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Papers by John Meyers

Chronic pain and neuropsychological assessment

APA handbook of forensic neuropsychology.

Archives of Clinical Neuropsychology, 2019

Objective This paper examines the long-term stability of the Automated Neuropsychological Assessm... more Objective This paper examines the long-term stability of the Automated Neuropsychological Assessment Metrics (ANAM) over 1-year, 3-year, and 5-year time periods. Methods The sample was drawn from active duty military personnel. All individuals were administered the ANAM and were re-administered the ANAM a second time, either 1 year, 3 years, or 5 years later. All individuals had no reported cognitive problems or concussion or any traumatic brain injury between the first and second assessments and had no intervening contact with the ANAM. All were assessed using the military standard approach with trained proctors. Results The results for (n = 19,997) individuals who were tested 1 year apart showed an intra-class correlation (ICC) of .6 for simple reaction time and simple reaction time repeat and .7 and above for all other scales. For the sample with 3 years between testings (n = 9,166), the ICC was similar to the 1-year sample. When the 5 year between testings data was examined (n =...

The Clinical Neuropsychologist, 2019

Objective: Discrimination of patients passing vs. failing the Word Memory Test (WMT) by performan... more Objective: Discrimination of patients passing vs. failing the Word Memory Test (WMT) by performance on 11 performance and symptom validity tests (PVTs, SVTs) from the Meyers Neuropsychological Battery (MNB) at pertest false positive cutoffs ranging from 0 to 15%. PVT and SVT intercorrelation in subgroups passing and failing the WMT, as well as the degree of skew of the individual PVTs and SVT in the pass/fail subgroups, were also analyzed. Method: In 255 clinical and forensic cases, 100 failed and 155 passed the WMT, at a base-rate of invalid performance of 39.2%. Performance was contrasted on 10 PVTs and 1 SVT from the MNB, using pertest false positive rates of 0.0%, 3.3%, 5.0%, 10.0%, and 15.0% in discriminating WMT pass and WMT fail groups. These two WMT groups were also contrasted using the 10 PVTs and 1 SVT as continuous variables in a logistic regression. Results: The per-PVT false positive rate of 10% yielded the highest WMT pass/fail classification, and more closely approximated the classification obtained by logistic regression than other cut scores. PVT and SVT correlations were higher in cases failing the WMT, and data were more highly skewed in those passing the WMT. Conclusions: The optimal per-PVT and SVT cutoff is at a false positive rate of 10%, with failure of !3 PVTs/SVTs out of 11 yielding sensitivity of 61.0% and specificity of 90.3%. PVTs with the best classification had the greatest degree of skew in the WMT pass subgroup.

Applied Neuropsychology: Adult, 2019

The 1-minute estimation test is a relatively new task. This article is an initial offering showin... more The 1-minute estimation test is a relatively new task. This article is an initial offering showing normative data for children from age six up through adulthood (age ¼76). The task is quite simple, the individual was simply asked to estimate the passage of time for 1 minute. The normative data indicate that children's data needs to be stratified by age, whereas adult data did not need to be stratified by age. Demographic variables such as handedness, gender and ethnicity were not significantly related to 1-minute estimation performance. In looking at a comparison between Traumatic Brain Injured (TBI) patients and Normal Controls, there was a significant effect suggesting that the 1-minute estimation is sensitive to cognitive impairment. Further investigation is needed; however, investigation must begin with the availability of adequate norms so that comparisons can be made. This article provides the needed normative data.

An Adaptation of the MMPI-2 Meyers Index for the MMPI-2-RF

Applied Neuropsychology: Adult, 2013

Using an overall sample of 278 individuals who had taken the Minnesota Multiphasic Personality In... more Using an overall sample of 278 individuals who had taken the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) and who had clear diagnostic information available in their medical records, the Meyers Index (MI) for the MMPI-2 (Meyers, Millis, & Volkert, 2002 ) was calculated for each individual, and a new version of the MI created for the MMPI-2 Restructured Form (MMPI-2-RF) was calculated. The MI is a method of combining multiple MMPI-2 validity scales into a single weighted index to assess exaggerated self-report on the MMPI-2. The new index is intended to provide the same type of global assessment of validity but for the MMPI-2-RF (MI-r). The MI and the MI-r were compared at both individual and group levels and were found to correlate well (r = .87). Diagnostic groups of litigants and nonlitigants of traumatic brain injury, chronic pain, and posttraumatic stress disorder were also examined; and the performance of the MI and the MI-r were similar. Similarly, the pass and fail agreement rate for the two scales was 93%. The results indicate that the MI and MI-r perform very similarly and are good methods of assessing overall validity of MMPI-2 and MMPI-2-RF test performance.

