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Biomedical subjects

T J Boll

Publications and source records attributed to T J Boll.

At least 37 records · Page 2Linked to original sources

A shortened intermediate version of the Halstead Category Test.

An effort was made to determine whether the intermediate (ages 9-14) version of the Halstead Category Test (HCT) could be shortened to increase clinical utility without altering it's basic psychometric properties. The Long Intermediate Halstead Category Test was administered to four clinical groups. Statistics were conducted to verify that these groups did not relate differentially to the Category Test or other neuropsychological measures. Twelve shortened Category Tests were then extracted. The psychometric properties of these extracted shortened versions were compared to the long version and the three best were selected for further tests. These three shortened versions were then cross validated. Results indicated that the psychometric properties were similar across the shortened versions. The shortest version was there for chosen which best retained the characteristics of the original test.

Journal Article↗

The effectiveness of different methods of defining traumatic brain injury in predicting postdischarge adjustment in a spinal cord injury population.

Traumatic brain injury (TBI) can occur concomitantly with spinal cord injury (SCI). Much of the initial work in this area has focused on identifying coincidence rates and risk factors; less has focused on possible long-term implications of TBI when it occurs with SCI. In this study, SCI/TBI and neurologically matched SCI-only groups were formed on the basis of clinicians' ratings of neuropsychologic test scores. SCI/TBI and SCI-only groups were also formed using Halstead Category cutoff scores, presence/absence of loss of consciousness, and clinicians' ratings of severity of TBI. Dependent measures assessed an average of two years postinjury measured personal, social, and family adjustment of the individual with SCI and that of a significant other. Loss of consciousness and nonconsensus clinical ratings of presence/absence of TBI predicted postdischarge adjustment poorly. Severity ratings in the moderate to severe range, and Category cutoff scores did have some predictive value, with patients defined as impaired being more likely to report adjustment difficulties or being described as having adjustment difficulties by a significant other. The difficulty of making unequivocal diagnoses of TBI in this population is discussed and implications for future research delineated.

Activities of Daily Living↗

Confirmatory factor analysis of the Wechsler Memory Scale-Revised in a sample of head-injured patients.

As part of a standard evaluation of neuropsychological sequelae, the Wechsler Memory Scale-Revised (WMS-R) was administered to 107 patients with a history of traumatic brain injury. Confirmatory factor analyses were conducted on the 12 subtests of the WMS-R to examine the fit of various hypothesized factor patterns, including patterns identified in previous exploratory factor analytic studies. Because part of the correlation between immediate and delayed recall trials of the same material is attributable to a common measurement procedure, this correlation due to measurement commonality was partialled out of the conceptual factor structure. The results suggested the presence of 3 distinct but highly correlated factors: attention/concentration, immediate memory, and delayed recall. Models that posited separate verbal and nonverbal memory processes failed to improve fit over more parsimonious models. Comparisons with previous factor analytic studies and implications for clinical assessment are discussed.

Adolescent↗

Intellectual ability of children after perinatal cytomegalovirus infection.

The intellectual ability of 16 children who had not had congenital cytomegalovirus (CMV) infection, but acquired it before the age of six months, was compared with that of two other groups: one comprising 32 children who had had CMV-excreting mothers but who were not infected themselves: the other comprising 18 healthy controls. Serial audiological, ophthalmological and psychometric examinations were performed. The only statistically significant difference found was that the children with acquired CMV infection had lower mean arithmetic scores. The results suggest that healthy term infants who acquire early CMV infection are not at increased risk of intellectual impairment.

Child↗

Postdoctoral education and training for clinical service providers in health psychology.

It was recommended by the 1983 National Working Conference on Education and Training in Health Psychology (Stone, 1983) that 2 years of postdoctoral education and training be mandated for future licensed health service providers in health psychology. The background for requiring this postdoctoral training, a model for education, criteria for developing programs, issues of funding, and a rationale for accepting this mandate are presented. Highlighted are the stable and consistent growth of health psychology, the need to expand the period of clinical training to meet the many advances in the field, and the challenges that exist for the fully trained clinical health service provider.

