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Terry C, Lecci L. Anosognosia in Alzheimer's Pathology: Validation of a New Measure. Arch Clin Neuropsychol 2024:acae020. [PMID: 38469927 DOI: 10.1093/arclin/acae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/18/2024] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
OBJECTIVE Two studies were performed to validate a brief measure of cognitive insight and compare it to an empirical model - the Cognitive Awareness Model (CAM). METHOD A pilot study included 31 (52% male; Mage = 69.42) patients from an outpatient neuropsychological assessment clinic. Seven patients were diagnosed with likely Alzheimer's dementia (AD), 15 mild cognitive impairment (MCI), and 9 no diagnosis (i.e., cognitively normal; CN). The Cognitive Coding Form (CCF) and several other measures were administered. Study 2 entailed archival data extraction of 240 patients (80 CN, 80 MCI, and 80 AD; 53.3% female; Mage = 72.8) to examine whether the CCF predicts memory (Wechsler Memory Scale - IV) and executive functioning (Trail-Making Test B). RESULTS The pilot study found preliminary evidence of convergent and discriminant validity for the 8-item CCF. Study 2 confirmed that both patient-reported cognitive concerns (F(2,237) = 10.40, p < .001, ω2 = .07, power = .99) and, more strongly, CCF informant-patient discrepancy scores (F(2,237) = 24.52, p < .001, ω2 = .16, power = .99) can distinguish CNs from those with MCI and AD. A regression indicated that depression (5.5%; β = -.38, p < .001) and TMT-B (13%; β = -.43, p < .001), together accounted for 18.5% of the variance in insight (R2 = .19, F(2,219) = 26.10, p < .001), supporting the CAM. CONCLUSIONS These studies establish an efficient measure of insight with high clinical utility and inform the literature on the role of insight in predicting performance in those with Alzheimer's pathology.
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Affiliation(s)
- Christian Terry
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Len Lecci
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
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Kavé G, Bloch A, Shabi A, Maril S. Neuropsychological assessment in the Israeli healthcare system: a practitioners' survey. Isr J Health Policy Res 2020; 9:46. [PMID: 32928292 PMCID: PMC7488707 DOI: 10.1186/s13584-020-00403-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background The current study examines self-reported professional practices and attitudes of Israeli neuropsychologists, in an attempt to understand how they contribute to funding of neuropsychological assessment (NPA) through the Israeli healthcare system. Methods Two hundred seventy-nine neuropsychologists (176 board-certified experts and 103 interns) participated in an online survey that targeted characteristics of NPA practice in Israel, attitudes toward NPA, and familiarity with healthcare referral procedures. Results Overall, 68% of respondents conducted NPA, with a smaller proportion of experts (56%) doing so than interns (88%). The most common purpose of NPA was to provide treatment recommendations, and respondents listed indications for NPA that matched indications for neuropsychological rehabilitation. Almost two thirds of respondents reported that none of the NPAs that they performed received healthcare funding. While all practitioners believed that the healthcare system should fund NPA, the majority demonstrated lack of familiarity with referral procedures. Conclusions To increase referral rates and create effective neuropsychological services within the Israeli healthcare system, neuropsychologists should work more closely with physicians in integrated care teams. In addition, they should engage in greater advocacy activities that will emphasize the need for publicly funded NPA.
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Affiliation(s)
- Gitit Kavé
- Department of Education and Psychology, The Open University, 1 University Road, 4353701, Ra'anana, Israel. .,Center for Memory and Attention Disorders, Sourasky Medical Center, Tel Aviv, Israel.
| | - Ayala Bloch
- The National Institute for the Rehabilitation of the Brain Inured, Tel Aviv, Israel.,Department of Psychology, Ariel University, Ariel, Israel
| | - Adi Shabi
- Center for Memory and Attention Disorders, Sourasky Medical Center, Tel Aviv, Israel
| | - Sari Maril
- The National Institute for the Rehabilitation of the Brain Inured, Tel Aviv, Israel
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Marcopulos BA, Guterbock TM, Matusz EF. Survey research in neuropsychology: A systematic review. Clin Neuropsychol 2019; 34:32-55. [DOI: 10.1080/13854046.2019.1590643] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Bernice a. Marcopulos
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Thomas M. Guterbock
- Center for Survey Research and Department of Sociology, University of Virginia, Charlottesville, Virginia, USA
| | - Emily F. Matusz
- Department of Graduate Psychology, James Madison University, Harrisonburg, Virginia, USA
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Baum KT, von Thomsen C, Elam M, Murphy C, Gerstle M, Austin CA, Beebe DW. Communication is key: the utility of a revised neuropsychological report format. Clin Neuropsychol 2017; 32:345-367. [PMID: 29243544 DOI: 10.1080/13854046.2017.1413208] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The neuropsychological report is a critical tool for communicating evaluation results to multiple audiences who have varying knowledge about neuropsychology and often have limited ability to review long, complex reports. Considerable time is spent writing these reports and challenges persist related to readability, length/complexity, and billable clinical time (which may be capped by third-party payors or families' ability to pay). METHODS This quality improvement effort systematically evaluated the redesign of pediatric neuropsychological reports in an outpatient clinic serving primarily medical populations. RESULTS Revised reports were shorter, with improved readability, structure, and effectiveness in communicating results and recommendations. Improved clinical efficiency was also observed. CONCLUSIONS We suggest that adaptation to efficient, readable, and effective reports is possible within the practice of neuropsychology. Findings encourage replication in other settings. Through collaboration with key stakeholders, providers can identify their populations' and audience's unique needs and set report targets accordingly. To encourage that practice, we summarize our general process, provide a set of guidelines that can be adapted across multiple settings, and include an appended sample report.
