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Verbal learning and memory impairment in adult civilians following penetrating missile wounds.

Verbal memory and learning patterns, as measured by the California Verbal Learning Test (CVLT), following penetrating head injury (PHI) from gunshot wound were studied in 10 acutely injured patients (mean age 25.3 years) at a mean of 2.1 months post-injury. Primary impairment was found on measures of free recall of new verbal information which appeared to be related to deficits in organisational and retrieval functions: (1) the group's learning characteristics were marked by disorganization and an underutilization of active learning strategies; (2) rate of acquisition also appeared to be mildly decreased; (3) nevertheless, the PHI group did not show severe disruption in all aspects of learning and memory. In fact, the group showed a relatively intact capacity to store new information in memory.

Adolescent↗

Rey Auditory Verbal Learning Test performance of a Federal corrections sample with acquired immunodeficiency syndrome.

The Rey Auditory-Verbal Learning Test (AVLT) was administered to 30 inmates from three United States Federal corrections facilities. Fifteen were HIV seropositive and carried a diagnosis of AIDS; 15 were seronegative controls. The groups were comparable in age, education, sex, estimated premorbid IQ, and ethnic make-up. Both groups learned across trials, and produced similar acquisition curves. They also showed equivalent registration, but controls performed significantly better than subjects with AIDS on AVLT Trials II, IV, V, Recognition, and sum of I through V. AIDS subjects made significantly more intrusion errors than controls, suggesting that seropositive inmates performed more poorly, at least in part, because they experienced difficulty discriminating relevant from irrelevant responses during recall. Evaluation of serial position effects suggested that AIDS subjects experienced recall problems only with the middle segment of the word list. This finding may be unique to persons with AIDS and is consistent with the view that distinct clinical groups produce different recall patterns.

Acquired Immunodeficiency Syndrome↗

Performance discrepancies on the California Verbal Learning Test-Children's Version in the standardization sample.

The standardization data for the California Verbal Learning Test-Children's Version (CVLT-C) were used to evaluate statistically significant discrepancies between key quantitative variables of this instrument, as well as the base rate of specific discrepancies. The results indicated that apparently large discrepancies between the respective standard scores were actually fairly common. However, for 3 of the 4 contrasts, discrepancies that equaled or exceeded 1.5 z-score points in the hypothesized direction were sufficiently unusual to be considered clinically significant. For a 4th contrast, discrepancies that equaled or exceeded 1 z-score point in the hypothesized direction appeared to meet this criterion. It is suggested that the interpretation of clinically obtained CVLT-C profiles should focus primarily on specific quantitative variables, with inclusion of consideration of the presented base rates of discrepancies between the respective z scores.

Adolescent↗

First-Last Names and the Grocery List Selective Reminding Test: two computerized measures of everyday verbal learning.

Data are presented on two computerized tests of everyday verbal learning: Paired associate learning of First-Last Names (FLN), and the Grocery List Selective Reminding Test (GLSRT). MANOVA and multiple regression analyses demonstrated that performance on FLN and GLSRT was most strongly related to age, with significant secondary associations found for gender, with females performing better than males. Additional factor analysis of FLN and GLSRT supported the construct validity of these measures by demonstrating significant associations of performance with traditional newopsychological measures of memory and related functions, including the Paired Associate Learning and Logical Memory subtests from the Wechsler Memory Scale, the Benton Visual Retention Test, and WAIS Digit Symbol.

Journal Article↗

Stability and correlates of the California Verbal Learning Test for a sample of normal elderly persons.

The test-retest stability of the California Verbal Learning Test was examined for a normal elderly sample of 28 men and 74 women along with the correlation for total recall with scores on selected variables. Mean age was 72 yr. The test was re-administered after one year. Mean total recall did not change; the stability coefficient was .64. Coefficients for the other scores ranged considerably (.27 for recognition hits to .62 for perseverations) and were compared with prior research findings. Recall was moderately correlated with scores on the North American Reading Test, Trails B, visual reproductions, and subjective memory ability.

