Digit Memory Test Research Articles

Malingering assessment after severe traumatic brain injury in forensic psychology with a potential embedded symptom validity indicator of Symptom Checklist 90.

Malingering of neuropsychological damage is common among traumatic brain injury patients pursuing disability compensation in forensic contexts. There is an urgent need to explore differences in neuropsychological assessment outcomes with different levels of cooperation. A total of 420 participants with severe traumatic brain injury were classified into malingering group, partial cooperation group, and complete cooperation group according to the Binomial forced-choice digit memory test. The Wechsler Adult Intelligence Scale, event-related potential component, and Symptom Checklist 90 were applied subsequently to assess the psychological status of participants. Participants in the malingering group presented lower scores in the binomial forced-choice digit memory test and the Wechsler Adult Intelligence Scale, lower P3 amplitude, and simultaneously higher scores in the Symptom Checklist 90 than the other two groups. The actual intelligence quotient of participants with malingering tendencies ranged mostly between normal and marginal damage, and they often reported elevated whole scale scores in the Symptom Checklist 90. The Cooperation Index (defined as the ratio of positive symptom distress index to global severity index, CI) was proposed and validated to function as an embedded validity indicator of the Symptom Checklist 90, and the area under the receiver operating characteristic (ROC) curve was 0.938. When valued at 1.28, CI has the highest classification ability in differentiating malingering from non-malingering. Combined with the CI and P3 amplitude, the area under the ROC curve for malingering diagnosis further reached 0.952. Any non-optimal effort in a forensic context will lead to unexpected deviation in psychology evaluation results. CI is a potential candidate to act as an embedded validity indicator of the Symptom Checklist 90. The combination of CI and P3 amplitude can help to identify malingering in participants after severe traumatic brain injury.

Effects of Life Kinetic and Brain Gym Training Models On Working Memory and Concentration of Football Athletes

The purpose of this study was to find out the effect of Life Kinetic and Brain Gym training models on working memory and concentration of junior football athletes and to examine the more effective training model, the Life Kinetic or Brain Gym training models, to improve working memory and concentration of junior football athletes. In this study, the researcher used a quantitative research using the true experiment and the pre-test and post-test two treatment design. The population of this study were all students of Saswco Bandung U-13 Football School, totalling of 26 people. The samples were selected using total sampling technique. Respondents were given the Life Kinetic and Brain Gym training models 3 times a week, carried out for 4 weeks. The instrument for measuring working memory was The Digit Memory Test, while the instrument for measuring concentration was The Amazing 1 to 50. The hypothesis testing analysis technique used was the Multivariate test. The results of the research for the Life Kinetic and Brain Gym training models on working memory and concentration was sig. 0.000 0.05, while the between-subjects effect test value was Sig. 0.000 0.05. It shows that there was a difference between Life Kinetic and Brain Gym training on working memory and concentration of junior football athletes. In conclusion, the Life Kinetic and Brain Gym training models can improve working memory and concentration of junior football athletes. Life Kinetic training had a better effect than Brain Gym training on working memory and concentration of junior football athletes. It is suggested that further research should recall information more specifically during matches and practices of football games by simplifying Life Kinetic and Brain Gym Exercises.

Working memory span and receptive vocabulary assessment in Urdu speaking children with speech sound disorder

Emerging evidence suggests that impaired speech may be related to reduced working memory (WM). The current study aimed to validate and compare the influence of articulation, short-term memory (STM), WM, and receptive vocabulary abilities of Pakistani children with speech sound disorder (SSD; N = 50) versus typically developing (TD; N = 30) children aged 7–13 years. Assessments included the Test for Assessment of Articulation and Phonology in Urdu (TAAPU), Peabody Picture Vocabulary Test-4, translated to Urdu (U-PPVT-4), and Digit Memory Test (DMT) used to determine speech articulation, receptive vocabulary, and memory abilities respectively. The percentage correct consonants (PCC) score was used to divide the SSD group further into SSD severity groups. The TD and SSD groups significantly differed in performance on all tasks (p < 0.05). Moreover, the SSD severity groups showed significant differences (p < 0.0001) in performance on different components of TAAPU (total errors and substitution errors) and DMT tasks. However, the SSD severity groups did not show significant differences in performance on the U-PPVT-4. Correlational analyses indicate statistically significant correlations of PCC with STM, WM, and receptive vocabulary. Regression analyses suggested that both WM and STM contribute to speech intelligibility in children with SSD. Our findings in Urdu-speaking children support previous results in English-speaking children suggesting the articulation skills, receptive vocabulary, STM, and WM were less developed in children with SSD than in TD children.