Encyclopedia of Clinical Neuropsychology, 2011

Lie scale Definition One of the original validity scales on the Minnesota Multiphasic Personality... more Lie scale Definition One of the original validity scales on the Minnesota Multiphasic Personality Inventory (MMPI) and its revisions, the L scale consists of 15 items designed to detect attempts to avoid responding honestly. The items reflect patterns of behavior that are socially desirable but only found in the most conscientious individuals. ''True'' is the non-elevating response for all items, making the scale also sensitive to systematic response bias. There is good face validity to these items; however, because of their transparency, the scale may not detect more sophisticated attempts to respond dishonestly. Elevations on this scale have been associated with denial and lack of psychological sophistication. In addition to its value in the validation of MMPI data, the clinical neuropsychologist may find value in the L scale in validating information obtained in the clinical interview. Readers are referred to the MMPI entry for a discussion of limitations of this self-report measure when used with neuropsychological populations (see also Gass, 2006 and Lezak, Howieson, & Loring, 2004).

The Journal of the American Osteopathic Association, 1989

Physicians may encounter unique problems in providing medical services to patients with severe he... more Physicians may encounter unique problems in providing medical services to patients with severe hearing impairments, and they may not be aware of the legal rights of these patients to specific services under section 504 of the Rehabilitation Act of 1973. Most physicians have relatively little contact with the hearing impaired and thus are unprepared for the unique challenges presented by this population. The authors present basic information needed by physicians and their staffs to appropriately serve the hearing impaired.

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, 2018

In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit ... more In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit on Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients in Denver, Colorado. The Summit brought together representatives of a broad range of stakeholders invested in the care of older adults to focus on the topic of cognitive health and aging. Summit participants specifically examined questions of who should be screened for cognitive impairment and how they should be screened in medical settings. This is important in the context of an acute illness given that the presence of cognitive impairment can have significant implications for care and for the management of concomitant diseases as well as pose a major risk factor for dementia. Participants arrived at general principles to guide future screening approaches in medical populations and identified knowledge gaps to direct future research. Key learning points of the summit included: recognizing the importance of educating patients and healthcare providers about the value of assessing current and baseline cognition; emphasizing that any screening tool must be appropriately normalized and validated in the population in which it is used to obtain accurate information, including considerations of language, cultural factors, and education; and recognizing the great potential, with appropriate caveats, of electronic health records to augment cognitive screening and tracking of changes in cognitive health over time.

Trail Making Test

Encyclopedia of Clinical Neuropsychology, 2011

Archives of Clinical Neuropsychology, 2011

A sample of 314 consecutive clinical and forensic referrals with mild traumatic brain injury was ... more A sample of 314 consecutive clinical and forensic referrals with mild traumatic brain injury was evaluated using the Meyers Neuropsychological Battery (MNB). A comparison was made of the test performance and performance on the embedded Symptom Validity Tests (SVTs) with a control for multicolinearity utilized. Using the nine embedded SVTs in the MNB, the incidence of poor effort fell at 26% of the total sample. Involvement in litigation was related to more failures on the individual SVTs. The correlation between failed effort measures and the Overall Test Battery Mean (OTBM) was consistently negative, regardless of litigation status, in that more failures were associated with lower OTBM scores. The correlation between the number of SVTs failed and the OTBM was 2.77. Our results are similar to those presented by Green, Rohling, Lees-Haley, and Allen (2001); who reported a .73 correlation with the failure on the Word Memory Test and performance on the OTBM. The results of the current study also indicate that 50% of the variance in neuropsychological testing can be accounted by failures on internal SVTs.

Archives of Clinical Neuropsychology, 2002

The object of this study was to provide an expanded normative base for the Dichotic Word Listenin... more The object of this study was to provide an expanded normative base for the Dichotic Word Listening Test (DWLT), with particular emphasis on the performance of older individuals. The normative study consisted of 336 community living volunteers. These new norms were used to compare several groups of neurologically impaired patient groups. DWLT was found to be sensitive to the presence of brain injury, and also to the degree of acute injury as measured by loss of consciousness. The results of the short form version of the DWLT test showed 100% specificity and 60% sensitivity for mildly brain-injured patients to 80% sensitivity for more severely brain-injured patients. The respective sensitivities for Left CVA and Right CVA were 55% and 88%. The present findings suggest that the DWLT is a valid and easy to use clinical tool.

