Halstead-Reitan Neuropsychological Battery Research Articles

Evaluation of executive dysfunction in clinical practice- pragmatic challenges and solutions

IntroductionExecutive dysfunction (ED) is an important clinical dimension that need to be evaluated in neurologic and psychiatric disorders, due to this factor’s impact over patients functionality, quality of life, and overall prognosis. Working memory, inhibition, set shifting, and fluency are the most widely accepted dimensions of ED. The evaluation of these aspects in clinical practive should be more frequently implemented, because they may offer an image about the patients ability to cope with new situations, stressful events, social challenges being included.ObjectivesTo determine the most appropriate methods of ED evaluation in psychiatric practice.MethodsA literature review was conducted through main electronic databases, and papers published between January 2000 and August 2020 were included in the analysis.ResultsWisconsin Card Sorting Test (WCST), Halstead-Reitan Neuropsychological Battery, Cambridge Neuropsychological Automated Battery (CANTAB), Wechsler Adult Intelligence Scale (WAIS), and Controlled Oral Word Association Test (COWAT) have been the most frequently cited instruments for ED evaluation. The neuropsychiatric disorders in which ED was recommended in clinical trials were schizophrenia and other psychotic disorders, neurocognitive disorders, bipolar disorders, and major depressive disorders. An integrated approach, that combines initial evaluation and periodic monitoring of symptoms severity, global functioning, quality of life, and ED severity should be considered standard-of-practice for neuropsychiatric disorders.ConclusionsED is an important dimension of clinical evaluation in many psychiatric disorders that is useful because the results may correlate to the patients prognosis, quality of life, and overall functional evolution.Conflict of interestNo significant relationships.

Performance Validity Classification Accuracy of Single-, Pairwise-, and Triple-Failure Models Using the Halstead-Reitan Neuropsychological Battery for Adults

Embedded performance validity tests (PVTs) have been criticized for their poor specificity and sensitivity. Aggregated models of embedded PVTs have been proposed to improve their classification accuracy; however, limitations to aggregation-based improvement of PVTs have yet to be explored. The current study evaluated the classification accuracy of 3 types of models of embedded PVTs in the Halstead-Reitan Neuropsychological Battery for Adults (HRNB): a single-, a pairwise-, and a triple-failure model. In addition, this study evaluated the impact of aggregating between 1 and 6 embedded PVTs in each of these 3 types of models. Analyzing only the 2, 4, and 6 most discriminating embedded PVTs in the single-, pairwise-, and triple-failure models maximized classification accuracy, respectively. Comparisons across these models indicated that the single-failure model including only the two most discriminating embedded PVTs had the best classification accuracy; however, classification accuracy was only minimally improved in this model relative to analyzing just Reliable Digit Span. These results suggest that aggregation of embedded PVTs from the HRNB does not substantially improve their classification accuracy and that the benefits of aggregating PVTs may only emerge when the PVTs entered into the aggregated models have sufficient classification accuracy on their own.

Assessing Neuropsychological Impairment Using Reitan and Wolfson's Screening Battery

The aim was to verify the applicability of Reitan and Wolfson's proposed neuropsychological screening battery for adults (2006, 2008) in the Czech population. The sample consisted of 70 participants aged 19-65 years, all of whom were examined using a screening method as well as the full Halstead-Reitan neuropsychological battery (HRNB). The correlation, logistic regression, ROC curve analysis, sensitivity and specificity, and positive and negative predictive values were all calculated. The Pearson correlation between the screening scale of neuropsychological deficit and the General Neuropsychological Deficit Scale (GNDS) from HRNB was 0.78 (p < .001). When optimal cut-off scores of 8 were utilized (in accordance with Horwitz, Lynch, McCaffrey, & Fisher in Screening for neuropsychological impairment using Reitan and Wolfsońs preliminary neuropsychological test battery. Archives of Clinical Neuropsychology, 23, 393-398, 2008, but different from Reitan, & Wolfson in The use of serial testing in evaluating the need for comprehensive neuropsychological testing of adults. Applied Neuropsychology, 15, 21-32, 2008), 78.6% of individuals were correctly classified having neuropsychological impairment or no impairment according to the GNDS. Our results confirm that this neuropsychological screening battery has good psychometric properties in the Czech population.

