Biomedical subjects

M D Franzen

Publications and source records attributed to M D Franzen.

At least 19 recordsLinked to original sources

PubMed2001

Use of Wisconsin Card Sorting Test short forms with school-age children.

Short forms of the Wisconsin Card Sorting Test (WCST) have been developed and studied in adult populations, however studies addressing their use in children are lacking. This study compared the full WCST to two short forms in a sample of 174 school-age children who were referred for neuropsychological evaluation. Multiple regression was used to predict standard scores (SSs) on the full WCST. Percent scores were obtained, and normative data from the WCST manual was then used to obtain SSs. We found that scores from the short forms were significantly correlated with corresponding scores on the full WCST, however a high proportion of children obtained short form SSs, which differed significantly from the SSs obtained on the full WCST. It is recommended that clinicians use the full WCST with children, unless at least four categories are reached in the first deck.

Journal Article↗

PubMed2000

Evaluation of a WMS-R malingering index in a non-litigating clinical sample.

The purpose of this study was to examine the prevalence of a Wechsler Memory Scale-Revised "malingering index" in a large sample of non-litigating individuals from an inpatient substance abuse program. Past research has demonstrated that experimental-malingerers often obtain substantially lower scores on the Attention/Concentration Index than on the General Memory Index. In the present study, only a small percentage of patients showed large General Memory - Attention/Concentration difference scores. These results provide further support for the validity of this difference score as a marker for non-optimal effort.

Adult↗

PubMed2000

Prevalence of abnormal CT-scans following mild head injury.

PRIMARY OBJECTIVE: The purpose of this study was to examine the prevalence of day-of-injury intracranial abnormalities in a large sample of patients with mild head injuries who were admitted to a Trauma Service. METHODS AND PROCEDURES: There were 912 patients who obtained admission Glasgow Coma Scale (GCS) scores of 13-15. MAIN OUTCOMES AND RESULTS: The base rate of complicated mild head injuries (i.e. abnormal CT scans) in this sample was 15.8%. However, nearly 25% of the sample, most of whom had very mild injuries, did not receive CT-scans. Therefore, the actual prevalence is more likely in the range 16-21%. There was a tremendous overlap in injury characteristics between patients with complicated and uncomplicated mild head injuries. None the less, there were modest, yet statistically significant, relationships between the presence of intracranial abnormalities and lower GCS scores, greater frequency of positive loss of consciousness, greater frequency of skull fractures, and lower GOAT scores.

Adolescent↗

PubMed2000

Neuropsychological assessment in traumatic brain injury.

The care of patients provided in trauma centers involves many different variables. One of the complicating factors is related to the cognitive and emotional-behavioral consequences of traumatic brain injury. Impairment in attention, memory, communication skills, or planning and problems solving may present significant impediments in the ability of the patient to participate in his or her health care. In addition, the presence of emotional consequences such as anxiety, depression, irritability, and impulsivity may interfere with the ability of the patient to interact successfully with health care personnel. The role of the neuropsychologist is to provide a clinical assessment of the relevant cognitive and emotional problems areas and make suggestions for ways of interacting with and intervening with the brain-injured patient.

Brain Injuries↗

PubMed2000

Clinical normative data for the WCST-64 following uncomplicated mild head injury.

Clinical norms for the 64-item Wisconsin Card Sorting Test (WCST-64) are presented. The norms were derived from 303 persons presenting for emergency services who met criteria for uncomplicated mild head injury. Most data were obtained within 2 days of injury, and the remaining data were obtained within 10 days of injury. The norms may be used to help determine whether or not a person's scores on the WCST-64 are typical of those seen shortly after sustaining an uncomplicated mild head injury.

Adult↗

PubMed1999

Normative comparisons for the controlled oral word association test following acute traumatic brain injury.

The Controlled Oral Word Association Test (COWAT) is widely used in clinical neuropsychology as a measure of verbal fluency. It is important for psychologists to realize that using the recently published normative data will result in different clinical conclusions because the updated normative sample performed better than the original normative sample. The purpose of this study was to compare the original and updated norms in a large sample of patients with acute traumatic brain injuries (N=669). The percentages of patients who scored below the 5th centile in each system varied as a function of brain injury severity. Moreover, a substantially larger number of patients scored in the impaired range according to the updated normative data.

Acute Disease↗

PubMed1999

A validity study of the WAIT in closed head injury.