Receptive vocabulary, memory span, and speech articulation in Pakistani children with developmental language disorders

ABSTRACT This study aimed to find the association of receptive vocabulary in the development of speech and language among school-going children (4–13 years) with language disorders. On the basis of non-verbal receptive vocabulary and percentage correct consonants (PCC) scores, children from public schools in Punjab, Pakistan with speech and language issues were separated into three groups; Speech sound disordered (SSD, N = 15), Language Impaired (LI) comorbid with SSD (N = 42) and typically developed (TD, N = 15). Urdu version of Peabody picture vocabulary test, fourth edition (U-PPVT-4), Digit memory test (DMT), and Test for assessment of articulation and phonology in Urdu (TAAPU) were used to assess non-verbal receptive vocabulary, Short-term memory (STM), Working memory (WM), and SSD. Correlation and regression analyses were performed to find the association of receptive vocabulary with other measures used. Receptive vocabulary, STM, WM, omission, substitution, and PCC scores were significantly different (p < 0.01) when compared among LI+SSD, SSD, and TD groups. Regression analysis showed that receptive vocabulary was significantly associated with STM and WM in the LI+SSD group. A positive correlation was found between the U-PPVT-4 standard score with STM and WM for LI+SSD and SSD groups. Our findings in Urdu-speaking children suggested that STM and WM were less developed in children with speech and language impairments. Moreover, children with speech and language deficits not only had weaker receptive vocabulary but also attention should be given to improving STM and WM that contribute to LI.

Simulated malingering on binomial forced-choice digit memory test – using eye movements to understand faking cognition impairment process

ABSTRACT Intentional faking and/or exaggeration of disability increase unnecessary burden and costs for society, and they could be difficult to detect. This study aimed to explore which and how eye-based measures could be applied in detecting malingering of traumatic brain injury in a laboratory setting. Undergraduates were randomly grouped into two conditions in a mixed study-design experiment: malingering (n = 25) and honest (n = 24). Binomial forced-choice digit memory test (BFDMT) was used to test performance validity. Behavioral and eye-based measures were collected. Compared to the honest individuals, the malingering participants exhibited longer dwell time, glance duration, and fixation time and more glance count and fixation count in false response while less dwell, glance, and fixations in true response. Individuals coached to malinger had more dwell, glance, and fixations in false than in true response. Findings suggested that gaze pattern may have a potential application in understanding the faking process and detecting malingering. In addition, individuals that were incentivized to malinger allocated intensive attention to desirable information as a strategy to avoid detection and maximize gains in this simulated setting.

