Randall W. Evans

The ruff figural fluency test: A normative study with adults

Tests of verbal production, or fluency, have proved to be reliable and sensitive indices of brain dysfunction in a variety of clinical populations. Also, numerous studies suggest that disturbed verbal fluency can be linked to specific brain lesions. Less is known, however, about figural fluency performance in normal or in clinical groups. Although Jones‐Gotman and Milner (1977) tested an experimental figural, or design, fluency test in a circumscribed group of brain‐impaired patients, their test lacked psychometric sophistication. Presented herein is a new figural fluency test in a sample of 358 normal adults. The test proved to be reliable, and the data support that the performance depended not on sex, but on age and education. Moreover, figural fluency did not correlate with measures of motor speed or verbal fluency; modest correlations, however, were present with Performance IQ. Finally, the potential for neuropsychological applications of this new test are discussed.

Further psychometric evaluation and revision of the Mayo-Portland Adaptability Inventory in a national sample

Objectives:To evaluate the internal consistency of the Mayo-Portland Adaptability Inventory (MPAI), further refine the instrument, and provide reference data based on a large, geographically diverse sample of persons with acquired brain injury (ABI). Subjects:386 persons, most with moderate to severe ABI. Settings:Outpatient, community-based, and residential rehabilitation facilities for persons with ABI located in the United States: West, Midwest, and Southeast. Methods:Rasch, item cluster, principal components, and traditional psychometric analyses for internal consistency of MPAI data and subscales. Results:With rescoring of rating scales for 4 items, a 29-item version of the MPAI showed satisfactory internal consistency by Rasch (Person Reliability = .88; Item Reliability = .99) and traditional psychometric indicators (Cronbachs alpha = .89). Three rationally derived subscales for Ability, Activity, and Participation demonstrated psychometric properties that were equivalent to subscales derived empirically through item cluster and factor analyses. For the 3 subscales, Person Reliability ranged from .78 to .79; Item Reliability, from .98 to .99; and Cronbachs alpha, from .76 to .83. Subscales correlated moderately (Pearson r = .49–.65) with each other and strongly with the overall scale (Pearson r = .82–.86). Conclusions:Outcome after ABI is represented by the unitary dimension described by the MPAI. MPAI subscales further define regions of this dimension that may be useful for evaluation of clinical cases and program evaluation.

AUTOMATIC DETECTION VS CONTROLLED SEARCH: A PAPER-AND-PENCIL APPROACH!

A new measure of selective attention was presented to 259 normal volunteers. The test was derived from earlier work which emphasized the importance of controlling the distracting conditions using a selective-attention paradigm. In the present study a paper-and-pencil, digit-cancellation format was introduced and the data documented a significant dissociation between tasks analogous to controlled search and automatic detection, two theoretically important aspects of selective attention. Presented is a discussion of similarities and differences of the new measure and classical methods of discriminating between controlled search and automatic detection and the potential significance of this discrimination in clinical neuropsychological investigations.

Carbamazepine in Pediatric Psychiatry

Abstract The tricyclic anticonvulsant carbamazepine (CBZ) is used in increasing numbers of pediatric patients to treat a wide variety of neuropsychiatric disorders, including hyperkinesis, aggression, impulsivity, and emotional lability. Although the literature investigating CBZ efficacy in adult patients is well established for certain disorders (complex-partial seizures, lithium nonresponsive bipolar patients), specific indications for CBZ in pediatric populations have not been studied within the parameters of well-controlled clinical trials. In this paper, the psychiatric literature regarding the potential utility of CBZ in pediatric psychiatry is reviewed. Three case studies are presented as examples of therapeutic successes and failures. Ideas are advanced for future research with emphasis on the need for carefully controlled, prospective investigations of carbamazepine in children with traditional neuropsychiatric disorders.

Methylphenidate and memory: Dissociated effects in hyperactive children

Fourteen children with Attention Deficit Disorder with Hyperactivity (ADD + H) were administered the psychostimulant methylphenidate in a double-blind, placebo-controlled, crossover study. Subjects were evaluated on a well-validated measure of verbal memory and learning with an experimental design comprised of four conditions: placebo and active drug at three doses. Positive memory effects were found in the drug conditions. Significant dose-response relationships were found, indicating enhanced learning from placebo to low to medium to high dose. However, there was a differential drug effect on the memory task; methylphenidate selectively enhanced storage and retrieval mechanisms without affecting immediate acquisition.

Motor Performance in Hyperactive Children Treated with Imipramine

The effects of the tricyclic antidepressant imipramine were evaluated in a study of 9 children with Attention Deficit-Hyperactivity Disorder. The study was double-blind, placebo-controlled, with three drug conditions, low, medium, and high doses. The focus was on neuropsychological drug effects. Imipramine exerted negative dose-response effects on motor performance (motor speed, motor pursuit), while it improved hyperactive behavior and attention and raised the heart rate slightly.

Verbal fluency and figural fluency in bright children.

Intellectually bright children in Grades 2, 4, and 6 from one school and adults were assessed on measures of verbal and on a new measure of figural fluency. Consistent with previous research, age-dependent performance was observed on both fluency tasks. Analysis of covariance with motor speed as the covariate reduced the F ratio for the figural task, although age-related significant differences persisted. Results suggest that age-related improvement of performance on fluency measures with intellectually bright subjects differs from that for intellectually average subjects. Hypotheses are also advanced regarding the proposed reliable figural-fluency task as preferable to previously employed nonverbal measures, suggesting a more valid dissociation of function. These preliminary findings encourage further research on the age- and IQ-related aspects of verbal and figural fluency.

Alternate selective reminding forms for children

Presented herein are nine selective reminding forms suggested for use in pediatric populations. These test forms were assembled according to criteria recommended by researchers in verbal memory research, and preliminary findings indicate that the proposed tests are equivalent in studies of serial administration. Additional word lists are also provided for clinicians and researchers requiring supplementary forms.

The Medical Treatment of Autistic People

The proper study of risks attendant on a particular medical treatment, or on a class of treatments, can only be made if proper deference is paid to the potential benefits that may reasonably be expected to accrue. In considering the risks and side effects of medical treatments that are brought to bear in the management of autistic persons, therefore, there is a fatal irony since little direct benefit is known to derive from any somatic treatment. There is no rational chemotherapy for autism. There is no medical intervention that can reverse or undo the physiological basis of the disorder. Indeed, the disorder is not known to be characterized by any specific pathophysiologic defect. From the biologist’s perspective, autism is an impossible concept, one that embraces a wide range of individual deficits and individual patients who differ widely in clinical presentation (Wing, 1969), developmental level, etiology, associated disorders, and prognosis. A generation of research has failed to uncover any single biological mechanism by dint of which such diversity might be reconciled. In the face of such ambiguity, the hope for a specific biological “treatment” is vain.

Hemispheric asymmetry and recategorized WIsc-R patterns in learning-disabled and nondisabled children

The relationship between hemispheric processing and recategorized WISC—R patterns (spatial strengths and depressed Acquired Knowledge scores) in 14 learning-disabled and 14 nondisabled boys was examined. A genetic-prenatal hormonal basis appears most plausible.