The Degree of Conation on Neuropsychological Tests Does Not Account for Performance Invalidity among Litigants

Conation has been defined as the ability to focus and maintain intellectual energy over time. Prior research has shown that conation contributes to the magnitude of differences in test scores among brain-damaged and non-brain-damaged examinees. The purpose of the current investigation was to determine if conation might similarly account for differences in test scores among performance valid and performance invalid examinees. An archival analysis was therefore carried out on 52 examinees administered the Halstead-Reitan Neuropsychological Battery (HRNB) and several performance validity tests in a medico-legal context. Analyses revealed that conation had no impact on the magnitude of test score differences between groups and that performance invalid examinees scored worse than performance valid examinees on all but one test of the HRNB. These results support the idea that the identification of performance invalidity calls into question the reliability and the validity of all test score interpretations in an evaluation, even those with less conative load.

Factor Structure of the Halstead-Reitan Neuropsychological Battery: A Review and Integration

The Halstead-Reitan Neuropsychological Battery (HRNB) was the first factor-analyzed neuropsychological battery. It was based on a series of tests studied in Ward Halstead's laboratory at the University of Chicago, was accomplished in collaboration with a group of eminent statisticians, and was published in 1947. Four factors were extracted based on Halstead's tests called central integrative field, abstraction, power, and directional and constituted what was described as biological intelligence. Since this original analysis, Reitan's additions to the battery, and the proposal of Reitan and Wolfson's model of neuropsychological functioning, this factor-analytic research continued. This article reviews factor-analytic research concluding that Halstead's analysis has held up reasonably well and there is support for the Reitan and Wolfson model. However, Reitan's revisions of the battery added tests that form a distinct language factor and the sensory-perceptual tests that generally form a separate factor. Other tests and scoring methods used in individual studies modified the core battery and produced somewhat differing solutions. The complexity of the tests prevents the HRNB from being a factorially pure battery, and simple structure is rarely, if ever, reached. Current versions of the HRNB appear to evaluate both “biological” and “psychometric” intelligence, which appear to load on separate factors.

Factor Structure of the Halstead-Reitan Neuropsychological Battery for Children: A Brief Report Supplement

The Halstead-Reitan Neuropsychological Battery (HRNB) is the first factor-analyzed neuropsychological battery and consists of three batteries for young children, older children, and adults. Halstead's original factor analysis extracted four factors from the adult version of the battery, which were the basis for his theory of biological intelligence. These factors were called Central Integrative Field, ion, Power, and Directional. Since this original analysis, Reitan's additions to the battery, and the development of the child versions of the test, this factor-analytic research continued. An introduction and the adult literature are reviewed in Ross, Allen, and Goldstein (in press). In this supplemental article, factor-analytic studies of the HRNB with children are reviewed. It is concluded that factor analysis of the HRNB or Reitan-Indiana Neuropsychological Battery with children does not replicate the extensiveness of the adult literature, although there is some evidence that when the traditional battery for older children is used, the factor structure is similar to what is found in adult studies. Reitan's changes to the battery appear to have added factors including language and sensory-perceptual factors. When other tests and scoring methods are used in addition to the core battery, differing solutions are produced.

Assessing Neuropsychological Impairment Among Sex Offenders and Paraphilics

ABSTRACT A sample of 1,180 sex offenders and paraphilics (SOPs) and 113 non–sex offender controls were compared on the Halstead-Reitan (HR) Neuropsychological Battery. The SOPs were further divided into offenders against adults versus offenders against children and into offenders against males, females, or both genders, regardless of victim age. The confounding influence of substance abuse, history of brain trauma and abnormalities, as well as age, education, IQ, learning disorders, endocrine abnormalities, and birth and developmental abnormalities were also examined. Overall, 33.5% of SOPs were impaired on the HR Battery, but they did not differ significantly from non–sex offender controls. It was the SOPs against children who were significantly more impaired than offenders against adults. Stepwise regression analysis examining all significant variables, showed that age and IQ were the first factors that entered in the analysis, but the presence of learning disorders and endocrine abnormalities also contributed significant variance in predicting the HR impairment index. Results suggest that examination of neuropsychological impairment in sex offenders is a complex but important dimension of their forensic assessment and treatment planning.

