Michael L. Stutts

Neuropsychological performance of adults with attention deficit hyperactivity disorder (ADHD): Diagnostic classification estimates for measures of frontal lobe/executive functioning

ADHD adults (N = 26) were compared to normal controls (N = 26) on 6 neuropsychological measures believed sensitive to frontal lobe-executive functioning. MANOVA analyses and subsequent univariate tests indicated that most of the neuropsychological measures discriminated between the two groups. To address clinical significance diagnostic classification rates were also generated for each measure individually, and for the battery as a whole. Levels of positive predictive power (PPP) for each of the 6 measures (83-100%) indicated that abnormal scores on these tests were good predictors of ADHD. However, estimates of negative predictive power (NPP) suggested that normal scores poorly predicted the absence of ADHD. When classification rates were calculated for the overall battery classification accuracy improved substantially. Thus, neuropsychological tests can differentiate adults suffering from ADHD from adults without ADHD, while also providing good classification accuracy. Finally, the pattern of neurobehavioral impairments exemplified through the Summary Index scores was interpreted as consistent with conceptualizations of ADHD depicting mild neurologic dysfunction in networks associated with the frontal lobes.

THE PREDICTION OF CHANGE: NORMATIVE NEUROPSYCHOLOGICAL TRAJECTORIES

While the application of normative standards is vital to the practice of clinical neuropsychology, data regarding normative change remains scarce despite the frequency of serial assessments. Based on 285 normal individuals, we provide co-normed baseline data with demographic adjustments and test-retest standardized regression based (SRB) models for three time points for several measures. These models delineate normal, expected change across time, and yield standardized z-scores that are comparable across tests. Using a new approach, performance on any previous trial was accounted for in the subsequent models of change, yielding serial normative formulas that model change trajectories rather than simple change from point to point. These equations provide indices of deviation from expected baseline and change for use in clinical or research settings.

Comparative utility of Barona Formulae, Wtar demographic algorithms, and WRAT-3 reading for estimating premorbid ability in a diverse research sample.

Various Barona formulae, a WTAR algorithm based on demographic data, and WRAT-3 oral reading methods of estimating premorbid ability were compared in a diverse research sample of 119 subjects. These methods were correlated with one another and with a modified version of the Raven Standard Progressive Matrices. Descriptive data are provided to illustrate advantages and disadvantages of various methods of estimating premorbid ability when no formal intellectual testing is available. While predicting premorbid ability for individual subjects involves varying degrees of error, we found that the revised Barona formula was superior to the original formula for subjects at the upper end of ability level. When researchers have screened out learning disability and have subject samples with few individuals likely to be of superior premorbid intelligence, oral reading scores are a reasonable measure of premorbid ability. Otherwise, researchers are advised to use both demographic and oral reading methods to estimate premorbid ability.

Wechsler Verbal-Performance IQ discrepancies among psychiatric inpatients: Implications for subtle neuropsychological dysfunctioning

One hundred seventy-nine psychiatric inpatients were administered the WAIS-R and several neuropsychological and academic achievement tests. All subjects were assigned to three groups based on their WAIS-Rs VIQ-PIQ discrepancy scores: (i) Low Verbal (Verbal IQ < Performance IQ. by at least 13 points); (ii) Low Performance (Performance IQ < Verbal IQ by at least 13 points); and (iii) Equal (Verbal IQ-Performance IQ within 13 points). The Low Verbal group made significantly more errors on the Speech Sounds Perception Test, demonstrated lower spelling scores, evinced more aphasic signs, and had had more special education placements than did the Equal or Low Performance groups. The Low Performance subjects demonstrated significantly more signs of constructional dyspraxia and performed more poorly on the Grooved Pegboard test. The neuropsychiatric patients who had Verbal-Performance IQ discrepancies of at least one standard deviation may be at risk for specific, subtle neuropsychological deficits.

Modification and Factor Analysis of the Grief Experience Inventory in Non-Death Loss/Bereavement Situations

The Grief Experience Inventory (GEI), developed by Sanders, Mauger, and Strong in 1985, is a broad multidimensional measure of grief applicable to both death and non-death loss/bereavement situations. Further modification of the non-death GEI form was undertaken and employed in assessing grief reactions of mothers of brain-injured adolescents and young adults across three years, post-injury. Factor analysis of these data was computed and compared to factors derived from the original GEI General Reference Group. There were strikingly similar factor structures between the modified non-death form and the original GEI, affirming the rationale and method of inventory construction, and supporting the validity and strength of the GEI as a measure of grief in varied loss situations. Recommendations for future application are offered.

Correlations for scores on the 180-item version of the MMPI-2 and the Neuroticism scale of the NEO-Personality Inventory.

64 normal adult controls (53 men, 11 women; M age 45.2 yr.) in a study of an estuary-associated syndrome were administered the MMPI–2-180 and the Neuroticism scale from the NEO-Personality Inventory. Pearson product-moment correlations between MMPI–2 scales and the Neuroticism scale were similar to those previously reported using the full-length MMPI. Correlations between MMPI–2 scales, D, Pt, Sc, and Si, and NEO-PI Neuroticism (range .44 to .52) suggest that many psychiatric conditions are associated with psychological distress of the type individuals high in trait neuroticism are prone to experience.