Validation of an adult ADHD measure of feigning in a sample including individuals with depression and anxiety symptoms.

Few studies of measures or techniques designed to detect feigning of Attention-Deficit/Hyperactivity Disorder (ADHD) have included groups reporting symptoms of depression and anxiety. Based on the high rate of comorbidity between ADHD and mood disorders, inclusion of such groups is important to mimic clinical referral patterns. The current study evaluated the validity of the ADHD Symptom Infrequency Scale (ASIS), a measure designed to detect malingered symptoms of ADHD, in a four-known groups design that included a group consisting of subjects with symptoms of anxiety and depression. Four groups were included in the current study: (1) control, (2) simulator, (3) ADHD diagnosed, (4) individuals with elevated symptoms of depression/anxiety. The ASIS Infrequency scale showed strong internal consistency (α = .83). Discriminant validity for the Infrequency Scale was established through a low correlation between the ASIS scale assessing feigning and a measure of anxiety and depression (r = -.02). Sensitivity was high for detection of simulation (.71), while specificity was high across comparisons, ranging from .86 to .99. Results support the ASIS as a reliable and valid measure of ADHD that is sensitive to feigning, even when including a sample of individuals reporting symptoms of depression and anxiety.

Emotion Dysregulation and Workplace Satisfaction in Direct Care Worker Burnout and Abuse Risk.

BACKGROUND/OBJECTIVES: Direct care workers frequently encounter difficult interactions with the patients they serve and experience frustration and burnout. The current study tested a hypothesized model in which predictors of caregiver abuse risk (emotional dysregulation, difficulty managing patient behavior, and workplace satisfaction) were mediated by symptoms of burnout. DESIGN: The study used an online cross-sectional survey design. SETTING AND PARTICIPANTS: The study was implemented online via Qualtrics. Participants were 206 direct care workers (eg, certified nursing assistants, patient care technicians, home health aides, and medical assistants). MEASUREMENTS: All respondents completed the Caregiver Abuse Screen (CASE), Difficulty with Emotional Regulation Scale (DERS-SF), and the Abbreviated Maslach Burnout Inventory. Demographic data and employment history were also collected. Correlational methods, including path analysis, were used to assess associations between study variables. RESULTS: More than half of this heterogenous sample endorsed significant risk for engaging in patient abuse. Path analysis suggested emotional dysregulation and low workplace satisfaction were associated with greater risk of patient abuse, and these associations were partially and simultaneously mediated by burnout facets of depersonalization and emotional exhaustion. CONCLUSIONS AND IMPLICATIONS: This study provided preliminary support for a model of caregiver abuse in which underlying difficulties regulating emotions convey risk for caregiver abuse via burnout facets including emotional exhaustion and depersonalization. Enhancing basic emotion regulation skills and reducing burnout in direct care staff may reduce the risk of abuse for older adults. Thus, providing training necessary to help direct care workers manage their own emotions in order to better recognize, understand, and respond effectively to the needs of older adults may reduce staff burnout and, consequently, lower the risk of abuse for older adults.

Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF) characteristics of ADHD in a Korean psychiatric sample.

Global rates of attention-deficit/hyperactivity disorder (ADHD) have risen. In Korea, ADHD is associated with functional impairments and comorbidity with other psychological disorders. This study examined the correlates of ADHD in a psychiatric sample of Korean adolescents on the Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF). In a clinical sample of 247 adolescents, MMPI-A-RF scores from 46 patients diagnosed with ADHD were compared to the remainder of the clinical sample and to the Korean MMPI-A-RF norms. Results demonstrated significantly different scores for the ADHD group on scales indicating externalizing concerns and behavior dysfunction compared with the clinical group with other disorders and to a normative sample. Notable differences were also observed between clinical groups on scales reflecting interpersonal functioning. Relative risk ratio analyses demonstrated that an MMPI-A-RF T-score of 55 was generally most effective for predicting risk for an ADHD diagnosis in the clinical sample.

The ADHD Symptom Infrequency Scale (ASIS): A novel measure designed to detect adult ADHD simulators.

The current project outlines the development of the Attention-Deficit/Hyperactivity Disorder (ADHD) Symptom Infrequency Scale (ASIS), a stand-alone measure designed to identify individuals feigning or exaggerating symptoms to receive a diagnosis of ADHD. Over the course of 3 studies, valid data was collected from 402 participants assigned to control, simulator, ADHD diagnosed, or possible undiagnosed ADHD groups. Group assignment was based on self-reported history of ADHD diagnosis including information about the credentials of diagnosing professional and methods used. The ASIS includes an Infrequency Scale (INF) designed to detect rarely reported symptoms of ADHD and several clinical scales designed to measure genuine symptoms. The final version of the ASIS demonstrated high internal consistency for the INF (α = .96) and the ADHD Total scales (α= .96). Convergent validity for the ADHD Total was established through a strong correlation with Barkley Adult ADHD Rating Scale-IV (r = .92). Initial validation of the INF yielded high discriminability between groups (d = 2.76; 95% confidence interval [2.17, 3.36]). The final INF scale demonstrated strong sensitivity (.79-.86) and excellent specificity (.89). Using our study's malingering base rate of 29%, positive and negative predictive values were strong (.71-.79 and .92-.93, respectively). Additional information is provided for a range of base rates. Current results suggest that the ASIS has potential as a reliable and valid measure of ADHD that is sensitive to malingering when compared to a sample of individuals self-reporting a history of ADHD diagnosis. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Effects of Bone-Marrow-Derived MSC Transplantation on Functional Recovery in a Rat Model of Spinal Cord Injury: Comparisons of Transplant Locations and Cell Concentrations.

