Paul T. van der Heijden

WAIS-III factor index score patterns after traumatic brain injury.

Profile subtypes, based on the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) factor index scores, were examined in a sample of 166 patients with traumatic brain injury (TBI) by means of a two-stage clustering procedure. Three reliable subtypes were found that were differentiated primarily by level of performance across all factor index scores, although each of them demonstrated a relative weakness on the Processing Speed index. These subtypes were then validated on the basis of demographic variables, injury parameters, and additional psychometric measures that had not been included in the clustering procedures. The results indicated that performance on the WAIS-III after TBI was affected by both injury severity and level of education. It is concluded that there is no unique “signature” profile on the WAIS-III after TBI, except that a relative strength on the Processing Speed index is uncommon with this condition.

Representation of the Cattell–Horn–Carroll Theory of Cognitive Abilities in the Factor Structure of the Dutch-Language Version of the WAIS-IV

The Cattell–Horn–Carroll (CHC) theory of cognitive abilities has been guiding in the revision of the Wechsler Adult Intelligence Scale–Fourth edition (WAIS-IV). Especially the measurement of fluid reasoning (Gf) is improved. A total of five CHC abilities are included in the WAIS-IV subtests. Using confirmatory factor analysis, a five-factor model based on these CHC abilities is evaluated and compared with the four index scores in the Dutch-language version of the WAIS-IV. Both models demonstrate moderate fit, preference is given to the five-factor CHC model both on statistical and theoretical grounds. Evaluation of the WAIS-IV according to CHC terminology enhances uniformity, and can be important when interpreting possible sources of index discrepancies. To optimally assemblage CHC and WAIS-IV, more knowledge of the interaction of abilities is needed. This can be done by incorporating intelligence testing in neuropsychological assessment. Using this functional approach contributes to a better understanding of an individual’s cognitive profile.

Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

Aim Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8) was investigated in patients with Korsakoff’s syndrome (KS) and in alcohol use disorder (AUD) patients with mild neurocognitive deficits. Methods First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX) were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73). The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction.

Personality and Psychopathology Mapping the MMPI-2-RF on Cloninger’s Psychobiological Model of Personality

This study investigates the relationship between the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Temperament and Character Inventory (TCI) in a combined data set (N = 491) of patients with a broad range of psychiatric disorders (n = 286) as well as alcohol use disorder (n = 205). We examined bivariate correlations between both measures. The MMPI-2-RF scales relate to the TCI dimensions as was hypothesized, and relationships between both measurements were largely similar for psychiatric patients and alcohol-dependent patients. Theoretical and clinical implications are considered.

Psychotherapeutische diagnostiek : Naar een constructieve alliantie (Forum)

Samenvatting‘Echte’ psychotherapeuten testen niet. Zo is het al heel lang. Toch worden ze wel geacht psychodiagnostiek te bedrijven. Zij doen dat hoofdzakelijk met twee databronnen in plaats van met drie: kijken en praten. Hun testvaardigheden zijn verouderd, versleten of anderszins achteruitgegaan. Zij lopen, zeker bij complexe stoornissen, uit de pas met de tegenwoordige richtlijnen (Derksen, 2004). Maar de psychologie bevindt zich in een positieve fase: zelfs voor de psychologen / psychotherapeuten is er hoop. Psychologische tests worden namelijk niet meer uitsluitend afgenomen volgens het aloude ‘diagnose-recept’ model. Ze worden steeds vaker direct met de psychologische behandeling en psychotherapie verbonden door middel van een dialoog over de bevindingen en eventuele tegenstellingen daarin (Finn, 1996; 2007).

