Wechsler Adult Intelligence Scale-IV Research Articles

Direct Comparison of Multidimensional Clinical Assessment Tools: Sensitivity to Concussion in Student Athletes

Abstract Purpose Consensus guidelines recommend multidimensional assessment for concussion diagnosis and management. Among cognitive, oculomotor, and postural stability, it remains unclear which modalities perform best in the acute/subacute periods. We conducted a direct comparison to identify those with the strongest sensitivity to sport-related concussion. Methods High school and collegiate football players (aged 14–24) completed preseason baseline assessments. Concussed (n=91) and matched non-concussed teammates (n=85) underwent repeat testing at 48 hours, 8 days, and 15 days post-injury. Postconcussive symptoms (SCAT-3 symptom severity), cognition (Standardized Assessment of Concussion, Immediate Post-Concussion and Cognitive Testing, Trail Making Test, Wechsler Adult Intelligence Scale-IV Processing Speed Index), oculomotor functioning (King-Devick Test), and postural stability (Balance Error Scoring System) were compared using Cohen’s d and Receiver Operating Characteristic analyses. Results Symptom severity had the greatest sensitivity at 48 hours and 8 days post-injury (Cohen’s d=1.43 and 0.53, AUC=.93 and .63, p<.01). Of the performance-based assessments, BESS was most sensitive to SRC at 48 hours post-injury (Cohen’s d=.74, AUC=.70, p<.01). Oculomotor and cognitive testing via ImPACT, WAIS-IV PSI, and TMT-A were sensitive to a lesser degree (Cohen’s d=.35–.58, p<.05). Verbal memory was the only significant performance-based assessment at days 8 and 15, with small-to-medium effect sizes (Cohen’s d=.37 and .44, p<.05). Other cognitive measures (SAC, TMT-B) were not sensitive to SRC across timepoints (p>.05). Conclusion We observed heterogeneity in clinical assessment performance such that the clinical domains strongest in the initial days post-injury (symptom severity, balance) were less sensitive at later follow-up, supporting the potential need for multidimensional assessment.

Visuospatial processing bias in ADHD: A potential artifact in the Wechsler Adult Intelligence Scale and the Rorschach Inkblots Test.

Global processing bias is the automatic tendency to process the global picture before processing the local details. Recent studies suggest that individuals with attention-deficit/hyperactivity disorder (ADHD) show a lack of global processing bias. In the current study, we examined whether lack of global processing bias affects performance on 2 psychological tests, Wechsler Adult Intelligence Scale IV (WAIS-IV) and the Rorschach inkblots test, which require the use of visuospatial processing while measuring different psychological constructs. Adult participants (30 ADHD and 30 typically developing controls) completed the subtests of the WAIS-IV, which rely on visuospatial components, and the Rorschach inkblots test. We found no indication of differences in general fluid intelligence between the groups. On the WAIS-IV test, ADHD participants consistently exhibited superior performance on tasks that relied on local processing and inferior performance on tasks that relied on global processing when compared with healthy controls. On the Rorschach inkblots test, ADHD participants exhibited more responses that referred to local aspects (part/s) of the stimulus and fewer responses that referred to global aspects (whole) of the stimulus. These findings imply that when patients with ADHD are given psychological tests that require visuospatial processing, a potential confound of visuospatial processing style needs to be considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

T2*-weighted MRI values correlate with motor and cognitive dysfunction in Parkinson's disease

Brain iron load is one of the main neuropathologic hallmarks of Parkinson's disease (PD). Previous studies indicated that iron in the substantia nigra (SN) is related to disease duration and motor impairment. We explore, through a cross-sectional study, the association between brain iron distribution, evaluated by T2*-weighted magnetic resonance imaging (T2*), and clinical features in a cohort of patients with PD. Thirty-two patients with PD, compared with 10 control subjects, were evaluated for motor and cognitive features (attention and working memory, executive functions, language, memory, and visuospatial function). They underwent a magnetic resonance imaging protocol including T2* analysis of specific brain regions of interest to measure iron load compared with healthy control subjects. We found that iron content of the SN correlated positively with both disease duration and Unified Parkinson's Disease Rating Scale III off score. Montreal Cognitive Assessment, Spatial Span, and Graded Naming Test scores were inversely associated with iron load of the SN, whereas Wechsler Adult Intelligence Scale-IV Similarities score showed an inverse relationship with iron content in all the regions of interest examined. Our findings suggest a relationship between topographic brain iron distribution and cognitive domain impairment.