Behavior Therapy↗

Early clinical manifestations and intellectual outcome in children with symptomatic congenital cytomegalovirus infection.

The Developmental Profile was completed on 32 prospectively followed children with symptomatic congenital cytomegalovirus infection (mean age 6 7/12 years; 78% white, 59% male). The distribution of intelligence and general developmental scores was bimodal; one group had severe deficits (mean IQ 28.8), the other had relatively less severe intellectual sequelae (mean IQ 91.6). Correlation analysis (Pearson r) showed that three variables--microcephaly, neurologic abnormalities, and chorioretinitis--when apparent during the first year of life, were all significantly associated with low intelligence. No correlation was found between IQ and severity of neonatal reticuloendothelial disease or hearing loss. Multiple regression analysis showed that age at testing, chorioretinitis, and neurologic sequelae accounted for 63% of the IQ variance in our sample. We conclude that children with symptomatic congenital cytomegalovirus infection have a greater range of intellectual outcomes than has been previously reported, and that certain early clinical manifestations may be useful in anticipating special needs.

Child↗

Epilepsy, neuropsychological deficits, and EEG lateralization.

One hundred eight epileptic patients (59 men, 49 women; 55% partial seizures, 45% generalized) were examined on 45 indices comprising a modified Halstead Neuropsychological Test Battery. Factor analyses identified five dimensions: Verbal Comprehension, Perceptual Organization, Selective Attention, Motor Skills, Abstract Reasoning. These factors are similar to those previously reported for neurocognitive abilities in several different populations. Relative deficits on Verbal Comprehension and Abstract Reasoning were related, as predicted, to left hemispheric dysfunction as indexed by EEG localization. Perceptual Organization demonstrated a further, predictable relationship to right hemispheric function. Deficits on Selective Attention were not clearly lateralized, being correlated with a wide variety of electroencephalographic abnormalities. The implications of these findings for the use of neurocognitive profiles in treatment planning for this population are discussed.

Journal Article↗

Simultaneous-successive factor structure of the WISC-R: a validation study.

It has been suggested that the Wechsler Intelligence Scale for Children--Revised (WISC--R) may usefully be interpreted in terms of a Simultaneous-Successive factor structure. A previous attempt to validate this hypothesis via factor analysis of 8 of the 12 WISC--R subtests was later shown to be an unreliable test of this model. The present study, performed upon 36 children, aged 6 1/2 to 12 1/2 yr., 45% female, 83% black, tested the validity of the two-factor model vis-á-vis the Kaufman Assessment Battery for Children (K-ABC), which is reported to have an unambiguous Simultaneous-Sequential (Successive) factor structure. Present results do not support a salient Simultaneous-Successive structure for the WISC--R, and clinicians should be wary of using the proposed two-factor model of the WISC--R for diagnostic or remedial purposes.

Child↗

Intellectual development in school-aged children with asymptomatic congenital cytomegalovirus infection.

Congenital cytomegalovirus infection occurs in about 1% of live births. Although symptomatic congenital infection often results in severe developmental deficits and mental retardation, about 90% have asymptomatic infection. Previous studies of the intellectual development in children with asymptomatic congenital cytomegalovirus have resulted in mixed findings. To control for the effects of hearing impairment (which occurs in about 15% of asymptomatic children) on intelligence scores, we tested 18 prospectively followed, normally hearing, school-aged children with asymptomatic congenital cytomegalovirus (15 black, ten male) and 18 controls matched for age, sex, race, school grade, and socioeconomic status. Children were tested via the Wechsler Intelligence Scale for Children-Revised, the Kaufman Assessment Battery for Children, and the Wide Range Achievement Test. Multivariate analysis revealed no differences between groups on intelligence scores or subscales, achievement scores, or incidence of learning disabilities (defined as significant discrepancy between intelligence and achievement), and mean scores for both groups were very close to national norms. It is concluded that the 25,000 children born in the United States each year with asymptomatic congenital cytomegalovirus and normal hearing are not likely to be at increased risk of mental impairment.

Achievement↗

Developing issues in clinical neuropsychology.

