Recognition Trials Research Articles

A preliminary examination of the TOMM2 in a sample of Spanish speakers in the United States.

The Test of Memory Malingering (TOMM) is a widely used performance validity measure that is available in both English and Spanish. The Spanish version, however, has historically lacked normative data from samples that are representative of the U.S. Hispanic/Spanish speaking population. The aim of the current study was to collect normative data on the update TOMM 2 for Hispanic individuals residing in the U.S. Normative data on the TOMM 2 was collected across 9 sites from different regions of the U.S. The total sample consisted of n = 188 cognitively healthy adults aged 18 and over with no current or prior history of neurological or psychiatric disorder. Descriptive analyses were performed on total raw scores. Participants obtained a mean score of 48.15 (SD = 2.81) on trial 1 of the TOMM 2, 49.86 (SD = 0.487) on trial 2, and 49.84 (SD = 0.509) on the recognition trial. Scores are provided for traditional cutoff scores as well as some popular cutoffs reported in the literature. Item level analyses were conducted as well as evaluation of performance based on a variety of demographics. When compared to the English-speaking normative sample used for the original TOMM, this sample demonstrated better performance on the TOMM 2 indicating better cultural appropriateness of the items. This is the first study conducted that provides culturally appropriate descriptive norms for use with Spanish speakers living in the U.S.

Detecting malingered neurocognitive dysfunction: Comparative analysis of freestanding and embedded performance validity tests

Detecting malingered neurocognitive dysfunction is a major issue in forensic context, particularly in legal proceeding/insurance assessment after a traumatic brain injury (TBI), condition frequently associated with persistent cognitive impairments that may potentially be related to malingering. Consequently, research has devoted considerable efforts on developing tools to verify symptoms authenticity. This study compared two freestanding performance validity tests (PVTs) (Amsterdam Short-Term Memory Test—ASTM; Word Completion Memory Test—WCMT) and five embedded PVTs (Rey Complex Figure Test—RCFT—Copy and Recall trials; Reliable Digit Span—RDS; Rey Auditory Verbal Learning Test—RAVLT—Recognition and Total Learning trials) in a sample of 120 participants, including 15 patients with TBI (Mage = 44.40), 52 experimental simulators (Mage = 29.52) and 53 control (Mage = 29.77). Group performance was analyzed to assess tests’ discriminatory power, and Receiver Operating Characteristic (ROC) curves were used to examine tools’ sensitivity and specificity. Results indicated that experimental simulators performance on the ASTM, WCMT, and RAVLT differed significantly from TBI patients and controls. The RDS and RCFT did not discriminate experimental simulators from TBI group. ROC curves analysis reveals that the most accurate tests in this battery for detecting malingering were the ASTM and the RAVLT-Total Learning score. This study offers implications for identifying malingering in medico-legal settings, underscoring the importance of incorporating PVTs into clinical practice.

B - 137 Analyzing Completion Time on a Created Forced Choice Trial of the Hopkins Verbal Learning Test – Revised (HVLT-R) to Measure Engagement in a Mixed Clinical Sample

Abstract Objective We created a forced choice recognition trial (FCR) for the HVLT-R, including recording completion time (FCompT), to evaluate the utility of combining completion time with accuracy scores when using performance validity tests (PVTs). Method Participants included 29 clinically referred patients at a large medical center who completed the HVLT-R in addition to multiple free-standing and embedded PVTs including the TOMM, Word Choice Test (WCT), Reliable Digit Span (RDS), and the Dot Counting Test (DCT) as part of a larger battery of neuropsychological tests in an outpatient setting. Data from the sample (M age = 64.79, SD = 13.86; M education = 15.65, SD = 2.47; 62.1% females) were analyzed using correlation and linear regression. Results The HVLT-R FCR trial correlated with the TOMM-10, r(19) = 0.75, p = <0.001, TOMM trial 1, r(17) = 0.75, p = <0.01, the DCT r(12) = −0.71, p = <0.01, and the FCompT, r(29) = −0.72, p = <0.001. The FCompT was correlated with RDS, r(28) = −0.46, p = 0.03, TOMM-10, r(19) = −0.64, p = <0.01, and TOMM trial 1, r(17) = −0.61, p = <0.01. FCompT significantly predicted FCR accuracy b = −0.72, t(29) = −5.41, p < 0.001. Conclusions The HVLT-R FC and FCompT strongly correlated with free-standing and embedded PVTs. Data demonstrates that a longer completion time predicts poorer performance on FCR. Results demonstrate the value of measuring completion time for specific PVTs, in addition to providing support for the addition of a FCR trial to the HVLT-R.