Factors Associated with Māori Performance on the WAIS-IV.

Neuropsychological tests are routinely used to assess Māori, the indigenous people of New Zealand, yet very few investigations of the psychometric properties of these tests with this population have been conducted. This paper focuses on factors that may impact performance of Māori adults on neuropsychological testing. The Wechsler Adult Intelligence Scale-IV (WAIS-IV) was administered to a sample of 284 Māori stratified for age (between 16 years and 90 years) and gender in order to establish a Māori normative data set. The sample who primarily spoke English as their first language were recruited from a range of urban, regional and rural areas in New Zealand to obtain representation of the main Māori Iwi (tribes). Analysis of test results suggests acculturation, education, income, and, "a culturally positive experience" may have accounted for some of the variance in test performance.

Clinical and demographic correlates of apathy in Parkinson's disease.

To better understand the demographic, neuropsychiatric, cognitive, and motor predictors of apathy in Parkinson's disease (PD). 112 participants (Mage = 68.53 years; Mdisease duration = 6.17years) were administered the Apathy Scale (AS), Beck Depression Inventory-II (BDI-II), Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Trail Making Test (TMT), Wechsler Adult Intelligence Scale-IV Matrix Reasoning subtest, letter (F-A-S) and category (Animals) fluency, and Hopkins Verbal Learning Test-Revised. Psychosis was assessed. A stepwise logistic regression analysis was performed to investigate the ability of demographic factors and clinical assessments to predict nonapathetic (AS ≤ 13) versus apathetic (AS > 13) group membership. The regression analysis yielded a robust model in which older age, less education, elevated BDI-II, current psychosis, higher MDS-UPDRS PartIII (motor score), and slower TMT-B performance predicted membership in the apathetic group, with a correct classification rate of 77.5% (Nagelkerke R2 = 0.48, p < .001). Depression (OR = 9.20, p < .001) and education (OR = 0.66, p = 0.002) contributed significantly to the overall model. A linear regression with AS score as the outcome variable was similar, but TMT-B additionally contributed significantly (p = 0.02) to the overall model, F(6, 86) = 12.02, p < .001, adjusted R2 = 0.42. Of the factors examined, depression, education, and executive functioning were the strongest correlates of apathy in PD. These results support the idea that common underlying frontosubcortical disruptions in this population contribute to apathy, depression, and executive dysfunction.

Myelin water imaging of moderate to severe diffuse traumatic brain injury.

Traumatic axonal injury (TAI), a signature injury of traumatic brain injury (TBI), is increasingly known to involve myelin damage. The objective of this study was to demonstrate the clinical relevance of myelin water imaging (MWI) by first quantifying changes in myelin water after TAI and then correlating those changes with measures of injury severity and neurocognitive performance. Scanning was performed at 3 months post-injury in 22 adults with moderate to severe diffuse TBI and 30 demographically matched healthy controls using direct visualization of short transverse component (ViSTa) MWI. Fractional anisotropy (FA) and radial diffusivity (RD) were also obtained using diffusion tensor imaging. Duration of post-traumatic amnesia (PTA) and cognitive processing speed measured by the Processing Speed Index (PSI) from Wechsler Adult Intelligence Scale-IV, were assessed. A between-group comparison using Tract-Based Spatial Statistics revealed that there was a widespread reduction of apparent myelin water fraction (aMWF) in TBI, consistent with neuropathology involving TAI. The group difference map of aMWF yielded topography that was different from FA and RD. Importantly, aMWF demonstrated significant associations with PTA (r = −0.564, p = .006) and PSI (r = 0.452, p = .035). In conclusion, reduced myelin water, quantified by ViSTa MWI, is prevalent in moderate-to-severe diffuse TBI and could serve as a potential biomarker for injury severity and prediction of clinical outcomes.

Modality-Specific Working Memory Systems Verified by Clinical Working Memory Tests.

