Demographic effects on the Trail Making Test in hallucinogen abusers.

Demographic effects on the Trail Making test (TMT), a test often used for screening for cognitive impairment, were reexamined in a sample of hallucinogen abusers in drug abuse treatment programs. A sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of hallucinogen abusers' scores available for analysis were 128. Data were analyzed to determine the effects of sex, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of hallucinogen abusers. The variable of ethnicity was statistically significant for both parts A and B of the TMT and just at the edge of significance for age for part A. R-Square values for overall models were moderate (A = .30, B = .29) suggesting that demographic effects on the TMT account for a minority of overall variance in terms of hallucinogen abusers' TMT performance.

Sex, ethnicity, age and education effects on the Trail Making Test in a sample of heroin abusers.

Sex, ethnicity, age and education effects on the Trail Making test (TMT), a test often used for screening for cognitive impairment, are examined in a sample of heroin abusers in drug abuse treatment programs. A mixed race sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of heroin abusers with TMT scores available for analysis was 1548. Data were analyzed to determine the effects of sex, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of heroin abusers. The variables of sex, age, ethnicity and education were statistically significant for both parts A and B of the TMT. Nonetheless, R-Square values for overall models were quite weak (A = .08, B = .13) suggesting that sex, ethnicity, age and education effects on the TMT, while clearly present, account for relatively little overall variance in terms of heroin users' TMT performance. These results are consistent with earlier research using a more heterogenous drug abuse treatment sample.

Using the Trail Making test to screen for cognitive impairment in a drug abuse treatment sample.

The Trail Making test (TMT) is a brief paper and pencil neuropsychological test often used for screening for cognitive impairment. The value of the TMT is examined in a sample of 5619 males and 2902 females was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS), a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of specific drugs of abuse on parts A and B of the TMT in this large sample of patients in drug abuse treatment programs. Most subjects, regardless of type of drug abused, on TMT parts A and B appeared to fall within normal limits relative to commonly accepted cutoff scores. These results suggest that the TMT parts A and B would have great value as screening measures for cognitive impairment in a drug abuse treatment population.

Demographic effects on the Trail Making test in alcohol abusers.

Demographic effects on the Trail Making Test (TMT), a test often used for screening for cognitive impairment, are examined in a sample of alcohol abusers in drug abuse treatment programs. A sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of alcohol abuser's scores available for analysis was 1000. Data were analyzed to determine the effects of gender, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of alcohol abusers. The variables of age, ethnicity and education were statistically significant for both parts A and B of the TMT. R-Square values for overall models were quite weak (A = .12, B = .14) suggesting that demographic effects on the TMT, while clearly present, account for relatively little overall variance in terms of alcohol abuser's TMT performance. These results are consistent with earlier research using a more heterogenous drug abuse treatment sample.

Sex, ethnicity, age and education effects on the Trail Making test in a sample of cocaine abusers.

Sex, ethnicity, age and education effects on the Trail Making test (TMT), a test often used to for screen for cognitive impairment, were examined in a sample of cocaine abusers in drug abuse treatment programs. A mixed race sample of 5116 males and 2614 females was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of cocaine/crack abuser scores available for analysis was 4306. Data were analyzed to determine the effects of sex, ethnicity, age and education variables on the two parts of the TMT in this large treatment sample of cocaine abusers. The variables of sex age, ethnicity and education were statistically significant for both parts A and B of the TMT. In addition, R-Square values for overall models were quite weak (A = .08, B = .11) suggesting that sex, ethnicity, age and education effects on the TMT, while clearly present, account for relatively little overall variance in terms of cocaine users TMT performance. These results are consistent with earlier research using a more heterogenous drug abuse treatment sample.

Demographic effects on the Trail Making Test in marijuana abusers.

Demographic effects on the Trail Making Test (TMT), a test often used for screening for cognitive impairment, were examined in a sample of marijuana abusers in drug abuse treatment programs. A sample was drawn from electronic files of data from the Drug Abuse Treatment outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993 in 96 programs in 11 cities in the United States. The number of marijuana abusers' scores available for analysis were 259. Data were analyzed to determine the effects of sex, ethnicity, age, and education variables on the two parts of the TMT in this large treatment sample of marijuana abusers. The variables of age and education level were statistically significantly related to TMT parts A and B, and ethnicity was statistically significant for part B of the TMT. R-Square values for overall models were moderate (A = .15, B = .18) suggesting that demographic effects on the TMT are weak.

Demographic effects on the Trail Making Test in amphetamine abusers.

Demographic effects on the Trail Making Test (TMT), a test often used for screening for cognitive impairment, were examined in a sample of amphetamine abusers in drug abuse treatment programs. A sample was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991-1993, in 96 programs in 11 cities in the United States. The number of amphetamine abusers scores available for analysis were 185. Data were analyzed to determine the effects of sex, ethnicity, age, and education variables on the two parts of the TMT in this large treatment sample of amphetamine abusers. No variables were statistically significant for either parts A and B of the TMT. R-square values for overall models were also negligible (A = .03, B = .08) suggesting that demographic effects on the TMT account for a minuscule amount of overall variance in terms of amphetamine abusers' TMT performance.

