Computerized adaptive test strategies for the matrix reasoning subtest of the Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV).

OBJECTIVE: Most neuropsychological tests were developed without the benefit of modern psychometric theory. We used item response theory (IRT) methods to determine whether a widely used test - the 26-item Matrix Reasoning subtest of the WAIS-IV - might be used more efficiently if it were administered using computerized adaptive testing (CAT). METHOD: Data on the Matrix Reasoning subtest from 2197 participants enrolled in the National Neuropsychology Network (NNN) were analyzed using a two-parameter logistic (2PL) IRT model. Simulated CAT results were generated to examine optimal short forms using fixed-length CATs of 3, 6, and 12 items and scores were compared to the original full subtest score. CAT models further explored how many items were needed to achieve a selected precision of measurement (standard error ≤ .40). RESULTS: The fixed-length CATs of 3, 6, and 12 items correlated well with full-length test results (with r = .90, .97 and .99, respectively). To achieve a standard error of .40 (approximate reliability = .84) only 3-7 items had to be administered for a large percentage of individuals. CONCLUSIONS: This proof-of-concept investigation suggests that the widely used Matrix Reasoning subtest of the WAIS-IV might be shortened by more than 70% in most examinees while maintaining acceptable measurement precision. If similar savings could be realized in other tests, the accessibility of neuropsychological assessment might be markedly enhanced, and more efficient time use could lead to broader subdomain assessment.

Construct identification in the neuropsychological battery: What are we measuring?

OBJECTIVE: Major obstacles to data harmonization in neuropsychology include lack of consensus about what constructs and tests are most important and invariant across healthy and clinical populations. This study addressed these challenges using data from the National Neuropsychology Network (NNN). METHOD: Data were obtained from 5,000 NNN participants and Pearson standardization samples. Analyses included variables from four instruments: Wechsler Adult Intelligence Scale, 4th Edition (WAIS-IV); Wechsler Memory Scale, 4th Edition (WMS-IV); California Verbal Learning Test, 3rd Edition (CVLT3); and Delis-Kaplan Executive Function System (D-KEFS). We used confirmatory factor analysis to evaluate models suggested by prior work and examined fit statistics and measurement invariance across samples. We examined relations of factor scores to demographic and clinical characteristics. RESULTS: For each instrument, we identified four first-order and one second-order factor. Optimal models in patients generally paralleled the best-fitting models in the standardization samples, including task-specific factors. Analysis of the NNN data prompted specification of a Recognition-Familiarity factor on the WMS-IV and an Inhibition-Switching factor on the D-KEFS. Analyses showed strong to strict factorial invariance across samples with expected differences in factor means and variances. The Recognition-Familiarity factor correlated with age more strongly in NNN than in the standardization sample. CONCLUSIONS: Factor models derived from healthy groups generally fit well in patients. NNN data helped identify novel Recognition-Familiarity and Inhibition-Switching factors that were also invariant across samples and may be clinically useful. The findings support efforts to identify evidence-based and optimally efficient measurements of neuropsychological constructs that are valid across groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Rationale and Design of the National Neuropsychology Network.

OBJECTIVE: The National Neuropsychology Network (NNN) is a multicenter clinical research initiative funded by the National Institute of Mental Health (NIMH; R01 MH118514) to facilitate neuropsychology's transition to contemporary psychometric assessment methods with resultant improvement in test validation and assessment efficiency. METHOD: The NNN includes four clinical research sites (Emory University; Medical College of Wisconsin; University of California, Los Angeles (UCLA); University of Florida) and Pearson Clinical Assessment. Pearson Q-interactive (Q-i) is used for data capture for Pearson published tests; web-based data capture tools programmed by UCLA, which serves as the Coordinating Center, are employed for remaining measures. RESULTS: NNN is acquiring item-level data from 500-10,000 patients across 47 widely used Neuropsychology (NP) tests and sharing these data via the NIMH Data Archive. Modern psychometric methods (e.g., item response theory) will specify the constructs measured by different tests and determine their positive/negative predictive power regarding diagnostic outcomes and relationships to other clinical, historical, and demographic factors. The Structured History Protocol for NP (SHiP-NP) helps standardize acquisition of relevant history and self-report data. CONCLUSIONS: NNN is a proof-of-principle collaboration: by addressing logistical challenges, NNN aims to engage other clinics to create a national and ultimately an international network. The mature NNN will provide mechanisms for data aggregation enabling shared analysis and collaborative research. NNN promises ultimately to enable robust diagnostic inferences about neuropsychological test patterns and to promote the validation of novel adaptive assessment strategies that will be more efficient, more precise, and more sensitive to clinical contexts and individual/cultural differences.