ObjectiveThis study was to identify whether working memory (WM) can be clearly subdivided according to auditory and visual modality. To do this, we administered the most recent and universal clinical WM measures in a mixed psychiatric sample.MethodsA total of 115 patients were diagnosed on the basis of DSM-IV diagnostic criteria and with MINI-Plus 5.0, a structured diagnostic interview. WM subtests of Korean version of Wechsler Adult Intelligence Scale-IV and Korean version of Wechsler Memory Scale-IV were administered to assess WM. Confirmatory factor analysis (CFA) was used to observe whether WM measures fit better to a one-factor or two-factor model.ResultsCFA results demonstrated that a two factor model fits the data better than one-factor model as expected.ConclusionOur study supports a modality model of WM, or the existence of modality-specific WM systems, and thus poses a clinical significance of assessing both auditory and visual WM tests.

Local structural connectivity is associated with social cognition in autism spectrum disorder.

The current theory implying local, short-range overconnectivity in autism spectrum disorder, contrasting with long-range underconnectivity, is based on heterogeneous results, on limited data involving functional connectivity studies, on heterogeneous paediatric populations and non-specific methodologies. In this work, we studied short-distance structural connectivity in a homogeneous population of males with high-functioning autism spectrum disorder and used a novel methodology specifically suited for assessing U-shaped short-distance tracts, including a recently developed tractography-based atlas of the superficial white matter fibres. We acquired diffusion-weighted MRI for 58 males (27 subjects with high-functioning autism spectrum disorder and 31 control subjects) and extracted the mean generalized fractional anisotropy of 63 short-distance tracts. Neuropsychological evaluation included Wechsler Adult Intelligence Scale IV (WAIS-IV), Communication Checklist-Adult, Empathy Quotient, Social Responsiveness Scale and Behaviour Rating Inventory of Executive Function-Adult (BRIEF-A). In contradiction with the models of short-range over-connectivity in autism spectrum disorder, we found that patients with autism spectrum disorder had a significantly decreased anatomical connectivity in a component comprising 13 short tracts compared to controls. Specific short-tract atypicalities in temporal lobe and insula were significantly associated with clinical manifestations of autism spectrum disorder such as social awareness, language structure, pragmatic skills and empathy, emphasizing their importance in social dysfunction. Short-range decreased anatomical connectivity may thus be an important substrate of social deficits in autism spectrum disorder, in contrast with current models.

Education, and the balance between dynamic and stationary functional connectivity jointly support executive functions in relapsing-remitting multiple sclerosis.

Graphical network characteristics and nonstationary functional connectivity features, both derived from resting-state functional magnetic resonance imaging (rsfMRI) data, have been associated with cognitive performance in healthy subjects. How these features jointly relate to cognition in diseased states has not been investigated. In this study, 46 relapsing-remitting multiple sclerosis subjects underwent rsfMRI scans and a focused cognitive battery. With a sliding window approach, we examined six dynamic network features that indicated how connectivity changed over time as well as six measures derived from graph theory to reflect static network characteristics. Multiset canonical correlation analysis (MCCA) was then carried out to investigate the relations between dynamic network features, stationary network characteristics, cognitive testing, demographic, disease severity, and mood. Multiple sclerosis (MS) subjects demonstrated weaker connectivity strength, decreased network density, reduced global changes, but increased changes in interhemispheric connectivity compared to controls. The MCCA model determined that executive functions and processing speed ability measured by Wechsler Adult Intelligence Scale IV (WAIS-IV) Working Memory Index, WAIS-IV Processing Speed Index, and the Verbal Fluency Test were positively correlated with education, dynamic connectivity, and static connectivity strength; while poor task switching was correlated with disease severity, psychiatric comorbidities such as depression, anxiety, and fatigue, and static network density. Taken together, our results suggest that better executive functioning in MS requires maintenance of a continued coordination between stationary and dynamic functional connectivity as well as the support of education, and dynamic functional connectivity may provide an additional cognitive biomarker of disease severity in the MS population.

Do Patients With Advanced Cancer Have the Ability to Make Informed Decisions for Participation in Phase I Clinical Trials?