B - 145 CVLT-3 Forced Choice Recognition Failure Rate in a Mixed Clinical Population

Abstract Objective The CVLT-3 is a measure of verbal learning and memory used extensively in clinical and research settings that contains an embedded performance validity indicator, a forced choice recognition trial (CVLT-3-FCR). The CVLT-2-FCR was modified for the CVLT-3-FCR, replacing abstract with concrete distractor words. To date, no one has reported independent data on failure rates in clinical populations on the CVLT-3-FCR. Method Participants were 373 patients referred for clinical neuropsychological evaluation who completed the CVLT-3 (Standard form) as part of their evaluation. Mean age was 61.20 (SD = 14.30, range = 20–86), mean education was 15.00 years (SD = 2.87, range = 6–21), 53.1% were male, and 97.6% White. Failure was defined as CVLT-3-FCR score ≤ 14. Results 85.5% of our mixed clinical sample had CVLT-3-FCR score of 16/16, and 7.5% had 15/16. Only 7% (N = 26) scored ≤14, most common primary diagnoses being mild neurocognitive disorder (N = 9) and psychiatric (N = 7), while only four had dementia of any etiology. Those who failed tended to be a little older [pass = 60.82 years (SD = 14.44), fail = 66.38 years (SD = 11.28); p = 0.055) and scored lower for CVLT-3 Total Trials 1–5, short- and long-delay free recall, recognition hits, false positives, and discriminability (all p < 0.001). Conclusions Findings indicate CVLT-3-FCR ≤ 14 is extremely rare in a large mixed clinical sample of adults and older adults, even in subsamples for whom lower scores on PVTs have been suggested (e.g., dementia). While passing the CVLT-3-FCR does not in itself confirm adequate test engagement, failure should raise concern and the need for additional PVTs in one’s assessment.

A preliminary investigation of the utility of the Word Memory Test Immediate Recognition trial as a screener for noncredible performance

The assessment of performance validity is an important consideration to the interpretation of neuropsychological data. However, commonly used performance validity tests such as the Test of Memory Malingering (TOMM) and Word Memory Test (WMT) have lengthy administration times (20–30 minutes). Alternatively, utilizing a screener of performance validity (e.g., the TOMM T1 or TOMMe10) has proven to be an effective method of assessing performance validity while conserving time. The present study investigates the use of the WMT Immediate Recognition (IR) Trial scores as a screening measure for performance validity using an archival mTBI polytrauma sample (n = 48). Results show that the WMT IR demonstrates a high degree of accuracy in predicting WMT Delayed Recognition (DR) Trial performance across a range of base rates suggesting that the WMT IR is a useful screening measure for noncredible performance. Clinical implications and selection of optimal cutoff are discussed.

That old dog can still hunt—Alternative cutoffs and the recognition trial improve the classification accuracy of the Rey 15-Item Test.

That old dog can still hunt—Alternative cutoffs and the recognition trial improve the classification accuracy of the Rey 15-Item Test.

Replicating the classification accuracy of the Verbal Paired Associates and Visual Reproduction recognition trials as embedded performance validity tests.

This study was designed to replicate previous research on the clinical utility of the Verbal Paired Associates (VPA) and Visual Reproduction (VR) subtests of the WMS-IV as embedded performance validity tests (PVTs) and perform a critical item (CR) analysis within the VPA recognition trial. Archival data were collected from a mixed clinical sample of 119 adults (MAge = 42.5, MEducation = 13.9). Classification accuracy was computed against psychometrically defined criterion groups based on the outcome of various free-standing and embedded PVTs. Age-corrected scaled scores ≤ 6 were specific (.89-.98) but had variable sensitivity (.36-.64). A VPA recognition cutoff of ≤ 34 produced a good combination of sensitivity (.46-.56) and specificity (.92-.93), as did a VR recognition cutoff of ≤ 4 (.48-.53 sensitivity at .86-.94 specificity). Critical item analysis expanded the VPA's sensitivity by 3.5%-7.0% and specificity by 5%-8%. Negative learning curves (declining output on subsequent encoding trials) were rare but highly specific (.99-1.00) to noncredible responding. Results largely support previous reports on the clinical utility of the VPA and VR as embedded PVTs. Sample-specific fluctuations in their classification accuracy warrant further research into the generalizability of the findings. Critical item analysis offers a cost-effective method for increasing confidence in the interpretation of the VPA recognition trial as a PVT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Face recognition technology based on ResNet-50

