ABSTRACT
BACKGROUND: The number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia. METHOD: Using data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor. RESULTS: Multiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models. CONCLUSIONS: These results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.
Subject(s)
Cognition , Neuropsychological Tests , Schizophrenic Psychology , Attention , Factor Analysis, Statistical , Humans , Memory , Psychometrics , Schizophrenia , United StatesABSTRACT
This study examined differences in raw scores on the Symptom Validity Scale and Response Bias Scale (RBS) from the Minnesota Multiphasic Personality Inventory-2 in three criterion groups: (i) valid traumatic brain injured, (ii) invalid traumatic brain injured, and (iii) psychogenic non-epileptic seizure disorders. Results indicate that a >30 raw score cutoff for the Symptom Validity Scale accurately identified 50% of the invalid traumatic brain injured group, while misclassifying none of the valid traumatic brain injured group and 6% of the psychogenic non-epileptic seizure disorder group. Using a >15 RBS raw cutoff score accurately classified 50% of the invalid traumatic brain injured group and misclassified fewer than 10% of the valid traumatic brain injured and psychogenic non-epileptic seizure disorder groups. These cutoff scores used conjunctively did not misclassify any members of the psychogenic non-epileptic seizure disorder or valid traumatic brain injured groups, while accurately classifying 44% of the invalid traumatic brain injured individuals. Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders.
Subject(s)
Bias , Brain Injuries/psychology , Conversion Disorder/psychology , Malingering/psychology , Personality Inventory , Adult , Analysis of Variance , Disability Evaluation , Epilepsy/diagnosis , Epilepsy/psychology , Female , Humans , Male , Malingering/diagnosis , Middle Aged , Probability , Reproducibility of ResultsABSTRACT
The Test of Memory Malingering is one of the most popular and heavily researched validity tests available for use in neuropsychological evaluations. Recent research has suggested, however, that the original indices and cutoffs may require modifications to increase sensitivity rates. Some of these modifications lack cross-validation and no study has examined all indices in a single sample. This study compares Trial 1, Trial 2, the Retention Trial, and the newly created Albany Consistency Index in a criterion group forensic neuropsychological sample. Findings lend support for the newly created indices and cutoff scores. Implications and cautionary statements are provided and discussed.
Subject(s)
Forensic Psychiatry , Malingering/psychology , Memory Disorders/diagnosis , Retention, Psychology/physiology , Adult , Disability Evaluation , Female , Humans , Male , Malingering/diagnosis , Middle Aged , Neuropsychological Tests , Personality Tests , Psychometrics , ROC Curve , Reproducibility of Results , Statistics, NonparametricABSTRACT
Neuropsychological assessment plays an important role in the process of diagnosing DAT. Whereas the brief screens are sensitive to the cognitive deficits associated with DAT, full battery measures should be used to rule out early dementia or to differentiate among the various dementing illnesses. Following diagnosis, there are numerous assessment measures that facilitate management and placement decisions. These measures include instruments that help stage the illness to determine severity, instruments that evaluate the patient's capacity to perform activities of daily living, and measures that evaluate for the behavior symptoms common in later-stage dementia.