Purpose Patients with advanced cancer (ACPs) participating in phase I clinical trials inadequately understand many elements of informed consent (IC); however, the prevalence and impact of cognitive impairment has not been described. Patients and Methods ACPs enrolled onto phase I trials underwent neuropsychological assessment to evaluate cognitive functioning (CF) covering the following domains: memory (Hopkins Verbal Learning Test), executive functioning (Trail Making Test B), language (Boston Naming Test-Short Version and Controlled Oral Word Association Test), attention (Trail Making Test A and Wechsler Adult Intelligenence Scale-IV Digit Span), comprehension (Wechsler Adult Intelligence Scale-IV), and quality of life (Functional Assessment of Cancer Therapy-Cognitive Function). Structured interviews evaluated IC and decisional capacity. Psychological measures included distress (Hospital Anxiety Depression Scale) and depression (Beck Depression Inventory-II). Results One hundred eighteen ACPs on phase I trials were evaluated, with CF ranging from mild impairment to superior performance. Only 45% of ACPs recalled physician disclosure of the phase I trial purpose. The 50% of ACPs who correctly identified the phase I research purpose had greater CF compared with ACPs who did not, as revealed by the mean T scores for memory (37.2 ± 5.6 v 32.5 ± 5.1, respectively; P = .001), attention (29 ± 2.7 v 26.9 ± 2.4, respectively; P < .001), visual attention (35.2 ± 6.6 v 31.5 ± 6.2, respectively; P = .001), and executive function (38.9 ± 7.5 v 34 ± 7.1, respectively; P < .001). Older ACPs (≥ 60 years) were less likely to recall physician disclosure of phase I purpose than younger ACPs (30% v 70%, respectively; P = .02) and had measurable deficits in total memory (34.2 ± 5.0 v 37.3 ± 5.6, respectively; P = .002), attention (24.5 ± 2.6 v 28 ± 2.8, respectively; P < .001), and executive function (32.8 ± 7.3 v 36.4 ± 7.6, respectively; P = .01). Older ACPs, compared with younger ACPs, also had greater depression scores (10.6 ± 9.2 v 8.1 ± 5.2, respectively; P = .03) and lower quality-of-life scores (152 ± 29.6 v 167 ± 20, respectively; P = .03). After adjustment by age, no psychological or neuropsychological variable was further significantly associated with likelihood of purpose identification. Conclusion CF seems to play a role in ACP recall and comprehension of IC for early-phase clinical trials, especially among older ACPs.

Chronic Effects of Neurotrauma Consortium (CENC) multicentre study interim analysis: Differences between participants with positive versus negative mild TBI histories

ABSTRACTObjectives: Compare characteristics and outcomes of combat-exposed military personnel with positive versus negative mild traumatic brain injury (mTBI) histories.Setting: Recruitment was from registration lists and ambulatory clinics at four veterans administration hospitals.Participants: Consented veterans and service members completing initial evaluation by September 2016 (n = 492).Design: Observational with cross-sectional analyses.Main measures: Multimodal assessments including structured interviews, record review, questionnaires, neuroendocrine labs and neurocognitive and sensorimotor performance.Results: In unadjusted comparisons to those absent lifetime mTBI, the mTBI positive group (84%) had greater combat exposure, more potential concussive events, less social support and more comorbidities, including asthma, sleeping problems and post-traumatic stress disorder. They also fared worse on all sensory and pain symptom scores and self-reported functional and global outcomes. They had poorer scores on Wechsler Adult Intelligence Scale-IV coding (processing speed), TMT-B (visual-motor integration and executive function) and two posturography subtests, but were otherwise equal to TBI negative participants on neurocognitive and sensorimotor testing and neuroendocrine levels.Conclusions: Although differences in characteristics exist which were not adjusted for, participants with historical mTBI have greater symptomatology and life functioning difficulties compared with non-TBI. Performance measures were less dissimilar between groups. These findings will guide further research within this accruing cohort.

Preliminary Validation of a Free-to-Use, Brief Assessment of Adult Intelligence for Research Purposes: The Matrix Matching Test.