Spinal cord injury (SCI) is a widely disabling condition, constraining those affected by it to wheelchairs and requiring intense daily care and assistance. Cell replacement therapies, targeting regeneration of cells in the injured cord, are currently gaining momentum in the field of SCI research. Previous studies indicate that mesenchymal stem cells (MSCs) can reduce functional deficits through immunomodulation and production of trophic factors in a variety of neurological disorders. The present study assessed the efficacy of transplanted bone marrow-derived MSCs at different concentrations and locations for promoting functional recovery following SCI. Although effects were modest, MSCs facilitated an increase in the base of support, as measured by increased distance between the plantar surface of the hind paws, following incomplete contusive SCI, and reduced the density of astroglial scarring. Varying the concentrations or locations of transplanted cells did not provide additional benefits on these measures. These findings indicate that MSC transplants are safe at relatively high concentrations and confer therapeutic benefits that, when used as an adjunctive treatment, could significantly enhance functional recovery following SCI.

Learning style, judgements of learning, and learning of verbal and visual information.

The concept of learning style is immensely popular despite the lack of evidence showing that learning style influences performance. This study tested the hypothesis that the popularity of learning style is maintained because it is associated with subjective aspects of learning, such as judgements of learning (JOLs). Preference for verbal and visual information was assessed using the revised Verbalizer-Visualizer Questionnaire (VVQ). Then, participants studied a list of word pairs and a list of picture pairs, making JOLs (immediate, delayed, and global) while studying each list. Learning was tested by cued recall. The results showed that higher VVQ verbalizer scores were associated with higher immediate JOLs for words, and higher VVQ visualizer scores were associated with higher immediate JOLs for pictures. There was no association between VVQ scores and recall or JOL accuracy. As predicted, learning style was associated with subjective aspects of learning but not objective aspects of learning.

Cognitive ability predicts motor learning on a virtual reality game in patients with TBI.

BACKGROUND: Virtual reality games and simulations have been utilized successfully for motor rehabilitation of individuals with traumatic brain injury (TBI). Little is known, however, how TBI-related cognitive decline affects learning of motor tasks in virtual environments. OBJECTIVE: To fill this gap, we examined learning within a virtual reality game involving various reaching motions in 14 patients with TBI and 15 healthy individuals with different cognitive abilities. METHODS: All participants practiced ten 90-second gaming trials to assess various aspects of motor learning. Cognitive abilities were assessed with a battery of tests including measures of memory, executive functioning, and visuospatial ability. RESULTS: Overall, participants with TBI showed both reduced performance and a slower learning rate in the virtual reality game compared to healthy individuals. Numerous correlations between overall performance and several of the cognitive ability domains were revealed for both the patient and control groups, with the best predictor being overall cognitive ability. CONCLUSIONS: The results may provide a starting point for rehabilitation programs regarding which cognitive domains interact with motor learning.

Genetically engineered mesenchymal stem cells reduce behavioral deficits in the YAC 128 mouse model of Huntington's disease.

The purpose of this study was to evaluate the therapeutic effects of the transplantation of bone-marrow mesenchymal stem cells (MSCs), genetically engineered to over-express brain-derived neurotrophic factor (BDNF) or nerve growth factor (NGF) on motor deficits and neurodegeneration in YAC 128 transgenic mice. MSCs, harvested from mouse femurs, were genetically engineered to over-express BDNF and/or NGF and these cells, or the vehicle solution, were injected into the striata of four-month old YAC 128 transgenic and wild-type mice. Assessments of motor ability on the rotarod and the severity of clasping were made one day prior to transplantation and once monthly, thereafter, to determine the effects of the transplanted cells on motor function. The mice were sacrificed at 13-months of age for immunohistological examination. All YAC 128 mice receiving transplants had reduced clasping, relative to vehicle-treated YAC 128 mice, while YAC 128 mice that were transplanted with MSCs which were genetically engineered to over-express BDNF, had the longest latencies on the rotarod and the least amount of neuronal loss within the striatum of the YAC 128 mice. These results indicate that intrastriatal transplantation of MSCs that over-express BDNF may create an environment within the striatum that slows neurodegenerative processes and provides behavioral sparing in the YAC 128 mouse model of HD. Further research on the long-term safety and efficacy of this approach is needed before its potential clinical utility can be comprehensively assessed.

Development of a novel malingering detection method involving multiple detection strategies.