Raw-score equivalence of computer-assisted and paper versions of WISC-V.

The adaptation of individually administered psychological tests from paper to app-based administration formats can present unique threats to the construct and raw-score equivalence of the paper and digital formats. We discuss these potential threats and describe a study evaluating the equivalence of paper and digital versions of the Wechsler Intelligence Scale for Children, fifth edition (WISC-V), which has been adapted to an app-based testing platform called Q-interactive. The present study (N = 350) used an equivalent-groups design to assess the raw-score equivalence of 18 WISC-V subtests that were designed with the intent of minimizing format effect. Effect sizes in standard deviation units were small, ranging from -0.20 to 0.20 (mean absolute value = 0.09), and format effects were unrelated to ability level, age, sex, or parent education. These results suggest that when tests are designed or adapted with digital-paper equivalence as a goal, digital-paper raw-score equivalence can be achieved across a variety of construct domains. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Brief Cognitive Status Examination (BCSE): Comparing Diagnostic Utility and Equating Scores to the Mini-Mental State Examination (MMSE).

The study purpose was to compare the diagnostic utility of the Brief Cognitive Status Exam (BCSE) to that of the Mini-Mental State Examination (MMSE) and to develop equated scores to facilitate comparisons. One hundred and eighty-two patients underwent cognitive evaluation and were placed into three groups: dementia (DEM), cognitive impairment, no dementia (CIND), and no cognitive impairment (NCI). One hundred and eighty-two healthy controls from the BCSE standardization sample served as a comparison group. On both measures, the DEM group obtained significantly lower scores than the other two groups, and the CIND group scored significantly lower than the NCI group. The BCSE was more sensitive in all clinical groups, although at extremely low scores, the two tests displayed similar sensitivity. Results indicate the BCSE has diagnostic utility as a cognitive screening measure in a mixed clinical sample and is more sensitive at detecting cognitive impairment, particularly milder levels, than the MMSE.

The effect of acute tyrosine phenylalanine depletion on emotion-based decision-making in healthy adults.

Despite interest in dopamine's role in emotion-based decision-making, few reports of the effects of dopamine manipulations are available in this area in humans. This study investigates dopamine's role in emotion-based decision-making through a common measure of this construct, the Iowa Gambling Task (IGT), using Acute Tyrosine Phenylalanine Depletion (ATPD). In a between-subjects design, 40 healthy adults were randomized to receive either an ATPD beverage or a balanced amino acid beverage (a control) prior to completing the IGT, as well as pre- and post-manipulation blood draws for the neurohormone prolactin. Together with conventional IGT performance metrics, choice selections and response latencies were examined separately for good and bad choices before and after several key punishment events. Changes in response latencies were also used to predict total task performance. Prolactin levels increased significantly in the ATPD group but not in the control group. However, no significant group differences in performance metrics were detected, nor were there sex differences in outcome measures. However, the balanced group's bad deck latencies speeded up across the task, while the ATPD group's latencies remained adaptively hesitant. Additionally, modulation of latencies to the bad decks predicted total score for the ATPD group only. One interpretation is that ATPD subtly attenuated reward salience and altered the approach by which individuals achieved successful performance, without resulting in frank group differences in task performance.

Dopaminergic modulation of incentive motivation in adolescence: age-related changes in signaling, individual differences, and implications for the development of self-regulation.

Behavioral activation that is associated with incentive-reward motivation increases in adolescence relative to childhood and adulthood. This quadratic developmental pattern is generally supported by behavioral and experimental neuroscience findings. It is suggested that a focus on changes in dopamine neurotransmission is informative in understanding the mechanism for this adolescent increase in reward-related behavioral activation and subsequent decline into adulthood. Evidence is presented to indicate that incentive-reward motivation is modulated by mesoaccumbens dopamine, and that it increases in adolescence before declining into adulthood because of normative developmental changes at the molecular level. Potential mechanisms of variation in functional mesoaccumbens dopamine transmission are discussed with a focus on the interplay between tonic and phasic modes of dopamine transmission in modulating both general incentive-motivational biases and the efficacy of reward learning during exposure to novel reward experiences. Interactions between individual difference factors and these age-related trends are discussed.