Archives of Clinical Neuropsychology, 2003

The purpose of this study is to further previous research that has shown that common neuropsychol... more The purpose of this study is to further previous research that has shown that common neuropsychological tests can do "double duty" as test of motivation/malingering. Using a large clinical sample of 796 participants, it was found that the nine neuropsychological tests (when used together) were able to correctly identify litigant and nonlitigating groups. Failure on any two of the malingering tests suggested motivational/malingering issues. The groups consisted of mild, moderate, and severe traumatic brain-injured patients; chronic pain, depressed, community controls, and "malingering actors." Institutionalized and noninstitutionalized patient performance were also examined. This method showed 83% sensitivity and 100% specificity. A 0% false positive rate was found, suggesting good reliability especially in litigating settings. A group of patients for whom this method of motivational assessment might not be appropriate was also identified.

Archives of Clinical Neuropsychology, 2013

This study examined intra-individual variability in a large sample (n ¼ 629) of individuals with ... more This study examined intra-individual variability in a large sample (n ¼ 629) of individuals with a history of mild traumatic brain injury (mTBI) or TBI referred for neuropsychological evaluation. Variability was assessed using the overall test battery mean standard deviation (OTBM SD). We found a negative linear relation between OTBM and OTBM SD (r ¼ 2.672) in this sample with a history of neurologic pathology, indicating that the variability is inversely related to cognitive performance and contrary to what is observed in most normative data. Analyses revealed main effects for OTBM and OTBM SD across three TBI severity groups: loss of consciousness (LOC) ,1 h, LOC 1 h-6 days, and LOC .6 days. These effects were found for both a valid performance group (no failed embedded validity measures; n ¼ 504) and an invalid performance group (failed one or more embedded validity measures; n ¼ 125). These findings support that cognitive intra-individual variability is increased uniquely by both neuropathology and suboptimal effort, there is a dose-response relationship between neuropathology and cognitive variability, and intra-individual variability may have utility as a clinical index of both.

Archives of Clinical Neuropsychology, 2004

This manuscript reports the results of two studies focusing on patients with mild Traumatic Brain... more This manuscript reports the results of two studies focusing on patients with mild Traumatic Brain Injury (TBI). The first assesses the validity of the Meyers Short Battery (MSB) of neuropsychological tests. The second study reports on the reliability of the MSB. The groups consisted of normal controls, depressed, chronic pain patients, and patients with mild TBI. Validity was assessed using a discriminant function analysis comparing the non-TBI participants with the TBI participants, which showed a 96.1% correct classification rate. When patients were assessed at least 6 months post-injury and re-assessment 12-14 months later, an overall reliability of r = .86 was obtained. This indicates that the MSB has adequate psychometric properties for clinical use. The results are consistent with previous published research indicating that the MSB is sensitive not only to the presence of mild TBI but also to the degree of cognitive impairment based on loss of consciousness.

Archives of Clinical Neuropsychology, 2008

A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a m... more A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a method to detect malingering in chronic pain patients using seven scales from the Minnesota Multiphasic Inventory-2 (MMPI-2). This method may be impractical because two of the scales (Obvious minus Subtle and Dissimulation-revised) are not reported by the commercially available Pearson computerized scoring system. The current study recalculated the Meyers Index using the five Pearson-provided scales in the chronic pain data sets of Meyers et al. [

Archives of Clinical Neuropsychology, 2005

Eight individuals with Alzheimer's disease, and eight age-matched controls, were administered the... more Eight individuals with Alzheimer's disease, and eight age-matched controls, were administered the MMSE, the Yesavage GDS, and a customized subset of the Automated Neuropsychological Assessment Metrics (ANAM) Battery. Accuracy (percent correct) and efficiency (number of correct responses per minute) of performance on six ANAM tasks were assessed. The patients' GDS scores indicated no depression. Although their MMSE scores (mean ∼ 25) were significantly lower than those of the controls, they nonetheless indicated that the patients were still functioning at a fairly high level. Analysis of ANAM accuracy scores indicated that the patients were significantly impaired on three tasks measuring working memory. A discriminant function analysis revealed 93.8% correct classification. Analysis of ANAM efficiency scores revealed that except for simple reaction time, the patients were significantly impaired on all tasks. A discriminant function analysis correctly classified 100% of the participants. Given the small size of the groups in the present study, this finding especially underscores the sensitivity of ANAM to the cognitive effects of Alzheimer's disease, as indicated by the large effect sizes. The findings further indicate that ANAM might be capable of detecting more subtle effects of the disease at an earlier stage in its progress.