Face recognition technology is progressively finding its place across diverse domains. In pursuit of enhancing the efficacy of face recognition systems, this study employs a ResNet-50 deep convolutional neural network. The dataset is meticulously gathered and processed via OpenCV, thus amplifying the precision and utility of face recognition. ResNet, an advanced convolutional neural network, incorporates the concept of residual connections, bridging convolutional layers through shortcut connections. These connections facilitate the addition of input to output, forming residual blocks. Consequently, ResNet-50 efficiently tackles the vanishing gradient issue, enabling the training of exceptionally deep networks. With 49 convolutional layers and a fully connected layer, ResNet-50 boasts a robust architecture. To emulate varying brightness conditions, post-collection image adjustments are applied randomly. This strategy curbs the impact of divergent lighting scenarios on recognition accuracy, bolstering the models practical applicability. Notably, experimental outcomes underscore the commendable performance of the trained ResNet-50 model in face recognition trials. This substantiates the broad-spectrum viability of face recognition technology in domains such as security surveillance, human-machine interaction, identity verification, and beyond.

The nature of memory impairment in multiple sclerosis: understanding different patterns over the course of the disease.

Memory deficit is one of the most common and severe cognitive impairments in patients with multiple sclerosis and can greatly affect their quality of life. However, there is currently no agreement as to the nature of memory deficit in multiple sclerosis. This cross-sectional study, carried out at the Dr. Josep Trueta and Santa Caterina hospitals in Girona (Spain), was designed to determine the semiology of verbal memory deficit in the different stages of the disease. To this end, a modification of Rey's verbal auditory test was created by introducing two recognition trials between the five learning trials, thus monitoring what happens in terms of acquisition versus the retrieval of information during the learning phase. Linear regression models were used to evaluate verbal episodic memory performance between-groups adjusting results by age, sex, educational level, and the presence of anxiety and/or depressive symptoms. 133 patients with multiple sclerosis, clinically isolated syndrome, and radiologically isolated syndrome and 55 healthy controls aged 18-65 years were assessed. It was observed that the memory processes of multiple sclerosis patients worsen with the progression of the disease. In this respect, patients in pre-diagnostic phases (radiologically isolated syndrome and clinically isolated syndrome) show no differences in verbal episodic memory compared to the healthy controls. Patients in the inflammatory stage (relapsing-remitting multiple sclerosis) show a previously learned information retrieval deficit, while patients in progressive stages (secondary progressive multiple sclerosis and primary progressive multiple sclerosis) do not even correctly acquire information. These results provide significant information to assist in understanding the nature of memory deficits in multiple sclerosis over the course of the disease. These results are discussed in terms of possible cognitive rehabilitation strategies depending on the evolutive stage and are related to neuropathological mechanisms involved in the progression of the disease.

The utility of the Poreh Nonverbal Memory Test (PNMT) for the detection of noncredible performance

Performance validity tests (PVTs) aim to detect noncredible performance during neuropsychological testing. Despite their established utility, their cognitively undemanding nature and format may unintentionally reveal their purpose, leading to ongoing efforts to develop novel PVTs. In this study, we examined the ability of the embedded validity indices of the Poreh Nonverbal Memory Test (PNMT) to detect simulation. An initial sample of 61 participants was randomly assigned to either a simulation or control condition. Participants then completed the PNMT, the Test of Memory Malingering (TOMM), and the Digit Span subtest. A second validation study using 49 participants was conducted in Israel utilizing the same paradigm. In both studies, simulators were less accurate, exhibited shallow and– at times– reversed PNMT learning curves, and obtained lower scores on the delayed and recognition trials. Additionally, PNMT indices showed similar sensitivity and specificity and were highly correlated with more established validity measures. These findings, however, should be considered preliminary and await further validation in clinical settings.

