Rey-Osterreith Complex Figure Test Research Articles

Executive functions of people with drug addiction

This study aimed to see the impairments of executive functions in people with drug dependence. Participants were selected using a purposive sampling method and the sample size was 120, among them 60 were in drug user group and 60 were healthy control. Neuropsychological assessment tools were used – Frontal Assessment Battery (FAB) and Rey-Osterreith Complex Figure Test (RCFT), for assessing the executive functioning of the participants. Data were analyzed using SPSS software, version 20. Independent-Samples t-test was carried out and the result has shown that the control group performed better in all tests. In FAB, significant difference was found in performance between the drug users and control group, t (90.9) = 9.89, p = 0.00, α = 0.01. Both in copy and immediate recall phase of RCFT, there were significant differences of performance between the drug users and control group, t(70.9) = 8.11, p = 0.00, α = 0.01 and t (118) = 11.9, p = 0.00, α = 0.01, respectively. Results indicate that the executive functions of drug dependent people are significantly impaired. Therefore, this issue should be taken in consideration for creating individualized treatment programs and can also assist in taking preventive measures.
 Dhaka Univ. J. Biol. Sci. 29(1): 27-36, 2020 (January)

Features of the cognitive sphere in patients with a mixed episode of bipolar affective disorder

Background. Data of various meta-analyzes confirm that the majority of patients with bipolar affective disorder (BAD) have neurocognitive dysfunction, even during remission. According to the latest research, disturbed domains with moderate to pronounced changes are attention, verbal learning and memory, as well as executive functions, whereas premorbid intelligence may remain unchanged. The main body of research is devoted to the study of cognitive impairment in the first episode of BAD, in manic, depressive episodes and euthymia. At the same time, the features of cognitive dysfunction in mixed forms of biologically active substances remain insufficiently studied.
 Objective – to study the characteristics of the cognitive sphere in patients with a mixed episode of BAD.
 Materials and methods. With the help of battery tests (a test to memorize ten unrelated words; Rey-Osterreith Complex Figure Test; Verbal Fluency Test Digit Symbol Substitution Test; Trail making test), the cognitive functions of 25 patients with mixed episodes, 16 patients with manic episodes, and 15 patients with depressive episode of BAD.
 Results. Cognitive impairments were identified in all patients, regardless of the type of affective symptoms, in the form of a wide range of psychopathological phenomena, which are more pronounced in patients with a mixed episode BAD. The peculiarities of the phenomenological structure of cognitive impairment in patients with mixed phase BAD manifest themselves in the form of: a more pronounced deterioration of verbal memory, speed of information processing; more pronounced violations of spatial representations, impairment of visual memory, verbal associative performance and executive functions; reduction of attention and violations of its distribution.
 Conclusions. The findings suggest that the presence of depressive symptoms in the structure of mixed affect plays a dominant role in the formation of these disorders.

Distinct resting-state functional connections associated with episodic and visuospatial memory in older adults

Episodic and spatial memory are commonly impaired in ageing and Alzheimer's disease. Volumetric and task-based functional magnetic resonance imaging (fMRI) studies suggest a preferential involvement of the medial temporal lobe (MTL), particularly the hippocampus, in episodic and spatial memory processing. The present study examined how these two memory types were related in terms of their associated resting-state functional architecture. 3T multiband resting state fMRI scans from 497 participants (60–82 years old) of the cross-sectional Whitehall II Imaging sub-study were analysed using an unbiased, data-driven network-modelling technique (FSLNets). Factor analysis was performed on the cognitive battery; the Hopkins Verbal Learning test and Rey-Osterreith Complex Figure test factors were used to assess verbal and visuospatial memory respectively. We present a map of the macroscopic functional connectome for the Whitehall II Imaging sub-study, comprising 58 functionally distinct nodes clustered into five major resting-state networks. Within this map we identified distinct functional connections associated with verbal and visuospatial memory. Functional anticorrelation between the hippocampal formation and the frontal pole was significantly associated with better verbal memory in an age-dependent manner. In contrast, hippocampus–motor and parietal–motor functional connections were associated with visuospatial memory independently of age. These relationships were not driven by grey matter volume and were unique to the respective memory domain. Our findings provide new insights into current models of brain-behaviour interactions, and suggest that while both episodic and visuospatial memory engage MTL nodes of the default mode network, the two memory domains differ in terms of the associated functional connections between the MTL and other resting-state brain networks.

