Rowland Jared A, Miskey Holly M, Brearly Timothy W, Martindale Sarah L, Shura Robert D
Mid-Atlantic Mental Illness Research, Education, and Clinical Center and Research & Academic Affairs Service Line, W.G. "Bill" Hefner Veterans Affairs Medical Center, Salisbury, NC, USA.
Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Arch Clin Neuropsychol. 2017 May 1;32(3):306-315. doi: 10.1093/arclin/acw107.
The current study addressed two aims: (i) determine how Word Memory Test (WMT) performance relates to test performance across numerous cognitive domains and (ii) evaluate how current psychiatric disorders or mild traumatic brain injury (mTBI) history affects performance on the WMT after excluding participants with poor symptom validity.
Participants were 235 Iraq and Afghanistan-era veterans (Mage = 35.5) who completed a comprehensive neuropsychological battery. Participants were divided into two groups based on WMT performance (Pass = 193, Fail = 42). Tests were grouped into cognitive domains and an average z-score was calculated for each domain.
Significant differences were found between those who passed and those who failed the WMT on the memory, attention, executive function, and motor output domain z-scores. WMT failure was associated with a larger performance decrement in the memory domain than the sensation or visuospatial-construction domains. Participants with a current psychiatric diagnosis or mTBI history were significantly more likely to fail the WMT, even after removing participants with poor symptom validity.
Results suggest that the WMT is most appropriate for assessing validity in the domains of attention, executive function, motor output and memory, with little relationship to performance in domains of sensation or visuospatial-construction. Comprehensive cognitive batteries would benefit from inclusion of additional performance validity tests in these domains. Additionally, symptom validity did not explain higher rates of WMT failure in individuals with a current psychiatric diagnosis or mTBI history. Further research is needed to better understand how these conditions may affect WMT performance.
本研究旨在实现两个目标：（i）确定词语记忆测试（WMT）的表现与众多认知领域的测试表现之间的关系；（ii）评估当前的精神疾病或轻度创伤性脑损伤（mTBI）病史在排除症状效度差的参与者后如何影响WMT的表现。
参与者为235名伊拉克和阿富汗战争时期的退伍军人（平均年龄=35.5岁），他们完成了一套全面的神经心理学测试。根据WMT表现将参与者分为两组（通过=193人，未通过=42人）。测试被分为认知领域，并计算每个领域的平均z分数。
在记忆、注意力、执行功能和运动输出领域的z分数上，WMT通过者和未通过者之间存在显著差异。与感觉或视觉空间构建领域相比，WMT未通过与记忆领域更大的表现下降相关。即使排除了症状效度差的参与者，目前有精神疾病诊断或mTBI病史的参与者WMT未通过的可能性也显著更高。
结果表明，WMT最适合评估注意力、执行功能、运动输出和记忆领域的效度，与感觉或视觉空间构建领域的表现关系不大。综合认知测试组合将受益于在这些领域纳入额外的表现效度测试。此外，症状效度并不能解释目前有精神疾病诊断或mTBI病史的个体中WMT未通过率较高的情况。需要进一步研究以更好地理解这些情况如何影响WMT表现。