A comparison of the original ADAS‐cognitive subscale and a novel extended version in mild cognitive impairment and Alzheimer’s disease.

AbstractBackgroundThe Original Alzheimer’s disease Assessment Scale‐cognitive subscale (oADAS) is the gold standard for assessing cognition in Alzheimer’s disease (AD) medication clinical trials. One criticism is that this measure is not sensitive to pre‐dementia syndromes such as mild cognitive impairment (MCI), possibly due to ceiling effects for many of the subtests in the original ADAS‐cog (oADAS). In this study, we examined group differences between individuals with MCI, AD, and normal controls (NC) on the oADAS and a novel extended version of the ADAS (eADAS). We hypothesized the eADAS would be more sensitive than the oADAS at detecting differences between the groups after controlling for age, education, and sex.MethodThe oADAS was administered using standardized methods. The eADAS included short‐delay recall and recognition trials for the first wordlist, a short‐delay true‐false word recognition trial for the second word‐list, a letter‐digit timed psychomotor test, supermarket fluency, spontaneous clock drawing, three additional items to the object naming subtest, three additional figures to copy, and a similarities test. MCI and possible AD were diagnosed using established diagnostic criteria. The NC group was significantly younger and more educated than the MCI and AD groups. A 3×2 ANCOVA model with group as the between subject factor and ADAS type as the within subject factor was used. Total error scores from the oADAS and eADAS were converted to z‐scores.ResultThere was no main effect of ADAS type or ADAS type X education or ADAS type X group interactions. There were ADAS type x age and ADAS type x gender interactions (p’s = 0.01). Pairwise comparisons demonstrated that the NC group had lower total error scores compared to the MCI and AD groups and the MCI group had lower total error scores compared to the AD group for both the oADAS and eADAS (p’s<0.001).ConclusionThe results of the current study indicate that oADAS and eADAS are sensitive to group differences between MCI and AD, which was contrary to our hypothesis. We suggest more rigorous diagnostic criteria for MCI in the present study may explain some of the conflicting findings in the literature.

Longitudinal Trajectories of Normal versus Abnormal Cognitive Aging in the SIU Longitudinal Cognitive Aging Study as measured by the original Alzheimer’s disease Assessment Scale and a novel extended version

AbstractBackgroundThe original Alzheimer’s disease Assessment Scale‐cognitive subscale (oADAS) is a common measure of cognition used in Alzheimer’s disease (AD) clinical trials. The oADAS may not be sensitive to pre‐dementia syndromes such as mild cognitive impairment (MCI), possibly due to ceiling effects for many of the subtests. However, little is known about the trajectories of cognitive aging on the oADAS in cognitively‐normal individuals who decline over time. We used Linear Mixed Effects Modeling to examine trajectories of cognitive aging on the oADAS, a novel extended version (eADAS), and the MMSE. We hypothesized that, compared to non‐decliners, individuals who declined from normal to MCI and/or AD (decliners) would demonstrate increased error scores on the ADAS and lower scores on the MMSE over time.MethodsWe included data from 608 older adults (72% female, mean age = 69.0 years) who were enrolled in SIU Longitudinal Cognitive Aging Study (LCAS). Total years of educational attainment ranged from 8‐26 years. The vast majority of the participants were White/Not‐Hispanic. There were 50 decliners and 558 non‐decliners included in the present analysis. The eADAS included short‐delay recall/recognition trials for the first word list, a short‐delay true‐false word recognition trial for the second word list, a letter‐digit d psychomotor test, supermarket fluency, spontaneous clock drawing, three additional items to the object naming subtest, three additional figure copies, and a similarities test. All analyses were completed after controlling for gender, education, age at first visit, time between visits, and number of visits.ResultsThere was no significant difference between the groups for age at first visit. Greater age at first visit and lower education were associated with increased error scores for both ADAS versions and MMSE in the decliner group (p’s <0.001). There was no significant effect of the number of days between visits. The mean coefficients for the change in error score over time between visits for the oADAS, eADAS, and MMSE was 2.84, 10.30, and ‐1.09, respectively.ConclusionOur results indicate that the oADAS and eADAS are useful measures for examining trajectories of cognitive decline in cognitively‐normal individuals at increased risk for AD.

