Two hierarchical agglomerative methods were used to cluster analyze participants on the three validity scales and ten clinical scales of the MMPI-2 (Minnesota Multiphasic Personality Inventory). Participants were 97 Roman Catholic priests and brothers who were child sex offenders. Four clusters were identified and found to be valid and interpretively useful. These empirically derived subgroups included: “Sexually and Emotionally Underdeveloped”; “Significantly Psychiatrically Disturbed”; “Undefended Characterological”; and “Defended Characterological.” Clusters were validated and further described using additional MCMI-II (Millon Clinical Multiaxial Inventory, Second Edition), NEO-PI-R (NEO Personality Inventory, Revised), demographic, and offense-relate...

A Double-Blind Comparison of the Effects of Temazepam and Triazolam on Residual, Daytime Performance in Elderly Insomniacs

Benzodiazepine hypnotic medications are widely prescribed for elderly patients, but there is a paucity of information available concerning the residual cognitive and psychomotor (the morning-after) effects of these drugs. We compared two commonly used hypnotics--temazepam and triazolam--in a double-blind, placebo-controlled, single-dose study with community-dwelling healthy elderly with a DSM-III-R diagnosis of primary insomnia. Forty-five subjects over the age of 65 (mean age 72.23, SD = 4.44) qualified for the study. Subjects were randomly assigned to one of five treatment groups (placebo, triazolam 0.125 mg., triazolam 0.25 mg., temazepam 15 mg., and temazepam 30 mg.). Neuropsychological testing was completed at baseline and 12-14 hours after the dosing. Patients were evaluated with a variety of tests that measured attention, concentration, motor speed, immediate memory, and learning of new information. Separate repeated measured analyses of variance were performed to assess the significant changes among the five treatment groups. We found improved performance or no change in all the measures for all medication groups except for impairment of performance on a serial learning task for both high-dose medication groups. The significance of these results and the need for further research in elderly insomniacs is discussed.

Efficacy of progressive muscle relaxation for reducing state anxiety among elderly adults on memory tasks

Cognitively intact anxious elderly subjects were randomly assigned to either a progressive muscle relaxation-training condition or control condition (ns = 15) and then completed selected subtests from the Wechsler Memory Scale—Revised. Despite significant reductions in state anxiety in the relaxation group, no significant differences were detected between the two groups on memory measures. These results are discussed within the context of previous research, and suggestions for further research are made.

A Comparison of Insufficient Effort Rates, Neuropsychological Functioning, and Neuropsychiatric Symptom Reporting in Military Veterans and Civilians with Chronic Traumatic Brain Injury

Neuropsychological evaluation of persons with chronic traumatic brain injury (TBI) symptoms is complicated by multiple factors. The authors explored the impact of mechanism of injury, effort testing performance, and neuropsychiatric status in a sample of military veterans (V-TBI) and civilians (C-TBI) with chronic TBI. V-TBI (n = 74), C-TBI (n = 67), and healthy civilian control (C-HC) participants (n = 66), completed a battery of neuropsychological, effort, and self-report neuropsychiatric measures. Results indicated that C-HC and C-TBI participants exhibited comparably low failure rates on effort tests (6% and 3%, respectively). V-TBI participants exhibited significantly higher rates of failure (18%). Subgroups (n = 20) of effort-screened participants matched for demographics and disability level were compared regarding neuropsychological performance and neuropsychiatric self-report. Both TBI groups exhibited limited neuropsychological impairment, relative to the C-HC participants. The V-TBI group exhibited pronounced neuropsychiatric symptomology compared with the other participant groups. The implications of these findings are discussed for evaluation in the context of disability and litigation.

Measuring anxiety states in the elderly using the state-trait anxiety inventory for children

Healthy elderly persons aged 60 to 95 years were administered the Childrens State version of the State-trait Anxiety Inventory (STAIC-S), the Geriatric Depression Scale (GDS) and the Minimental State Examination (MMSE) in order to establish descriptive data on the STAIC-S for use with a geriatric population. The STAIC-S was found to be internally consistent and temporally stable over an average of 11 days. In addition, factor analysis and correlations with the GDS and MMSE are presented. The authors suggest that the STAIC-S is both reliable and valid when used with an elderly population.