Archives of Clinical Neuropsychology, 2002

There have been numerous methods developed for the detection of valid profiles on the Minnesota M... more There have been numerous methods developed for the detection of valid profiles on the Minnesota Multiphasic Personality Inventory (MMPI)-2. The current study examined a method of combining seven different validity scales of the MMPI-2 into a common weighted method in assessing malingering in chronic pain patients. The weighted method was able to correctly classify 100% of nonlitigants, using a cutoff score of ! 5. The findings of this study suggest that chronic pain patients in litigation produce a different profile on the MMPI-2 validity scales than do nonlitigants. In a group of knowledgeable actors (malingerers), 86% was correctly classified. The overall finding showed 100% specificity and 86% sensitivity. The findings support the need for multiple validity scales to be examined in determining a valid profile. The weighted validity scales method was robust enough to account for ''emotional distress'' and still identify invalid MMPI-2 performance.

Does the Source of a Forensic Referral Affect Neuropsychological Test Performance on a Standardized Battery of Tests?

The Clinical Neuropsychologist, 2011

The current study examines the differences in neuropsychological test performance between individ... more The current study examines the differences in neuropsychological test performance between individuals who were referred for evaluation by either plaintiff or defense attorneys. Comparisons were made using a standardized battery of tests, with the same tests being administered to both groups of individuals along with the MMPI-2. The results of the study showed no significant difference in domain-level performance, or on the psychological measures administered for plaintiff vs defense referrals who passed symptom validity tests (SVTs). Similarly, although those failing SVTs produced markedly lower test performance and reported more psychological symptoms in comparison to those passing SVTs, there were no differences between plaintiff or defense referrals on test performance for those failing SVTs.

Presidential Address National Academy of Neuropsychology Conference Boston 2017

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, Jan 5, 2018

This presidential address attempts to predict the future directions of neuropsychology. Predictin... more This presidential address attempts to predict the future directions of neuropsychology. Predicting the future is always a difficult thing. By examining population trends such as aging and demographics, a clearer picture becomes visible. The population is getting older and more ethnically diverse. Also, examination of the spending trends in health care indicates that neuropsychology needs to be able to adapt to working with larger population-based patient care as well as individual patient care. Shifts in the demographics of neuropsychology, in that the profession previously was 70% male dominate and now is >70% female dominant are also discussed. Trends in NAN's speaker and leader demographics are examined as well as the need to stay current in the trends and latest neuropsychological research lest we become dinosaurs in the next 5-10 years. Recommendations for new neuropsychologists and post-doctoral fellows are also presented.

Archives of Clinical Neuropsychology, 2016

Objective: This study assesses the psychometric properties of Ward's seven-subtest short form (SF... more Objective: This study assesses the psychometric properties of Ward's seven-subtest short form (SF) for WAIS-IV in a sample of adults with schizophrenia (SZ) and schizoaffective disorder. Method: Seventy patients diagnosed with schizophrenia or schizoaffective disorder were administered the full version of the WAIS-IV. Four different versions of the Ward's SF were then calculated. The subtests used were: Similarities, Digit Span, Arithmetic, Information, Coding, Picture Completion, and Block Design (BD version) or Matrix Reasoning (MR version). Prorated and regression-based formulae were assessed for each version. Results: The actual and estimated factorial indexes reflected the typical pattern observed in schizophrenia. The four SFs correlated significantly with their full-version counterparts, but the Perceptual Reasoning Index (PRI) correlated below the acceptance threshold for all four versions. The regression-derived estimates showed larger differences compared to the full form. The four forms revealed comparable but generally low clinical category agreement rates for factor indexes. All SFs showed an acceptable reliability, but they were not correlated with clinical outcomes. Conclusions: The WAIS-IV SF offers a good estimate of WAIS-IV intelligence quotient, which is consistent with previous results. Although the overall scores are comparable between the four versions, the prorated forms provided a better estimation of almost all indexes. MR can be used as an alternative for BD without substantially changing the psychometric properties of the SF. However, we recommend a cautious use of these abbreviated forms when it is necessary to estimate the factor index scores, especially PRI, and Processing Speed Index.