Adult↗

Test-retest stability of the California verbal learning test in older persons.

One hundred fifty-one healthy older persons were administered the California Verbal Learning Test (CVLT) on 2 occasions, an average of 1.30 years apart. Means for age and education were 69.63 years (SD = 6.46) and 14.91 years (SD = 2.54), respectively. Stability coefficients ranged from .24 on number of perseverations to .76 for both List A total recall and long-delay free recall. Only 5 CVLT scores demonstrated a significant change on retest, and the overall magnitude of improvement was small. To assist clinicians in the process of detecting significant change on retest, the authors provide standard error of difference values and 90% confidence intervals for 22 CVLT scores.

Aged↗

Performance discrepancies on the California Verbal Learning Test--Second Edition (CVLT-II) in the standardization sample.

The standardization data for the California Verbal Learning Test-Second Edition (CVLT-II; D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 2000) were used to evaluate the base rate of 6 specific discrepancies between various key variables. The results indicated that CVLT-II performance discrepancies should equal or exceed 1 or 1.5 z score points (depending on the individual comparison) in the hypothesized direction to be considered potentially unusual. However, because about 1 in 3 persons in the standardization sample displayed at least 1 such large discrepancy, it is concluded that these base rates should be viewed only as a starting point for interpretation.

Cues↗

The Hopkins Verbal Learning Test and screening for dementia.

The present study investigated the sensitivity and specificity of the Hopkins Verbal Learning Test (HVLT) for demented patients (n = 82, using NINCDS criteria) and 114 healthy controls--equivalent in age, years of education and gender-ratio--from the Oxford Project to Investigate Memory and Ageing. The HVLT 'Total Recall' score had 87% sensitivity and 98% specificity for dementia using a cut-off score of 14.5. Using a 'Memory' score (the sum of the 'Total Recall' and the 'Discrimination Index') with a cut-off score of 24.5 gave a 91% sensitivity and 98% specificity for Alzheimer's disease cases when compared to controls. Unlike the MMSE, the HVLT has no ceiling effects and does not have to be adjusted for education. We conclude that the HVLT is an easy to administer, quick and well tolerated tool for the screening of dementia.

Aged↗

Verbal learning patterns in moderate and severe traumatic brain injury.

Previous studies that have examined performances on the California Verbal Learning Test (CVLT) among individuals with traumatic brain injury (TBI) have found differing levels of performance. Differential patterns of performance, however, have only been inferred. The present investigation sought to determine empirically if differential patterns of performance could be discerned in a TBI sample of 65 subjects with CVLT variables. The CVLT variables were selected based on the instrument's factor structure. Cluster analysis yielded four distinct subtypes of brain-injured individuals. The Active subtype demonstrated impaired unassisted retrieval, but used active encoding strategies and showed relatively intact ability to store novel information. The Disorganized subtype demonstrated an inconsistent, haphazard learning style along with deficits in encoding. The Passive subtype was marked by an overreliance on a serial clustering strategy as well as impaired encoding and/or consolidation. The Deficient subtype was the most impaired of all groups, exhibiting a slowed rate of acquisition, passive learning style, and significant impairment in encoding. Implications for rehabilitation are discussed.

Adolescent↗

Auditory verbal learning in drug-free Ecstasy polydrug users.

Drug-free Ecstasy polydrug users have shown impairment on tasks of verbal working memory and memory span. Current research aims to investigate how these deficits may affect the learning of verbal material by administration of the Auditory Verbal Learning Task (AVLT) (Rey, 1964). The task provides a learning curve by assessing immediate memory span over multiple trials. Learning strategies are further analysed by tendencies to confabulate as well as demonstrate either proactive or retroactive interference elicited by a novel 'distractor' list. Three groups completed the task: two groups of 14 Ecstasy users (short- and long-term) and one group of 14 polydrug controls. Compared with controls both Ecstasy groups recalled significantly fewer words and made more confabulation errors on the initial three recall trials as well as a delayed recall trial. Long-term users demonstrated increased confabulation on the initial trials and the novel 'distractor7' trial, compared with short-term users. Only following repeated presentations were both short- and long-term users shown to perform at control levels. As such, deficits in verbal learning may be more related to storage and/or retrieval problems than problems associated with capacity per se. No interference errors were demonstrated by either of the Ecstasy groups. However, a high level of intrusion errors may indicate selective working memory problems associated with longer-term use of the drug. Copyright 2001 John Wiley & Sons, Ltd.