No cognitive-enhancing effect of GLP-1 receptor agonism in antipsychotic-treated, obese patients with schizophrenia.

Schizophrenia is associated with profound cognitive and psychosocial impairments. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used for diabetes and obesity treatment, and animal studies have indicated cognitive-enhancing effects. In this investigator-initiated, double-blind, randomized, placebo-controlled trial, we tested non-metabolic effects of exenatide once-weekly (Bydureon™) in obese, antipsychotic-treated patients with schizohrenia spectrum disorder. Before and after 3 months of exenatide (N = 20) or placebo (N = 20) treatment, patients were assessed with the following: Brief Assessment of Cognition in Schizophrenia (BACS), Rey-Osterreith complex figure test (REY), Short-Form Health Survey (SF-36), Personal and Social Performance Scale (PSP) and the Positive and Negative Syndrome Scale (PANSS). We used BACS composite score as the main outcome measure. Repeated measures analysis of variance on BACS composite score showed significant effect of 'Time' (P < 0.001), no effect of 'Group' (P = 0.64) and no 'Time*Group' interaction (P = 0.77). For REY, SF-36, PSP and PANSS, only significant 'Time' effects were found. The non-significant results of this first clinical trial exploring non-metabolic effects of a long-acting GLP-1RA in patients with schizophrenia could reflect a general problem of translating cognitive-enhancing effects of GLP-1RAs from animals to humans or be explained by factors specifically related to schizophrenia spectrum patients with obesity such as antipsychotic treatment.

The Effect of Visuospatial Rehabilitation on the Visuospatial Function and Attention in Patients with Schizophrenia

본 연구는 시공간 재활훈련이 조현병 환자들의 시공간 기능을 포함한 인지기능의 향상과 사회적 기능, 조현병 증상의 완화에 효과적인가를 알아보고자 하였다. 연구대상은 서울 소재 사회복귀시설에 거주하고 있는 조현병 환자 43명으로, 이들은 재활집단(n=14), 비교집단(n=14), 통제집단(n=15)으로 무선할당되었다. 재활집단은 주 3회 각 40분씩 6주에 걸쳐 총 18회기의 시공간 재활훈련을, 비교집단은 동일한 회기 동안 테트리스 게임을 실시하였고, 통제집단은 아무런 처지도 받지 않았다. 시공간 재활훈련 프로그램은 Bracy (1994)가 개발한 PSS CogReHab을 국내 상황에 맞게 수정하여 개발한 인지재활 프로그램을 사용하였다. 시공간 기능/시각기억, 주의, 언어기억, 작업기억, 집행기능을 평가하는 신경심리검사와 조현병 증상을 측정하는 Positive and Negative syndrome Scale (PANSS), 사회적 기능을 평가하는 한국판 정신사회적 기능-증상 평가척도(BASIS-32) 설문지를 재활훈련 전과 후에 실시하였다. 그 결과, 재활 후 실시한 신경심리검사에서 재활집단은 비교집단과 통제집단과 다르게 Rey 도형검사 모사단계, 숫자외우기 검사의 바로 따라외우기 조건, Stroop 검사의 단어-색채 조건의 수행이 유의하게 증가하였다. 그리고 재활집단에서 PANSS로 측정한 음성증상이 완화된 것이 관찰되었다. 이러한 결과는 시공간기능 재활이 조현병 환자의 시공간 기능 및 주의 기능 향상, 음성증상 완화에 효과적이라는 것을 의미하며, 조현병 환자의 치료에 시공간 기능을 포함하는 인지재활의 필요성을 시사한다.

Cognitive functioning in people with chronic fatigue syndrome: A comparison between subjective and objective measures.

The purpose of this study was to examine the relationship between subjective and objective assessments of memory and attention in people with chronic fatigue syndrome (CFS), using tests that have previously detected deficits in CFS samples and measures of potential confounds. Fifty people with CFS and 50 healthy controls were compared on subjective (memory and attention symptom severity, Cognitive Failures Questionnaire, Everyday Attention Questionnaires) and objective (California Verbal Learning Test, Rey-Osterreith Complex Figure Test, Paced Auditory Serial Addition Test, Stroop task) measures of memory and attention. Fatigue, sleep, depression, and anxiety were also assessed. The CFS group reported experiencing more cognitive problems than the controls, but the two groups did not differ on the cognitive tests. Scores on the subjective and objective measures were not correlated in either group. Depression was positively correlated with increased severity of cognitive problems in both the CFS and control groups. There is little evidence for a relationship between subjective and objective measures of cognitive functioning for both people with CFS and healthy controls, which suggests that they may be capturing different constructs. Problems with memory and attention in everyday life are a significant part of CFS. Depression appears to be related to subjective problems but does not fully explain them.

