Talin Babikian

Sensitivity and Specificity of Various Digit Span Scores in the Detection of Suspect Effort

ABSTRACT Digit Span Age-Corrected Scaled Score (ACSS) and Reliable Digit Span (RDS) have been suggested as effective in assessing credibility. The purpose of this study was to confirm the efficacy of suggested cutoffs for ACSS and RDS and to explore the utility of other Digit Span variables in a large sample (N = 66) of “real-world” ≥ suspect effort patients versus clinic patients with no motive to feign (N = 56) and controls (N = 32). With specificity at ≥ 90%, sensitivity of ACSS increased from 32% to 42% when a ≤ 5 cutoff was used instead of the recommended ≤ 4. The RDS recommended cutoff of ≤ 7 resulted in a sensitivity of 62% but with an unacceptably high false positive rate (23%); dropping the cutoff to ≤ 6 raised the specificity to 93% but sensitivity fell to 45%. Cutoffs for other Digit Span scores did not exceed 45% sensitivity with the exception of 50% sensitivity (11% false positive rate) for average time per digit for all attempted items > 1.0 second. A criterion of ACSS ≤ 5 or RDS ≤ 6 was associated with 51% sensitivity (91% specificity) while RDS ≤ 6 or longest string with at least one item correct ≤ 4 was associated with 54% sensitivity (88% specificity). While only moderately sensitive, Digit Span scores, including new time variables, may have a unique and effective role in the detection of suspect effort.

An Assessment of HIV/AIDS Risk in Higher Education Students in Yerevan, Armenia

Armenias current sociopolitical and economic instability and the alarming HIV incidence rates in neighboring countries amplify its risk for a national epidemic. The goals of this study were to assess HIV/AIDS knowledge and risk behaviors among higher education students in Yerevan. Knowledge of HIV transmission through sexual intercourse was markedly higher than that on intravenous transmission and prevailing myths; however, HIV/AIDS knowledge was not related to risk behaviors. Tobacco and alcohol prevalence was relatively high. Students reported risky sexual behaviors, including inconsistent condom use, casual sex, and multiple partners. In addition to descriptive statistics delineating gender differences across the target behavioral domains, bivariate and multivariate statistical analyses were used to understand factors that contributed to increased risk, including early age of initiation and the relationship between substance use and risky sexual activity. The study results provide much-needed information for the development of school- and community-based AIDS prevention programs in Armenia.

Substance Use Among Students Attending a Christian University that Strictly Prohibits the Use of Substances

This study examines substance use at a church-affiliated university which prohibits the use of alcohol, tobacco, and drug substances. The purpose was to investigate the prevalence of substance use, the prevention efforts put forth by the university, and whether religious beliefs, which prohibit substance use, are protective. While the findings indicate that alcohol, tobacco and other drugs were used in varying degrees by this student sample, the overall use was significantly lower relative to a national comparison group. The data suggests that religion is a protective factor concerning substance use. However, since students use substances even at church-affiliated campuses with prohibitive substance use beliefs, the problem of how to deal with substance use remains.

The process of research in international settings: From risk assessment to program development and intervention

Although there are many challenges, international HIV prevention research and program evaluation are critical to advances in the health and welfare of people around the globe. While there is an increasing amount of literature describing outcomes of international prevention programs, there is sparse information regarding the process of developing and implementing international research. This brief report describes key elements in the development of collaborative international prevention research and programmatic implementation.

Long-term neuropsychological sequelae of infant cardiac transplant recipients: trends and predictors of outcome

Abstract Studies on long-term neuropsychological sequelae of infant cardiac transplantation are limited as few sites have populations old enough for assessment beyond the infant/toddler years. The intellectual functioning of 63 infant cardiac transplant recipients at Loma Linda University Childrens Hospital (mean age 6.2 years, s.d. 1.3) was assessed using the age appropriate Wechsler Scale of Intelligence - WPPSI-R (N=38) or WISC-III (N=25). Full Scale IQ (FSIQ) scores fell in the below average range (79.2, s.d.18.6). A one-way ANOVA indicated a statistical difference in FSIQ by age (F=3.37, df=6, p=.01); verbal and nonverbal scores markedly improved with increasing age, falling in the average range by ages 7 (86) and 8 (105). Contrary to studies that have examined intellectual abilities as the sole measure of neuropsychological outcome, a stepwise regression was used to predict learning difficulties (≥15 point split between verbal (VIQ) and performance (PIQ) scores). The subset of perinatal and/or perisurgical variables used as predictors of VIQ/PIQ split included: birth and transplant weight, height and head circumference; intubation, PHCA, CPB, & ischemic period; Apgar scores at 1 & 5 minutes; transplant & current age; and number of rejections. Birth head circumference (BHC) explained a significant proportion (51%) of the variance in the VIQ/PIQ split (F=22.6, df=1, p

A longitudinal perspective on neurodevelomental outcome following infant cardiac transplantation

Abstract Few studies have examined the neurodevelopmental sequelae associated with infant heart transplantation. Existing publications have generally reported one-time assessments of developmental status using varying outcome measures. The present study investigated longitudinal patterns of neurodevelopmental outcome in 41 children who were cardiac transplant recipients at Loma Linda University Childrens Hospital. The Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development were used to monitor the performance of each child across four testing sessions (T). A Repeated Measures ANOVA (N=10) was conducted to test overall differences in MDI and PDI scores across the testing sessions. Although no statistically significant changes in PDI scores were apparent (F=2.685, p=.07, df=3), a trend of increased scores with repeated measurements was observed; however, a statistically significant change in MDI scores was noted (F =3.961, p=.020, df=3). Paired samples t-tests on the larger sample (N=41) showed a significant decline in average MDI scores between the first and each subsequent assessment (T1:T2, t=2.6, p=.02, df=21; T1:T3, t=2.3, p=.04, df=12; T1:T4, t=4.0, p=.04, df=9). A significant dip in MDI scores occurred at approximately 18 and 28 months of age, suggesting a notable decrease in performance specifically during these two periods, after which they appeared to increase. Developmental delays such as language difficulties, characteristic of infant heart transplant recipients, were notable factors responsible for the observed change in MDI scores. These findings iterate the importance of longitudinally assessing changes in neurodevelopmental status instead of presenting collective averages across a wide range of age groups. To better identify and potentially remediate such trends in neurodevelopment, future studies should use longitudinal assessments extending beyond the period examined in this study to replicate and confirm these tentative findings.