The foundations of Neuropsychology lie in the fields of behavioral neuroscience, applied psychological evaluation, and behavioral neurological investigation. These areas have provided increasing sophistication about the nature of the relationship between changes in brain function and human behavior. Continuing developments in these fields will provide the foundation upon which our applied activities rest and from which they take their scientific validity. The use of neuropsychological evaluative tools as aids in understanding the consequences of subtle and, in many instances, not primarily neurological medical illnesses represents a threshold of investigation and clinical application. The sensitivity of clinical neuropsychological tools to disruptions in brain function, previously left unrecognized in individuals who have sustained neurological injury or illness, represents the second threshold issue. Yet another threshold issue is the use of neuropsychological investigation as a preventive tool and as an early warning signal for the appreciation of a broad range of risk factors encountered by individuals not typically thought of as potential patients for neuropsychologists. This article discusses the growing use of neuropsychological tools to understand the broader range of human behavioral difficulties and human medical consequences.

Neuropsychology↗

Patients with pseudoseizures: intellectual and cognitive performance.

We compared cognitive and intellectual performance of patients with pseudoseizures (pseudoseizure-only group), pseudoseizures and epilepsy (mixed seizure group), and generalized epileptic seizures (generalized seizure group). The pseudoseizure-only group performed significantly better on all measures except those of simple motor function. There were no significant differences between those with mixed and generalized seizures. Therefore, cognitive and intellectual performances of patients with pseudoseizures are influenced by the presence or absence of concomitant epilepsy, and suggest that it is necessary to distinguish patients with and without epilepsy in studies of pseudoseizures.

Adolescent↗

Effects of age of onset of partial and generalized seizures on neuropsychological performance in children.

Neuropsychological performance data from 106 children with epilepsy were evaluated to determine the effects of seizure type and age of onset. The performance of children with partial seizures (N = 49) was similar to that of children with generalized seizures (N = 57). Only one of 13 tests showed a significant difference between groups, with children with partial seizures performing better on that test. The effects of age of onset were also similar in the two seizure groups. Children whose seizures began before the age of 5 years performed significantly worse than children whose seizures began later on four measures (Verbal IQ, Performance IQ, Trails A, and Trails B) and performed more poorly, but not significantly so, on the other nine measures in the battery. A breakdown of the partial group into simple partial, complex partial, and secondarily generalized partial seizure groups found a significant difference between the groups on only one variable, but there were suggestions in the data that the performance of the partial secondarily generalized group was worse than the other two groups. These results indicate that variables associated with an early onset of seizures, regardless of type, place a child at risk for cognitive dysfunction.

Age Factors↗

Improvement in neuropsychological performance in patients with refractory seizures after intensive diagnostic and therapeutic intervention.

Tests of cognitive, perceptual, motor, and memory function were administered to patients with refractory seizures before and after intensive treatment on a specialized epilepsy unit. Improved test performance related to withdrawal of barbiturates and an overall reduction in the number of antiepileptic drugs but not with reduction of seizure frequency.

Adolescent↗

Neuropsychological sequelae of minor head injury.

Seventy-one patients with minor head injury were given extensive neuropsychological evaluations 3 months after injury. A significant percentage of the patients demonstrated cognitive impairment, which seemed essentially unrelated to the length of unconsciousness or of posttraumatic amnesia. Impaired patients evidenced memory and visuospatial deficits. Cognitively impaired patients also had difficulty returning to work after injury. The psychological and cognitive impairment that follows minor head injury is discussed in relation to diagnostic and intervention issues.

Adolescent↗

Cerebrally lateralized epileptogenic foci and performance on a verbal and visual-graphic learning task.

A set of verbal and visual-graphic learning tasks sensitive to differential cerebral hemisphere impairment was administered to 50 patients with epileptogenic focus localized in either the left or right cerebral hemisphere. Patients with left-hemisphere seizure-foci and those with generalized seizures performed the verbal task significantly more poorly than did patients with right-hemisphere epileptogenic foci. In contrast, there were no significant differences between groups on the non-verbal tasks. Results are discussed in light of findings in the literature relating cognitive dysfunction to epilepsy and with regard to the possible contribution of such dysfunction to patients' complaints.

Adolescent↗