This investigation is a validity study on an instrument designed to assess the cognitive status of CHI patients in the acute phase. The Wolinsky Amnesia Information Test (WAIT) is a questionnaire, orally administered and then scored in a standardized format. Interrater reliability has been previously demonstrated. In this study, the WAIT was compared to the Galveston Orientation and Amnesia Test (GOAT), CT scans, and the Glasgow Coma Scale (GCS). Seventy-five subjects participated in the study, all hospital trauma patients at an urban regional trauma centre, who had been referred to the neuropsychology consult service for cognitive testing. Patients were screened to rule out preexisting developmental, drug, alcohol, or documented prior LOC history. Patients' ages ranged from 18-59, with a mean of 33.45 years. A large majority of the patients (81.3%) were diagnosed with a mild level of CHI. Concurrent, discriminative, and construct validity of the WAIT were investigated, and found satisfactory. The data were submitted to factor analysis in order to uncover underlying constructs. In addition to the 'orientation' and 'amnesia' factors identified through factor analysis, a third factor was found and labelled: 'personal temporal/continuum memory'. Limitations of the study and possible directions for future research are discussed.

Adolescent↗

PubMed1999

Neurobehavioral effects of acute exposure to inorganic mercury vapor.

Mercury has well-established toxic effects on the central nervous system. This article describes comprehensive neuropsychological and emotional functioning of a group of 13 workers exposed to inorganic mercury vapor compared to that of a normal control group. The exposed group was exposed over a 2- to 4-week period and had elevated blood mercury levels. The evaluations were conducted between 10 and 15 months after exposure was terminated. Observed cognitive deficits included impairment in the following domains: motor coordination, speeded processing with and without a motor component, cognitive flexibility, verbal fluency, verbal memory, and visual problem solving and conceptualization. Emotional problems included increased focus on physical functioning, depression, anxiety, and social withdrawal. Cognitive deficits were, for the most part, not significantly associated with the degree of depression present.

Acute Disease↗

PubMed1998

Detecting malingered memory deficits with the Recognition Memory Test.

The purpose of the present study was to examine the efficacy of using the Recognition Memory Test (RMT) as a marker for malingered memory deficits. Data from 60 subjects, including 40 patients seen for neuropsychological evaluation and 20 university undergraduates, are reported. The university students were given experimental instructions to malinger. Students were compared to 20 memory-impaired and 20 memory-nonimpaired patients. The students who were instructed to malinger memory impairment performed more poorly than both groups of patients. Discriminant function analyses using the two scores derived from the RMT as predictors of group membership resulted in a 100% initial correct classification rate and a 96.7% correct classification rate on cross-validation.

Adolescent↗

PubMed1997

Neuropsychological function in restrained versus unrestrained motor vehicle occupants who suffer closed head injury.

It is known that using seatbelts reduces the incidence and severity of closed head injury (CHI) from motor vehicle crashes. One would expect unrestrained occupants in motor vehicle crashes to suffer more severe CHIs than restrained occupants, as reflected by Glasgow Coma Scale (GCS) scores. One might also expect an increased risk of focal injury due to contact forces in unrestrained occupants. The purpose of this study was to test the hypothesis that failure to use seatbelts results in increased severity of neuropsychological sequelae, even with GCS controlled. We also examined the impact of demographic variables on seatbelt use. Subjects included patients admitted to a hospital trauma service who were suspected of having suffered CHI. All patients completed neuropsychological testing, which was entered into a data base along with demographic and clinical information. People who had documented use of seatbelt restraints were compared with those who were unrestrained. Results confirmed that certain demographic variables are associated with the use of seatbelts. Results also suggested that failure to use seatbelt restraints is associated with more severe impairment on tests that are sensitive to frontal lobe dysfunction.

Adolescent↗

PubMed1997

Methods of estimating premorbid functioning.

Clinical neuropsychological assessment frequently requires the comparison of obtained scores against some estimate of premorbid level of functioning, but only recently has significant attention been turned to objective methods to accomplish this objective. Clinical judgment, although useful in some circumstances, is generally insufficient. Other methods of estimating premorbid function include demographic regression formulae, such as the Barona formula, subtest scatter methods, such as that suggested by Lezak, and the use of current scores on tests of presumably spared abilities, such as the National Adult Reading Test (NART). Almost all methods predict to some general level of intellectual functioning rather than to specific neuropsychological skills. This paper reviews the suggested methods in terms of the underlying assumptions and the available empirical evidence. Suggestions for future research include the development of skill specific predictors as well as investigations regarding the relation between predictor accuracy and characteristics of the subject, such as high versus low premorbid functioning in the subject. Additionally, there is a great need for methods to predict premorbid functioning in children.

Journal Article↗

PubMed1997

Neuropsychologists' practice patterns in assessing premorbid intelligence.

The current study surveyed practicing neuropsychologists about the methods they use to estimate premorbid levels of function, and their prior training with these methods. Doctoral level psychologists, who are members of the National Academy of Neuropsychology, were sent a questionnaire developed by the authors to assess these variables. Findings suggest that there is relatively little use of strategies specifically designed to assess premorbid ability. Demographics and training were not associated with methods used. Over one third of the respondents indicated that they believed their formal training had not been adequate in helping them to address this issue.

Journal Article↗

PubMed1997

Performance of substance abusers with memory deficits on measures of malingering.