Neurobehavioral evidence for changes in dopamine system activity during adolescence.

Human adolescence has been characterized by increases in risk-taking, emotional lability, and deficient patterns of behavioral regulation. These behaviors have often been attributed to changes in brain structure that occur during this developmental period, notably alterations in gray and white matter that impact synaptic architecture in frontal, limbic, and striatal regions. In this review, we provide a rationale for considering that these behaviors may be due to changes in dopamine system activity, particularly overactivity, during adolescence relative to either childhood or adulthood. This rationale relies on animal data due to limitations in assessing neurochemical activity more directly in juveniles. Accordingly, we also present a strategy that incorporates molecular genetic techniques to infer the status of the underlying tone of the dopamine system across developmental groups. Implications for the understanding of adolescent behavioral development are discussed.

Developmental changes in dopamine neurotransmission in adolescence: behavioral implications and issues in assessment.

Adolescence is characterized by increased risk-taking, novelty-seeking, and locomotor activity, all of which suggest a heightened appetitive drive. The neurotransmitter dopamine is typically associated with behavioral activation and heightened forms of appetitive behavior in mammalian species, and this pattern of activation has been described in terms of a neurobehavioral system that underlies incentive-motivated behavior. Adolescence may be a time of elevated activity within this system. This review provides a summary of changes within cortical and subcortical dopaminergic systems that may account for changes in cognition and affect that characterize adolescent behavior. Because there is a dearth of information regarding neurochemical changes in human adolescents, models for assessing links between neurochemical activity and behavior in human adolescents will be described using molecular genetic techniques. Furthermore, we will suggest how these techniques can be combined with other methods such as pharmacology to measure the impact of dopamine activity on behavior and how this relation changes through the lifespan.

Variations in the catechol O-methyltransferase polymorphism and prefrontally guided behaviors in adolescents.

BACKGROUND: The catechol-O-methyltransferase (COMT) gene codes for an enzyme that degrades prefrontal cortex (PFC) synaptic dopamine. Of two identified alleles (Met and Val), the Met allele results in COMT activity that is up to 4 times less pronounced than that conferred by the Val allele, resulting in greater PFC dopamine concentrations. Met-Met homozygotes perform better than individuals who possess the Val allele on PFC-mediated cognitive tasks. These genotypic variations and their associations with executive functions have been described in adults and prepubescent children, but there is a paucity of research assessing these relations in adolescent samples. METHODS: In this study, 70 children aged 9-17 were genotyped for COMT and completed measures of working memory, attention, fine motor coordination, and motor speed. RESULTS: COMT genotype modulated all but the motor speed measures. The Val-Met genotype was optimal for performance in this adolescent sample. CONCLUSIONS: Results are discussed within the context of developmental changes in the dopaminergic system during adolescence.

Affective bias and response modulation following tyrosine depletion in healthy adults.

Acute phenylalanine/tyrosine depletion (ATPD) has been used to transiently lower central nervous system dopamine activity in animals and humans. Findings suggest that ATPD may impact dopamine transmission in limbic and striatal regions. Impact on cognitive functions has varied across studies, although several recent reports suggest that affective processing in the context of a go/no-go response control task may be impaired during ATPD. In this study, response control under affective vs nonaffective conditions was examined in healthy individuals who underwent either ATPD or a balanced condition in a between-subjects design. Effects of ATPD were validated through its effects on serum prolactin secretion. ATPD resulted in significantly increased prolactin levels relative to the balanced mixture. Although there were no differences in self-reported mood between the groups, individuals in the ATPD condition demonstrated diminished sensitivity to positively valenced words and seemingly enhanced sensitivity to negatively valenced words in an affective go/no-go task. They also showed difficulties in modulating ongoing behavior in a nonaffective go/no-go task when responses had to be intermittently inhibited then immediately restarted. Basic motor functions were not impacted. Findings are discussed in relation to dopamine's role in switching signals within neural networks that are important for response modulation and affective control.