Apparently abnormal Wechsler Memory Scale index score patterns in the normal population.

Interpretation of the Wechsler Memory Scale-Fourth Edition may involve examination of multiple memory index score contrasts and similar comparisons with Wechsler Adult Intelligence Scale-Fourth Edition ability indexes. Standardization sample data suggest that 15-point differences between any specific pair of index scores are relatively uncommon in normal individuals, but these base rates refer to a comparison between a single pair of indexes rather than multiple simultaneous comparisons among indexes. This study provides normative data for the occurrence of multiple index score differences calculated by using Monte Carlo simulations and validated against standardization data. Differences of 15 points between any two memory indexes or between memory and ability indexes occurred in 60% and 48% of the normative sample, respectively. Wechsler index score discrepancies are normally common and therefore not clinically meaningful when numerous such comparisons are made. Explicit prior interpretive hypotheses are necessary to reduce the number of index comparisons and associated false-positive conclusions. Monte Carlo simulation accurately predicts these false-positive rates.

Shorter and proximal Timeline Followback windows are representative of longer posttreatment functioning.

Very little research has been conducted on what time window provides a representative picture of daily drinking. With respect to pretreatment drinking, one study that used the Timeline Followback (TLFB) with problem drinkers found that a 3-month window is generally representative of annual pretreatment drinking. The objective of the present study was to determine the shortest representative time window for reports of annual posttreatment drinking. A second objective was to determine which of two time windows, 90 days from the end of treatment or 90 days prior to the end of follow-up, was the most representative proxy for annual posttreatment drinking. TLFB reports from 467 problem drinkers who participated in a randomized controlled trial of a mail-based intervention were used in the present analysis. The results show that a 3-month posttreatment window (i.e., first 90 days after the intervention) is sufficiently representative (r = .94) of annual posttreatment drinking for problem drinkers (i.e., less severely dependent alcohol abusers). In addition, although there were no clinically significant differences in drinking behavior between the two 90-day posttreatment windows, the use of proximal windows (i.e., closer to the end of treatment) would minimize participant attrition. In addition, a 3-month versus 12-month TLFB follow-up time frame resulted in a much higher percentage of participants completing the full TLFB (89% vs. 71%). Further research is needed to determine if these findings will generalize to more severely dependent alcohol abusers.

Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment.

The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations.

Rates of apparently abnormal MMPI-2 profiles in the normal population.

MMPI-2 standardization data were re-sampled using Monte Carlo simulations to estimate the base rate of apparently abnormal scores expected by chance in the normal population when multiple scales are interpreted. 36.8% of normal adults are likely to obtain a score that would otherwise be considered clinically significant at 65T on one or more of the 10 Clinical scales. The normal incidence of at least one apparently abnormal score was 38.3% on the Content and 55.1% on the Supplementary scales. When the Clinical, Supplementary, and Content scales and subscales are interpreted together, at least three seemingly meaningful scores will be found in 47.4% of perfectly normal individuals, and five or more scales that appear to be clinically significant can be expected in 30.1% of cases that are actually unremarkable. These results imply that the number of MMPI-2 scales that can be meaningfully interpreted in clinical practice is limited, and that high T-scores are necessary for an adequate level of confidence even when interpretation is appropriately limited to the Clinical scales.

Corollary-and discrepancy-based approaches for examining the appropriateness of premorbid cognitive estimation in geriatric schizophrenia.

OBJECTIVE: This article addresses whether measures for assessing premorbid intellectual functioning are adequate for geriatric schizophrenia. METHOD: We included geriatric schizophrenia-spectrum disorders (SSD; n = 37), frontotemporal dementia (FTD; n = 41), and geriatric controls (n = 107), and employed measures of verbal ability. RESULTS: Pearson's correlations and ANOVAs for discrepancy comparisons showed unique patterns of spared function in SSD when compared to FTD and controls. CONCLUSIONS: Findings lend support to the specificity of cognitive processes in SSD, even when accounting for processes common to the theoretically similar FTD. SSD showed a distinct pattern of spared ability which supports clinical utilization of discrepant measures of premorbid intellectual estimation for SSD.

Comparison of the quick drinking screen and the alcohol timeline followback with outpatient alcohol abusers.