ERPS AS AN INDEX OF IMPAIRED COGNITIVE CONTROL IN AN ISCHEMIC BRAIN STROKE APHASIC PATIENT

Stroke is a sudden-onset neurological deficit resulting from focal vascular lesions. This is either due to a clot-induced obstruction of a vessel (ischemic stroke) or a rupture of a vessel causing haemorrhage (hemorrhagic stroke). The appropriate diagnosis of brain stroke aphasic patients is a major public health problem one so important for effective rehabilitation. Here an important role is played by the diagnosis of impaired cognitive processes. The aim of the research was to find the index of impaired cognitive control with the use of ERPs in a patient following an ischemic stroke with aphasia. A male patient, aged 69, after an ischemic brain stroke experienced 4 months previously with resulting naming problem, was admitted to the Reintegrative and Teaching Center of the Polish Neuropsychological Society. In the neuropsychological evaluation three neuropsychological tests were employed: (a) the Boston Naming Test-Polish version, to evaluate the naming and word finding problem; (b) the nonverbal Bell test to ascertain a selective, visuospatial and strategic attentional evaluation; (c) the Digit Memory test to evaluate working memory capabilities; (d) ERPs as a neurophys- iological index of impaired cognitive control. Significant changes were observed in testing. All cognitive functions including naming, non- verbal, visuospatial and strategic attention, along with the digit memory deviate substantially from the norm. The patient obtained a lo wer score, compared to the norm (p &lt;0.05). Boston Naming Test (patient = 21&lt; Mean-Norm = 57.29; SD= 0.52). Bell test (patient = 23 &lt; Mean-Norm = 31.29; SD= 2.52). Digit Memory Test scores: Forward digit span (patient = 3 &lt; Mean-Norm = 7.65, SD = 0.49). Backward digit span (patient = 2 &lt;Mean-Norm = 6.51, SD = 0.7). Significant changes were observed also in neurophysiological testing: behavioral parameters (except RT) deviate substantially from the reference. EEG spectra show clear abnormalities on the left side within the left Rolandic fis- sure. The deviations include excessive mu-rhythm and beta activity, which means that this area is inhibited. The ERPs show no difference between GO and NOGO conditions in the patient in comparison to the norm from HBI database indicating poor cognitive control. ERPs could be treated as an index of impaired cognitive control in the ischemic stroke aphasic patient.

Accuracy Analysis of Distinguishing the Cooperation Degree during Image Completion Test by Eye Movement Parameters.

Objective To analyze the differences in accuracy of different eye movement parameters in distinguishing the cooperation and non-cooperation during image completion test of patients with mental disorders caused by craniocerebral trauma. Methods One hundred and forty cases of patients with mental disorders caused by craniocerebral trauma who took psychiatric impairment assessments were collected. The 21 pictures from "image completion" of Wechsler intelligence test were used as stimulating pictures, then divided into cooperation group and non-cooperation group according to binomial forced-choice digit memory test and expert opinions. The eye movement parameters of research subjects during completion of images were obtained by the SMI eye-tracker. The accuracy of eye movement parameters in distinguishing the cooperation or non-cooperation of patients with mental disorders caused by craniocerebral trauma in psychiatric impairment assessments were evaluated by the ROC curve. Results During the process of the image completion test, the area under curve （AUC） value of frequency of blink, frequency of fixation, pupil size, frequency of saccade, latency of saccade, average acceleration of saccade, the average and peak longitudinal velocity of saccade was above 0.5. When it comed to a specific stimulating picture, the AUC value of frequency of blink in looking at a specific stimulating picture could be above 0.8, and the AUC value of X axis diameter of pupil size could be above 0.7. Conclusion The accuracy of eye movement parameters in distinguishing the cooperation or disguise of patients with mental disorders caused by craniocerebral trauma is related with the stimulating picture. The accuracy of frequency of blink in distinguishing cooperation and non-cooperation is better than that of other eye movement parameters.

Pharmacodynamic and pharmacokinetic profile of SM‐1, a triple‐drug combination to increase total sleep time

The primary objective was to characterize the pharmacokinetics and pharmacodynamics of SM-1 after administration of a single oral dose to healthy volunteers in a placebo-controlled double-blind trial of daytime sedation. Secondary objectives were to determine the onset, duration, and offset of the sedative effects using subjective and objective measures of sedation. Safety and tolerability of SM-1 were also investigated. Males and females 18-45 years of age received SM-1, a combination drug product comprised of diphenhydramine, zolpidem (delayed release), and lorazepam (delayed release). The pharmacokinetic profile of each drug was determined from blood samples. Sedative effects were assessed by visual analog scale, digit symbol substitution test, memory test, and quantitative electroencephalography. Similar number and severity of adverse events were observed following administration of SM-1 and placebo. Onset of sedation, as determined by subjective, performance, and electroencephalography measures, occurred 0.5-1 hr postdose, lasting about 7-7.5 hr. Plasma concentration curves for the two delayed-release components were altered compared with published data for unmodified drugs. Exposure values obtained with the combination product were in good agreement with published values of the drugs given individually. SM-1 was well tolerated and has pharmacologic activity starting within an hour of ingestion, lasting approximately 7-8 hr. Sedative activity was seen with subjective, psychomotor, and electroencephalography assays.

