Two studies were conducted to examine the adequacy of the Visual Reproduction and Logical Memory Subtests of Form II of the Wechsler Memory Scale (WMS-II) as an alternate form for Russell's Revision of the WMS (RWMS). An archival data study on 46 inpatient alcoholics revealed greater pre-/post-treatment differences on Immediate Figural Recall scores for participants tested first on the RWMS, compared with participants tested first on the alternate subtests. In a second study, both forms were administered to 60 noninstitutionalized examinees. Immediate Figural Recall was again higher for subtests from WMS-II; Immediate and Delayed Semantic Recall were higher for RWMS. Data indicate apparent problems in the use of subtests of WMS-II as an alternate form for RWMS.
Questionnaires concerning the incidence of memory failures in everyday life were used in a postal survey of the aftereffects of severe head injury. Several years after a severe injury, 50 patients were compared to 33 patients a similar period after a very mild injury. A questionnaire completed on behalf of each patient by someone living in daily contact with him appeared to have some validity as a memory measure. The pattern of memory failures reported was similar to that found in a previous study and this may primarily reflect the ease with which certain forms of memory failure can be observed. A questionnaire completed by the patients themselves had little validity, possibly because severely injured patients could not recall their own memory failures. Only a minority of severely injured patients were reported to be significantly handicapped by memory failures at this stage in their recovery.
A memory-retraining program was designed for a patient approximately 2 1/2 months after he suffered a closed-head injury. Tests showed his memory deficit to be relatively isolated in the verbal sphere. An attempt was made to design a program in which tasks resembled the environmental demands on the patient for retention of verbal material. On a routine basis, the patient was read various paragraphs and was subsequently required to write them from memory. Three different strategies were used in an attempt to improve memory. After 15 days of training, the patient improved from an impaired level of verbal recall to a normal level. Strategies employing (a) visual imagery and other mnemonic devices and (b) questioning during presentation appeared to be most effective in facilitating retention. There was some drop in memory performance at a 9 month follow-up, and the patient was encouraged to resume active use of mnemonic strategies. Implications for further study are discussed.
The eye-movement patterns of good and poor readers at two age levels during slide-presented reading, arithmetic and perceptual-closure tasks were compared. Older dyslexics were deficient in reading and arithmetic, but performed well on perceptual-closure tasks. Younger dyslexics were deficient on all tasks. Both younger good readers and older poor readers appeared to use a right-hemispheric reading strategy, while older dyslexics appeared to show a left-hemispheric approach. Younger dyslexics did not exhibit any strategy at all. Implications for Bakker's balance model of dyslexia and for subtypes research in dyslexia are discussed.
Use of a search procedure to control processing during learning results in apparently normal cued recall by some amnesic patients with impaired free-recall learning. This suggests that their ability to encode and retrieve may be relatively intact when they are induced to carry out effective processing during learning. When processing is controlled during learning, cued recall should be useful for neuropsychological evaluation of residual learning and memory capacity.
The pattern and type of errors on the Speech-Sounds Perception Test was examined in a sample of 513 patients referred for neuropsychological evaluation. There was considerable variability in the rate of correct response. Groups of patients with independently documented lesions were compared in regard to number and type of errors. It was found that patients with left-hemisphere lesions made a higher percentage of ending errors and a lower percentage of beginning errors than patients with right-hemisphere or bilateral lesions. These differences were maintained when the total error score was included as a covariate. It was also found that a cutoff score based on the percentage of ending errors correctly classified the unilateral-lesion patients at a statistically significant level. The potential clinical utility of these results were discussed.
Ennio De Renzi, Disorders of Space Exploration and Cognition New York, John Wiley&Sons, 1982, 268 pp. $16.75
The study involved a comparison between language tests derived from the Halstead-Reitan and Luria-Nebraska neuropsychological test batteries. Language-related measures from each battery were entered into a factor analysis based on a sample of 150 nonaphasic neuropsychiatric patients. Five factors were extracted and were named Academic Achievement, Basic Skills, Verbal Intelligence, Auditory Discrimination, and Comprehension of Syntactical Relations. Measures from both the Halstead-Reitan and Luria-Nebraska loaded on most of these factors. A canonical correlation analysis revealed a strong relationship between the Halstead-Reitan and Luria-Nebraska measures. However, it was noted that interpretation of this relationship must be qualified by the association found between the measures used and educational achievement.
The relationship of duration of illness and severity of neurological impairment to psychometric performance and activities of daily living was examined in 57 patients with Huntington's Disease (HD). As earlier studies suggested, a distinct cognitive profile characterized patients early in the disease. Duration of symptoms, however, proved to be a weaker correlate of cognitive decline than was motor impairment at the time of testing. For predicting adaptive functioning, both duration of symptoms and neurological status were important variables. This study underscores the limitations of length of illness as a classificatory variable in studies of dementia in HD. We further suggest that future studies consider the contribution of defects in precise timing and sequential operations to the cognitive and adaptive deficits of these patients.
A number of specific methodological issues have arisen in studies of the social, emotional, and behavioural sequelae of head injury. The accounts given by patients and relatives may differ: Patients may lack insight, and relatives--who are often under considerable stress--may themselves give distorted accounts. Moreover, the sequelae of head injury may not all be specific to brain injury but may include effects common to other forms of traumatic injury: The use of control groups may help disentangle specific and non-specific effects.