Evaluating WAIS-IV structure through a different psychometric lens: Structural causal model discovery as an alternative to confirmatory factor analysis

Abstract Objective: Since the publication of the WAIS–IV in the U.S. in 2008, efforts have been made to explore the structural validity by applying factor analysis to various samples. This study aims to achieve a more fine-grained understanding of the structure of the Dutch language version of the WAIS–IV (WAIS–IV–NL) by applying an alternative analysis based on causal modeling in addition to confirmatory factor analysis (CFA). The Bayesian Constraint-based Causal Discovery (BCCD) algorithm learns underlying network structures directly from data and assesses more complex structures than is possible with factor analysis. Method: WAIS–IV–NL profiles of two clinical samples of 202 patients (i.e. patients with temporal lobe epilepsy and a mixed psychiatric outpatient group) were analyzed and contrasted with a matched control group (N = 202) selected from the Dutch standardization sample of the WAIS–IV–NL to investigate internal structure by means of CFA and BCCD. Results: With CFA, the four-factor structure as proposed by Wechsler demonstrates acceptable fit in all three subsamples. However, BCCD revealed three consistent clusters (verbal comprehension, visual processing, and processing speed) in all three subsamples. The combination of Arithmetic and Digit Span as a coherent working memory factor could not be verified, and Matrix Reasoning appeared to be isolated. Conclusions: With BCCD, some discrepancies from the proposed four-factor structure are exemplified. Furthermore, these results fit CHC theory of intelligence more clearly. Consistent clustering patterns indicate these results are robust. The structural causal discovery approach may be helpful in better interpreting existing tests, the development of new tests, and aid in diagnostic instruments.

Psychotherapeutische diagnostiek revisited: Dupliek op de repliek van Jan Jaspers

SamenvattingOver de waarde van de psychodiagnostiek in psychotherapeutische context is de laatste tijd veel discussie (zie onder meer Derksen, Egger & Van der Heijden, 2008; Verbraak, 2007).

Predictive Value of Traditional Measures of Executive Function on Broad Abilities of the Cattell–Horn–Carroll Theory of Cognitive Abilities:

The neuropsychological construct of executive functions (EFs), and the psychometric Cattell–Horn–Carroll (CHC) theory of cognitive abilities are both approaches that attempt to describe cognitive functioning. The coherence between EF and CHC abilities has been mainly studied using factor-analytical techniques. Through multivariate regression analysis, the current study now assesses the integration of these latent constructs in clinical assessment. The predictive power of six widely used executive tasks on five CHC measures (crystallized and fluid intelligence, visual processing, short-term memory, and processing speed) is examined. Results indicate that executive tasks—except for the Stroop and the Tower of London—predict overall performance on the intelligence tests. Differentiation in predicting performance between the CHC abilities is limited, due to a high shared variance between these abilities. It is concluded that executive processes such as planning and inhibition have a unique variance that is not well-represented in intelligence tests. Implications for the use of EF tests and operationalization of CHC measures in clinical practice are discussed.

De ballade van de psychotherapeutische diagnostiek

SamenvattingOnze bijdrage in het Tijdschrift voor Psychotherapie (Van der Heijden, Derksen & Egger, 2008a) blijkt te inspireren tot reacties. De laatste (Hafkenscheid, 2009) heeft het karakter van een refreindicht, een ballade, door de niet onaanzienlijke overlap met de reactie van Jaspers (2008). Niettemin maken we graag gebruik van de mogelijkheid om enkele aperte onjuistheden in Hafkenscheids reactie aan te wijzen en tevens hier en daar wat nuanceringen aan te brengen. Wij zullen ons beperken tot de belangrijkste kritiekpunten van Hafkenscheid op de hoofdtekst.

Van oude misverstanden en stormen die voorbijgaan

SamenvattingHet is verheugend dat er voor het eerst in de 27 jaargangen van het tijdschrift Directieve Therapie aandacht is besteed aan de Minnesota Multiphasic Personality Inventory (MMPI-2; Verbraak, 2007). In de klinische psychologie is dit wereldwijd de meest gebruikte en onderzochte psychologische test. Jammer genoeg gaat het niet om een origineel artikel, maar slechts om het vestigen van de aandacht op een artikel uit Psychological Assessment van 2005 (Lima et al., 2005), waaruit zou blijken dat de informatie die de MMPI-2 aan het diagnostisch proces toevoegt, niet bijdraagt aan een beter behandelresultaat. Zonder de brenger van het slechte nieuws te willen onthoofden, mogen we wel stellen dat Verbraaks selectie, en die van de redactie, interessant zijn. Marc Verbraak wijst terecht op het ontbreken van empirische ondersteuning voor het gebruik van een uitgebreid testpsychologisch onderzoek. Dit behoeft echter wel enige toelichting en nuancering. Daarom allereerst een illustrerende casus.