Postoperative Increase in Cerebral White Matter Fractional Anisotropy on Diffusion Tensor Magnetic Resonance Imaging Is Associated With Cognitive Improvement After Uncomplicated Carotid Endarterectomy

Carotid endarterectomy (CEA) might improve cognitive function. Fractional anisotropy (FA) values in the cerebral white matter derived from diffusion tensor magnetic resonance imaging (DTI) correlate with cognitive function in patients with various central nervous system diseases. To use tract-based spatial statistics to determine whether postoperative changes of FA values in the cerebral white matter derived from DTI are associated with cognitive improvement after uncomplicated CEA. In 80 patients undergoing CEA for ipsilateral internal carotid artery stenosis (≥70%), FA values in the cerebral white matter were derived from DTI before and 1 month after surgery and were analyzed by using tract-based spatial statistics. Neuropsychological testing, consisting of the Wechsler Adult Intelligence Scale Revised, the Wechsler Memory Scale and the Rey-Osterreith Complex Figure test, was also performed preoperatively and after the first postoperative month. Based on the neuropsychological assessments, 11 (14%) patients were defined as having postoperatively improved cognition. The difference between the 2 mean FA values (postoperative values minus preoperative values) in the cerebral hemisphere ipsilateral to surgery was significantly associated with postoperative cognitive improvement (95% confidence intervals, 2.632-9.877; P = .008). White matter FA values in patients with postoperative cognitive improvement were significantly increased after surgery in the whole ipsilateral cerebral hemisphere, in the contralateral anterior cerebral artery territory, and in the watershed zone between the contralateral anterior and middle cerebral arteries. Postoperative increase in cerebral white matter FA on DTI is associated with cognitive improvement after uncomplicated CEA.

Intervening Tasks and Visuospatial Memory: The Role of Similarity in Retroactive Interference

Verbal tasks are often administered during the Rey-Osterreith Complex Figure Test (ROCFT) delay period in order to minimize retroactive interference resulting from similarity between tests (Meyers & Meyers, 1995). However, previous studies showed that similarity between the California Verbal Learning Test-II (CVLT-II) and intervening tasks administered during the delay period did not affect memory performance on the CVLT-II. In the current study we examined whether intervening tasks similar to the ROCFT would increase retroactive interference compared to dissimilar tasks, thereby negatively impacting visuospatial memory performance. A total of 106 undergraduate students were divided into three groups. Each group completed different intervening tasks during the ROCFT delay interval. Groups did not differ on copy, immediate recall, and delayed recall trials of the ROCFT. However, a repeated-measures ANOVA revealed an interaction between group and trial (p < .001), suggesting group performance on the ROCFT was differentially impacted by the intervening task. Planned comparisons indicated that the group completing two similar non-verbal intervening tasks had poorer memory of the complex figure and performed significantly worse on recognition (p = .003) and percent retention (p < .001) trials, respectively. This suggests that similarity of intervening tasks impacts memory performance on a complex figure test.

Neuroanatomical target theory as a predictive model for radiation-induced cognitive decline

In a retrospective review to assess neuroanatomical targets of radiation-induced cognitive decline, dose volume histogram (DVH) analyses of specific brain regions of interest (ROI) are correlated to neurocognitive performance in 57 primary brain tumor survivors. Neurocognitive assessment at baseline included Trail Making Tests A/B, a modified Rey-Osterreith Complex Figure, California or Hopkins Verbal Learning Test, Digit Span, and Controlled Oral Word Association. DVH analysis was performed for multiple neuroanatomical targets considered to be involved in cognition. The %v10 (percent of ROI receiving 10 Gy), %v40, and %v60 were calculated for each ROI. Factor analysis was used to estimate global cognition based on a summary of performance on individual cognitive tests. Stepwise regression was used to determine which dose volume predicted performance on global factors and individual neurocognitive tests for each ROI. Regions that predicted global cognitive outcomes at doses <60 Gy included the corpus callosum, left frontal white matter, right temporal lobe, bilateral hippocampi, subventricular zone, and cerebellum. Regions of adult neurogenesis primarily predicted cognition at %v40 except for the right hippocampus which predicted at %v10. Regions that did not predict global cognitive outcomes at any dose include total brain volume, frontal pole, anterior cingulate, right frontal white matter, and the right precentral gyrus. Modeling of radiation-induced cognitive decline using neuroanatomical target theory appears to be feasible. A prospective trial is necessary to validate these data.

