Continuous Visual Memory Test Research Articles

Well-designed manufacturing work improves some cognitive abilities in individuals with cognitive impairments.

Employment is recognized as a fundamental human right, which correlates with better physical and mental health. Importantly, well-designed work, which considers the physical, social, and psychological impacts of work, can serve to enhance the cognitive abilities of workers. Although often overlooked, work for individuals with disabilities, including cognitive impairments, is equally important for their physical and mental well-being. What has not been established, however, is whether well-designed work can also enhance the cognitive abilities of individuals with cognitive impairments. Using a longitudinal study design, we investigated the impact of well-designed work on the cognitive abilities of 60 participants (operators) at the AMIPI Foundation factories, which employ individuals with cognitive impairments to produce electrical cables and harnesses for the automobile industry. The same operators were assessed at three different time points: upon hiring (n = 60), and after working in the factory for 1 year (n = 41, since 19 left the factory) and 2 years (n = 28, since 13 more left the factory). We used five cognitive tests evaluating: (1) finger and manual dexterity, bimanual dexterity, and procedural memory using the Purdue Pegboard; (2) sustained and selective attention using the Symbol Cancellation Task; (3) short- and long-term declarative verbal memory and long-term verbal recognition memory using Rey's Audio-Verbal Learning Test; (4) short- and long-term visual recognition memory using the Continuous Visual Memory Test; and (5) abstract reasoning using Raven's Standard Progressive Matrices. We observed improvements in procedural memory, sustained and selective attention, and short- and long-term visual recognition memory after working in the factory for 1 or 2 years. We did not observe improvements in finger or manual dexterity or bimanual dexterity, nor short- or long-term declarative verbal memory or verbal recognition memory, nor abstract reasoning. We conclude that, in addition to improving physical and mental well-being, well-designed manufacturing work can serve as a training intervention improving some types of cognitive functioning in individuals with cognitive impairments.

The Continuous Visual Memory Test: Update and extension on the operating characteristics as an embedded measure of cognitive performance validity

Objective: To compare and update predictive models comprised of embedded measures from the Continuous Visual Memory Test (CVMT) in their ability to predict performance validity in personal injury litigants. Methods: Ninety-two personal injury litigants underwent a comprehensive neuropsychological examination. Criterion groups were formed, i.e. PVT-Pass and PVT-Fail, based upon their performance on stand-alone measures of performance validity (PVT). Independent-samples t-tests investigated group differences on dependent variables of interest while logistic regression analyses, as well as a decision tree classification procedure, were employed to identify the best predictive model. Results: The PVT-Fail group scored significantly lower on the 20-item Larrabee Index (LI), and three CVMT variables comprising the Henry-Enders Index (HEI) including Hits, Total Score, and Delayed Recall, but significantly higher on False Alarm Errors. Although the Total score was the best single predictor of PVT status, the addition of LI improved sensitivity. The best predictive model was derived via a classification and regression tree analysis which selected LI and CVMT-FA resulting in .91 specificity, .60 sensitivity, and ROC = 0.832. Conclusion: In the current study total CVMT scores < 70, and LI scores < 18 were rare for PI litigants with MTBI and not seen in litigants with moderate and severe brain injury who passed PVTs. Three predictive CVMT models were derived. When failure on one of the models is observed then concerns about the credibility of visual memory performance should be considered with particular attention to other stand-alone and embedded measures of performance validity.

Is overestimation of body size associated with neuropsychological weaknesses in anorexia nervosa?

Recent research indicates some evidence of neuropsychological weaknesses in visuospatial memory, central coherence and set-shifting in adults with anorexia nervosa (AN). The growing interest in neuropsychological functioning of patients with AN is based upon the assumption that neuropsychological weaknesses contribute to the clinical features of the illness. However, due to a paucity of research on the connection between neuropsychological difficulties and the clinical features of AN, this link remains hypothetical. The main objective of this study was to explore the association between specific areas of neuropsychological functioning and body size estimation in patients with AN and healthy controls. The sample consisted of 36 women diagnosed with AN and 34 healthy female controls. Participants were administered the continuous visual memory test and the recall trials of Rey Complex Figure Test to assess visual memory. Central coherence was assessed using the copy trial of Rey Complex Figure Test, and the Wisconsin Card Sorting Test was used to assess set-shifting. Body size estimation was assessed with a computerized morphing programme. The analyses showed no significant correlations between any of the neuropsychological measures and body size estimation. The results suggest that there is no association between these areas of neuropsychological difficulties and body size estimation among patients with AN. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

False-positive rates associated with the use of multiple performance and symptom validity tests.