This study utilized a novel computer-administered measure designed to assess multiple malingering detection strategies, as well as measure genuine impairment in a brain-injured sample. Ninety-four neurologically normal subjects comprised control and simulator groups. Twenty individuals with moderate to severe head injuries comprised a clinical sample. The summary score from the measure yielded a sensitivity of .81 and a specificity of .89. Total completion time and learning curves were utilized as genuine impairment indicators. Sensitivity (.95) and specificity (.95) were quite high for these dimensions. Results suggest there is utility to combining detection techniques, including indicators of genuine impairment.

Personality and performance-based measures in the prediction of alcohol use.

Research has demonstrated a variable relationship between alcohol consumption and self-report personality measures of novelty seeking and harm avoidance. Research has also demonstrated a relationship between performance-based measures of risk taking and substance use. The current study compared the utility of personality measures and performance-based measures in the prediction of alcohol use. The authors hypothesized that the domains would contribute uniquely and would also interact in the prediction of alcohol consumption. Data on alcohol consumption were collected on a daily basis for 2 weeks. Performance-based measures included the Bechara Gambling Task and the Balloon Analogue Risk Task. The Tridimensional Personality Questionnaire was the primary personality measure. Results partially supported hypotheses, in that personality measures showed strong relationships with alcohol use and interacted with performance-based measures in predicting alcohol consumption. Thus, both behavioral and personality measures contributed to prediction of alcohol consumption, and performance-based measures played a moderating role. Results suggest that a combination of behavioral and self-report personality measures may be useful for those screening groups for risk factors for excessive alcohol consumption.

A pilot investigation of the effects of stress on neuropsychological performance in Asian-Indians in the United States.

The present study evaluated the effects of stress and the ethnicity of the examiner on neuropsychological performance in a sample of Asian-Indian males in the United States. Participants were 60 Asian-Indian college students randomly assigned to one of four conditions in a 2 x 2 factorial design. The first factor was level of stress induction and the second was ethnicity of examiners. Results suggested that both stress inducing instructions and examiner ethnicity impacted highly demanding tasks, while moderately difficult tasks were less sensitive to ethnicity of the examiner. Results also indicate that examiners should recognize the potential impact of ethnicity and heightened level of stress when administering and interpreting neuropsychological measures.

The relationship between visual contrast sensitivity and neuropsychological performance in a healthy elderly sample.

Visual acuity and contrast sensitivity are two visual domains affected by normal aging; however, the potential impact of well-documented changes in these abilities on neuropsychological assessment is relatively unstudied. The current study examined the relationship between these abilities and neuropsychological performance in a healthy, community-based elderly sample. Fifty-one individuals (Age: M = 79.6) were assessed for visual acuity and visual contrast sensitivity, and received a brief neuropsychological battery. Results indicated contrast sensitivity was significantly related to neuropsychological performance on visually based measures, but not auditory measures. Visual acuity was only weakly related to neuropsychological performance. Clinical implications for assessment of elderly individuals are discussed.

African American women: a life course of care?

Twenty-five years of research on family care to dependent elders has produced a theoretically sophisticated understanding of the process of family caregiving. Although caregiving models initially were developed and tested on predominantly White samples, more recent work has applied these models to African American caregivers. This investigation builds on the comparative perspective by describing elder care in African American families through the eyes of the culture in which it occurs. Thirty-two African American caregivers were interviewed and asked to discuss their caregiving careers from a life course perspective. Qualitative narratives described three pathways to care: elder care only, limited life course of care, and live course of care. Recognition of the various pathways to care will enlighten tailored interventions.

Comparison of Predicted-difference, Simple-difference, and Premorbid-estimation methodologies for evaluating IQ and memory score discrepancies.

Discrepancies between WAIS-III and WMS-III scores for a group of 39 males and 48 females with a history of TBI were examined using three methodologies: Predicted-difference, Simple-difference, and Premorbid-estimation methods. Overall, the Predicted-difference method tended to classify the fewest individuals as impaired based on statistical rarity of discrepancies (11-16% classified as impaired), while the regression-based Premorbid method tended to classify the fewest individuals as impaired based on clinical rarity of discrepancies (4-8% classified as impaired). Degree of agreement is reported and was substantial. The only comparison between methods to reach statistical significance was the Predicted-difference method classifying subjects as impaired at a higher rate than other methods for Auditory Delayed memory index (Cochran's Q = 7.00, P < .05). Findings suggest a combination of estimates of premorbid functioning and regression-based predicted scores is optimal for interpreting IQ/memory score discrepancies. Clinical implications are discussed.

The relationship between performance-based visual acuity screening, self-reported visual acuity, and neuropsychological performance.

Despite frequent cautions in the literature concerning the importance of visual acuity in neuropsychological testing, there are few published empirical investigations of what constitutes "sufficient" visual acuity, nor are there published guidelines for performance-based visual screening techniques. The current study attempted to validate the utility of a visual acuity screening technique by examining individuals with varying visual ability on neuropsychological measures. Results revealed declines on neuropsychological measures associated with reduced visual acuity, as well as discrepancies between self-reported and measured visual acuity, with neuropsychological performance being more closely related to a performance-based measure of visual acuity than to self-reported visual acuity. Clinical implications are discussed.