The concept of intelligence as a measurable trait of intellectual function continues to be an important issue in psychology. Traditionally, a core field of differential psychology and widely employed in applied settings, it is also important in various research fields. Here, I describe development of a new assessment of general intelligence of adults that has no language component and can be administered in about 10 minutes. A total sample of 176 adult participants, from various settings, was assessed with a set of matrix tasks that involved either visuospatial (fluid) or semantic (crystallized) reasoning. The internal consistency was acceptable (α = .748), and there was good four-week test-retest reliability ( r = .931). Concurrent validity was demonstrated by a high correlation between the new test and the (seven-subtest version) Wechsler Adult Intelligence Scale-IV (WAIS-IV) scores ( r = .889). A principal component analysis also suggested that the new test measures the same latent construct as the WAIS-IV-thought to be general intelligence. Predictive validity was shown in a subsample of 60 undergraduates by a medium-sized correlation between test scores and grade point average data ( r = .396). These preliminary results suggest that the Matrix Matching Test may be a useful research tool.

Compromised Motor Dexterity Confounds Processing Speed Task Outcomes in Stroke Patients.

Most conventional measures of information processing speed require motor responses to facilitate performance. However, although not often addressed clinically, motor impairment, whether due to age or acquired brain injury, would be expected to confound the outcome measure of such tasks. The current study recruited 29 patients (20 stroke and 9 transient ischemic attack) with documented reduction in dexterity of the dominant hand, and 29 controls, to investigate the extent to which 3 commonly used processing speed measures with varying motor demands (a Visuo-Motor Reaction Time task, and the Wechsler Adult Intelligence Scale-IV Symbol Search and Coding subtests) may be measuring motor-related speed more so than cognitive speed. Analyses include correlations between indices of cognitive and motor speed obtained from two other tasks (Inspection Time and Pegboard task, respectively) with the three speed measures, followed by hierarchical regressions to determine the relative contribution of cognitive and motor speed indices toward task performance. Results revealed that speed outcomes on tasks with relatively high motor demands, such as Coding, were largely reflecting motor speed in individuals with reduced dominant hand dexterity. Thus, findings indicate the importance of employing measures with minimal motor requirements, especially when the assessment of speed is aimed at understanding cognitive rather than physical function.

Changes in protein expression in developed experimental pancreatitis: a Tandem Mass Tag (TMT) proteomics analysis

Letter-Number Sequencing, Figure Weights, and Cancellation are supplemental Wechsler Adult Intelligence Scale, Fourth Edition subtests only for examinees ages 16:0–69:11. Scores and norms for these three subtests are not available for examinees ages 70:0–90:11. The decision to exclude these subtests for such populations is not adequately substantiated in the literature. The present study aims to investigate the factorial invariance and factor mean differences of the hierarchical model of the Wechsler Adult Intelligence Scale IV between Italian adults and elders when all 15 subtests are administered. The overall results from the present paper generally support both the configurational and factorial invariances of the Wechsler Adult Intelligence Scale IV. Therefore, the second-order Wechsler Adult Intelligence Scale IV structure is equivalent across adults and elders.

Turning 1 Year of Age in a Low Socioeconomic Environment: A Portrait of Disadvantage.

To evaluate maternal, home, and neighborhood environment of low and higher socioeconomic status (SES) infants from birth to 1 year and to evaluate the impact of SES and environment on infant developmental outcome at 1 year. Low (n = 30) and higher SES (n = 30) African-American mothers and their healthy term gestation female infants were prospectively compared for environmental characteristics and infant developmental outcome. Wechsler Adult Intelligence Scale-IV (WAIS-IV); Beck Depression Inventory; Perceived Stress Scale; Parenting Stress Index-Fourth Edition (PSI-4); Social Support Scale; Home Observation Measurement of the Environment (HOME); Household Food Insecurity (HFI); Concentrated Neighborhood Disadvantage (CND). Bayley Scales of Infant Development Third Edition (BSID-III); Preschool Language Scale (PLS-5). Environmental risk was greater for low compared with higher SES: lower WAIS-IV (p < .001); higher PSI-4 total (p = .003); lower HOME total and 3 subscales (p < .002); higher HFI (p = .012); and higher CND (p = .027). Low SES infant outcomes differed from higher SES: lower BSID-III Cognitive Composite (p = .005), PLS-5 Total Language (p ≤ .017), and Auditory Comprehension (p ≤ .008). In regressions, after controlling for SES, effects of environmental factors were not found. By age 1, low SES infants had been exposed to greater environmental disadvantage and already exhibited poorer developmental functioning than higher SES infants. These findings suggest that support for families and children from impoverished circumstances cannot begin too early.