Performance validity test (PVT) error rates using Monte Carlo simulation reported by Berthelson and colleagues (in False positive diagnosis of malingering due to the use of multiple effort tests. Brain Injury, 27, 909-916, 2013) were compared with PVT and symptom validity test (SVT) failure rates in two nonmalingering clinical samples. At a per-test false-positive rate of 10%, Monte Carlo simulation overestimated error rates for: (i) failure of ≥2 out of 5 PVTs/SVT for Larrabee (inDetection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410-425, 2003) and ACS (Pearson, Advanced clinical solutions for use with WAIS-IV and WMS-IV. San Antonio: Pearson Education, 2009) and (ii) failure of ≥2 out of 7 PVTs/SVT for Larrabee (Detection of malingering using atypical performance patterns on standard neuropsychological tests. The Clinical Neuropsychologist, 17, 410-425, 2003; Malingering scales for the Continuous Recognition Memory Test and Continuous Visual Memory Test. The Clinical Neuropsychologist, 23, 167-180, 2009 combined). Monte Carlo overestimation is likely because PVT performances are atypical in pattern or degree for what occurs in actual neurologic, psychiatric, or developmental disorders. Consequently, PVT scores form skewed distributions with performance at ceiling and restricted range, rather than forming a standard normal distribution with mean of 0 and standard deviation of 1.0. These results support the practice of using ≥2 PVT/SVT failures as representing probable invalid clinical presentation.

Effects of chronic ketamine use on frontal and medial temporal cognition

BackgroundRecreational ketamine use has been on the rise worldwide. Previous studies have demonstrated that it disrupts various memory systems, but few studies have examined how it affects learning and frontal functioning. The present study investigates the effects of repeated ketamine self-administration on frontal fluency, attention, learning, and memory along the verbal/nonverbal axis. MethodsTwenty-five ketamine users and 30 healthy controls took a battery of neuropsychological tests. Frontal fluency was measured by the Verbal Fluency Test for semantic organization ability and the Figural Fluency Test for nonverbal executive functioning. Learning and memory were measured with the Chinese Auditory-Verbal Learning Test for acquisition and retention abilities of verbal information, as well as with the Continuous Visual Memory Test for nonverbal information. Participants also took several tests tapping subdomains of attention. To test for the potential effects of other drug use, 10 polydrug controls were included for comparison with the ketamine users and healthy controls. ResultsKetamine users had impaired verbal fluency, cognitive processing speed, and verbal learning. Verbal learning impairment was strongly correlated with estimated lifetime ketamine use. Ketamine users showed no impairments in figural fluency, sustained attention, selective attention, visual learning, or verbal/nonverbal memory. However, heavier lifetime ketamine use was significantly correlated with deficits in verbal memory (both immediate recall and delayed recall) and visual recognition memory. Deficits in cognitive processing speed and verbal learning persisted even after polydrug controls were included in the control group, but their inclusion did make the impairment in verbal fluency barely reach statistical significance. ConclusionsThis study suggests that repeated ketamine use causes differential impairment to multiple domains of frontal and medial temporal functioning, possibly specific to verbal information processing.

Embedded Assessment of Validity Using the Continuous Visual Memory Test in Patients with Traumatic Brain Injury

Retrospective review of a consecutive patient series (n = 115) referred for neuropsychological examinations for traumatic brain injury was undertaken to evaluate an embedded measure of symptom validity for the Continuous Visual Memory Test (CVMT). Performance on the Test of Memory Malingering (TOMM) and Word Memory Test (WMT) was used for classification. Individuals who failed the TOMM or WMT were almost six times more likely to fail the CVMT validity criteria than those who passed the TOMM or WMT. The addition of compensation seeking increased this odds ratio to 9.80. The area under the curve for the latter classification was 0.74. Maximum likelihood ratio optimization of the CVMT validity test cutoff score indicated sensitivity of 0.25 and specificity of 0.99 at a revised cutoff of <12 items. Classification accuracy was 91%. The original cutoff score of <14 items also performed acceptably, with a classification accuracy of 88%. While low sensitivity argues against use in isolation, the proposed measure has utility in conjunction with other established effort measures.

Validity of the Continuous Visual Memory Test (CVMT) after traumatic brain injury

The criterion validity of the Continuous Visual Memory Test (CVMT) was investigated using a sample of 53 patients with moderate–severe traumatic brain injury (TBI) and a demographically matched control group from the standardization sample. There was a statistically significant main effect of groups for both CVMT Total and Delayed Recognition scores ( p < .0001). Hierarchical linear regression analyses suggested that, in the clinical group, the effect of injury severity on the CVMT Total score was mediated by visuospatial ability. Logistic regression analyses revealed that the CVMT Total score correctly classified about three quarters of the combined participants, with slightly better specificity than sensitivity. It is concluded that the CVMT is a clinically useful instrument with satisfactory criterion validity but that it should not be used in isolation to determine the presence or absence of memory impairment.