Relation Between Central Adiposity and Cognitive Function in the Maine–Syracuse Study: Attenuation by Physical Activity

Previous studies have demonstrated a relationship between central adiposity and cognitive function. However, only some of these studies have adjusted for cardiovascular risk factors and cardiovascular disease, and none have also adjusted for physical activity level. The purpose of the study was to examine the association between anthropometric measures of central adiposity (waist circumference and waist/hip ratio) and cognitive functioning with adjustment for cardiovascular disease risk factors and physical activity. Participants were 917 stroke- and dementia-free community-dwelling adults (59% women) in the Maine-Syracuse Study. The design was cross-sectional. Outcome measures included tests from the Wechsler Adult Intelligence Scale, the Halstead-Reitan Neuropsychological Battery, the Wechsler Memory Scale Revised, and the Mini-Mental State Examination. Waist circumference and waist/hip ratio were inversely related to multiple cognitive domains with adjustment for age, education, gender, and number of prior exams. For example, a 20-cm increment in waist circumference was associated with a 0.14 SD decrement in the Global Composite score. These relations were attenuated with adjustment for cardiovascular disease risk factors. However, with further adjustment for physical activity level, only waist circumference remained significantly associated with performance on the Similarities test. Waist circumference and waist/hip ratio are inversely related to cognitive function. Measures of central adiposity predict cognitive function independently of associated cardiovascular risk factors and events; however, the association between central adiposity and cognitive function is attenuated, to a large extent, by adjustment for physical activity level. Physical activity is an important covariate in studies relating measures of central adiposity to cognition.

Potential for interpretation disparities of Halstead–Reitan neuropsychological battery performances in a litigating sample

The performances of 110 litigants on seven variables from the Halstead–Reitan neuropsychological battery (HRNB) were used to compare Heaton, Miller, Taylor, and Grant's (2004) Deficit Scale (DS) and Reitan and Wolfson's (1993) Neuropsychological Deficit Scale (NDS). Additional comparisons were made for people who passed or failed the Test of Memory Malingering (TOMM) to determine effects of effort on scores generated by either scoring system. Wilcoxon signed-rank tests revealed that all seven comparisons were significantly different for the full sample ( p ≤ 0.001). The NDS indicated greater levels of impairment compared to DS across all variables. These findings were also obtained when considering effort, though TOMM failure was related to non-significant differences for two variables. These findings suggest that the two scoring systems are not equivalent, with Heaton et al.'s DS resulting in consistently higher identification rates of normal brain functioning compared to those generated from Reitan and Wolfson's NDS system.

SPECT study of Chinese schizophrenic patients suggests that cerebral hypoperfusion and laterality exist in different ethnic groups

Hypofrontality is a common finding in schizophrenia in many countries. To date, there have been few studies on Chinese patients with schizophrenia. We thus wondered whether hypofrontality exists in Chinese patients with schizophrenia. We investigated 45 patients with schizophrenia and 21 healthy controls using brain perfusion single photon emission computed tomography (SPECT). Subjects were also administered the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Halstead–Reitan Neuropsychological Battery (HRNB) and the Wechsler Memory Scale-Revised (WMS-R). Images were analyzed using a semi-quantitative reading and a quantified region of interest analysis. We found that schizophrenic patients showed hypoperfusion in the frontal and temporal lobes and hyperperfusion in the basal ganglia. Schizophrenic patients with both negative and positive symptoms showed asymmetric perfusion in the temporal lobe. Schizophrenic patients with prominent negative symptoms also showed asymmetric perfusion in the prefrontal lobes. Negative symptoms showed a significantly negative correlation with regional cerebral blood flow (rCBF) in the left frontal lobe. Improved memory quotient (MQ) was significantly correlated with increased rCBF in the left temporal lobe. These findings from Chinese patients confirm a similar regional neuroanatomic dysfunction as in Western patients with the disease.

Sensory-Perception Dysfunction in Patients with Schizophrenia and Comorbid Alcoholism

We studied the effects of aging and comorbid alcoholism on sensory-perceptual dysfunction in patients with schizophrenia. Using sensory-perceptual tests from the Halstead-Reitan Neuropsychological Battery included in the Russell, Neuringer, and Goldstein (1970) Perceptual Disorders Index, samples were compared of 54 patients with comorbid schizophrenia and alcoholism, 234 patients with schizophrenia but no history of alcoholism, 132 patients with chronic alcoholism and 171 patient controls. Data were analyzed by one-way analyses of variance followed by Scheffe multiple comparison tests. Numerous significant differences were found among groups, with the comorbid schizophrenia group doing more poorly than the other groups on measures of touch perception and suppression, finger agnosia, and fingertip number writing. Multiple regression analyses using the sensory-perceptual tests as predictor variables and age as the dependent variable indicated that the strength of association between age and the multivariate set of sensory-perceptual test scores was greater in the comorbid schizophrenia group than the noncomorbid schizophrenia, alcoholism and patient control groups. The preponderance of age-related deficits was left-sided, suggesting accelerated decline in right hemispheric function. A comparison of groups across ages on a single Perceptual Disorders Index score showed a substantially larger age effect in the comorbid schizophrenia group relative to the other groups.