Validity assessment in Eastern Europe: cross-validation of the Dot Counting Test and MODEMM against the TOMM-1 and Rey-15 in a Romanian mixed clinical sample.

This study investigated performance validity in the understudied Romanian clinical population by exploring classification accuracies of the Dot Counting Test (DCT) and the first Romanian performance validity test (PVT) (Memory of Objects and Digits and Evaluation of Memory Malingering/MODEMM) in a heterogeneous clinical sample. We evaluated 54 outpatients (26 females; MAge = 62.02; SDAge = 12.3; MEducation = 2.41, SDEducation = 2.82) with the Test of Memory Malingering 1 (TOMM-1), Rey Fifteen Items Test (Rey-15) (free recall and recognition trials), DCT, MODEMM, and MMSE/MoCA as part of their neuropsychological assessment. Accuracy parameters and base failure rates were computed for the DCT and MODEMM indicators against the TOMM-1 and Rey-15. Two patient groups were constructed according to psychometrically defined credible/noncredible performance (i.e., pass/fail both TOMM-1 and Rey-15). Similar to other cultures, a cutoff of ≥18 on the DCT E score produced the best combination between sensitivity (0.50-0.57) and specificity (≥0.90). MODEMM indicators based on recognition accuracy, inconsistencies, and inclusion false positives generated 0.75-0.86 sensitivities at ≥0.90 specificities. Multivariable models of MODEMM indicators reached perfect sensitivities at ≥0.90 specificities against two PVTs. Patients who failed the TOMM-1 and Rey-15 were significantly more likely to fail the DCT and MODEMM than patients who passed both PVTs. Our results offer proof of concept for the DCT's cross-cultural validity and the applicability of the MODEMM on Romanian clinical examinees, further recommending the use of heterogeneous validity indicators in clinical assessments.

81 An Examination of a Multiple Cutoff Performance Validity Index

Objective:Recent consensus guidelines have advocated for the use of multivariate performance validity assessment on ability-based measures such those used in neuropsychological assessment. Further, previous research has demonstrated that aggregating performance validity indicators may produce superior classification accuracy. The present study builds upon this research by aggregating data from three of the most commonly used performance validity measures (Test of Memory Malingering [TOMM], Rey Fifteen Item Test with recognition trial [FIT plus recognition], and Reliable Digit Span [RDS]) to create a performance validity composite measure in a veteran mild traumatic brain injury (mTBI) population.Participants and Methods:Data of patients evaluated at a VA hospital who had completed the RDS, FIT plus recognition, and TOMM as part of their clinical neuropsychological evaluation were analyzed (n = 20). Two composite performance validity indexes were created: a Single Cutoff Performance Validity Index (SC-PVI), which measures the quantity of failures across performance validity measures (PVMs) by summing the total number of PVM failures, and a Multiple Cutoff Performance Validity Index (MC-PVI) which measures the number of failures as well as degree of failure(s) across measures of performance validity (e.g., a participant would attain a score of 3 if their PVM performance failed to reach a conservative cut point; they would obtain a score of 1 if they met conservative cut point, yet failed to reach a liberal cut point).Results:Only one participant (5%) attained a score of 0 on the SC-PVI (i.e., passing all PVTs using standard cutoffs) and MC-PVI (i.e., passing the most liberal cut points on all three PVMs). Conversely, eight participants (40%) attained a score of 3 on the SC-PVI (i.e., failed all three PVMs) and four participants (20%) attained a score of 9 (i.e., failed the most conservative cut points on all three PVMs). Results showed a significant (p < .001) ordinal association between the two indices (G = .984); however, there was no significant agreement between SC-PVI and MC-PVI models (k = -.087; p = .127).Conclusions:Data revealed discordant findings between the three PVMs utilized. The majority of participants (75%) scored between 2-8 on the MC-PVI, meaning that they did not exceed all liberal cut points or fail all conservative cut points. These “grey area” scores suggest an indeterminate range of performance validity, which cannot be captured by a solitary cut point or neatly classified as pass or fail. The utility of multiple cutoff performance validity models (i.e., aggregating PVMs to consider the severity of failure and number of failures) is that they capture the nuance of these data when determining and discussing the credibility of a profile. Multiple cut point data also highlight how the choice of cutoff influences the outcome of performance validity research and clinical decision making. As such, future research on the classification accuracy of this MC-PVI is needed.