STROKE IMPACT ON THE COGNITIVE FUNCTIONS OF MOROCCAN NEURO-LESIONED PATIENTS IN THE GHARB REGION

Stroke (ischemic and hemorrhagic stroke) is a sudden-onset neurological deficit resulting from focal vascular lesions. This is due to a clot-induced obstruction of a vessel (ischemic stroke) or a rupture of a vessel causing haemorrhage (hemorrhagic stroke). The management of neuro-injured patients (AVC) is a major public health problem. The principal aim of this study is to evaluate the short and long term neuropsychological sequences following a neurological accident of neuro-injured patients hospitalized at the Kenitra Provincial Center (Morocco) in comparison with the control group. We tested 34 stroke patients, with an average age sample of 59.12 years, for a standard deviation of 14.35 with extremes between 32 and 82 years. Of these patients, 20 were female (58.82%) and 14 male (41.18%). The sex ratio is 0.7 in favour of the female sex. Both the neuro-lesioned patients and the control group benefited from neuropsychological tests. In the neurocognitive evaluation we used three neuropsychological tests: (a) The bell test or non-verbal bell dam test allows for a selective, visuospatial and strategic attentional evaluation; (b) Raven's test focuses on the nonverbal neuropsychological intelligence where the subject is led to analyze and solve each test problem based on inductive reasoning; (c) The digit memory test is a test to evaluate the short-term verbal memory and working memory capabilities of stroke patients. Our results showed through the various neurocognitive tests that our stroke patients obtained lowers score, compared to the control group (p &lt;0.05). Raven Standard Progress Matrix Test Scores (SPMR):(Mean-Patients = 32.49, SD = 7.43 &lt; Mean-Controls = 42.01, SD = 3.98). Digit Memory Test scores: Forward digit span (Mean-Patients = 2.21, SD = 0.5 &lt;Mean-Controls = 2.65, SD = 0.49). Backward digit span (Mean-Patients = 1.74; SD = 0.6 &lt;Mean-Controls = 2.41, SD = 0.5). Bell test (Mean-Patients = 24.35; SD = 2.62 &lt; Mean-Controls = 30.18; SD= 2.52). The patient quality of life is consequently highly affected. Rehabilitation was effective and is very important because it improves cognitive functions such as nonverbal skills, visuospatial and strategic attention, along with the digit memory equally improving patient quality of life.

Eye Movement Characteristics of Cooperation Degree during Image Completion Test in Psychiatric Impairment Assessment

To explore the difference of eye movement characteristics between uncooperative and cooperative subjects with mental disorder after cerebral trauma. Thirty-nine subjects which needed psychiatric impairment assessment were selected. According to the binomial forced-choice digit memory test （BFDMT）, all subjects were divided into cooperative and uncooperative groups. The subjects were asked to take the image completion test from Wechsler adult intelligence scale. Meanwhile, the data of eye movement track, fixation, saccade, pupil and blink were recorded by the track system of eye movement. There were significantly differences （P<0.05） in the data of saccade between cooperative （10 cases） and uncooperative groups （29 cases）. The frequency, time, amplitude, acceleration of saccadic in uncooperative group were significantly higher than cooperation group. The saccade latencies of cooperation group increased more than uncooperative group. There was a significant difference （P<0.05） in total discrete distance, average distance and total time of fixation between two groups, while the average duration time, number and frequency of fixation had no significantly difference （P>0.05） between two groups. And the blink frequency of cooperation group was higher than uncooperative group. Eye movement can be an objective index for the primary judgment of cooperation level.