Chronic pain and neuropsychological assessment

APA handbook of forensic neuropsychology.

Archives of Clinical Neuropsychology, 2019

Objective This paper examines the long-term stability of the Automated Neuropsychological Assessm... more Objective This paper examines the long-term stability of the Automated Neuropsychological Assessment Metrics (ANAM) over 1-year, 3-year, and 5-year time periods. Methods The sample was drawn from active duty military personnel. All individuals were administered the ANAM and were re-administered the ANAM a second time, either 1 year, 3 years, or 5 years later. All individuals had no reported cognitive problems or concussion or any traumatic brain injury between the first and second assessments and had no intervening contact with the ANAM. All were assessed using the military standard approach with trained proctors. Results The results for (n = 19,997) individuals who were tested 1 year apart showed an intra-class correlation (ICC) of .6 for simple reaction time and simple reaction time repeat and .7 and above for all other scales. For the sample with 3 years between testings (n = 9,166), the ICC was similar to the 1-year sample. When the 5 year between testings data was examined (n =...

The Clinical Neuropsychologist, 2019

Objective: Discrimination of patients passing vs. failing the Word Memory Test (WMT) by performan... more Objective: Discrimination of patients passing vs. failing the Word Memory Test (WMT) by performance on 11 performance and symptom validity tests (PVTs, SVTs) from the Meyers Neuropsychological Battery (MNB) at pertest false positive cutoffs ranging from 0 to 15%. PVT and SVT intercorrelation in subgroups passing and failing the WMT, as well as the degree of skew of the individual PVTs and SVT in the pass/fail subgroups, were also analyzed. Method: In 255 clinical and forensic cases, 100 failed and 155 passed the WMT, at a base-rate of invalid performance of 39.2%. Performance was contrasted on 10 PVTs and 1 SVT from the MNB, using pertest false positive rates of 0.0%, 3.3%, 5.0%, 10.0%, and 15.0% in discriminating WMT pass and WMT fail groups. These two WMT groups were also contrasted using the 10 PVTs and 1 SVT as continuous variables in a logistic regression. Results: The per-PVT false positive rate of 10% yielded the highest WMT pass/fail classification, and more closely approximated the classification obtained by logistic regression than other cut scores. PVT and SVT correlations were higher in cases failing the WMT, and data were more highly skewed in those passing the WMT. Conclusions: The optimal per-PVT and SVT cutoff is at a false positive rate of 10%, with failure of !3 PVTs/SVTs out of 11 yielding sensitivity of 61.0% and specificity of 90.3%. PVTs with the best classification had the greatest degree of skew in the WMT pass subgroup.

Applied Neuropsychology: Adult, 2019

The 1-minute estimation test is a relatively new task. This article is an initial offering showin... more The 1-minute estimation test is a relatively new task. This article is an initial offering showing normative data for children from age six up through adulthood (age ¼76). The task is quite simple, the individual was simply asked to estimate the passage of time for 1 minute. The normative data indicate that children's data needs to be stratified by age, whereas adult data did not need to be stratified by age. Demographic variables such as handedness, gender and ethnicity were not significantly related to 1-minute estimation performance. In looking at a comparison between Traumatic Brain Injured (TBI) patients and Normal Controls, there was a significant effect suggesting that the 1-minute estimation is sensitive to cognitive impairment. Further investigation is needed; however, investigation must begin with the availability of adequate norms so that comparisons can be made. This article provides the needed normative data.

An Adaptation of the MMPI-2 Meyers Index for the MMPI-2-RF

Applied Neuropsychology: Adult, 2013

Using an overall sample of 278 individuals who had taken the Minnesota Multiphasic Personality In... more Using an overall sample of 278 individuals who had taken the Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) and who had clear diagnostic information available in their medical records, the Meyers Index (MI) for the MMPI-2 (Meyers, Millis, & Volkert, 2002 ) was calculated for each individual, and a new version of the MI created for the MMPI-2 Restructured Form (MMPI-2-RF) was calculated. The MI is a method of combining multiple MMPI-2 validity scales into a single weighted index to assess exaggerated self-report on the MMPI-2. The new index is intended to provide the same type of global assessment of validity but for the MMPI-2-RF (MI-r). The MI and the MI-r were compared at both individual and group levels and were found to correlate well (r = .87). Diagnostic groups of litigants and nonlitigants of traumatic brain injury, chronic pain, and posttraumatic stress disorder were also examined; and the performance of the MI and the MI-r were similar. Similarly, the pass and fail agreement rate for the two scales was 93%. The results indicate that the MI and MI-r perform very similarly and are good methods of assessing overall validity of MMPI-2 and MMPI-2-RF test performance.