84 Using a Combination Score from the Full Rey Complex Figure Test (RCFT) as a Performance Validity Measure (PVT)

Objective:Some RCFT indices are effective Performance Validity Test (PVTs) during neuropsychological evaluations. A combination score that includes the copy score, true positive recognition, and atypical errors has proven to be especially useful (see Lu et al, 2003). However, this score was derived from administration that deviated from protocols outlined by Meyers & Meyers (1995) in that the Recognition trial was administered after the 3-minute delay instead of the 30-minute delay. The current study examined the utility of the RCFT combination score as a performance validity test (PVT) when completing the recognition trial after the 30-minute delay.Participants and Methods:This study utilized archival data from 298 Veterans who presented for a clinical neuropsychological evaluation at a southern Veterans Affairs Medical Center. The evaluation included up to nine PVTs and all trials of the RCFT (per Meyers & Meyers, 1995). Patients were considered credible if all PVT performance fell within normal limits. This resulted in 232 patients in the credible group (Mage = 52.9 years, SDage = 15.2, Medu = SDedu = 2.5, 88% male, 71.2% White, 28.3% Black/African American). Patients were considered non-credible if they failed >2 PVTs. This resulted in 66 patients in the non-credible group (Mage = 51.6, SDage = 13.79, Medu = SDedu = 2.4, 92.4% male, 56.1% White, 43.9% Black/African American). Group assignment was also clinically confirmed. Receiver operating characteristic (ROC) curve analyses were conducted to discriminate between credible and non-credible groups utilizing the established RCFT combination score.Results:RCFT combination scores distinguished groups, with credible participants scoring higher than non-credible participants (F[1, 296]=63.76, p<.001, d=1.11; M = 56.9, SD = 9.3 vs. M = 46.5, SD = 9.5, respectively). A ROC analysis indicated AUC = .800 (95% CI = .73 to .86). When specificity was set at >90%, a cut-score of <46.5 yielded sensitivity at 46.0%. The analogous cut-score from the Lu et al. (2003) study (i.e., <47) was associated with a specificity of 88.7 and sensitivity of 46.0% in the current study.Conclusions:As the Lu et al. (2003) established the combination score of the RCFT with procedures that deviated from the standardized protocol outlined by Meyers and Meyers (1995), clinicians who opted to adhere to Meyers and Meyers’ full protocol may have concerns about using the combination score as a PVT. The current study established a similar cut-off score to what Lu et al., (2003) reported (i.e., <46.5 vs. <47) while following a different administration procedure of the RCFT. Also, the index was moderately sensitive in the current study (i.e., 45.5%) but less so than what Lu et al. reported when using a cut-score that had >90% specificity (i.e., 75.9% sensitivity). This suggests that the index may be robust to deviations in administration procedures. Difference in sensitivity could be related to difference between samples. As the current sample was derived from a clinical, VA setting, current findings extend the generalizability of the index. Future research would benefit exploring if any subgroups would benefit from adjusted cut-scores to reduce the risk of false positive identification.

82 Single Errors on Trial 1 of the Test of Memory Malingering may be Indicative of Invalid Performance on Neuropsychological Measures in a Sample of Youth Athletes

