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Farrer TJ, Bigler ED, Tsui-Caldwell YHW, Abildskov TJ, Tschanz JT, Welsh-Bohmer KA. Scheltens ratings, clinical white matter hyperintensities and executive: Functioning in the Cache County Memory Study. Appl Neuropsychol Adult 2023:1-7. [PMID: 38052027 DOI: 10.1080/23279095.2023.2287140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE Examine the association between neuropsychologically assessed executive function and clinically identifiable white matter burden from magnetic resonance imaging, using a visual rating system (Scheltens Rating System) applied to the Cache County Memory Study (CCMS) archival database. METHOD We used the Scheltens Ratings Scale to quantify white matter lesion burden in the CCMS sample and used this metric as a predictor of executive function. The sample included 60 individuals with dementia and 13 healthy controls. RESULTS Higher Scheltens ratings were associated with poorer task performance on an Executive Function composite score of common neuropsychological tests. This association held true for both controls and dementing cases. CONCLUSIONS The current findings support extensive prior literature demonstrating the association between brain vascular health determined by white matter burden and clinical outcomes based on neuropsychological assessment of cognitive performance.
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Affiliation(s)
- Thomas J Farrer
- WWAMI Medical Education Program, University of Idaho, Moscow, ID, USA
| | - Erin D Bigler
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
| | | | - Tracy J Abildskov
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - JoAnn T Tschanz
- Department of Psychology, Utah State University, Logan, UT, USA
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Garner AR, Blocher N, Tierney D, Baumgardner M, Watson A, Romero G, Skadberg R, Younginer T, Waugh MH. Applying the DSM-5 Alternative Model of Personality Disorders and the Shedler-Westen Assessment Procedure to the Classic Case of "Madeline G.": Novice and Expert Rater Convergences and Divergence. Front Psychol 2022; 13:794616. [PMID: 35242078 PMCID: PMC8885620 DOI: 10.3389/fpsyg.2022.794616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders (AMPD). However, researchers have yet to compare novice ratings on the AMPD's Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure (SWAP). We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels of reliability to that of an expert rater using the crucible of the classical case of "Madeline G." Examination of AMPD and SWAP ratings of "Madeline G." revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment.
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Affiliation(s)
- Alisa R Garner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Natalie Blocher
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - David Tierney
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Megan Baumgardner
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Alayna Watson
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Gloria Romero
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Rebecca Skadberg
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Taylor Younginer
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States
| | - Mark H Waugh
- Department of Psychology, University of Tennessee-Knoxville, Knoxville, TN, United States.,Oak Ridge National Laboratory, Oak Ridge, TN, United States
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Tsui-Caldwell YHW, Farrer TJ, McDonnell Z, Christensen Z, Finuf C, Bigler ED, Tschanz JT, Norton MC, Welsh-Bohmer KA. MRI Clinical Ratings and Cognitive Function in a Cross-Sectional Population Study of Dementia: The Cache County Memory Study. J Prev Alzheimers Dis 2019; 6:100-107. [PMID: 30756116 DOI: 10.14283/jpad.2019.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND White matter integrity in aging populations is associated with increased risk of cognitive decline, dementia diagnosis, and mortality. Population-based data can elucidate this association. OBJECTIVES To examine the association between white matter integrity, as measured by a clinical rating scale of hyperintensities, and mental status in older adults including advanced aging. DESIGN Scheltens Ratings Scale was used to qualitatively assess white matter (WM) hyperintensities in participants of the Cache County Memory Study (CCMS), an epidemiological study of Alzheimer's disease in an exceptionally long-lived population. Further, the relation between Mini-Mental State Exam (MMSE) and WM hyperintensities were explored. METHOD Participants consisted of 415 individuals with dementia and 22 healthy controls. RESULTS CCMS participants, including healthy controls, had high levels of WM pathology as measured by Scheltens Ratings Scale score. While age did not significantly relate to WM pathology, higher Scheltens Ratings Scale scores were associated with lower MMSE findings (correlation between -0.14 and -0.22; p < .05). CONCLUSIONS WM pathology was common in this county-wide population sample of those ranging in age from 65 to 106. Increased WM burden was found to be significantly associated with decreased overall MMSE performance.
