Unpacking the NIH Toolbox Emotion Battery in Persons With Parkinson's disease

Multivariate base rates of potentially problematic scores on the NIH Toolbox Emotion Battery

OBJECTIVE

To examine the normal frequency of obtaining one or more scores considered potentially problematic based on normative comparisons when completing the NIH Toolbox Emotion Battery (NIHTB-EB).

METHOD

Participants (N = 753; ages 18-85, 62.4% women, 66.4% non-Hispanic White) from the NIHTB norming study completed 17 scales of emotional functioning fitting into three subdomains (i.e., Negative Affect, Psychological Well-being, Social Satisfaction). Scores were considered potentially problematic if they were 1 SD above/below the mean, depending on the orientation of the scale, and cutoffs for 1.5 and 2 SD were also included for reference. Multivariate base rates quantified the rate at which participants obtained one or more potentially problematic scale or subdomain scores.

RESULTS

The portion of participants obtaining one or more potentially problematic scores on the NIHTB-EB scales and subdomains was 61.2 and 23.2%, respectively. Participants who were younger (i.e., 18-49) or had less education had higher rates of potentially problematic scores within specific subdomains. There were no significant differences by sex or race/ethnicity.

CONCLUSIONS

Elevated scores on the NIHTB-EB were common in the normative sample and related to education/age. The multivariate base rates provided indicate obtaining one or more potentially problematic scores on the NIHTB-EB is broadly normal among adults, which may guard against overinterpreting a single score as clinically significant. These base rates should be considered in the context of other assessment findings, such as interviews, medical history or informant reports, to ensure that true emotional problems are not dismissed, and normal variation in emotional functioning is not pathologized.

Psychometric properties of the NIH Toolbox Cognition and Emotion Batteries among children and adolescents with congenital heart defects

The NIH Toolbox offers brief, computerized measures of cognitive and psychosocial functioning. However, its psychometric properties were established among typically developing children and adolescents. The current study provides the first comprehensive assessment of its psychometric properties among young patients with congenital heart defects (CHD). We prospectively recruited 58 patients with CHD and 80 healthy controls between the ages of 6 and 17. Participants completed the NIH Toolbox Cognition and Emotion Batteries, a battery of clinician-administered neuropsychological tests, and ratings of their quality of life. Their parents also completed ratings of their functioning. On the Cognition Battery, we found expectable group differences and developmentally expected gains across ages. For the most part, composites and subtests were significantly correlated with neuropsychological measures of similar constructs. Higher scores were generally associated with ratings of better day-to-day functioning among children with CHD. On the Emotion Battery, we found no significant group differences, echoing prior research. For the most part, scales showed acceptable internal consistency among both groups. There was adequate construct coherence for most of questionnaires among healthy control but not participants with CHD. Correlations with a comparison tool were largely within expectable directions. The NIH Toolbox may provide a valid and useful assessment of cognitive functioning among youths with CHD. While it may offer reliable and valid scales of psychosocial functioning, further research is needed to understand the meaningfulness of the scales for participants with CHD.

The Paradox in Positive and Negative Aspects of Emotional Functioning Among Older Adults with Early Stages of Cognitive Impairment

Introduction: Emotional functioning in older adults is influenced by normal aging and cognitive impairment, likely heterogeneous across positive versus negative aspects of emotional functioning. Little is known about positive emotional experiences at the early stages of cognitive impairment. Methods: We assessed different aspects of emotional functioning among 448 participants aged 65+ (Normal Control (NC) = 276, Mild Cognitive Impairment (MCI) = 103, and mild dementia of the Alzheimer type (mild DAT) = 69) and tested moderators. Results: Compared to NC, older adults with MCI and mild DAT have maintained many positive aspects of emotional functioning, despite higher levels of negative affect, sadness, and loneliness. Among the oldest-old, the mild DAT group experienced higher fear and lower self-efficacy. Discussion: Older adults at early stages of cognitive impairment can experience positive aspects of emotional functioning, such as positive affect, purpose, and life satisfaction, all of which are important buildable psychological resources for coping.