The effects of memory impairment on various malingering indices were assessed in a substance abusing population. Groups were formed by using scores from the Delayed Memory Index of the Wechsler Memory Scale-Revised and selecting individuals from an addictions recovery unit in the top and bottom quintiles. Quintile group differences were found for number correct on free and forced-choice recall on the 21-Item Wordlist; total time for grouped and ungrouped dots on the Rey Dot Counting procedure; and addition errors on the Memorization of 16 Items test. All differences found were in the direction of better performance by subjects with better Delayed Memory Index scores; however, all of the differences were small. With the exception of the free recall index from the 21-Item Wordlist, all subjects had scores on the malingering measures beyond the cutoffs typically used to detect malingering in clinical populations. These findings suggest that, even in memory-impaired populations, memory measures of malingering are valid.

Journal Article↗

PubMed1996

Using multiple objective memory procedures to detect simulated malingering.

The present study evaluated five objective assessment procedures used to detect malingered memory deficits. Twenty students and 20 psychiatric subjects completed the procedures under instructions to malinger and/or try their best. These groups were compared to 20 memory-impaired subjects who completed the procedures under instructions to try their best. While each test was able to correctly classify all of the subjects performing their best and the actual memory-impaired patients, the correct classification rates for experimental-malingerers varied from 5%-85% on the 10 scores derived from the five tests. Combining all of the cutting scores, and using deficient performance on one procedure as the criteria for classification, resulted in a 92.5% hit rate for subjects who were instructed to malinger and a 100% hit rate for the control and memory-impaired subjects who were instructed to try their best.

Adult↗

PubMed1996

Factorial equivalence of the Wechsler Memory Scale: revised across standardization and clinical samples.

A two-phased analysis of the WMS-R is reported In the first phase, confirmatory factor analyses of the WMS-R standardization sample were conducted in order to identify a baseline model against which to compare two large samples of substance abusers These analyses revealed that most of the exploratory factor models reported in the literature were plausible representations of the WMS-R, however, a three-factor oblique model representing Attention/Concentration, Verbal Memory, and Visual Memory emerged as the best fitting model In the second phase, we conducted multi-sample factor analyses to test the generality of this model in two large samples of inpatients at an addiction recovery unit The results revealed that the factor loadings, subtest error variances (reliabilities), factor variances, and factor covariances were identical across groups Thus the factor structure of the WMS-R appears to be unaltered in these clinical groups Researchers may thus make meaningful comparisons of the dimensions indexed by the WMS-R between normal samples and neuropsychological groups with diffuse pathology.

Journal Article↗

PubMed1996

Do people with knowledge fake better?

Research on malingering that involves analog methods is frequently criticized for using normal subjects Critics have suggested that analog subjects probably perform differently from clinical Malingerers because of the absence of an identifiable incentive for analog malingerers, and because analog subjects have no opportunity to gain knowledge about the disorder to be malingered In contrast, clinical malingerers have an obvious incentive and may have at least a basic knowledge of the characteristics of the disorder they are feigning In this study, psychology graduate students and faculty were asked to malinger a memory deficit on several brief neuropsychological instruments on the premise that malingering would be difficult to detect in this population because of their supposed sophistication Results indicated that in sophisticated subjects, malingering was relatively easy to detect using indices of pattern of performance on standardized neuropsychological instruments, but more difficult to detect using instruments designed to detect malingering based on probability theory, and on specified knowledge of the effects of brain damage.

Journal Article↗

PubMed1996

An interrater reliability study of the Luria-Nebraska Neuropsychological Battery Form-II quantitative scoring system.

This study provides information on the interrater reliability of the quantitative scoring system of the Luria-Nebraska Neuropsychological Battery Form II (LNNB-II). The accuracy of each rater following a training procedure was also evaluated. Six college students served as raters, and participated in a 20-22-hour training procedure. This training procedure utilized a protocol similar to one used in previous interrater reliability studies performed with Form I. Following the training procedure, raters were asked to score two videotaped LNNB-II administrations in which a confederate portrayed test performance that was relatively straightforward to score, as well as more ambiguous test performance. Excellent interrater agreement and accuracy were found on the quantitative scoring on both tapes. Implications for training in administration and scoring are discussed.

Journal Article↗

PubMed1995

The factor structure of the Wechsler Memory Scale-Revised and several brief neuropsychological screening instruments in recently detoxified substance abusers.

The Wechsler Memory Scale-Revised (WMS-R) has attracted a fair amount of research activity since its publication. Much of this activity has centered on the factor structure of the WMS-R. The present study examines the factor structure of the WMS-R, both when the indices are used as variables and when the scale scores themselves are used as variables. Three hundred fifty-two recently detoxified substance abusers were used as subjects. Both sets of analyses included other neuropsychological variables in order to facilitate clear explications of memorial and cognitive functions tapped by the WMS-R. The results indicate support both for use of the indices and for use of the subscale scores. Differences between these results and the results of earlier factor analyses are discussed in terms of sample characteristics.

Journal Article↗