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Affiliation(s)
- Y H W Tsui-Caldwell
- Thomas J. Farrer Ph.D., 932 Morreene Road, Durham, NC 27710, USA, (919)-668-6802,
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Haggerty G, Stein M, Siefert C, Zodan J, Mehra A, Ogbuji K, Sangha J, Habib M, Sinclair SJ, Blais MA. Dimensional measure of self and interpersonal functioning: Comparisons with treatment alliance and readiness for inpatient psychotherapy. Clin Psychol Psychother 2018; 25:575-582. [PMID: 29667270 DOI: 10.1002/cpp.2193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 11/08/2022]
Abstract
The social cognition and object relations scale-global rating method is a clinical rating system assessing 8 domains of self and interpersonal functioning. It can be applied to score numerous forms of narrative data. In this study, we investigate the SCORS-G relationship to measures of alliance and readiness for psychotherapy with an adolescent inpatient sample. Seventy-two psychiatrically hospitalized adolescents were consented and subsequently rated by their individual and group therapist using the SCORS-G. The unit psychiatrist also completed an assessment of patients' readiness for inpatient psychotherapy. The patients completed a self-report of their alliance with the inpatient treatment team as a whole. SCORS-G ratings were positively correlated with assessments of readiness for inpatient psychotherapy and patient-reported alliance. This study further demonstrates the clinical utility of the SCORS-G with adolescents.
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Affiliation(s)
- Greg Haggerty
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Michelle Stein
- Psychiatry Department, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Caleb Siefert
- Psychology, University of Michigan-Dearborn, Dearborn, MI, USA
| | - Jennifer Zodan
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Ashwin Mehra
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Kelechi Ogbuji
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Jaspreet Sangha
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Michael Habib
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | | | - Mark A Blais
- Psychiatry Department, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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Kreiter CD, Wilson AB, Humbert AJ, Wade PA. Examining rater and occasion influences in observational assessments obtained from within the clinical environment. Med Educ Online 2016; 21:29279. [PMID: 26925540 PMCID: PMC4770864 DOI: 10.3402/meo.v21.29279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/30/2015] [Accepted: 01/31/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND When ratings of student performance within the clerkship consist of a variable number of ratings per clinical teacher (rater), an important measurement question arises regarding how to combine such ratings to accurately summarize performance. As previous G studies have not estimated the independent influence of occasion and rater facets in observational ratings within the clinic, this study was designed to provide estimates of these two sources of error. METHOD During 2 years of an emergency medicine clerkship at a large midwestern university, 592 students were evaluated an average of 15.9 times. Ratings were performed at the end of clinical shifts, and students often received multiple ratings from the same rater. A completely nested G study model (occasion: rater: person) was used to analyze sampled rating data. RESULTS The variance component (VC) related to occasion was small relative to the VC associated with rater. The D study clearly demonstrates that having a preceptor rate a student on multiple occasions does not substantially enhance the reliability of a clerkship performance summary score. CONCLUSIONS Although further research is needed, it is clear that case-specific factors do not explain the low correlation between ratings and that having one or two raters repeatedly rate a student on different occasions/cases is unlikely to yield a reliable mean score. This research suggests that it may be more efficient to have a preceptor rate a student just once. However, when multiple ratings from a single preceptor are available for a student, it is recommended that a mean of the preceptor's ratings be used to calculate the student's overall mean performance score.
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Affiliation(s)
- Clarence D Kreiter
- Department of Family Medicine, University of Iowa College of Medicine, Iowa City, IA, USA
- Office of Consultation and Research in Medical Education, University of Iowa College of Medicine, Iowa City, IA, USA;
| | - Adam B Wilson
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aloysius J Humbert
- Office of Undergraduate Medical Education, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patricia A Wade
- Office for Mentoring and Student Development, Medical Student Affairs, Indiana University School of Medicine, Indianapolis, IN, USA
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