OBJECTIVE: A recent study comparing the Quick Drinking Screen (QDS) with the Timeline Followback (TLFB) found that in a nonclinical population of problem drinkers both measures produced reliable summary measures of drinking. The current study was designed to replicate these findings with a clinical population of alcohol abusers. The data were collected over three years (2004-2006). METHOD: Participants were 124 alcohol abusers who voluntarily enrolled for outpatient treatment. Over half (52.4%) were female with an average age of almost 40 years. About a third were married, had completed university, and a quarter were unemployed and nonwhite. Participants reported having a drinking problem for an average of 8.3 years, and reported drinking on about 5 days per week, averaging six drinks per drinking day. On two different occasions, they responded to two different sets of questions about their alcohol use. The instruments were: (a) the Quick Drinking Screen (QDS), a summary drinking measure, administered by telephone prior to the assessment; and (2) the TLFB self-administered by computer at the assessment. RESULTS: As in a previous study, this study found that the QDS and the TLFB, two very different drinking measures, collected similar aggregate drinking data for four drinking variables in a clinical sample of alcohol abusers. CONCLUSIONS: When it is not necessary or not possible to gather detailed drinking data, the QDS produces reliable brief summary measures of drinking for problem drinkers. Generalization to nonclinical samples awaits further research.

Using the Timeline Followback to determine time windows representative of annual alcohol consumption with problem drinkers.

When assessing individuals with alcohol use disorders, measurement of drinking can be a resource intensive activity, particularly because many research studies report data for intervals ranging from 6 to 12 months prior to the interview. This study examined whether data from shorter assessment intervals is sufficiently representative of longer intervals to warrant the use of shorter intervals for clinical and research purposes. Participants were 825 problem drinkers (33.1% female) who were recruited through media advertisements to participate in a community-based mail intervention in Toronto, Canada. Participants' Timeline Followback (TLFB) reports of drinking were used to investigate the representativeness of different time windows for estimating annual drinking behavior. The findings suggest that for aggregated reports of drinking and with large sample (e.g., surveys), a 1-month window can be used to estimate annual consumption. For individual cases (e.g., clinical use) and smaller samples, a 3-month window is recommended. These results suggest that shorter time windows, which are more time and resource efficient, can be used with little to no loss in the accuracy of the data.

Pattern of memory compromise in chronic geriatric schizophrenia, frontotemporal dementia and normal geriatric controls.

OBJECTIVE: The purpose of this study was to explore whether memory deficits in schizophrenia are attributable to poor organisation/encoding during initial learning vs. memory decay. METHODS: Subjects included geriatric schizophrenia/schizoaffective disorders [SSD; n = 37; age = 59.92 (55-74); education = 11.70 (7-18)]; frontotemporal dementia [FTD; n = 41; age = 76.59 (64-83); education = 14.61 (12-20)] and geriatric controls [n = 107; age = 70.97 (55-93); education = 13.76 (6-20)]. Subjects were administered the Wechsler Memory Scale, Third Edition and discrepancy scores between immediate and delayed subtests/indices were used to explore possible differences between groups in pattern of impairment. RESULTS: Significant differences were found between groups on age/education and these variables were related to several outcome measures. Gender was not related to diagnostic group and there were no gender differences on study variables. There were differences between the SSD subjects on several variables, with the schizoaffective subjects performing worse despite equivalence on global cognitive function, living status and chronicity. Seven one-way between-subjects ANCOVAs compared groups on discrepancy scores. RESULTS failed to suggest differences between groups on immediate-delayed memory discrepancy scores (p > 0.05). Subsequent analyses revealed differences in percentage retention scores between SSD and FTD on the faces subtest (p = 0.040), with SSD retaining greater information over time. CONCLUSION: RESULTS failed to show distinctions between groups on pattern of memory impairment when using discrepancy comparisons. However, an analysis examining percentage retention scores revealed better maintenance of non-contextual visual information over time in SSD. Findings may suggest deficits in immediate encoding rather than memory decay for some types of memory ability among geriatric SSD. Our failure to document group differences when using discrepancy comparisons may be attributable to relative similarity in pattern between groups or the limited sensitivity of this technique.

