Review of Studies on Incremental Validity of Assessment Measures Used in Psychological Assessment of Attention-Deficit Hyperactivity Disorder.

Few studies have summarized the literature relevant to the incremental validity of tools and procedures for the assessment of attention-deficit hyperactivity disorder (ADHD). The current project reviewed such studies published in the prior 18 years. Results from studies on the incremental validity of measures used in the assessment of ADHD were reviewed. Measures included symptom reports, clinical interviews, behavioral observation, continuous performance and other psychomotor tasks, intelligence tests, and measures of executive function. Twenty-nine published studies and two reviews were identified from 2004 to 2022. Incremental validity was determined using various statistics including R2, classification metrics, odds ratios, and post-test probabilities. Findings suggest that symptom reports from a collateral source and continuous performance test measures have incremental validity over self-reports and clinical interviews. Measures of intellectual and executive functioning did not show incremental validity in the diagnosis of ADHD. Findings are relevant to the practitioner, as they bear on the optimization of both the cost-effectiveness and the diagnostic accuracy of combined procedures in the assessment of ADHD.

Identifying set-switching difficulties in autism spectrum disorder using a rule following task.

OBJECTIVES: The aim of the study is to distinguish between perceptuomotor and cognitive inflexibility as the source of set-switching difficulties in children with autism spectrum disorder (ASD). METHODS: Seventeen adolescents with ASD and 17 neurotypical controls were presented with a computerized sequencing game using colored shapes. The sequence required a shift in perceptuomotor responding that could also be represented at a conceptual level. Measures of perceptuomotor inflexibility were based on errors and response times specifically on the critical switch item in the sequence. The task included three transfer phases in which the same rule was to be applied to new shapes and colors. Higher-order rule conceptualization was operationalized as the ability to abstract the switching rule and apply it across these phases. RESULTS: Participants with ASD showed predicted difficulties on the perceptuomotor shift, but no deficit on the transfer phases. CONCLUSIONS: The study indicates a problem with perceptuomotor inflexibility in ASD that can explain why 'extra-dimensional' shifting is sometimes reported as problematic in this group. Implications for difficulties in more real-world contexts are discussed.

Pattern reversal visual evoked potentials in adults: variability with age.

PURPOSE: Pattern reversal visual evoked potential (PRVEP) is an electrophysiological test for evaluating the visual pathway. This study measured the changes in the latencies and amplitudes of the PRVEP with age and gender in normal subjects. METHODS: Healthy participants (n=81; 162 total eyes), between the ages of 20 and 92 years were recruited for the study. Stimulation was performed monocularly with a high-contrast (>50%) black-white checkerboard pattern with a check size of 30° at a reversal rate of 2 Hz, a band-pass of 1-100 Hz, a sweep of 250 msec and an average of 150 stimulations in a dark room. Mean and standard deviations for three latencies (N75, P100 and N145) and the amplitude (N75-P100) for each decade were measured. RESULTS: There was a linear trend by age for all three latencies, indicating that the higher age groups had longer latencies. The latencies decreased in the 5th decade before increasing in the higher age groups. The amplitude of N75-P100 decreased with age. The P100 latencies were longer in males than females in all age groups and the difference increased with increasing age.

Adaptation and initial validation of the Patient Health Questionnaire - 9 (PHQ-9) and the Generalized Anxiety Disorder - 7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample.

The Patient Health Questionnaire - 9 (PHQ-9) and Generalized Anxiety Disorder - 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. The aim of this study is to translate the screening tools into Arabic and evaluate their psychometric properties in an Arabic-speaking Lebanese psychiatric outpatient sample. The patients completed the questionnaires, among others, prior to being evaluated by a clinical psychiatrist or psychologist. The scales' internal consistency and factor structure were measured and convergent and discriminant validity were established by comparing the scores with clinical diagnoses and the Psychiatric Diagnostic Screening Questionnaire - MDD subset (PDSQ - MDD). Results showed that the PHQ-9 and GAD-7 are reliable screening tools for depression and anxiety and their factor structures replicated those reported in the literature. Sensitivity and specificity analyses showed that the PHQ-9 is sensitive but not specific at capturing depressive symptoms when compared to clinician diagnoses whereas the GAD-7 was neither sensitive nor specific at capturing anxiety symptoms. The implications of these findings are discussed in reference to the scales themselves and the cultural specificity of the Lebanese population.

Resting-state functional connectivity of antero-medial prefrontal cortex sub-regions in major depression and relationship to emotional intelligence.

BACKGROUND: Major depressive disorder has been associated with abnormal resting-state functional connectivity (FC), especially in cognitive processing and emotional regulation networks. Although studies have found abnormal FC in regions of the default mode network (DMN), no study has investigated the FC of specific regions within the anterior DMN based on cytoarchitectonic subdivisions of the antero-medial pre-frontal cortex (PFC). Studies from different areas in the field have shown regions within the anterior DMN to be involved in emotional intelligence. Although abnormalities in this region have been observed in depression, the relationship between the ventromedial PFC (vmPFC) function and emotional intelligence has yet to be investigated in depressed individuals. METHODS: Twenty-one medication-free, non-treatment resistant, depressed patients and 21 healthy controls underwent a resting state functional magnetic resonance imaging session. The participants also completed an ability-based measure of emotional intelligence: the Mayer-Salovey-Caruso Emotional Intelligence Test. FC maps of Brodmann areas (BA) 25, 10 m, 10r, and 10p were created and compared between the two groups. RESULTS: Mixed-effects analyses showed that the more anterior seeds encompassed larger areas of the DMN. Compared to healthy controls, depressed patients had significantly lower connectivity between BA10p and the right insula and between BA25 and the perigenual anterior cingulate cortex. Exploratory analyses showed an association between vmPFC connectivity and emotional intelligence. CONCLUSIONS: These results suggest that individuals with depression have reduced FC between antero-medial PFC regions and regions involved in emotional regulation compared to control subjects. Moreover, vmPFC functional connectivity appears linked to emotional intelligence.

Gene mutations and stroke in the young adult.

BACKGROUND: The purpose of this study is to evaluate the existence of the genetic mutation in the different types of cerebral and spinal strokes in previously healthy young adults. METHODS: We performed a retrospective study of the medical records of 35 young adults who presented to our institution with the diagnosis of acute cerebrovascular insult. We defined the localization of their stroke, specified their risk factors, defined their genetic mutation, and correlated these variables to assess their significance in the predisposition of stroke in the young. RESULTS: We found that the MTHFR and Factor V gene mutations are the most likely mutations to be associated with cerebral strokes in young adults. Spinal strokes are also associated with beta fibrinogen, factor XIII, and prothrombin II mutations. We did not find that a homozygous gene mutation is more thrombogenic than its heterozygous component. CONCLUSIONS: We concluded that the major etiologies for stroke in young adults were multiple gene mutations rather than systemic illnesses. We found out that mutation of the MTHFR gene in isolation or in combination with other gene mutations is the most important risk factor for stroke in the young.