Objective:The Test of Memory Malingering (TOMM) is a performance validity test (PVT) that aims to assess whether participants are giving adequate effort to perform well on tasks of memory performance (Tombaugh, 1996). Other PVTs, specifically the Forced Choice Recognition Trial in the California Verbal Learning Test, have shown that even single errors may indicate invalid performance (Erdodi et al., 2018). Finally, youth are often understudied in the PVT literature, and athletes are at increased risk of invalid performance on baseline testing due to many wanting to return to play following concussion (Erdal, 2012). Therefore, the objective of the current study is to examine whether single errors on TOMM Trial 1 are indicative of lower, and possibly invalid, cognitive performance in a youth sample, given that cognitive performance declines with even small decreases in effort (Green, 2007).Participants and Methods:Healthy youth athletes (n=174) aged 8-16 years (M=12.07) completed the TOMM as well as other neuropsychological measures during baseline neuropsychological evaluation in a clinical research program for sports concussion. Independent samples t-tests compared youth athletes who scored 49 points on the TOMM (n=28) to youth athletes who scored a perfect 50 (n=50) across several groupings of neuropsychological measures. Participants who scored less than 49 or who didn’t complete the TOMM were excluded from the analyses.Results:Participants scoring 50/50 on TOMM Trial 1 scored significantly higher on Stroop Color Naming task (p=0.036), Verbal Learning Delayed task from the second edition of the Wide Range Assessment of Learning and Memory (WRAML-2, p=0.018), and Letter Number Sequencing task from the Weschler Intelligence Scale for Children (WISC-IV, p=0.025), relative to participants scoring 49/50. Though not statistically significant, results also showed a trend toward participants scoring 50/50 scoring higher on nearly every test in the battery.Conclusions:Participants with a single error on TOMM Trial 1, as compared to participants with a perfect score, performed significantly worse on a processing speed task, a verbal learning task, and a working memory task as part of a comprehensive neuropsychological battery. The single-error group also trended toward scoring lower on nearly all of the remaining attention, processing speed, perceptual ability, memory, and executive functioning tasks in the battery. The results could lead to a more liberal interpretation of TOMM scores, given that the trend towards lower performance may be due to putting forth significantly less effort. These results point to the need for a similar comparison of the TOMM in a larger sample size, as greater power may reveal even more significant differences in performance. Findings also emphasize the importance of viewing performance validity on a continuum rather than as a dichotomous pass/fail. Understanding the TOMM and how single errors may be indicative of poorer performance in a youth sample could help to reframe the way PVT results are interpreted in clinical and forensic settings.

87 Examining the use of the Embedded Performance Validity Test in the Brief Visuospatial Memory Test-Revised Among Spanish-Speaking Patients

Objective:The Brief Visuospatial Memory Test-Revised (BVMT-R) Recognition Discrimination (RD) index has emerged as an embedded performance validity test (PVT). However, there do not appear to be any studies that have examined its utility in Spanish-speaking samples. This pilot study examined the classification accuracy of the BVMT-R RD for detecting performance invalidity in a Spanish-speaking forensic sample.Participants and Methods:This cross-sectional study utilized a sample of 89 Spanish speakers that were administered the BVMT-R during an outpatient neuropsychological evaluation. Out of the 89 Spanish speakers, 43 were subjects in litigation, 32 were neurological patients evaluated for clinical purposes, and 14 were healthy controls. The sample was 67% male/33% female, 53% South American, 33% Caribbean (Dominican, Puerto Rican, Cuban), 10% Central American, 3% North American (Mexican), and 1% Spanish, with a mean age of 44.2 years (SD = 14.2; range = 20-78) and mean education of 11 years (SD = 3.7; range = 0-20). Test administration for each patient was completed in Spanish by a fluent, Spanish-speaking examiner. In total, 64/89 (72%) were classified as valid and 25/89 (28%) as invalid based on performance across the Test of Memory Malingering (TOMM), at least one additional PVT (Rey-15 item memory test; Rey Dot Counting Test; Reliable Digit Span; WHO-AVLT recognition trial) and objective diagnostic criteria identifying invalid performance. Analyses included three univariate analyses of variance (ANOVA), with the groups (healthy vs neurological vs litigation) as independent variables and performance on BVMT-RD as the dependent variable.Results:Statistically significant differences among the groups were found F(2,86)=8.32, p < .001). Post-hoc analysis (Scheffe test) showed the mean of the litigation group to be significantly lower than the means of the other two groups (healthy and neurological), which showed no difference between them. An ANOVA with validity groups as the fixed factor and BVMT-R RD index as the dependent variable was significant F(1,85)= 21.02, p <.001). Results of a ROC curve analysis yielded statistically significant AUC (.794). The optimal cut-score was BVMT-R RD < 5 (48% sensitivity/88% specificity).Conclusions:Results of the BVMT-R RD index in this Spanish-speaking population differed by subgroup, with worse performance seen in individuals involved in litigation, compared to those who were not (healthy and neurological). Notably, the BVMT-R RD index significantly differentiated validity groups, maintaining adequate sensitivity and good specificity. Overall, results demonstrate promise for BVMT-RD as a PVT for Spanish-speaking populations.

