ABSTRACT
Embedded symptom validity measures facilitate the detection of below-capacity performance in neuropsychological assessment. A number of such indicators have been proposed for the Controlled Oral Word Association Test (COWAT), a widely used test of word generation. However, several of these embedded indicators have not been cross-validated and it is currently unclear which represent the optimal combination of predictors. This study used Bayesian Model Averaging (BMA) to determine the set of predictors that best differentiate between patients presenting with (n = 46) and without (n = 55) malingered neurocognitive dysfunction (MND). Mild traumatic brain injury was the most common diagnosis in the MND group (96%). BMA selected the COWAT total score and a measure of change in output over time. A logistic regression model combining these variables yielded good discriminability, with an AUC of. 774, (95% confidence interval = .679 to. 869), 78% of cases were classified correctly, with 67% sensitivity and 88% specificity. Two alternative models performed similarly, but the variables involved required slightly longer administration and/or calculation time, making them somewhat less desirable. These results support the use of a weighted combination of embedded symptom validity measures in the COWAT.
Subject(s)
Malingering/diagnosis , Neuropsychological Tests/standards , Word Association Tests/standards , Adult , Brain Injuries/diagnosis , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Models, Statistical , Predictive Value of Tests , Reproducibility of ResultsABSTRACT
Student drinking is a major problem on North American campuses and impulsivity is a significant risk factor for heavy drinking. The present study investigates the moderation of the impulsivity-drinking relationship by the expectation that having a drink will lead to positive experiences. Undergraduate drinkers (n=292) completed measures of impulsivity (Barratt Impulsiveness Scale 11; BIS-11), positive drinking expectancies, and alcohol use. Expectancies moderated the relationship between BIS-11 scores and alcohol use. BIS-11 scores were significantly related to typical alcohol quantity, frequency, quantity X frequency, and binge drinking frequency for individuals with average and high levels of positive expectancies, but not for those with few positive expectancies. Implications for interventions targeted at highly impulsive students, using expectancy modification are discussed.
Subject(s)
Alcohol Drinking/psychology , Impulsive Behavior/psychology , Motivation , Students/psychology , Attitude to Health , Female , Humans , Male , Personal Satisfaction , Random Allocation , Sex Factors , Surveys and Questionnaires , Universities/statistics & numerical data , Young AdultABSTRACT
Binge drinking is a major problem at North American universities. Disinhibited traits have provided insight on other patterns of alcohol involvement, but less is known about how they relate to bingeing. Drinkers at a large urban university (n=293) completed the Barratt Impulsiveness Scale 11 (BIS-11), the Aggression Questionnaire, and the Thrill and Adventure Seeking and Boredom Susceptibility scales. Binge drinking was assessed using the NIAAA recommendation for standardizing binge frequency. Hierarchical regression was used to evaluate relationships between disinhibited traits and bingeing. BIS-11 Motor Impulsiveness, Thrill and Adventure Seeking and Boredom Susceptibility predicted bingeing. As about 15% of the variability in bingeing was due to disinhibition facets, they should be considered in future models of student vulnerability to bingeing.