Encyclopedia of Clinical Neuropsychology, 2011

Lie scale Definition One of the original validity scales on the Minnesota Multiphasic Personality... more Lie scale Definition One of the original validity scales on the Minnesota Multiphasic Personality Inventory (MMPI) and its revisions, the L scale consists of 15 items designed to detect attempts to avoid responding honestly. The items reflect patterns of behavior that are socially desirable but only found in the most conscientious individuals. ''True'' is the non-elevating response for all items, making the scale also sensitive to systematic response bias. There is good face validity to these items; however, because of their transparency, the scale may not detect more sophisticated attempts to respond dishonestly. Elevations on this scale have been associated with denial and lack of psychological sophistication. In addition to its value in the validation of MMPI data, the clinical neuropsychologist may find value in the L scale in validating information obtained in the clinical interview. Readers are referred to the MMPI entry for a discussion of limitations of this self-report measure when used with neuropsychological populations (see also Gass, 2006 and Lezak, Howieson, & Loring, 2004).

The Journal of the American Osteopathic Association, 1989

Physicians may encounter unique problems in providing medical services to patients with severe he... more Physicians may encounter unique problems in providing medical services to patients with severe hearing impairments, and they may not be aware of the legal rights of these patients to specific services under section 504 of the Rehabilitation Act of 1973. Most physicians have relatively little contact with the hearing impaired and thus are unprepared for the unique challenges presented by this population. The authors present basic information needed by physicians and their staffs to appropriately serve the hearing impaired.

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, 2018

In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit ... more In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit on Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients in Denver, Colorado. The Summit brought together representatives of a broad range of stakeholders invested in the care of older adults to focus on the topic of cognitive health and aging. Summit participants specifically examined questions of who should be screened for cognitive impairment and how they should be screened in medical settings. This is important in the context of an acute illness given that the presence of cognitive impairment can have significant implications for care and for the management of concomitant diseases as well as pose a major risk factor for dementia. Participants arrived at general principles to guide future screening approaches in medical populations and identified knowledge gaps to direct future research. Key learning points of the summit included: recognizing the importance of educating patients and healthcare providers about the value of assessing current and baseline cognition; emphasizing that any screening tool must be appropriately normalized and validated in the population in which it is used to obtain accurate information, including considerations of language, cultural factors, and education; and recognizing the great potential, with appropriate caveats, of electronic health records to augment cognitive screening and tracking of changes in cognitive health over time.

Trail Making Test

Encyclopedia of Clinical Neuropsychology, 2011

Archives of Clinical Neuropsychology, 2011

A sample of 314 consecutive clinical and forensic referrals with mild traumatic brain injury was ... more A sample of 314 consecutive clinical and forensic referrals with mild traumatic brain injury was evaluated using the Meyers Neuropsychological Battery (MNB). A comparison was made of the test performance and performance on the embedded Symptom Validity Tests (SVTs) with a control for multicolinearity utilized. Using the nine embedded SVTs in the MNB, the incidence of poor effort fell at 26% of the total sample. Involvement in litigation was related to more failures on the individual SVTs. The correlation between failed effort measures and the Overall Test Battery Mean (OTBM) was consistently negative, regardless of litigation status, in that more failures were associated with lower OTBM scores. The correlation between the number of SVTs failed and the OTBM was 2.77. Our results are similar to those presented by Green, Rohling, Lees-Haley, and Allen (2001); who reported a .73 correlation with the failure on the Word Memory Test and performance on the OTBM. The results of the current study also indicate that 50% of the variance in neuropsychological testing can be accounted by failures on internal SVTs.

Archives of Clinical Neuropsychology, 2002

The object of this study was to provide an expanded normative base for the Dichotic Word Listenin... more The object of this study was to provide an expanded normative base for the Dichotic Word Listening Test (DWLT), with particular emphasis on the performance of older individuals. The normative study consisted of 336 community living volunteers. These new norms were used to compare several groups of neurologically impaired patient groups. DWLT was found to be sensitive to the presence of brain injury, and also to the degree of acute injury as measured by loss of consciousness. The results of the short form version of the DWLT test showed 100% specificity and 60% sensitivity for mildly brain-injured patients to 80% sensitivity for more severely brain-injured patients. The respective sensitivities for Left CVA and Right CVA were 55% and 88%. The present findings suggest that the DWLT is a valid and easy to use clinical tool.