Postoperative Cerebral White Matter Damage Associated with Cerebral Hyperperfusion and Cognitive Impairment after Carotid Endarterectomy: A Diffusion Tensor Magnetic Resonance Imaging Study

Background: Cerebral hyperperfusion after carotid endarterectomy (CEA), even when asymptomatic, often impairs cognitive function. However, conventional magnetic resonance (MR) imaging rarely demonstrates structural brain damage associated with postoperative cognitive impairment. MR diffusion tensor imaging (DTI) is potentially more sensitive for detection of white matter damage. Among the common parameters derived by DTI, fractional anisotropy (FA) is a marker of tract integrity, and mechanical disruption of axonal cylinders and loss of continuity of myelin sheaths may be responsible for reduced FA in white matter. The purpose of the present study was to determine whether postoperative cerebral white matter damage that can be detected by FA derived by DTI is associated with cerebral hyperperfusion after CEA and correlates with postoperative cognitive impairment. Methods: In 70 patients undergoing CEA for ipsilateral internal carotid artery stenosis (≥70%), cerebral blood flow (CBF) was measured using single-photon emission computed tomography (SPECT) before and immediately after CEA and on postoperative day 3. FA values in cerebral white matter were assessed using DTI before and 1 month after surgery. These values were normalized and analyzed using statistical parametric mapping 5. In each corresponding voxel in the pre- and postoperative normalized FA maps of each patient, a postoperative FA value minus a preoperative FA value was calculated, and a voxel with postoperatively reduced FA was defined based on data obtained from healthy volunteers. The number of voxels with postoperatively reduced FA was calculated and defined as the volume with postoperatively reduced FA. Neuropsychological testing, consisting of the Wechsler Adult Intelligence Scale Revised, the Wechsler Memory Scale and the Rey-Osterreith Complex Figure test, was also performed preoperatively and after the first postoperative month. Postoperative cognitive impairment on neuropsychological testing in each patient was defined based on data obtained from patients with asymptomatic unruptured cerebral aneurysms. Results: Post-CEA hyperperfusion on brain perfusion SPECT (CBF increase ≥100% compared with preoperative values) and postoperative cognitive impairment on neuropsychological testing were observed in 11 (16%) and 9 patients (13%), respectively. The volume with postoperatively reduced FA in cerebral white matter ipsilateral to surgery was significantly greater in patients with post-CEA hyperperfusion than in those without (p < 0.0001). This volume in cerebral white matter ipsilateral to surgery was also significantly associated with postoperative cognitive impairment (95% confidence interval, 1.559–8.853; p = 0.0085). Conclusions: Cerebral hyperperfusion after CEA results in postoperative cerebral white matter damage that correlates with postoperative cognitive impairment.

Reliable Change Indices and Regression-Based Measures for the Rey-Osterreith Complex Figure Test in Partial Epilepsy Patients

The Rey-Osterreith Complex Figure (ROCF) is commonly used in evaluations of patients undergoing epilepsy surgery. We assessed test–retest performance on ROCF in 30 partial epilepsy patients (mean interval = 33.7 months) to derive reliable change indices (RCIs) and regression-based measures for change. ROCF reproductions were rescored by three raters (IRR Copy: 0.963; Delayed Recall: 0.986). The derived adjusted RC (90% CI) cutoff values for the ROCF Copy were (≤–6.5, ≥8.4) and were (≤–6.8, ≥10.0) for the Delayed Recall. Results from regression-based analyses were negative, using age, education, seizure duration, and age of onset, whereas a baseline score was a significant predictor of a follow-up score. The results provide a means to evaluate long-term outcome in epilepsy patients using the ROCF.