Evaluation of Attention and Verbal Memory in Yoga Practicing Pre-Adolescents: A Cross-Sectional Study

Background and objectives: Yoga is a holistic mind‐body practice used for physical and mental health, which is most commonly looked upon by educators as a wellness program for students. This study aims to analyze whether pre-adolescent school students who practiced yoga performed better in attention and memory tasks in comparison with controls that did not practice yoga.Design and interventions: This is a single-center cross-sectional study involving healthy students between grades 3 and 9 (8‐14 years of age) from the same school. Forty students who practiced yoga (yogic breathing and postures) for 30 minutes, 5 days a week in the past 12 months (Y group) were assessed against a control group of 40 students in the same age group (NY group) who were not involved in any yogic practices for differences in scores of trail making tests (TMT), Stroop color task, and digit memory tests. Data were analyzed using independent samples t-test with a confidence interval of 95% and P<0.05 considered statistically significant.Main outcome measure: To establish the difference in scores of visual attention, selective attention, and verbal memory/auditory attention between the groups.Results: The mean scores for TMT-A (joining numbers in numerical order) were 42.7±21.66 in the Y group compared with 50.8±22.0 for the NY group (P=0.02). Mean scores of TMT-B (joining numbers in intermittent order) were 91.4±34.9 in the Y group compared with 125.7±48.3 in the NY group. The mean scores of digit span forwards in Y and NY groups were 9.82±1.72 and 7.62±1.67, respectively. Digit span backward scores in Y and NY groups were 8.75±22.07 and 5.8±4.82, respectively. The mean scores of Stroop color test in Y and NY groups were 2.02±1.94 and 4.21±1.87, respectively, which were statistically significant (P<0.0001).Conclusion: Pre-adolescent school students who practiced yoga in the past 12 months showed better performance in visual attention, selective attention, and verbal memory/auditory attention compared with the pre-adolescent controls. Randomized controlled trials are needed to assess the generalizability of these study findings.

The Role of Phonological Working Memory in Children with SLI

ABSTRACTThis article studies three measures of phonological working memory as tools to identify SLI children: word repetition, nonce word repetition, and digit memory. We propose that a deficit in the phonological loop causes a delay in the acquisition of lexicon, morphosyntax, and discourse. In this research we try to find out whether the scores in these three measures correlate with language performance in SLI and normally developing children. We run tests of word repetition, nonce word repetition, digit memory, and language tests on lexicon and morphosyntax. We found that SLI children scored lower than normally developing children in word, nonce word repetition, and digit memory for all age groups. Scores of the tests show that these can differentiate SLI and normally developing children for all age groups. The results of this research suggest that processing limitations may increase the language difficulties of SLI children.

Discriminating Among ADHD Alone, ADHD With a Comorbid Psychological Disorder, and Feigned ADHD in a College Sample

Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III).

Health related quality of life in patients recently diagnosed with multiple sclerosis

To describe a representative population of patients recently diagnosed with MS in terms of both motor and non-motor disability. In particular we wanted to examine the HRQoL in this population to get a better understanding of what impact various clinical features have on the patients' experience of distress in the early phase of the disease. Ninety three patients diagnosed with MS in Hordaland and Rogaland county in 1998-2000 and 96 healthy controls were examined through questionnaires on HRQoL (SF-36), depression (Beck's depression inventory), fatigue (fatigue severity scale) and apathy (Starkstein's apathy scale). The patients also underwent neurological examination including the expanded disability status scale and the Multiple Sclerosis Functional Composite, as well as the symbol digit memory test and the selective reminder test. Patients with MS reported a lower HRQoL than the controls with a mean physical health summary score of 57.3 compared to 84.5 (P < 0.001), and a mental health summary score of 66.4 vs 79.2 (P < 0.001). The controls scored significantly higher on all SF-36 sub scores except for bodily pain. The incidence of fatigue was 71% in patients compared to 27% in controls (P < 0.001), whereas 46% of patients vs 18% of controls reported depression (P < 0.001). The mean score for apathy was significantly higher among patients. Patients with recently diagnosed MS reported significantly lower on both physical and mental aspects of HRQoL compared with controls. Depression, fatigue and apathy were more common and more severe in MS. We found no correlation between cognitive decline and HRQoL scores.