Dimensions of successive and simultaneous processing in the Halstead-Reitan neuropsychological battery

Dimensions of successive and simultaneous processing in the Halstead-Reitan neuropsychological battery

Alcohol use disorders and cognitive abilities in young adulthood: a prospective study.

The effect of alcohol use disorder (AUD) on cognitive and neuropsychological abilities was investigated in a prospective study of 68 freshmen who met past-year criteria for AUD on 2 or more occasions during their college years and 66 matched controls. At baseline, participants were administered a total of 14 subtests from the Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale, and Halstead-Reitan Neuropsychological Battery. At 7-year follow-up, most measures were readministered, along with the Reflective Judgment Interview, Watson-Glaser Critical Thinking Appraisal, and Plant Test. Analyses revealed few differences between AUD and control groups. However, visuospatial deficits may be present among AUD participants with poor baseline visuospatial performance. Alcohol exposure measures yielded similar patterns to those shown with AUD.

Neuropsychological assessment of battered women: a pilot study.

Mean performance of 19 battered women was significantly lower than that of 9 control women on the Halstead-Reitan Neuropsychological Battery, the Wechsler Memory Scale-Revised, and the Quick Neurological Screening Test. 58% of the battered women scored in the impaired range on the Halstead-Reitan Impairment Index; and 53% scored in the impaired range on the Quick Neurological Screening Test. More definitive research was recommended.

Assessment of Cognitive Functioning in Men who Batter

The present investigation examined neuropsychological functioning in 50 male batterers court-ordered into treatment and 23 nonpatient controls. Subjects were administered a neuropsychological screening battery consisting of the Screening Test for the Luria-Nebraska Neuropsychological Battery, the Stroop Color and Word Test, two memory subtests from the Luria-Nebraska Neuropsychological Battery-III (Figural Memory and Delayed Figural Memory), and two subtests from the Halstead-Reitan Neuropsychological Battery (Trails A & B). Subjects were categorized as having neuropsychological dysfunction if their scores exceeded the statistical cut offs on two or more subtests. Results indicated that 24 (48%) of the male batterers exhibited cognitive dysfunction, as compared to only 1 (4.3%) of the nonpatient controls. Inspection of individual neuropsychological measures indicated poorer performance across all subtests for impaired male batterers as compared to both nonimpaired batterers and normal controls. In contrast, no significant differences on any of these measures emerged between nonimpaired male batterers and normal controls. Implications for the appropriate screening and treatment of male batterers are discussed.

NEUROPSYCHOLOGICAL ASSESSMENT OF BATTERED WOMEN: A PILOT STUDY

Mean performance of 19 battered women was significantly lower than that of 9 control women on the Halstead-Reitan Neuropsychological Battery, the Wechsler Memory Scale-Revised, and the Quick Neurological Screening Test. 58% of the battered women scored in the impaired range on the Halstead-Reitan Impairment Index; and 53% scored in the impaired range on the Quick Neurological Screening Test. More definitive research was recommended.

Patrón de déficit neuropsicológico en la demencia tipo Alzheimer y en la demencia vascular

