Letter and category fluency tasks are used to assess semantic knowledge, retrieval ability, and executive functioning. They appear to be useful in detecting different types of dementia, but accurate detection of neuropsychological impairment relies on appropriate normative data. Multiple regression analysis was used to develop demographically corrected norms for letter and category fluency in 768 normal adults. T-score equations were developed on a base subsample of 403, and crossvalidated on a separate subsample (n = 365). Participants ranged in age from 20 years to 101 years; in educational level from 0 to 20 years; 55% were Caucasian and 45% were African American. Together, age, education, and ethnicity were significant predictors of letter and category fluency performance, accounting for 15% and 25% of variance, respectively. Formulas and tables for converting raw fluency scores to demographically corrected T scores are presented.
Two studies were conducted to examine the relationship
of acculturation to neuropsychological test performance
among (1) medically healthy, neurologically normal African
Americans (N = 170); and (2) HIV positive (HIV+)
subgroups of African Americans and Whites (Ns
= 20) matched on age, education, sex, and HIV disease stage.
Acculturation was measured through self report for all
participants, and linguistic behavior (Black English use)
was assessed in a subset of medically healthy individuals
(N = 25). After controlling for the effects of
age, education, and sex, medically healthy African Americans
who reported less acculturation obtained lower scores on
the WAIS–R Information subtest and the Boston Naming
Test than did more acculturated individuals. Black English
use was associated with poor performance on Trails B and
the WAIS–R Information subtest. HIV+ African Americans
scored significantly lower than their HIV+ White counterparts
on the Category Test, Trails B, WAIS–R Block Design
and Vocabulary subtests, and the learning components of
the Story and Figure Memory Tests. However, after accounting
for acculturation, ethnic group differences on all measures
but Story Learning became nonsignificant. These results
suggest that there are cultural differences within ethnic
groups that relate to neuropsychological test performance,
and that accounting for acculturation may improve the diagnostic
accuracy of certain neuropsychological tests. (JINS,
1998, 4, 291–302.)
While the standard 200-item version of the Paced Auditory Serial Addition Task (PASAT) is a sensitive neuropsychological instrument, it can be quite aversive to some patients due to its length and progressively increasing difficulty. We present demographically-corrected norms for 50 and 100-item short-form versions in a sample of 560 neurologically normal adults. Age, education, and ethnicity (but not gender) were found to be significant predictors of performance. In a clinical sample of 786 HIV-infected adults, diagnostic accuracy of the 50, 100, and 200-item versions was essentially equivalent (using clinical ratings of a comprehensive neuropsychological battery as the gold standard, overall classification rates of the three PASAT versions were 71%, 74%, and 73%, respectively), with better specificity (89-92%) than sensitivity (46-53%). The 50-item version showed moderate ceiling effects, but the 100-item test did not. In a mixed clinical sample of 40 subjects, the 50-item version was administered more than twice as fast as the 200-item version, and was tolerated better (discomfort rating of 4.0 vs. 5.9 on a 10-point scale, p < .05). We conclude that in many cases the PASAT-50 and PASAT-100 provide equivalent diagnostic accuracy with a significant reduction in administration time and patient discomfort.
The current study explored the extent to which children above and below the age of 7 years are able to benefit from either training in cumulative rehearsal or in the use of interactive imagery when carrying out working memory tasks. Twenty-four 5- to 6-year-olds nd 24 8- to 9-year olds were each assigned to one of three training groups who either received cumulative rehearsal, interactive imagery, or passive labeling training. Participants’ ability to maintain material during a filled delay was then assessed, and the nature of the distraction that was imposed during this delay was varied to shed further light on the mechanisms that individuals used to maintain the memoranda in working memory in the face of this distraction. The results suggest that the rehearsal training employed here did improve recall by virtue of encouraging rehearsal strategies, in a way that was not observed among participants receiving interactive imagery training. The fact that these effects were not mediated by age group counts against the view that younger individuals are either unable to rehearse, or show impoverished verbal serial recall because they do not spontaneously engage in rehearsal.
The Paced Auditory Serial Addition Task (PASAT) is a complex cognitive test sensitive to neuropsychological disorders. Its traditional Total Correct score seemingly reflects multiple cognitive abilities, including attention, working memory, and processing speed. Snyder, Aniskiewicz, and Snyder (1993) modified scoring guidelines for the PASAT to give credit only for "dyads." This method emphasizes working memory operations and has been found superior to Total Correct scores at detecting cognitive impairments in several investigations. To date, normative standards are not available for the "dyad" scoring method, thus limiting its utility in clinical and research settings. The current investigation provides demographically adjusted normative data based on a sample of 500 healthy adults of varied age, education, sex, and race (African American and Caucasian) for various indices of performance on the PASAT, including "Total Dyads" obtained across the four PASAT trials. In addition, we describe and present normative data on four other indices designed to quantify various aspects of performance on the PASAT: invalid responding, effects of varied information processing speed demands, and tendency to omit responses and to make arithmetic errors.
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