Simple alerted auditory reaction time (SRT) behavior with various foreperiods was investigated in a group of long-term survivors of childhood ALL who were in continuous first remission. As part of therapy, the patients had received cranial irradiation and intrathecal chemotherapy to prevent the development of central nervous system leukemia. The patients were divided into three groups on the basis of CT brain scan findings: (1) those with normal CT scans (n=10); (2) those with evidence of cortical atrophy (n=8), and (3) those with intracerebral calcifications (n=5). The SRT results indicated significant differences between patients with normal and abnormal CT scans. Specifically, patients with abnormal scans reacted slower, and this latency was exaggerated by increasing the length of the warning interval. Furthermore, they reacted with larger variability which increased with the prolongation of testing. Moreover, the severity of impairment was related to the type of CT-scan abnormality: patients with calcifications performed more poorly than patients with evidence of atrophy. The present results revealed a strong correlation between the presence and type of CT-scan abnormalities and attentional performance in long-term survivors of childhood ALL.
(1984). Methodological problems in neuropsychological research. Journal of Clinical Neuropsychology: Vol. 6, No. 1, pp. 37-37.
Reasons for limited equivalence of Form II of the Wechsler Memory Scale (WMS-II) Figural Memory Subtest as an alternate form for the Russell's Revision of the Wechsler Memory Scale (RWMS) Figural Memory Subtest were investigated. Thirty college students rated figural stimuli from RWMS and WMS-II on dimensions related to memory. Raters judged figural stimuli from RWMS to be less memorable, more complex, and more difficult to label verbally. Forms can be made more equivalent by either changes in scoring or the interchanging of stimuli across forms.
In this study the effects of familial sinistrality and strength of handedness on dichotic listening and tactual mental rotation were investigated. Nonfamilial left-handers were inferior to familial left-handers, particularly in right-ear performance. The decrement in right-ear performance is interpreted as indicative of a pathologically functioning left hemisphere in nonfamilial left-handers. The direction of ear asymmetry tends to be more predictable in strong left-handers than in weak left-handers, with nonfamilial strong left-handers showing a significant left-ear superiority and familial strong left-handers a nonsignificant right-ear superiority. In the tactual mental rotation task, the results suggest a preference of left-handers for a verbal encoding strategy, especially in the right hemisphere. This preferential strategy is particularly manifest in familial weak left-handers and nonfamilial strong left-handers. The results are discussed in terms of their implications for underlying patterns of cerebral organization in the left-handers.
The findings of studies involving brain-damaged patients and those with normal subjects are considered separately in a review of the most important investigations that have led to the hypothesis that the right hemisphere is dominant for various aspects of emotional behavior. This paper examines some of the methodological problems encountered in studies of laterality of emotions, again looking at investigations of brain-damaged patients and of normal subjects. Future directions for research into emotional lateralization are suggested.
We consider the logic of basing theories of normal and pathological cognitive functioning upon the selective deficits revealed by single-case studies. Objections to this strategy, concerned with the rarity of pertinent cases, the role of methodological artifacts, and the existence of normal variation in brain functions are refuted. We conclude that, in neuropsychology, a group has no significance over and above the individual members it contains.
In this report we describe a patient with a right-hemisphere lesion who showed a dissociation between the processing of affective and nonaffective faces. Although he performed normally on neutral facial tasks, he was impaired in naming and pointing to facial expressions. This dissociation is discussed in terms of four possible mechanisms: (a) a high-level visuoconfigurational defect; (b) an associative agnosic type of defect for facial expressions; (c) a specific "activation" defect; and (d) a visual-verbal disconnection resulting in an anomic type of defect for facial expressions.
Four groups of patients with intrinsic cerebral neoplasms were compared to determine the differential effect of neoplasm (rapidly vs. slowly growing) and lateralization of damage (right vs. left hemisphere) upon neuropsychological functioning. No prior study has had enough subjects with neoplastic lesions to permit this kind of investigation. The group with rapidly growing neoplasms consistently had greater neuropsychological impairment. Lateralization of cerebral damage was found to have a differential effect on neuropsychological functions. Results indicate that neuropathological and lateralization characteristics of neoplastic lesions (and probably of cerebral lesions in general) are important variables in understanding the behavioral correlates of cerebral damage.
Clinical experience suggests that the diagnosis of psychosis in epilepsy with the MMPI is problematic, perhaps because the symptomatology of epilepsy and psychosis overlap. This study attempted to differentiate psychotic and nonpsychotic epileptics using the MMPI clinical and content scales, code-type categories, and modified Goldberg rule. A comparison group of schizophrenics was employed to explore differences between epileptic and schizophrenic psychoses. The failure of clinical scales and profile classification systems to differentiate the two epileptic groups implies that the MMPI might be insensitive to differential psychopathology in seizure-type subgroups.
Lance E. Trexler (Ed.) Cognitive Rehabilitation: Conceptualization and Intervention. New York: Plenum Press, 280 pp. 1982. $ 37.50.