Cummings et al, 1987, hypothesized that Alzheimer dementia type (ADT) patients would present poorer performances than vascular dementia (VD) patients on the neuropsychological tests that mainly involve cortical neurological structures, and that VD would perform worse on tests that mainly involve subcortical structures. The main purpose of the research was to identify a cognitive impairment pattern that discriminates the type of dementia in the initial stages. Two groups of patients, one affected by mild ADT (n = 30) and the other by multi-infarct dementia (VD, n = 30) were given a neuropsychological battery. The battery was composed by Temporal Orientation (Benton et al.); Vocabulary, Similarities, Digits, Coding and Kohs (WAIS) of Wechsler; the Colour-Form Test of Weigh; the Trail Making Test (A and B) (Halstead-Reitan Neuropsychological Battery); Tapping (McQuarrie); Logical Memory, Visual Memory and Paired Association (Wechsler Memory Scale) of Wechsler; Delayed Memory (Russell). The two groups were similar in age and socio-cultural features. The z-score and its statistical significance on the Mann-Whitney test were made and we performed an exploratory discriminant analysis to the classification. In general, results were poorer in the ADT group. But we detected no significant differences in the tests, although some test (Immediate Visual Memory and Kohs' Blocks) almost reached significance. The discriminant analysis reached a classification of the 67% of the subjects into the ADT group and the 70% of the subjects into the VD group. In the initial stages of dementia it is difficult to differentiate between a cortical pattern of cognitive impairment in ADT and a subcortical pattern in VD, a distinction that the other researchers have reported. When complex tests were used the performance depended on the coordination of multiple related systems. These findings are in agreement with the holistic models of higher mental functions.

Lateralized brain dysfunction in schizophrenia: a comparison with patients with lateralized structural lesions

A comparison was made among participants with schizophrenia and those with structural lateralized or diffuse brain damage in order to determine the extent to which the cognitive profile of the schizophrenia sample resembled the profiles obtained from patients with left-hemisphere, right-hemisphere, and diffuse brain damage. The Halstead–Reitan Neuropsychological Battery was used as the testing procedure. The data were subjected to discriminant analysis in order to obtain frequencies of predicted classification of the participants with schizophrenia into schizophrenia, left-hemisphere, right-hemisphere, and diffuse groups. Half of the participants with schizophrenia were classified into the schizophrenia group. The other half was evenly distributed across the left-hemisphere, right-hemisphere, and diffuse brain damage groups. There was not a disproportionately large number of participants classified into the left-hemisphere group. Comparisons among these four predicted groups were accomplished for each of the Halstead–Reitan Battery measures using one-way analysis of variance. The comparison of the subtest scores among the predicted groups indicated that the patients classified into the left-hemisphere group were characterized by a pattern of language dysfunction thought to be developmental in nature, and an abnormal lack of asymmetry in tapping speed favoring the right hand.

Intellectual and neuropsychological features of patients with psychogenic pseudoseizures

Psychogenic pseudoseizures typically are thought to reflect emotional disturbances. Studies have suggested that patients with psychogenic pseudoseizures may also have impaired neuropsychological function. We examined intellectual and neuropsychological performance in a large sample of patients with well-documented psychogenic pseudoseizures. Patients with pseudoseizures only (Pure group) and patients with both pseudoseizures and epilepsy (Mixed group) were included. For the total sample, the WAIS-R IQ scores were quite variable. Full Scale and Performance IQ ranged from deficient to very superior. The Full Scale IQ was in the low average or borderline range in 41.5% of patients. A striking finding was the high incidence of impaired performance on the Halstead–Reitan Neuropsychological Battery in both the Pure and Mixed groups. Considering the neuropsychological variables for which published cut-off scores are available, more than 50% of the total sample (as well as the Pure and Mixed groups) scored in the impaired range on more than half the measures. The Halstead Impairment Index, which reflects the overall level of neuropsychological performance, was in the impaired range (0.5–1.0) in 63% of the sample. Given the high incidence of accidents and physical trauma reported by our patients, we postulate that head trauma might be responsible for neuropsychological impairment in an appreciable number of the patients in this sample.

Internal consistency of three tests from the Halstead-Reitan neuropsychological battery for older children.

The internal consistency of three neuropsychological tests was examined in a sample of 334 referred children (9-14 years of age). Coefficient alpha was calculated to estimate reliability on the Seashore Rhythm Test (SRT), two forms of the Speech Sounds Perception Test (SSPT), and the Aphasia Screening Test (AST). The standard SSPT appears to have relatively good internal consistency with an average coefficient of.81. The average coefficient for the abbreviated form of the SSPT was considerably lower (i.e.,.73), highlighting the superiority of the standard form in clinical practice. Internal consistency of the SRT was relatively low (i.e.,. 67). This level of reliability may be acceptable in group research and for component tests, but is marginal for independent clinical use. Coefficient alpha for the AST was moderate (i.e.,.77), suggesting adequate reliability for a screening test. These reliability estimates are compared to those obtained in previous studies using these tests in adult samples and with other tests commonly used with children.