Recognition subtests of the Repeatable Battery for the Assessment of Neuropsychological Status: evidence for a cortical vs. subcortical distinction

ABSTRACT Introduction Within clinical neuropsychology, a classic diagnostic distinction is made between cortical and subcortical disorders, especially based on their memory profiles. Typically, this is based on the comparison of recall and recognition trials, where individuals with cortical conditions do not tend to benefit (i.e., score well) on recognition trials and individuals with subcortical conditions do. Although the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used brief cognitive battery, there is a lack of evidence to support this measure’s utility in distinguishing between the memory profiles of these conditions. Method Thirty-six mild Alzheimer’s disease (AD), 55 Parkinson’s disease (PD), and 105 essential tremor (ET) participants (N = 196) were administered the RBANS with additional Story and Figure Recognition subtests. Group differences on recall and recognition scores (Total Correct, Hits or True Positives, False Positive Errors, and discriminability index) were examined across the three groups, while controlling for the influence of age and gender. Results As expected, individuals with AD had poorer recognition scores compared to the other clinical groups across tasks (all p-values < .05), while the ET sample largely performed comparably to the PD sample. With the exception of comparable Figure Recognition and Recall in the PD sample, all groups exhibited significantly greater recognition Hit performance compared to Recall (all p-values < .05). Conclusions The group differences in performance across RBANS recognition subtests suggest support for traditional “cortical” and “subcortical” profiles. However, all groups, including the mild AD sample, demonstrated a benefit from recognition cues compared to free recall. Overall, these findings support the inclusion of the newly developed Story and Figure Recognition subtests in future clinical practice and research endeavors.

Re-investigation of the Mediating Effect of Brain Activities between Dispositional Factors and Hazard Recognition: A Multilevel Logistic Regression Approach

Understanding the relationships among dispositional factors, brain activities, and hazard recognition is important for developing auxiliary safety technologies and improving construction safety performance. However, current logistic statistical models have embedded potential biases into the interpretation of brain activities. The purpose of this study was to re-investigate the mediation effect of brain activities between dispositional factors (risk propensity, work experience, and injury history) and hazard recognition performance (HRP). An experiment was designed in which 71 construction workers each completed 120 hazard recognition trials (N = 8520), while the research team used an electroencephalogram recorder to record the brainwaves of the participants. The data were analyzed by the multilevel logistic regression method, and the results showed that the brain activities in FP1, FP2, and AF3 significantly mediated the relationship between dispositional factors and HRP. The findings theoretically supplement the understanding of brain activities in different hazard cognitive stages for hazard recognition. The results should contribute to the development of neuro-engineering technology and safety management strategies.

Assessing learning and memory among patients with pediatric brain tumor (PBT): a comparison of measures

ABSTRACT Patients with pediatric brain tumor (PBT) can have memory deficits due to tumor location, medical complications, and treatment. The main objective of this study was to investigate whether the California Verbal Learning Test-Children’s Version (CVLT-C; 1994) and briefer Child and Adolescent Memory Profile (ChAMP; 2015) similarly identify such deficits. Seventy-five patients with PBT ages 8–16 ( = 13.1 years, SD = 2.1) were administered the ChAMP or CVLT-C. Rote verbal learning, long-term retrieval, and recognition were analyzed using standardized z-scores. Analyses of differences between measures did not reach statistical significance. Both measures indicated significant downward shifts across free retrieval trials from normative means, with scores approximately 1/3 (ChAMP) to 1/2 (CVLT-C) SD below means across learning and long-term retrieval trials. Scores on recognition trials did not differ significantly from the normative mean. Post-hoc analyses using a subset of the sample who received cranial irradiation (n = 45) similarly found no significant differences between memory measures. Additional post-hoc examination of proportion of participants falling within or below the “below average” range (≤8th percentile) revealed comparable performance between the two measures, whereas the proportion of participants falling at or below 1.5 SDs below the mean on retrieval trials was lower using ChAMP Lists as compared to the CVLT-C. Given the ChAMP is less demanding in terms of time and effort and utilizes more updated and representative normative data, this study supports the ChAMP as a useful tool to evaluate learning and memory within this population.