Malingering Scales for the Continuous Recognition Memory Test and the Continuous Visual Memory Test

Continuous Visual Memory Test (CVMT) and Continuous Recognition Memory Test (CRM) scores of 24 litigants with definite malingered neurocognitive dysfunction (definite MND) were contrasted with those of 27 patients with moderate (n = 12) and severe (n = 15) traumatic brain injury (TBI). Analysis with chi-square identified 20 CVMT and 33 CRM items that discriminated the definite MND from TBI cases. Receiver operating characteristic (ROC) area under curve (AUC) was 0.918 for the CVMT scale, and 0.962 for the CRM scale, p = 0.184. Cutting scores were derived yielding sensitivity and specificity of 0.83 and 0.889 for the 20-item CVMT scale, and 0.875 and 0.93 for the 33-item CRM scale. On cross-validation contrasting performance of 17 litigants with evidence of probable MND and non-litigating psychiatric (n = 14) and neurologic (n = 13) patients, ROC AUC was 0.779 for the CVMT scale, and 0.847 for the CRM scale, p = 0.447. Sensitivity and specificity were 0.35 and 0.93 for the CVMT, and 0.529 and 0.96 for the CRM, using the cutting scores from the derivation sample. ROC AUC differences contrasting values for the definite MND/TBI comparison to the probable MND/neurologic and psychiatric comparison approached significance for the CRM SVT scale (p = 0.059), and for the CVMT SVT scale (p = 0.082). These data suggest that the malingering scales for the CVMT and CRM are more sensitive to definite rather than probable MND, and these scales are better at ruling in than ruling out malingered visual memory deficits.

Probable Malingering and Performance on the Continuous Visual Memory Test

A known groups design involving 54 personal injury litigants, and disability claimants was employed to investigate group differences on the Continuous Visual Memory Test (CVMT). Group status was determined by performance on symptom validity testing and application of the Slick et al., 1999 diagnostic criteria for probable Malingered Neurocognitive Dysfunction (MND). Twenty-seven subjects who met the Slick et al., 1999 criteria formed the Probable Malingering (PM) group, while 27 subjects who did not comprised the Not Malingering (NM) group. Subjects in the PM group performed significantly worse on all CVMT variables (Hits, False Alarm Errors, Total Score, and Delayed Recall) relative to subjects in the NM group. Cutscores for the CVMT variables were empirically derived via logistic regression analyses. False Alarm Errors ≥ 21 Total Score ≤ 72 and Delayed Recall ≤ 3 were associated with good classification accuracy (70–74%), and specificity (85–93%). A CVMT Total Score ≤ 69, False Alarm Errors ≥ 22, and Delayed Recall ≤ 2 were all associated with 100% positive predictive power. The CVMT may be a valuable adjunct to the neuropsychological test battery for evaluating effort of personal injury litigants and disability claimants undergoing forensic neuropsychological evaluations.

Assessment of visual working memory using event-related potentials

Objective This study sought to determine if recognition/familiarity memory can be measured using event-related potentials (ERP) in response to a computer-adapted version of a commonly used non-verbal memory assessment instrument. If successful, resulting ERP would further our knowledge of the neurophysiology of recognition memory and could be used in a cognitive assessment battery for individuals whose capacity for verbal and/or non-verbal communication is impaired. Methods Behavioral and ERP responses were recorded during performance on a computer-adapted version of the Continuous Visual Memory Test (CVMT) [Trahan DE, Larrabee GJ. Continuous Visual Memory Test. Lutz, FL: Psychological Assessment Resources; 1988] and examined offline for recognition memory old/new effects. Behavioral performance was also compared with performance on an alternate form of the test under standard administration procedures. Results ERP to old (repeated) visual designs in the CVMT were more positive-going than those to new designs and reflected by both early frontal and late parietal old/new effects as commonly reported in the recognition memory literature. The behavioral results from the computer-adapted and standard administration versions of the CVMT showed a significant correlation. Conclusions The computer-adapted ERP version of the CVMT provides a way to directly assess, using neurophysiological responses, the cognitive processes associated with recognition memory as measured by the CVMT. Significance The results from this study contribute to linking the functional and neurophysiological profile of memory produced by experimental neuroimaging research with traditional clinical neuropsychological assessment.