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Affiliation(s)
| | | | - Megan Elam
- c Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Christel Murphy
- c Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Melissa Gerstle
- c Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Cynthia A Austin
- c Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
| | - Dean W Beebe
- c Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA
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Hanks RA, Jackson AM, Crisanti LK. Predictive validity of a brief outpatient neuropsychological battery in individuals 1–25 years post traumatic brain injury. Clin Neuropsychol 2016; 30:1074-86. [DOI: 10.1080/13854046.2016.1194479] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Robin A. Hanks
- Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Rehabilitation Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI, USA
| | | | - Lauren K. Crisanti
- Department of Rehabilitation Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI, USA
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Rabin LA, Paolillo E, Barr WB. Stability in Test-Usage Practices of Clinical Neuropsychologists in the United States and Canada Over a 10-Year Period: A Follow-Up Survey of INS and NAN Members. Arch Clin Neuropsychol 2016; 31:206-30. [DOI: 10.1093/arclin/acw007] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
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Benitez A, Hassenstab J, Bangen KJ. Neuroimaging training among neuropsychologists: a survey of the state of current training and recommendations for trainees. Clin Neuropsychol 2013; 28:600-13. [PMID: 24215451 DOI: 10.1080/13854046.2013.854836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Neuroimaging has gained widespread use in neuropsychological research and practice. However, there are neither established guidelines on how neuropsychologists might become competent researchers or consumers of neuroimaging data, nor any published studies describing the state of neuroimaging training among neuropsychologists. We report the results of two online surveys, one of 13 expert neuropsychologist-neuroimagers whose responses informed the formulation of a second, larger survey to neuropsychologists-at-large that were a random selection of a third of the members of the International Neuropsychological Society and American Academy of Clinical Neuropsychology. A total of 237 doctoral-level neuropsychologists, or 15.3% of potential participants, provided complete responses. Most respondents (69.2%) received training in neuroimaging, mostly at the post-doctoral level, largely through independent study, clinical conferences, instruction by clinical supervisors, and individualized mentoring, on topics such as neuroimaging modalities in neurology, neuroanatomy, and the appropriate information to glean from neuroradiology reports. Of the remaining respondents who did not receive training in neuroimaging, 64.4% indicated that such training would be very or extremely beneficial to one's career as a neuropsychologist. Both neuropsychologist-neuroimagers and neuropsychologists-at-large provided specific recommendations for training. Findings from this initial effort will guide trainees who seek to develop competence in neuroimaging, and inform future formulations of neuropsychological training.
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Affiliation(s)
- Andreana Benitez
- a Center for Biomedical Imaging and Department of Radiology and Radiological Science , Medical University of South Carolina , Charleston , SC , USA
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Pella RD, Hill BD, Shelton JT, Elliott E, Gouvier WD. Evaluation of Embedded Malingering Indices in a Non-Litigating Clinical Sample using Control, Clinical, and Derived Groups. Arch Clin Neuropsychol 2011; 27:45-57. [DOI: 10.1093/arclin/acr090] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Calamia M, Markon K, Denburg NL, Tranel D. Developing a short form of Benton's Judgment of Line Orientation Test: an item response theory approach. Clin Neuropsychol 2011; 25:670-84. [PMID: 21469016 DOI: 10.1080/13854046.2011.564209] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Judgment of Line Orientation (JLO) test was developed to be, in Arthur Benton's words, "as pure a measure of one aspect of spatial thinking, as could be conceived" (Benton, 1994, p. 53). The JLO test has been widely used in neuropsychological practice for decades. The test has a high test-retest reliability (Franzen, 2000), as well as good neuropsychological construct validity as shown through neuroanatomical localization studies (Tranel, Vianna, Manzel, Damasio, & Grabowski, 2009). Despite its popularity and strong psychometric properties, the full-length version of the test (30 items) has been criticized as being unnecessarily long (Straus, Sherman, & Spreen, 2006). There have been many attempts at developing short forms; however, these forms have been limited in their ability to estimate scores accurately. Taking advantage of a large sample of JLO performances from 524 neurological patients with focal brain lesions, we used techniques from item response theory (IRT) to estimate each item's difficulty and power to discriminate among various levels of ability. A random item IRT model was used to estimate the influence of item stimulus properties as predictors of item difficulty. These results were used to optimize the selection of items for a shorter method of administration that maintained comparability with the full form using significantly fewer items. This effectiveness of this method was replicated in a second sample of 82 healthy elderly participants. The findings should help broaden the clinical utility of the JLO and enhance its diagnostic applications.
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Affiliation(s)
- Matthew Calamia
- Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.
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