HIV-Associated Episodic Memory Impairment: Evidence of a Possible Differential Deficit in Source Memory for Complex Visual Stimuli

HIV-Associated Episodic Memory Impairment: Evidence of a Possible Differential Deficit in Source Memory for Complex Visual Stimuli

Nonverbal memory dysfunction in obsessive-compulsive disorder patients with checking compulsions

Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder; nonetheless, most of the previous neuropsychological studies for assessing the involvement of memory dysfunction grouped together patients with different symptoms, thereby potentially accounting for the inconsistencies of results. The goals of this study were to compare the memory dysfunction of two main subtypes of OCD and to identify the type of memory dysfunction that is associated with the checking symptoms in OCD patients. The sample population comprised the cleaning-type OCD group (N=23), checking-type OCD group (N=24), and a control group of healthy volunteers (N=20). All the OCD patients were selected from the outpatient clinic. All the subjects underwent the Rey-Osterreith Complex Figure Test (RCFT) for the assessment of nonverbal memory function, the Hopkins Verbal Learning Test (HVLT) for verbal memory function, the Wechsler Adult Intelligence Scale-Revised (WAIS-R), and the Wisconsin Card Sorting Test (WCST). The immediate and delayed memory scores of RCFT were significantly lower in the checking-type OCD group; there were no significant differences in HVLT scores amongst the three groups. Our results indicate that the checking-type compulsion of OCD patients is associated with nonverbal memory deficits and not with verbal memory deficits.

Perceptual-Organizational Characteristics of the Rorschach Task

The present study was designed to begin to explore the perceptual and visuospatial organization required to respond to the Rorschach task. Previous research has shown a relative independence of Rorschach scores from other measures of neurocognitive functioning (e.g., Zillmer & Perry, 1996). However, many of the neuropsychological measures used in previous studies did not require the patient to organize a complex visuospatial stimulus in the same way that the Rorschach does. In this study, data from 27 children and adolescents administered the Rorschach and the Rey-Osterreith Complex Figure Test (ROCF) were examined. Results of analyses indicated that, accounting for age and Full Scale IQ, there were a number of significant relationships between accuracy of ROCF renditions and Rorschach measures of developmental quality and perceptual accuracy. Implications for the understanding the nature of the Rorschach response process and its utility in clinical neuropsychology are discussed.

Executive function impairment in early-treated PKU subjects with normal mental development.

Executive functions were studied in 14 early and continuously treated PKU subjects (age 10.8 years, range 8-13) in comparison with controls matched for IQ, sex, age and socioeconomic status. Brain MRI examination was normal in all PKU patients. Neuropsychological evaluation included Wisconsin Card Sorting Test, Rey-Osterreith Complex Figure Test, Elithorn's Perceptual Maze Test, Weigl's Sorting Test, Tower of London, Visual Search and Motor Motor Learning Test. Whatever the IQ, PKU subjects performed worse than controls in tests exploring executive functions. Subgrouping the PKU subjects according to the quality of dietary control for the entire follow-up period (using 400 micromol/L as cut-off value for blood phenylalanine (Phe) concentration) showed that patients with worse dietary control performed more poorly than both the PKU group with the best dietary control and the control group. However, a mild impairment of executive functions was still found in PKU patients with a good dietary control (Phe <400 micromol/L) compared to controls. Concerning the PKU group as a whole, no linear correlation was found between neuropsychological performance and historical and concurrent biochemical parameters. We conclude that (a) PKU patients, even when treated early, rigorously and continuously, show an impairment of frontal lobe functions; (b) a protracted exposure to moderately high levels of Phe can affect frontal lobe functions independently of the possible effect of the same exposure on IQ; (c) in order to reduce the risk of frontal lobe dysfunction, the target of dietary therapy should be to maintain blood Phe concentration below 400 micromol/L.

A brief neuropsychological assessment for the differential diagnosis between frontotemporal dementia and Alzheimer's disease.

The neuropsychological performance (including measures of language, semantic memory, visual and spatial perception and executive functions) of a group of 14 patients with the clinical diagnosis of probable frontotemporal dementia was compared with that of a group of 14 patients with a clinical diagnosis of probable Alzheimer's disease. The aim was to identify a specific cognitive profile of frontotemporal dementia, which could be used to select a sensitive, short evaluation for the differential diagnosis with Alzheimer's disease. Both groups were severely impaired in most tasks, including those 'frontal lobe' tests which have been suggested to play an important role in differential diagnosis. Significant differences were found only for a minority of tests (oral praxis, visual-spatial perception, and verbal fluency). A logistic regression showed that a shortened testing procedure based on four tests (Rey-Osterreith complex figure test recall, phonemic fluency, oral apraxia, and cube analysis) achieved a 70% sensitivity and 80% specificity for the correct classification of patients in the frontotemporal dementia or Alzheimer's disease group. In conclusion, a brief neuropsychological evaluation including these four tests, as well as other measures sensitive to the frontal impairment, can be useful in the differential diagnosis between the two pathologies, along with the clinical data.

