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PubMed2006

The California Verbal Learning Test--second edition: test-retest reliability, practice effects, and reliable change indices for the standard and alternate forms.

The California Verbal Learning Test - second edition (CVLT-II) is one of the most widely used neuropsychological tests in North America. The present study evaluated the 1-month test-retest reliability and practice effects associated with the standard and alternate forms of the CVLT-II in a sample of 195 healthy adults. Eighty participants underwent repeat assessment using the standard form of the CVLT-II on both occasions, whereas the remaining 115 individuals received the standard form at baseline and the alternate form at follow-up. Consistent with prior research, results revealed generally large test-retest correlation coefficients for the primary CVLT-II measures in both the standard/standard (range=0.80-0.84) and standard/alternate (range=0.61-0.73) cohorts. Despite exhibiting slightly lower test-retest reliability coefficients, participants in the alternate form group displayed notably smaller practice effects (Cohen's d range=-0.01 to 0.18) on the primary indices relative to individuals who received the standard form on both occasions (Cohen's d range=0.27-0.61). Reliable change indices were also generated and applied to primary CVLT-II variables to determine the base rates of significant improvements (range=2-10%), declines (range=0-7%), and stability (range=85-97%) in performance over time. Overall, findings from this study support the test-retest reliability of the standard and alternate forms of the CVLT-II in healthy adults and may enhance the usefulness of this test in longitudinal neuropsychological evaluations.

Adolescent↗
PubMed1989

Rey-Auditory Verbal Learning and Rey-Osterrieth Complex Figure Design performance in Alzheimer's disease and closed head injury.

Performance on the Rey-Auditory Verbal Learning (R-AVL) and Rey-Osterrieth Complex Figure Design (R-O CFD) tests was examined in patients (N = 94) with dementia of the Alzheimer's type (DAT) and closed head injury (CHI). On the R-AVL, DAT patients demonstrated considerably greater impairment than CHI patients, along with a flat learning/retention curve that showed negligible improvement with repeated trials, recency effects only, and an excessive number of word intrusions (confabulation) on the recognition trial. CHI patients demonstrated both a recency and primacy effect along with improvement over repeated trials (positive slope learning curve). Both groups demonstrated impairment R-O CFD recall; the DAT group again displayed substantially greater copying and recall deficits. Clinical guidelines are given for the use of the R-AVL and R-O CFD for these two patient populations.

Adult↗
PubMed2004

Application of clinically-derived malingering cutoffs on the California Verbal Learning Test and the Wechsler Adult Intelligence Test-Revised to an analog malingering study.

This study examined the comparability of the California Verbal Learning Test (CVLT) and subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) in clinically identified malingerers and undergraduates instructed to malinger in an analog design. Cutoffs on these measures were derived from various clinical samples of identified malingerers and were applied to these simulating malingerers to distinguish them from controls. Simulating malingerers performed significantly more poorly than controls on both tests and clinically derived cutoffs accurately discriminated between groups. As compared to the clinically-based findings from which these cutoffs were derived, sensitivity (detection of simulating malingering) tended to be lower, specificity (detection of not malingering) tended to be higher, but the overall classification rate was only slightly lower. These findings were consistent across the CVLT and subtests of the WAIS-R, several different sets of clinically derived cutoffs, and two base rates. Reasons for this pattern of findings are discussed, as are implications of the similarity between clinical and analog studies of malingering.

Adult↗
PubMed1999

Regional cerebral volume loss associated with verbal learning and memory in dementia of the Alzheimer type.

Twenty-seven research participants with dementia of the Alzheimer type were studied with the California Verbal Learning Test (D. C. Delis, J. H. Kramer, E. Kaplan, & B. A. Ober, 1987) and standardized volume measures of the mesial temporal cortical gray matter, neocortical gray matter, thalamus, and caudate nuclei, from magnetic resonance imaging. A pattern of atrophic brain changes in the mesial temporal lobes (MTL) and the thalamus, with relatively less severe atrophy in the neocortical gray matter, was associated with poorer learning of the word list. Similar patterns of brain atrophy were observed for measures of delayed recall and recognition hits. However, for delayed recall, neither contribution was statistically significant, and for recognition hits, MTL was only at the trend level for significance. These results provide evidence that the verbal memory deficit of Alzheimer's disease (AD) is associated not only with the mesial temporal limbic cortex, thought to be the site of earliest and most severe pathology in AD, but also with damage in the thalamus.

Aged↗
PubMed1990

Are all subcortical dementias alike? Verbal learning and memory in Parkinson's and Huntington's disease patients.