Journal Article↗

Effect of referent object familiarity on verbal learning in the sighted and the blind.

In a series of paired-associate tasks we investigate why some highly concrete nouns are easier to remember than other highly concrete nouns, even when such word attributes as imagery value are held constant. In Experiment 1 both the congenitally blind and the sighted remembered nouns with referents highly familiar to the blind better than nouns with referents of low familiarity to the blind. Although this effect was anticipated for the blind, it was unexpected for the sighted because the referents of low familiarity to the blind have been visually experienced by the sighted and are as easy for the sighted to image as the referents highly familiar to the blind. Experiments 2 through 5 explore why the extent to which the blind are familiar with an object should predict verbal learning for the sighted. As it turned out, referents that were familiar to the blind were also familiar to the sighted. After ruling out various alternative explanations we were able to conclude that it is the extent of perceptual experience with a noun's referent, irrespective of the modality through which the experience is acquired, that determines ease of verbal learning. Any theory that accounts for the concrete-noun effect must also be able to account for the effect of referent familiarity, and our results are discussed within this context.

Adult↗

The California Verbal Learning Test-Children's Version: relation to factor indices of the Wechsler Intelligence Scale for Children-Third Edition.

The California Verbal Learning Test-Children's Version (CVLT-C) provides clinicians with a method of assessing various aspects of children's verbal memory and has been found to be sensitive to memory deficits resulting from a variety of neurological conditions. Intuitively, the CVLT-C would be expected to be highly related to a child's verbal cognitive abilities; however, with only a few exceptions, the relationship of this test to various domains of cognitive function has not been broadly studied empirically. To examine this issue, we evaluated the amount of unique variance in CVLT-C scores that could be predicted by the Verbal Comprehension, Perceptual Organization, Freedom from Distractibility, and Processing Speed indices of the Wechsler Intelligence Scale for Children, Third Edition (WISC-III) beyond that accounted for by age and gender in a sample of 62 children referred to an outpatient psychiatry clinic for neuropsychological evaluation. While the Processing Speed Index predicted a significant amount of variance for both short and long delay free and cued recall, the Verbal Comprehension Index was a poor predictor of CVLT-C performance on all outcome variables, accounting for only 1.5 to 4.5% additional variance above age and gender. These findings indicate that while the CVLT-C may be relatively independent of influences of verbal intelligence and abstract verbal reasoning, general speed and efficiency of processing play an important role in successful encoding for later retrieval on the CVLT-C.

Adolescent↗

Assessment of incomplete effort with the California Verbal Learning Test.

The false-positive rates of 2 formulas for the detection of incomplete effort on the California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober, 1987) were evaluated in a sample of 134 patients with traumatic head injury (THI) who had been carefully screened to eliminate any individuals who might be expected to have financial incentives for poor performance. One formula incorrectly identified only 7.46% of the sample as providing incomplete effort, confirming its potential usefulness in clinical settings. The other formula fared much worse, misidentifying an unacceptably high 18.66% of the sample. Lower levels of education were found to increase the likelihood of false-positive results with that formula. It is concluded that the CVLT holds promise for the evaluation of incomplete effort after THI but only within the context of a more comprehensive neuropsychological evaluation.

Adult↗

Convergent and discriminant validity of the CVLT (dementia version). California Verbal Learning Test.