The Rey-Osterreith Complex Figure Test: Norms for young adolescents and an examination of validity

Although recent studies have investigated theoretically relevant aspects of performance and psychometric properties of the Rey-Osterreith Complex Figure Test (ROCFT), there is no documentation of the instrument's construct and predictive validity in an unselected, nonclinical population. This is necessary because knowledge of base rates of poor performance in the general population is required to evaluate the significance of performance deficits in clinical populations. The ROCFT was administered to 740 children aged 13 years who are members of an unselected birth cohort, representative of the general population. Normative findings are presented. Correlational analysis indicated that performance on the ROCFT was closely related to performance on the Block Design and Object Assembly subtests of the WISC-R. The first documentation was obtained of the ROCFT's predictive validity. Subjects in an unselected nonclinical sample who had a history of central nervous system health problems scored below the rest of the sample. Implications for the continued use of this instrument are discussed.

The Rey-Osterreith Complex Figure Test: Norms for young adolescents and an examination of validity

Although recent studies have investigated theoretically relevant aspects of performance and psychometric properties of the Rey-Osterreith Complex Figure Test (ROCFT), there is no documentation of the instrument's construct and predictive validity in an unselected, nonclinical population. This is necessary because knowledge of base rates of poor performance in the general population is required to evaluate the significance of performance deficits in clinical populations. The ROCFT was administered to 740 children aged 13 years who are members of an unselected birth cohort, representative of the general population. Normative findings are presented. Correlational analysis indicated that performance on the ROCFT was closely related to performance on the Block Design and Object Assembly subtests of the WISC-R. The first documentation was obtained of the ROCFT's predictive validity. Subjects in an unselected nonclinical sample who had a history of central nervous system health problems scored below the rest of the sample. Implications for the continued use of this instrument are discussed.

The Role of Cirrhosis in Memory Functioning of Alcoholics

The effects of alcoholism and liver disease on memory functioning in alcoholics were studied by comparing four groups: normal healthy controls, alcoholics without liver disease, alcoholics with biopsy-confirmed cirrhosis, and nonalcoholics with postnecrotic cirrhosis. Memory capacity was evaluated employing the Benton Visual Retention Test (BVRT), the Rey-Osterreith Complex Figure Test, Digit Span, and the Brown Peterson four-word short-term memory test. A 2 x 2 ANOVA revealed significant main effects for both alcohol and cirrhosis on Digits Forward and the total score on the Brown Peterson test. Additionally, there were significant main effects for cirrhosis on the BVRT. The Brown Peterson test was analyzed using a repeated measures 2 x 2 ANOVA. Significant effects for cirrhosis were observed at all three interpolation periods. The effects for alcohol approached significance at the 30-sec (most difficult) interpolation period. Analysis of error patterns on the Brown Peterson test indicated that overall omission errors were most commonly made among all groups. Significant effects were found for alcohol on omissions and intrusion, while the cirrhosis factor yielded significant effects for phonemic, perseverative, and omission errors. This study demonstrates the importance of liver disease underlying the etiology of memory impairments in alcoholics. The results confirm our earlier findings that neuropsychologic deficits seen in alcoholics may be the result of the combination of alcohol abuse and liver disease.

Sensitivity of two visual reproduction tests to alcoholic brain impairment.

The Wechsler Memory Scale Visual Reproduction subtest and the Rey-Osterreith Complex Figure Test were administered to alcoholics to examine visual reproduction impairment. The initial test group was comprised of 28 inpatients in an alcohol treatment program while 16 subsequent inpatients served as the cross-validation group. The Visual Reproduction subtest correlated significantly with an average impairment index both in the initial group and the less-impaired cross validation group. The Complex Figure scores showed significant correlations with the average impairment index only in the initial group. It was concluded that the most likely reason for this outcome was the emphasis upon intentional learning in the Visual Reproduction subtest as opposed to the emphasis upon incidental learning in the Complex Figure recall task. The results were discussed in the context that alcoholics may have an impaired ability to use efficient encoding strategies spontaneously.