Demographic effects on the Trail Making Test in narcotic/other opiate abusers.

Demographic effects on the Trail Making Test (TMT), a test often used to screen for cognitive impairments, were examined in a sample of narcotic/other opiate abusers in drug abuse treatment programs. A sample was drawn from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991 through 1993 in 96 programs within 11 cities in the United States. The number of narcotic/other opiate abusers' scores available for analysis was 191. Data were analyzed to determine the effects of sex, ethnicity, age, and education on the two parts of the TMT in this sample of narcotic/other opiate abusers. The variables of age and education level were statistically significantly related to TMT parts A and B, and ethnicity was statistically significant for part B of the TMT. R-square values for overall models were moderate (A = .34, B = .24), suggesting that demographic effects on the TMT are moderate.

Derived trail making test indices in a sample of substance abusers: demographic effects.

Derived indices on the Trail Making Test (TMT), a test often used to screen for cognitive impairments, were examined in a sample of substance abusers in drug abuse treatment programs. A mixed race sample was drawn from electronic files of data from the Drug Abuse Treatment Outcome Study (DATOS). The DATOS was a naturalistic, prospective cohort study that collected data from 1991 through 1993 within 96 programs in 11 cities in the United States. Data were analyzed to determine the effects of demographic variables on derived indices created by adding, subtracting, multiplying, and dividing parts A and B of the TMT in this large treatment sample of substance abusers. The variables of sex, age, ethnicity, and education were statistically significant for selected derived indices of the TMT.

Prediction of brain injury severity by subscales of the alternative impairment index.

A new screening index, the Alternative Impairment Index (AII) reflects the severity of brain damage with hit rates of 60% with the Halstead Impairment Index (HII) and 64% with the General Neuropsychological Deficit Scale (GNDS) and a cross-validation study found a hit rate between the AII and the HII of 66%. This paper explores the use of demographic corrections (e.g., age, education and sex) to enable Cognitive (Cog) and Motor (Mot) Subscales of the AII to predict the severity of brain damage. A sample of 40 normal, psychiatric and brain-damaged subjects with Halstead-Reitan Neuropsychological Test Battery results was selected. The GNDS, HII, Cog and Mot were calculated for each brain-damaged patient. There were 36 males and four women in the subject group. Ages ranged from 19-66 and years of education ranged from 8-22. Demographic corrections produced worse than chance level results (Cog vs. GNDS = 42.5%, Cog vs. HII = 42.5%/Mot vs. GNDS = 42.5%, Mot vs. HII = 35%).

Above-average intelligence and neuropsychological test score performance.

Recent studies regarding the effects of above average intelligence and neuropsychological performance have been mixed with Dodrill (1977) suggesting that above-average performances on neuropsychological test scores should not be expected when intellectual abilities are above average and Tremont, Hoffman, Scott and Adams (in press) clearly suggesting better neuropsychological skills in the higher IQ group. This paper described a reanalysis of a previously presented Canadian data-set assembled by Pauker (1980) of three hundred and sixty-three persons (152 males, 211 females) who were administered the core tests of the Halstead-Reitan Neuropsychological Test Battery (HRNTB) and the Wechsler Adult Intelligence Scale (WAIS). The results were that subjects with higher intelligence had better neuropsychological test score performances except for the Finger Tapping with the dominant hand test.

Prediction of severity of brain damage by a processing speed variable in older children: a brief report.

This paper reports an attempt to predict severity of brain damage, as reflected by neuropsychological test scores, based on subtests of Wechsler Intelligence Scale for Children-Revised Factor analytic derived indices were compared with the Neuropsychological Deficit Scale for Older Children. A sample of 20 normal and heterogeneously brain-damaged children (12 males and eight females) aged 9-14, who have been administered the complete Halstead-Reitan Neuropsychological Test Battery for Older Children, were selected from case records. The hit rates obtained for agreement on level of severity with the Older Children's Neuropsychological Deficit Score was best for Processing Speed (70%), worst for Freedom from Distraction (45%), and intermediate for Perceptual Organization (65%) and Verbal Comprehension (55%).

Prediction of brain damage severity: demographic corrections.

This study investigated the value of using age and education corrections to the Alternative Impairment Index (AII), to predict the severity of brain damage on the General Neuropsychological Deficit Score (GNDS) and the Halstead Impairment Index (HII). A sample of 40 normal, psychiatric and brain-damaged subjects who had been administered the HRNTB was obtained and the AII, GNDS and HII were calculated for each subject. Hit rates for agreement on level of severity, after correction for age and education effects, for the GNDS and AII were 52.5% and for the AII and HII were 47.5%. Examination of the data suggested that AII, after correction for age and education effects, reflects severity of brain damage at a chance level on both the HII and on the GNDS.

Recognition and management of catheter-induced pulmonary artery rupture.