A Computer-Assisted Administration of the Continuous Visual Memory Test

The Continuous Visual Memory Test (CVMT) is a continuous design recognition test designed for the assessment of visual memory for clinical and research applications. Comparisons were made between the traditional and a computer-assisted format of the CVMT using 51 university students. Formats were compared on five CVMT dependent measures, concurrent validity, split-half reliability, and selected dependent measures from the California Verbal Learning Test (CVLT). Participants scored higher on the computer format dependent measures, with the exception of false alarms (new items incorrectly identified as old), which remained comparable between formats. Adequate concurrent validity (r = .70) and split-half reliability (rs = .61–.70) were demonstrated for CVMT Total Score. Restriction of range and ceiling effects precluded reliability and validity conclusions for CVMT Delay. The computer format showed a nonsignificant trend towards lower correlations with CVLT dependent measures.

Neuropsychological evidence for a topographical learning mechanism in parahippocampal cortex

The Parahippocampal Place Area (PPA; Epstein & Kanwisher, 1998) is a region within posterior parahippocampal cortex that responds selectively to visual stimuli that convey information about the layout of local space. Here we describe two patients who suffered damage to the PPA after vascular incidents. Both subsequently exhibited memory problems for topographical materials and were unable to navigate unassisted in unfamiliar environments. Performance on a continuous n-back visual memory test was significantly lower for novel scene-like stimuli than for novel object-like stimuli. In contrast, performance was normal on a famous landmark recognition task and on two perceptual tasks that required on-line analysis of scene geometry. Both patients were able to produce accurate maps of premorbidly learned places but were unable to produce accurate maps of new places. These results converge with previous neuroimaging work to demonstrate that the PPA (1) is selectively involved in processing information about the geometry of surrounding space, and (2) may play a more critical role in the encoding of this information into memory than in the initial perceptual processing, recognition, or recall of this information.

Neuropsychological evidence for a topographical learning mechanism in parahippocampal cortex

The Parahippocampal Place Area (PPA; Epstein & Kanwisher, 1998) is a region within posterior parahippocampal cortex that responds selectively to visual stimuli that convey information about the layout of local space. Here we describe two patients who suffered damage to the PPA after vascular incidents. Both subsequently exhibited memory problems for topographical materials and were unable to navigate unassisted in unfamiliar environments. Performance on a continuous n-back visual memory test was significantly lower for novel scene-like stimuli than for novel object-like stimuli. In contrast, performance was normal on a famous landmark recognition task and on two perceptual tasks that required on-line analysis of scene geometry. Both patients were able to produce accurate maps of premorbidly learned places but were unable to produce accurate maps of new places. These results converge with previous neuroimaging work to demonstrate that the PPA (1) is selectively involved in processing information about the geometry of surrounding space, and (2) may play a more critical role in the encoding of this information into memory than in the initial perceptual processing, recognition, or recall of this information.

Executive functions and Continuous Visual Memory Test performance in a general neuropsychological sample

Executive functions and Continuous Visual Memory Test performance in a general neuropsychological sample

Process scoring for the continuous visual memory test: An exploratory data analysis

Process scoring for the continuous visual memory test: An exploratory data analysis

Process scoring for the continuous visual memory test: An exploratory data analysis

Process scoring for the continuous visual memory test: An exploratory data analysis

A computer-assisted administration of the continuous visual memory test

A computer-assisted administration of the continuous visual memory test

A computer-assisted administration of the continuous visual memory test

A computer-assisted administration of the continuous visual memory test

Differing Patterns of Cognitive Dysfunction and Heart Rate Reactivity in Chemically-Intolerant Individuals With and Without Lifestyle Changes

AbstractThe purpose of the present study was to compare specific neuropsychological, psychological, and family history patterns, as well as cardiovascular reactivity of three community-recruited groups of nonsmoking, nonalcoholic middle-aged individuals with and without the symptom of intolerance to low levels of environmental chemicals (CI). CI is a common symptom in chronic fatigue syndrome and fibro-myalgia. The groups included: (i) CI who had made associated lifestyle changes because of the CI (CI/LSC); (ii) CI who had not made such changes (CI); and (iii) normals without CI (N). All subjects underwent an evaluation session followed by two laboratory cognitive and psycho-physiological test sessions one week apart. The CI/LSC diverged from the other groups in exhibiting poorer performance on the Continuous Visual Memory Test (CVMT) in terms of more false alarms and fewer correct hits, but normal performance on a visuospatial test of divided attention (DAT). In contrast, the CI group showed progressivel...

Test-Retest Stability of the Continuous Visual Memory Test in Elderly Persons

Ninety-two normal elderly persons were administered the Continuous Visual Memory Test (CVMT) on two occasions an average of 1.1 years apart. Means for age and education were 69.02 years ( SD = 5.79) and 14.80 years ( SD = 2.64), respectively. Stability coefficients were .49 on the Total score, .44 on d-prime, and .48 on Delayed Recognition. D-Prime and Delayed Recognition scores demonstrated significant change on retest. To assist clinicians in the process of detecting meaningful change on retest, standard error of difference values and 90% cut-off scores were provided.