Cognitive Assessment via Telephone: A Scoping Review of Instruments.

OBJECTIVE: Telephone-based cognitive assessment (TBCA) has long been studied but less widely adopted in routine neuropsychological practice. Increased interest in remote neuropsychological assessment techniques in the face of the coronavirus 2019 (COVID-19) pandemic warrants an updated review of relevant remote assessment literature. While recent reviews of videoconference-based neuropsychological applications have been published, no updated compilation of empirical TBCA research has been completed. Therefore, this scoping review offers relevant empirical research to inform clinical decision-making specific to teleneuropsychology. METHOD: Peer-reviewed studies addressing TBCA were included. Broad search terms were related to telephone, cognitive, or neuropsychological assessment and screening. After systematic searching of the PubMed and EBSCO databases, 139 relevant articles were retained. RESULTS: In total, 17 unique cognitive screening measures, 20 cognitive batteries, and 6 single-task measures were identified as being developed or adapted specifically for telephone administration. Tables summarizing the identified cognitive assessments, information on diagnostic accuracy, and comparisons to face-to-face cognitive assessment are included in supplementary materials. CONCLUSIONS: Overall, literature suggests that TBCA is a viable modality for identifying cognitive impairment in various populations. However, the mode of assessment selected clinically should reflect an understanding of the purpose, evidence, and limitations for various tests and populations. Most identified measures were developed for research application to support gross cognitive characterization and to help determine when more comprehensive testing was needed. While TBCA is not meant to replace gold-standard, face-to-face evaluation, if appropriately utilized, it can expand scope of practice, particularly when barriers to standard neuropsychological assessment occur.

Susceptibility of the MMPI-2-RF neurological complaints and cognitive complaints scales to over-reporting in simulated head injury.

We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.

Exploration of malingering indices in the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span subtest.

Prior research shows that Digit Span is a useful embedded measure of malingering. However, the Wechsler Adult Intelligence Scale-IV (Wechsler, 2008) altered Digit Span in meaningful ways, necessitating another look at Digit Span as an embedded measure of malingering. Using a simulated malingerer design, we examined the predictive accuracy of existing Digit Span validity indices and explored whether patterns of performance utilizing the new version would provide additional evidence for malingering. Undergraduates with a history of mild head injury performed with best effort or simulated impaired cognition and were also compared with a large sample of non-head-injured controls. Previously established cutoffs for the age-corrected scaled score and Reliable Digit Span (RDS) performed similarly in the present samples. Patterns of RDS length using all three subscales of the new scale were different in malingerers when compared with both head-injured and non-head-injured controls. Two potential alternative RDS scores were introduced, which showed better sensitivity than the traditional RDS, while retaining specificity to malingering.