Using Symptom Validity Tests to Detect Malingered ADHD in College Students

Recently there has been growing concern that college students may feign symptoms of ADHD in order to obtain academic accommodations and stimulant medication. Unfortunately research has only begun to validate detection tools for malingered ADHD. The present study cross-validated the results of Sollman, Ranseen, and Berry (2010) on the efficacy of several symptom validity tests for detection of simulated ADHD among college students. Undergraduates with a history of diagnosed ADHD were randomly assigned either to respond honestly or exaggerate symptoms, and were compared to undergraduates with no history of ADHD or other psychiatric disorders who were also randomly assigned to respond honestly or feign symptoms of ADHD. Similar to Sollman et al. (2010) and other recent research on feigned ADHD, several symptom validity tests, including the Test of Memory Malingering (TOMM), Letter Memory Test (LMT), Digit Memory Test (DMT), Nonverbal Medical Symptom Validity Test (NV-MSVT), and the b Test were reasonably successful at discriminating feigned and genuine ADHD. When considered as a group, the criterion of failure of 2 or more of these SVTs had a sensitivity of. 475 and a specificity of 1.00.

Research on event-related potentials of dissimulation in memory test

Objective To examine the dissimulation in memory test by event-related potentials (ERP).Methods Recording the ERP of 20 students in the choosing tasks according to Binomial Forced-Choice Digit Memory Test (BFMDT) in three situations including reality,dissimulation and forced wrong choose. Results The reaction time was lengthened gradually by the situation of reality ( 681 ± 21 ) ms, dissimulation ( 741 ± 25 ) ms and forced wrong choose( 946 ± 31 ) ms (F= 115.73, P = 0.000). The main components in ERP waveforms, N2 ( 180 ～184 ms) and P2 ( 214 ～ 243 ms) had higher amplitudes in situations of dissimulation and forced wrong choose than that of reality. The amplitude of N2 showed significant difference in three groups(F=6. 896, P＜0.01 ). The amplitudes were increased gradually by the situation with reality( -0.376 ± 0.58 )μV, dissimulation( 0. 86 ± 0.71 )μV and forced wrong choose( 1.77 ±0.82)μV. Conclusion ERP may be an electrophysiological index of the intention of dissimulation in memory test. Key words: Binomial forced-choice digit memory test ; Dissimulation ; Event related potentials ;

Detection of feigned ADHD in college students.

Significant motivations and incentives exist for young-adult students to seek a diagnosis of attention-deficit/hyperactivity disorder (ADHD). With ADHD information readily accessible on the Internet, today's students are likely to be symptom educated prior to evaluation. This may result in false-positive diagnoses, particularly when students are motivated to convey symptoms. We evaluated the utility of ADHD symptom checklists, neurocognitive tests, and measures initially developed to detect feigned neurocognitive or psychiatric dysfunction (symptom validity tests [SVTs]). The performance of 31 undergraduates financially motivated and coached about ADHD via Internet-derived information was compared to that of 29 ADHD undergraduates following medication washout and 14 students not endorsing symptomatology. Results indicated malingerers readily produced ADHD-consistent profiles. Symptom checklists, including the ADHD Rating Scale and Conners's Adult ADHD Rating Scale-Self-Rating Form: Long, were particularly susceptible to faking. Conners's Continuous Performance Test-II findings appeared more related to motivation than condition. Promising results were seen with all cognitive SVTs (Test of Memory Malingering [TOMM], Digit Memory Test, Letter Memory Test, and Nonverbal-Medical Symptom Validity Test), particularly TOMM Trial 1 when scored using Trial 2 criteria. All SVTs demonstrated very high specificity for the ADHD condition and moderate sensitivity to faking, which translated into high positive predictive values at rising base rates of feigning. Combining 2 or more failures resulted in only modest declines in sensitivity but robust specificity. Results point to the need for a thorough evaluation of history, cognitive and emotional functioning, and the consideration of exaggerated symptomatology in the diagnosis of ADHD.