Archives of Clinical Neuropsychology, 2003

The purpose of this study is to further previous research that has shown that common neuropsychol... more The purpose of this study is to further previous research that has shown that common neuropsychological tests can do "double duty" as test of motivation/malingering. Using a large clinical sample of 796 participants, it was found that the nine neuropsychological tests (when used together) were able to correctly identify litigant and nonlitigating groups. Failure on any two of the malingering tests suggested motivational/malingering issues. The groups consisted of mild, moderate, and severe traumatic brain-injured patients; chronic pain, depressed, community controls, and "malingering actors." Institutionalized and noninstitutionalized patient performance were also examined. This method showed 83% sensitivity and 100% specificity. A 0% false positive rate was found, suggesting good reliability especially in litigating settings. A group of patients for whom this method of motivational assessment might not be appropriate was also identified.

Archives of Clinical Neuropsychology, 2013

This study examined intra-individual variability in a large sample (n ¼ 629) of individuals with ... more This study examined intra-individual variability in a large sample (n ¼ 629) of individuals with a history of mild traumatic brain injury (mTBI) or TBI referred for neuropsychological evaluation. Variability was assessed using the overall test battery mean standard deviation (OTBM SD). We found a negative linear relation between OTBM and OTBM SD (r ¼ 2.672) in this sample with a history of neurologic pathology, indicating that the variability is inversely related to cognitive performance and contrary to what is observed in most normative data. Analyses revealed main effects for OTBM and OTBM SD across three TBI severity groups: loss of consciousness (LOC) ,1 h, LOC 1 h-6 days, and LOC .6 days. These effects were found for both a valid performance group (no failed embedded validity measures; n ¼ 504) and an invalid performance group (failed one or more embedded validity measures; n ¼ 125). These findings support that cognitive intra-individual variability is increased uniquely by both neuropathology and suboptimal effort, there is a dose-response relationship between neuropathology and cognitive variability, and intra-individual variability may have utility as a clinical index of both.

Archives of Clinical Neuropsychology, 2004

This manuscript reports the results of two studies focusing on patients with mild Traumatic Brain... more This manuscript reports the results of two studies focusing on patients with mild Traumatic Brain Injury (TBI). The first assesses the validity of the Meyers Short Battery (MSB) of neuropsychological tests. The second study reports on the reliability of the MSB. The groups consisted of normal controls, depressed, chronic pain patients, and patients with mild TBI. Validity was assessed using a discriminant function analysis comparing the non-TBI participants with the TBI participants, which showed a 96.1% correct classification rate. When patients were assessed at least 6 months post-injury and re-assessment 12-14 months later, an overall reliability of r = .86 was obtained. This indicates that the MSB has adequate psychometric properties for clinical use. The results are consistent with previous published research indicating that the MSB is sensitive not only to the presence of mild TBI but also to the degree of cognitive impairment based on loss of consciousness.

Archives of Clinical Neuropsychology, 2008

A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a m... more A validity index for the MMPI-2. Archives of Clinical Neuropsychology, 17, 157-169] developed a method to detect malingering in chronic pain patients using seven scales from the Minnesota Multiphasic Inventory-2 (MMPI-2). This method may be impractical because two of the scales (Obvious minus Subtle and Dissimulation-revised) are not reported by the commercially available Pearson computerized scoring system. The current study recalculated the Meyers Index using the five Pearson-provided scales in the chronic pain data sets of Meyers et al. [

Archives of Clinical Neuropsychology, 2005

Eight individuals with Alzheimer's disease, and eight age-matched controls, were administered the... more Eight individuals with Alzheimer's disease, and eight age-matched controls, were administered the MMSE, the Yesavage GDS, and a customized subset of the Automated Neuropsychological Assessment Metrics (ANAM) Battery. Accuracy (percent correct) and efficiency (number of correct responses per minute) of performance on six ANAM tasks were assessed. The patients' GDS scores indicated no depression. Although their MMSE scores (mean ∼ 25) were significantly lower than those of the controls, they nonetheless indicated that the patients were still functioning at a fairly high level. Analysis of ANAM accuracy scores indicated that the patients were significantly impaired on three tasks measuring working memory. A discriminant function analysis revealed 93.8% correct classification. Analysis of ANAM efficiency scores revealed that except for simple reaction time, the patients were significantly impaired on all tasks. A discriminant function analysis correctly classified 100% of the participants. Given the small size of the groups in the present study, this finding especially underscores the sensitivity of ANAM to the cognitive effects of Alzheimer's disease, as indicated by the large effect sizes. The findings further indicate that ANAM might be capable of detecting more subtle effects of the disease at an earlier stage in its progress.

