Behavioural Assessment Of The Dysexecutive Syndrome Research Articles

A Review of Rating Scales for Measuring Behavior Change Due to Frontal Systems Damage

To perform a critical review of scales designed to measure frontal behavior change. Changes in cognition due to frontal disease or damage have been well described, but noncognitive changes in behavior are often more deleterious functionally for frontal patients. The review concentrates on five behavior rating scales: the Behavior Rating Inventory of Executive Functions (BRIEF), the Dysexecutive Questionnaire (DEX), the Frontal Behavior Inventory (FBI), the Frontal Systems Behavior Scale (FrSBe), the Iowa Rating Scales of Personality Change (IRSPC), and the Neuropsychiatric Inventory (NPI). Other scales purporting to measure specific aspects of frontal functioning, but having less research support, are described briefly. The BRIEF and FrSBe have good reliability and large-scale norms. No norms are available for the other scales. The FrSBe and IRSPC have been shown to be valid in discriminating frontal from nonfrontal lesioned patients, but this has not been shown in the other scales. The FBI and NPI require trained raters, whereas the FrSBe, IRSPC, and BRIEF are administered to patients and/or family informants directly. The NPI and FBI are sensitive to certain changes in behavior attributed to frontal systems disruption but have been used primarily in dementia.

Executive Dysfunction and Clinical Outcome in Chronic Alcoholics

Background The purpose of this study was to investigate which of 12 neuropsychological tests predict alcoholic patients’ alcohol‐specific and/or alcoholic‐nonspecific outcome. Our hypothesis was that the ecologically valid neuropsychological tests that measure executive function are better predictors of alcoholics’ functional outcome.Methods We administered 12 neuropsychological tests to chronic alcoholics. Included in the tests were tasks of Reaction Time, Symbol Digit Modalities, Figure Position, Digit Span, Block Design, Trail Making, and six subtests of a battery called the Behavioral Assessment of the Dysexecutive Syndrome (BADS). Previous investigators have suggested that the BADS has ecological validity. Twenty‐two male alcoholics were compared with 15 nonalcoholic control subjects on these neuropsychological measures 7 weeks after detoxification. Two functional outcome indices, i.e., resumption of drinking and occupation, were evaluated 18 months after discharge.Results The total profile score and the score on three of the six subtests of the BADS were lower in alcoholics than in nonalcoholic controls. Alcoholics’ performance on the BADS predicted alcohol‐nonspecific outcome (occupation) but not alcohol‐specific (drinking) outcome. In contrast, other neuropsychological tests did not predict either of the two outcome indices.Conclusions The BADS total profile score is related to alcohol‐nonspecific outcome but not to alcohol‐specific outcome.

Test-Retest Stability of the Behavioural Assessment of the Dysexecutive Syndrome in a Sample of Psychiatric Patients

The Behavioural Assessment of the Dysexecutivc Syndrome (BADS) is a relatively new test battery designed lo measure disorders of executive functions. We studied the temporal stability of the BADS in a sample of 22 adult psychiatric patients. All patients were administered the BADS twice with an interval of 3 weeks. Test-retest correlations for the BADS tests ranged from. 22 to. 85. On the repeat administration, patients obtained higher scores on one test as well as on the total BADS. Our results suggest that the BADS should not be administered on two occasions a few weeks apart.

The Behavioural Assessment of the Dysexecutive Syndrome (BADS): Ecological, Concurrent and Construct Validity

Issues of validity, and in particular ecological validity, are a current concern for tests examining disorders of executive abilities related to frontal systems dysfunction. The Behavioural Assessment of the Dysexecutive Syndrome (BADS, Wilson et al., 1996) was developed in response to the need for better neuropsychological tests in this area. The present study examines the validity of the BADS, along with six other commonly used tests of executive ability in two groups of participants with either neurological disorder (n = 36) or without brain damage (n = 37). The BADS and most of its subtests correlate significantly with the standard executive tests indicating that it possesses adequate concurrent validity. In terms of construct validity, it is comparable to standard executive tests in discriminating between neurological and non-brain-damaged participants. The ecological validity of the BADS is superior to standard executive tests in terms of predicting competency in role functioning.

The Behavioural Assessment of the Dysexecutive Syndrome as a Tool to Assess Executive Functions in Schizophrenia

The present investigation examined the validity of the revised Hopkins Verbal Learning Test (HVLT-R). In a principal components analysis with varimax rotation, measures of new learning and delayed recall loaded on a single factor distinguishable from measures related to general cognitive function and visual memory. The HVLT-R also correlated most strongly with other tests of verbal memory and relatively weakly with a test of general intelligence. Group comparisons showed that normal controls performed better than age- and education-matched patients with probable Alzheimer's disease (AD) or vascular dementia (VaD). Discriminant function analyses and Bayesian statistics revealed high classification accuracies for dementia patients versus controls. When scores on the HVLT-R and other neuropsychological tests were subjected to discriminant function analyses, performance on the HVLT-R delayed recognition task was found to be the most useful in discriminating patients with AD from those with VaD. We conclude that the HVLT-R is a valid test of verbal learning and memory that is best suited for use with elderly patients suspected of dementia.

Assessment of the dysexecutive syndrome in schizophrenia

Cognitive neuropsychological theories hypothesize a role for frontal lobe executive deficits in the aetiology of schizophrenic symptoms. The study examined the performance of a schizophrenic group on the Behavioural Assessment of the Dysexecutive Syndrome (BADS; Wilson et al. 1996), a test battery which assesses the 'everyday' difficulties associated with the dysexecutive syndrome. Performance of the schizophrenics was contrasted with that of brain injured and healthy volunteer groups. Matched groups of 31 schizophrenic patients, 35 patients with brain injuries and 26 healthy volunteers were administered the BADS. Patients were also given tests of general intelligence and memory. Patients and their relatives/carers also completed a questionnaire rating day-to-day failures of executive functioning. Schizophrenic and brain-injured patients showed impairment on the BADS, compared to healthy controls. There were no significant differences between the two patient groups. Significant impairment was found in a subgroup of 16 schizophrenics who showed otherwise intact general intellectual functioning, suggesting the existence of a specific executive deficit. Among the schizophrenic patient group there was evidence of a dissociation between executive and memory impairments. A significant correlation existed between performance on the BADS and relatives ratings of executive problems for the brain injured group, but not for the schizophrenic group. The BADS is a useful tool for identifying executive deficits in people with a diagnosis of schizophrenia, especially those who are otherwise generally intellectually intact. This is particularly important in the context of rehabilitation and community transition programmes.