BACKGROUND: Catheter-induced pulmonary artery rupture is a well-recognized complication of invasive monitoring, but the risk has not diminished. Although commonly associated with cardiopulmonary bypass, injuries also occur in intensive care. Definitive proof requires pulmonary angiography or autopsy. Many cases are never reported, and lesser injuries are probably under-diagnosed. METHODS: Seven cases fulfilling accepted diagnostic criteria discovered over 2 years are described in four groups illustrating the common modes of presentation: hemoptysis with hypoxemia, exsanguination, delayed recurrent hemorrhage, and bleeding with cardiopulmonary bypass. RESULTS: One patient had a planned elective operation deferred. Four patients were being monitored in intensive care. Two of them died of pulmonary artery rupture. Two other patients had bleeding on weaning from cardiopulmonary bypass. One settled with conservative treatment, the other survived after extracorporeal life support. Recognition and management are discussed, emphasizing means of avoiding pulmonary resection. CONCLUSIONS: Catheter-induced pulmonary artery rupture is unavoidable. Constant awareness is essential. A plan of management is presented. Extracorporeal life support may help to avoid pulmonary resection. Early pulmonary angiography is advocated for accurate diagnosis and to enable treatment by embolization.

Development of a short-form screening index for severity of brain damage in older children.

This article reports the development of a Short-Form Screening Index (SFSI) for severity of brain damage based on the Wechsler Intelligence Scale for Children-Revised (WISC-R) subtests. The new measure is compared with the Neuropsychological Deficit Scale for Older Children, a 45-variable summary measure from test scores derived from the Halstead-Reitan Neuropsychological Test Battery for Older Children. A sample of 20 normal and heterogeneously brain-damaged children (12 boys and 8 girls) between the ages of 9 and 14, who had been administered the complete Halstead-Reitan Neuropsychological Test Battery for Older Children and WISC-R, were selected from case records. The Older Children's Neuropsychological Deficit Scale and a simple total of scale scores of the selected Performance subtests of the WISC-R were computed for each participant. The SFSI is based on the Performance scale subtests. The hit rate was obtained for agreement on level of severity for the SFSI and the Older Children's Neuropsychological Deficit Score (i.e., 75% or 15/20 correct agreement).

Alternate Impairment Index-Revised: a measure of neuropsychological deficit.

The Alternative Impairment Index-Revised (AII-R), a revision of the Alternative Impairment Index (AII), is composed of a weighted set of scores from the Halstead-Reitan Neuropsychological Test Battery. In the research for this article, two experiments were conducted. First, the AII-R is compared with two established measures of neuropsychological deficit, the General Neuropsychological Deficit Scale (GNDS) and the Halstead Impairment Index (HH). Hit rates for agreement on severity for the GNDS and AII-R were 72% (i.e., 18 of 25), and for the HII and AII-R were 60% (i.e., 15 of 25) with patients with brain damage. In the second experiment with normal and psychiatric participants and participants with brain damage, hit rates for agreement of severity of brain damage for the GNDS and AII-R were 63% (i.e., 25 of 40), and for the HII and AII-R were 73% (i.e., 29 of 40).

Behavior modification with brain-injured children: a brief note on directions for research.

Research on behavior modification needed with brain-injured children is briefly noted. Previous studies indicate that the procedures of behavior modification work well with selected brain-injured children. The designs of most studies, however, have used small Ns or a single subject to evaluate interventions with brain-injured children. Some suggestions for research needed with this population are provided.

Neuropsychological findings in adult attention deficit disorder: a pilot study.

Relatively little is known about neuropsychological deficits in adults with Attention Deficit Disorder (ADD). This paper presents data for a consecutive series of 11 adults diagnosed as having adult ADD. The sample had a mean age of 33 4 years (range=22-56) and mean education of 15 years (range=8-19) and included 5 women and 6 men All were Caucasians. A neuropsychological test battery was administered. The results suggested few neuropsychological deficits except in the initial acquisition of verbal information on the Logical Memory Subtest, the Wechsler Memory Scale, and the Category Test. When a subsample was examined using age-, education-and gender-corrected norms, there appeared to be a tendency to obtain borderline scores on part B of the Trail Making Test and Category Test, but normal scores on the Rhythm Test, Speech Sounds Perception Test and Finger Tapping Test. These findings argue for the neuropsychological evaluation of adults suspected of having ADD.

Revised children's version of the alternative impairment index.

The Revised Children's Version of the Alternative Impairment Index, a measure composed of scores derived from the Halstead-Reitan Neuropsychological Test Battery for Older Children, has been proposed as a new measure of neuropsychological impairment in children aged 9-14. This study investigated the feasibility of a Children's Version of the Alternative Impairment Index. Test records for 16 normal and brain-damaged children, between the ages of 9 and 14, who have been administered the complete Halstead-Reitan Neuropsychological Test Battery for Older Children, were obtained. The Revised Children's Version of the Alternative Impairment Index and the Children's Total Neuropsychological Deficit Score were compared for agreement on level of severity. The resulting hit rate (i.e., 50% or 8/16 correct agreement) was worse than the hit rate obtained in the initial study (56%) and inadequate for clinical use.