Archives of Clinical Neuropsychology, 2002

There have been numerous methods developed for the detection of valid profiles on the Minnesota M... more There have been numerous methods developed for the detection of valid profiles on the Minnesota Multiphasic Personality Inventory (MMPI)-2. The current study examined a method of combining seven different validity scales of the MMPI-2 into a common weighted method in assessing malingering in chronic pain patients. The weighted method was able to correctly classify 100% of nonlitigants, using a cutoff score of ! 5. The findings of this study suggest that chronic pain patients in litigation produce a different profile on the MMPI-2 validity scales than do nonlitigants. In a group of knowledgeable actors (malingerers), 86% was correctly classified. The overall finding showed 100% specificity and 86% sensitivity. The findings support the need for multiple validity scales to be examined in determining a valid profile. The weighted validity scales method was robust enough to account for ''emotional distress'' and still identify invalid MMPI-2 performance.

Does the Source of a Forensic Referral Affect Neuropsychological Test Performance on a Standardized Battery of Tests?

The Clinical Neuropsychologist, 2011

The current study examines the differences in neuropsychological test performance between individ... more The current study examines the differences in neuropsychological test performance between individuals who were referred for evaluation by either plaintiff or defense attorneys. Comparisons were made using a standardized battery of tests, with the same tests being administered to both groups of individuals along with the MMPI-2. The results of the study showed no significant difference in domain-level performance, or on the psychological measures administered for plaintiff vs defense referrals who passed symptom validity tests (SVTs). Similarly, although those failing SVTs produced markedly lower test performance and reported more psychological symptoms in comparison to those passing SVTs, there were no differences between plaintiff or defense referrals on test performance for those failing SVTs.

Presidential Address National Academy of Neuropsychology Conference Boston 2017

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists, Jan 5, 2018

This presidential address attempts to predict the future directions of neuropsychology. Predictin... more This presidential address attempts to predict the future directions of neuropsychology. Predicting the future is always a difficult thing. By examining population trends such as aging and demographics, a clearer picture becomes visible. The population is getting older and more ethnically diverse. Also, examination of the spending trends in health care indicates that neuropsychology needs to be able to adapt to working with larger population-based patient care as well as individual patient care. Shifts in the demographics of neuropsychology, in that the profession previously was 70% male dominate and now is >70% female dominant are also discussed. Trends in NAN's speaker and leader demographics are examined as well as the need to stay current in the trends and latest neuropsychological research lest we become dinosaurs in the next 5-10 years. Recommendations for new neuropsychologists and post-doctoral fellows are also presented.

Archives of Clinical Neuropsychology, 2016

Objective: This study assesses the psychometric properties of Ward's seven-subtest short form (SF... more Objective: This study assesses the psychometric properties of Ward's seven-subtest short form (SF) for WAIS-IV in a sample of adults with schizophrenia (SZ) and schizoaffective disorder. Method: Seventy patients diagnosed with schizophrenia or schizoaffective disorder were administered the full version of the WAIS-IV. Four different versions of the Ward's SF were then calculated. The subtests used were: Similarities, Digit Span, Arithmetic, Information, Coding, Picture Completion, and Block Design (BD version) or Matrix Reasoning (MR version). Prorated and regression-based formulae were assessed for each version. Results: The actual and estimated factorial indexes reflected the typical pattern observed in schizophrenia. The four SFs correlated significantly with their full-version counterparts, but the Perceptual Reasoning Index (PRI) correlated below the acceptance threshold for all four versions. The regression-derived estimates showed larger differences compared to the full form. The four forms revealed comparable but generally low clinical category agreement rates for factor indexes. All SFs showed an acceptable reliability, but they were not correlated with clinical outcomes. Conclusions: The WAIS-IV SF offers a good estimate of WAIS-IV intelligence quotient, which is consistent with previous results. Although the overall scores are comparable between the four versions, the prorated forms provided a better estimation of almost all indexes. MR can be used as an alternative for BD without substantially changing the psychometric properties of the SF. However, we recommend a cautious use of these abbreviated forms when it is necessary to estimate the factor index scores, especially PRI, and Processing Speed Index.