Mothers' depressed mood and anxiety levels are reduced after massaging their preterm infants.

Forty mothers whose preterm infants were about to be discharged from the Neonatal Intermediate Care Nursery (NICU) were randomly assigned to two groups: the first group of mothers conducted preterm infant massage and the second group only observed their preterm infants receiving massage. Both groups of mothers had lower depressed mood scores following the session. However, only the group who massaged their infants had lower anxiety scores after the session.

Smokers' narrative accounts of quit attempts: AIDS and impediments to success.

In this study, the authors used cigarette smokers' narratives describing their quit attempts to understand factors related to the change process. Maintained quitters (MQs, n = 59) and temporary quitters (TQs, n = 47) wrote autobiographical narratives describing their most serious (TQs) or last (MQs) quit attempt. Two types of content analysis were used to analyze the reports: (a) dichotomous ratings of the presence or absence of an event and (b) computerized content analysis of event or word frequency. The valence (anti- or pro-smoking cessation) of change factors was also examined. MQs wrote significantly more affective statements than did TQs. When valence was examined, MQs made significantly more pro-smoking cessation social support, cognitive, and affective statements than TQs did, and TQs made significantly more anti-smoking cessation social support and affective statements than MQs did.

Psychometric characteristics of a Spanish version of the DAST-10 and the RAGS.

Although Hispanics/Latinos constitute the largest ethnic minority group in the United States, there are few culturally and linguistically valid Spanish language clinical assessment instruments. This shortage is even more critical in the addictions field. This article presents the psychometric characteristics of two drug abuse screening instruments; the Drug Abuse Screening Test (DAST-10), and the Reduce Annoyed Guilty Start (RAGS) test that were translated into Spanish. Participants included 60 drug abusers, 35 alcohol abusers, and 127 individuals with no alcohol and/or drug problem. Results indicated that the Spanish versions of the two drug abuse screening instruments were reliable and unidimensional and differentiated drug abusers from non-substance abusers and from alcohol abusers.

A test of the tripartite model of depression and anxiety in older adult psychiatric outpatients.

This study examined the tripartite model of depression and anxiety in 131 psychiatric outpatients, ages 55-87. Confirmatory factor analyses revealed that a 3-factor model provided an adequate fit to the observed data, that the 3-factor model was empirically superior to 1- or 2-factor models, and that the 3-factor structure obtained in the current sample of older adult outpatients converged with that obtained on a separate, younger 'sample. Negative affect was significantly related to depression and anxiety symptoms and syndromes, and positive affect was more highly related to depression than anxiety symptoms and syndromes. Ways for taking into account possible age-associated differences in emotion in older adults and thus improving the conceptual model of anxiety and depression are briefly noted.

Comparison of a quick drinking screen with the timeline followback for individuals with alcohol problems.

OBJECTIVE: Two major strategies have typically been used to assess recent drinking: (1) Daily Estimation (DE) measures such as the Timeline Followback (TLFB) and (2) Quantity-Frequency (QF) summary measures. Although QF measures provide a quick and easy measure of consumption, they have been criticized as not being able to capture sporadic and unpatterned drinking (e.g., days that reflect important social and/or health risks). The TLFB, a psychometrically sound drinking assessment method, is able to capture all drinking, including sporadic heavy days and unpatterned drinking. In some situations, however, recall of daily drinking may not be possible or practical (e.g., limited time; no resources). This article compares results obtained by using a QF measure and a DE measure to assess problem drinkers' pretreatment drinking. METHOD: The current study, part of a large community mail intervention with 825 alcohol abusers, compared results from two drinking measures covering the same time interval that were administered on two different occasions approximately 2.5 weeks apart. Both measures, the Quick Drinking Screen (QDS; a QF summary measure that collected data by telephone) and the TLFB (a self-administered daily estimation measure), collected drinking data for the year prior to the interview. RESULTS: Although the QDS and the TLFB are very different drinking measures, remarkably similar aggregate drinking data were obtained for five drinking variables. CONCLUSIONS: When it is not necessary or possible to gather detailed drinking data, the QDS produces reliable brief summary measures of drinking, at least for not severely alcohol dependent individuals. Also, respondents do not appear to use a repetitive response pattern when completing the TLFB.