This study investigated the convergent and discriminant validity of the 9-item "dementia version'' of the California Verbal Learning Test (CVLT-9) in a sample of 130 geriatric patients evaluated for memory complaints. Moderate correlations were observed between the CVLT-9 sum of words recalled for trials 1-5 (Trial 1-5 Recall) and Long-Delay Free Recall (LDFR) measures and the immediate and delayed Logical Memory (LM I and LM II) and Visual Reproduction (VR I and VR II) subtests from the Wechsler Memory Scale-Revised (WMS-R). However, the CVLT-9 Trial 1-5 Recall and VR I measures demonstrated significant correlations with a number of additional measures of language and visuospatial ability. The CVLT-9 LDFR, and the WMS-R LM I, LM II, and VR II showed less overlap with non-episodic memory functioning. A principal components analysis yielded a three-component solution consisting of a general or "g'' component, a specific memory component, and a mood component. The CVLT-9 Trial 1-5 Recall and VR I loaded on both the "g'' and the memory components, whereas LM I, LM II, and VR II loaded on only the memory component. We conclude that the CVLT-9 Trial 1-5 Recall and VR I demonstrate low discriminant validity, suggesting diminished specificity as memory measures.

Aged↗

[Differences in the spontaneous organization of auditory verbal learning in brain damaged adolescents].

OBJECTIVE: Subjective organization (SO) of verbal memory and learning was investigated for 44 adolescent patients. METHOD: The patients were subdivided into four clinical groups according to localization of lesion: right hemisphere (RH), left hemisphere (LH), frontal (FL), and brain stem (SL). RESULTS: As expected RH patients performed best on this verbal learning task, whereas FL and SL patients demonstrated very poor SO, indicating their failure in categorize memory input. LH patients increased SO, following successive trials, which suggests an active learning strategy. CONCLUSIONS: It is argued that the use SO analysis in neuropsychology will stimulate the course of further research towards attaining a better understanding of memory and learning impairments and their remission in brain-damaged patient.

Adolescent↗

Detecting dementia with the Hopkins Verbal Learning Test and the Mini-Mental State Examination.

The Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE) were administered to 323 non-demented elderly and 70 individuals who meet DSM-IV criteria for dementia in order to compare the validity of these two measures for detecting mild dementia and for the two most common dementia subtypes, Alzheimer's disease (AD) and vascular dementia (VaD). The study was conducted in an elderly, ethnically diverse community-dwelling population. Sensitivity, specificity, positive and negative predictive values were calculated over a range of clinically relevant cut scores for each test. We analyzed the influence of age, education, reading ability and sex on test performance using logistic regression models. When sensitivity is held constant at 0.69, the specificity for the HVLT total recall was 0.89 and the MMSE 0.82 for all dementias (P=.10). Age, sex and education did not significantly influence test performance for either test in this sample. Results were similar for AD and VaD. However, while adding a measure of reading ability to the regression models did not affect the overall dementia model, it resulted in improved specificities when combined with the MMSE for AD and combined with the HVLT for VaD. Additional tests such as reading ability can improve discrimination of dementia subtypes. The modest sensitivity of either the HVLT or the MMSE alone suggests that further neuropsychological evaluation is required to confirm dementia diagnosis.

Aged↗

Verbal learning and memory among heterozygous fragile X females.

In this paper we report the results of a brief examination of verbal learning and memory in 20 heterozygous fragile X [fra(X)] positive females and in 2 control groups of 20 subjects each. One control group was composed of fra(X)-negative mothers (obligate carriers) and sisters of male probands with fra(X) syndrome, while the other consisted of 14 head injured and 6 learning disabled females. Intellectual functioning was assessed by means of the Wechsler scales, and learning was assessed by several different clinical memory tests. Significant differences were found between groups on measures of short-term memory and learning efficiency. Groups did not differ on measures of cued recall or delayed recall. The findings are consistent with other data and suggest the possibility that central information processing and/or specific encoding processes are defective in persons with fra(X).

Adolescent↗