Abstracts from The 35th Annual National Neurotrauma Symposium July 7-12, 2017 Snowbird, Utah.

Abstracts from The 35th Annual National Neurotrauma Symposium July 7-12, 2017 Snowbird, Utah.

Diagnostic value of ultra-deep targeted next-generation sequencing in patients with suspect pancreatic and periampullary lesions

Letter-Number Sequencing, Figure Weights, and Cancellation are supplemental Wechsler Adult Intelligence Scale, Fourth Edition subtests only for examinees ages 16:0–69:11. Scores and norms for these three subtests are not available for examinees ages 70:0–90:11. The decision to exclude these subtests for such populations is not adequately substantiated in the literature. The present study aims to investigate the factorial invariance and factor mean differences of the hierarchical model of the Wechsler Adult Intelligence Scale IV between Italian adults and elders when all 15 subtests are administered. The overall results from the present paper generally support both the configurational and factorial invariances of the Wechsler Adult Intelligence Scale IV. Therefore, the second-order Wechsler Adult Intelligence Scale IV structure is equivalent across adults and elders.

Validity of a verbal incidental learning measure from the WAIS-IV in older adults

ABSTRACTIncidental memory may reflect a form of learning in everyday life, although it is not consistently evaluated during standard neuropsychological evaluations. Further validation of a recently created measure of verbal Incidental Learning (IL) from the Wechsler Adult Intelligence Scale-IV is necessary to understand the utility of such a measure in clinical settings. Sixty-eight adults aged 50 to 89 were recruited from a Cognitive Disorders Clinic while receiving a standard neuropsychological assessment, along with two additional measures of IL. IL-Total Score was significantly correlated with immediate and delayed memory trials from standard neuropsychological tests (rs = .43 to .73, ps < .001, ds = 0.94–2.14), with worse IL performance being associated with lower memory abilities. Participants with probable Alzheimer’s disease performed worse on the IL-Total Score than participants with Mild Cognitive Impairment, t(39.997) = 5.46, p < .001, d = 1.13. Given the strong relationships between this IL task and traditional memory measures in our sample, and the discrimination of IL-Total Score performance among diagnostic groups despite its short administration time, this IL task may play a role as a measure of memory in brief cognitive evaluations.

Confirmatory Factor Analysis of WAIS-IV in a Clinical Sample: Examining a Bi-Factor Model.

There have been a number of studies that have examined the factor structure of the Wechsler Adult Intelligence Scale IV (WAIS-IV) using the standardization sample. In this study, we investigate its factor structure on a clinical neuropsychology sample of mixed aetiology. Correlated factor, higher-order and bi-factor models are all tested. Overall, the results suggest that the WAIS-IV will be suitable for use with this population.

Age-related invariance of abilities measured with the Wechsler Adult Intelligence Scale-IV.

Assessment of measurement invariance across populations is essential for meaningful comparison of test scores, and is especially relevant where repeated measurements are required for educational assessment or clinical diagnosis. Establishing measurement invariance legitimizes the assumption that test scores reflect the same psychological trait in different populations or across different occasions. Examination of Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) U.S. standardization samples revealed that a first-order 5-factor measurement model was best fitting across 9 age groups from 16 years to 69 years. Strong metric invariance was found for 3 of 5 factors and partial intercept invariance for the remaining 2. Pairwise comparisons of adjacent age groups supported the inference that cognitive-trait group differences are manifested by group differences in the test scores. In educational and clinical settings these findings provide theoretical and empirical support to interpret changes in the index or subtest scores as reflecting changes in the corresponding cognitive abilities. Further, where clinically relevant, the subtest score composites can be used to compare changes in respective cognitive abilities. The model was supported in the Canadian standardization data with pooled age groups but the sample sizes were not adequate for detailed examination of separate age groups in the Canadian sample. (PsycINFO Database Record