Does neuropsychological intraindividual variability index cognitive dysfunction, an invalid presentation, or both? Preliminary findings from a mixed clinical older adult veteran sample.
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| Title: | Does neuropsychological intraindividual variability index cognitive dysfunction, an invalid presentation, or both? Preliminary findings from a mixed clinical older adult veteran sample. |
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| Authors: | Webber, Troy A. (AUTHOR), Lorkiewicz, Sara (AUTHOR), Woods, Steven Paul (AUTHOR), Miller, Brian (AUTHOR), Soble, Jason R. (AUTHOR) |
| Source: | Journal of Clinical & Experimental Neuropsychology. Aug2024, Vol. 46 Issue 6, p535-556. 22p. |
| Subjects: | Neurobehavioral disorders, Receiver operating characteristic curves, Neuropsychological tests, Test validity, Due diligence |
| Abstract: | Introduction: Intraindividual variability across a battery of neuropsychological tests (IIV-dispersion) can reflect normal variation in scores or arise from cognitive impairment. An alternate interpretation is IIV-dispersion reflects reduced engagement/invalid test data, although extant research addressing this interpretation is significantly limited. Method: We used a sample of 97 older adult (mean age: 69.92), predominantly White (57%) or Black/African American (34%), and predominantly cis-gender male (87%) veterans. Examinees completed a comprehensive neuropsychological battery, including measures of reduced engagement/invalid test data (a symptom validity test [SVT], multiple performance validity tests [PVTs]), as part of a clinical evaluation. IIV-dispersion was indexed using the coefficient of variance (CoV). We tested 1) the relationships of raw scores and "failures" on SVT/PVTs with IIV-dispersion, 2) the relationship between IIV-dispersion and validity/neurocognitive disorder status, and 3) whether IIV-dispersion discriminated the validity/neurocognitive disorder groups using receiver operating characteristic (ROC) curves. Results: IIV-dispersion was significantly and independently associated with a selection of PVTs, with small to very large effect sizes. Participants with invalid profiles and cognitively impaired participants with valid profiles exhibited medium to large (d =.55–1.09) elevations in IIV-dispersion compared to cognitively unimpaired participants with valid profiles. A non-significant but small to medium (d =.35–.60) elevation in IIV-dispersion was observed for participants with invalid profiles compared to those with a neurocognitive disorder. IIV-dispersion was largely accurate at differentiating participants without a neurocognitive disorder from invalid participants and those with a neurocognitive disorder (areas under the Curve [AUCs]=.69–.83), while accuracy was low for differentiating invalid participants from those with a neurocognitive disorder (AUCs=.58–.65). Conclusions: These preliminary data suggest IIV-dispersion may be sensitive to both neurocognitive disorders and compromised engagement. Clinicians and researchers should exercise due diligence and consider test validity (e.g. PVTs, behavioral signs of engagement) as an alternate explanation prior to interpretation of intraindividual variability as an indicator of cognitive impairment. [ABSTRACT FROM AUTHOR] |
| Copyright of Journal of Clinical & Experimental Neuropsychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 179554783 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Does neuropsychological intraindividual variability index cognitive dysfunction, an invalid presentation, or both? Preliminary findings from a mixed clinical older adult veteran sample. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Webber%2C+Troy+A%2E%22">Webber, Troy A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lorkiewicz%2C+Sara%22">Lorkiewicz, Sara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Woods%2C+Steven+Paul%22">Woods, Steven Paul</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Miller%2C+Brian%22">Miller, Brian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Soble%2C+Jason+R%2E%22">Soble, Jason R.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Journal+of+Clinical+%26+Experimental+Neuropsychology%22">Journal of Clinical & Experimental Neuropsychology</searchLink>. Aug2024, Vol. 46 Issue 6, p535-556. 22p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Neurobehavioral+disorders%22">Neurobehavioral disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Receiver+operating+characteristic+curves%22">Receiver operating characteristic curves</searchLink><br /><searchLink fieldCode="DE" term="%22Neuropsychological+tests%22">Neuropsychological tests</searchLink><br /><searchLink fieldCode="DE" term="%22Test+validity%22">Test validity</searchLink><br /><searchLink fieldCode="DE" term="%22Due+diligence%22">Due diligence</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Introduction: Intraindividual variability across a battery of neuropsychological tests (IIV-dispersion) can reflect normal variation in scores or arise from cognitive impairment. An alternate interpretation is IIV-dispersion reflects reduced engagement/invalid test data, although extant research addressing this interpretation is significantly limited. Method: We used a sample of 97 older adult (mean age: 69.92), predominantly White (57%) or Black/African American (34%), and predominantly cis-gender male (87%) veterans. Examinees completed a comprehensive neuropsychological battery, including measures of reduced engagement/invalid test data (a symptom validity test [SVT], multiple performance validity tests [PVTs]), as part of a clinical evaluation. IIV-dispersion was indexed using the coefficient of variance (CoV). We tested 1) the relationships of raw scores and "failures" on SVT/PVTs with IIV-dispersion, 2) the relationship between IIV-dispersion and validity/neurocognitive disorder status, and 3) whether IIV-dispersion discriminated the validity/neurocognitive disorder groups using receiver operating characteristic (ROC) curves. Results: IIV-dispersion was significantly and independently associated with a selection of PVTs, with small to very large effect sizes. Participants with invalid profiles and cognitively impaired participants with valid profiles exhibited medium to large (d =.55–1.09) elevations in IIV-dispersion compared to cognitively unimpaired participants with valid profiles. A non-significant but small to medium (d =.35–.60) elevation in IIV-dispersion was observed for participants with invalid profiles compared to those with a neurocognitive disorder. IIV-dispersion was largely accurate at differentiating participants without a neurocognitive disorder from invalid participants and those with a neurocognitive disorder (areas under the Curve [AUCs]=.69–.83), while accuracy was low for differentiating invalid participants from those with a neurocognitive disorder (AUCs=.58–.65). Conclusions: These preliminary data suggest IIV-dispersion may be sensitive to both neurocognitive disorders and compromised engagement. Clinicians and researchers should exercise due diligence and consider test validity (e.g. PVTs, behavioral signs of engagement) as an alternate explanation prior to interpretation of intraindividual variability as an indicator of cognitive impairment. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Journal of Clinical & Experimental Neuropsychology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1080/13803395.2024.2388096 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 22 StartPage: 535 Subjects: – SubjectFull: Neurobehavioral disorders Type: general – SubjectFull: Receiver operating characteristic curves Type: general – SubjectFull: Neuropsychological tests Type: general – SubjectFull: Test validity Type: general – SubjectFull: Due diligence Type: general Titles: – TitleFull: Does neuropsychological intraindividual variability index cognitive dysfunction, an invalid presentation, or both? Preliminary findings from a mixed clinical older adult veteran sample. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Webber, Troy A. – PersonEntity: Name: NameFull: Lorkiewicz, Sara – PersonEntity: Name: NameFull: Woods, Steven Paul – PersonEntity: Name: NameFull: Miller, Brian – PersonEntity: Name: NameFull: Soble, Jason R. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Text: Aug2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 13803395 Numbering: – Type: volume Value: 46 – Type: issue Value: 6 Titles: – TitleFull: Journal of Clinical & Experimental Neuropsychology Type: main |
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