A vitamin/nutriceutical formulation improves memory and cognitive performance in community-dwelling adults without dementia.

Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement within 2 weeks in Trail-making and Digit-Memory tests; both groups improved in a 2-week open-label extension. An increased percentage of participants > or = 74 years of age did not show improvement with NF, which may relate to age-related difficulties in adsorption and/or basal nutritional deficiencies, or age-related cognitive decline during the course of this study. These findings support the benefit of nutritional supplements for cognitive performance and suggest that additional supplementation may be required for the elderly.

Detection of malingered mental retardation.

In a cross-validation of results from L. O. Graue et al. (2007), standard psychological assessment instruments, as well as tests of neurocognitive and psychiatric feigning, were administered under standard instructions to 24 participants diagnosed with mild mental retardation (MR) and 10 demographically matched community volunteers (CVH). A 2nd group of 25 community volunteers was instructed to malinger MR (CVM) during testing. CVM participants obtained Wechsler Adult Intelligence Scale (3rd ed.; D. Wechsler, 1997) Full Scale Intelligence Quotient scores that were significantly lower than the demographically similar CVH group but comparable to the MR group, suggesting that CVM subjects feigned cognitive impairment. On the basis of standard cutting scores from test manuals or published articles, of the 11 feigning measures administered, only the Test of Memory Malingering (TOMM; T. N. Tombaugh, 1996) retention trial had a specificity rate >.90 in the MR group. However, the 2nd learning trial of the TOMM, as well as a short form of the Digit Memory Test (T. J. Guilmette, K. J. Hart, A. J. Guiliano, & B. E. Leininger, 1994), approached this level of specificity, with both at .88. These results raise concerns about the specificity rates at recommended cutting scores of commonly used feigning tests in defendants with MR.

Prenatal Exposure to Polychlorinated Biphenyls and Attention at School Age

ABSTRACT A previous study demonstrated lower IQ and reading comprehension scores at age 11 years in children whose mothers had eaten Lake Michigan fish contaminated by polychlorinated biphenyls (PCBs). The present prospective longitudinal study was designed to learn which specific elements of cognitive function are primarily affected. All 167 mothers had consumed the equivalent of at least 11.8 kg of Lake Michigan salmon or lake trout over a 6-year period. At age 11 years, 148 children were examined by a battery of 15 neuropsychologic tests. The tests were designed to evaluate 4 dimensions of attention function: sustained attention, focused attention, executive function, and working memory. Samples of umbilical cord serum and maternal milk were analyzed for PCBs by gas chromatography. Few associations with specific neuropsychologic end points were significant at age 11 years. There were deficits in digit cancellation, memory, and reaction time tests. Visual–spatial rotation efficiency remained intact. Adverse cognitive effects were much more frequent and also more marked in children who were not breast fed. Prenatal PCB exposure was associated with impulsivity on a number of different tasks. Highly exposed children were less able to inhibit their responses. Nevertheless, examiner-rated activity level was not significantly increased. The children were able to sustain attention when doing a relatively simple, repetitive task. Associations with executive function were not clear. Nonbreast fed children performed less well on several tests of working memory. The findings were not meaningfully altered when controlling for blood lead concentration. These findings are in accord with previous reports that children who are not breast fed are more vulnerable to PCB exposure in utero. It is not clear whether this protective effect is related to nutrients in breast milk or to a higher quality of intellectual stimulation that often is provided by mothers who breast feed their infants.