The utility of the concept of 'subcortical dementia' was investigated by comparing the verbal learning and memory abilities of Parkinson's disease (PD) patients with those of Huntington's disease (HD) patients. Many similarities between the PD and HD groups emerged, including impaired immediate memory spans, inconsistency of recall across learning trials, deficient use of a semantic clustering learning strategy, elevated intrusion rates on delayed recall, impaired recognition memory performance, normal retention of information over delay periods, normal vulnerability to proactive or retroactive interference, and normal types of intrusion errors. The HD subjects, however, displayed inferior free recall, deficient improvement across learning trials, abnormal serial position recall effects, higher perseveration rates, and supranormal improvement on recognition testing compared with free recall. Implications of these results for characterizing memory deficits associated with subcortical system dysfunction are discussed.

Adult↗
PubMed1998

Performance discrepancies between the Children's Category Test (CCT) and the California Verbal Learning Test-Children's (CVLT-C) Version in the standardization sample.

Standardization data for the Children's Category Test (CCT) and California Verbal Learning Test-Children's Version (CVLT-C) were used to evaluate covariances and statistically significant discrepancies between the T scores of those instruments, as well as the base rate of specific discrepancies. The results indicate that the CCT and CVLT-C share only a limited amount of common variance and that statistically significant discrepancies between the respective T scores are actually quite common. It is suggested that evaluation of the potential clinical significance of a discrepancy between the obtained results of these two instruments in individual cases should include consideration of the presented base rates.

Child↗
PubMed2006

Identifying patients at high and low risk of cognitive decline using Rey Auditory Verbal Learning Test among middle-aged memory clinic outpatients.

OBJECTIVES: To investigate whether application of cutoff levels in an episodic memory test (Rey Auditory Verbal Learning Test, RAVLT) is a useful method for identifying patients at high and low risk of cognitive decline and subsequent dementia. METHODS: 224 patients with memory complaints (mean age = 60.7 years, mean MMSE = 28.2) followed-up at a memory clinic over approximately 3 years were assigned retrospectively to one of three memory groups from their baseline results in RAVLT [severe (SIM), moderate (MIM) or no impairment (NIM)]. These groups were investigated regarding cognitive decline. RESULTS: Patients assigned to SIM showed significant cognitive decline and progressed to dementia at a high rate, while a normal performance in RAVLT at baseline (NIM) predicted normal cognition after 3 years. Patients with MIM constituted a heterogeneous group; some patients deteriorated cognitively, while the majority remained stable or improved. CONCLUSIONS: The application of cutoff levels in RAVLT at baseline showed that patients with severely impaired RAVLT performance were at a high risk of cognitive decline and progression to dementia, while patients with normal RAVLT results did not show cognitive decline during 3 years. Furthermore, the initial degree of memory impairment was decisive in the cognitive prognosis 3 years later.

Acoustic Stimulation↗
PubMed1998

Profiles of patients with left prefrontal and left temporal lobe lesions after cerebrovascular infarcations on California Verbal Learning Test-like indices.

We compared memory disorders of three patient groups suffering from brain lesions with a word list corresponding to the California Verbal Learning Test (CVLTgcor). Dependent measures were learning rate and efficiency, retention, and strategic control of the learning process. Compared to a control group of patients with right hemispheric lesions, a left Arteria cerebri posterior (LACP) group showed general memory deficits, an inflated recency effect, and increased serial clustering. A left prefrontal cortex (LPFC) group documented slowed learning and increased recall after semantic cues. Discriminant analysis correctly classified 86.11% of the patients. It is argued that (a) the CVLT helps to cover differences in memory disorders recently discussed in cognitive neuropsychology; (b) differences between PFC and ACP patients become evident only if strategic aspects of learning and increased recall after semantic cueing are taken into account. The results are discussed within the framework of recent cognitive neuropsychological findings and with a distinction between fronto-subcortical and cortical memory disorders.

Attention↗
PubMed1997

California Verbal Learning Test: normative data for the elderly.

Overlapping age tables were developed, separately for males and females, to provide additional normative information for the California Verbal Learning Test (CVLT) and extend the normative data to persons older than 80 years of age. Participants were 92 males and 120 females with means for age and education of 70.58 years (SD = 6.98) and 14.92 years (SD = 2.56), respectively. Normative information was also provided for additional measures of retention rate and proportion of perseverations and intrusions. The clinical utility of these norms strongly depends on how closely a person matches the demographic characteristics of the normative group.

Aged↗
PubMed1986

Validity and diagnostic accuracy of an alternate form of the Rey Auditory Verbal Learning Test.

The diagnostic validity of an alternate form of the Rey Auditory Verbal Learning Test (AVLT) is investigated. Subjects were 73 inpatients from a VA Medical Center who were classified as having either intact (n = 41) or impaired (n = 32) memory functions. Employing a counterbalanced design, both groups were administered the standard (Form A) and alternate (Form C) forms of the AVLT. Means for the learning trials, trial VI and the recognition procedure were calculated for the intact and memory-impaired subjects and contrasted for each test. Results suggested that Form C discriminated groups at a level comparable to that of Form A. This impression was confirmed by separate stepwise discriminant analyses for Form A and Form C that yielded identical hit-rates (i.e., 75.3%) in terms of identifying subjects as memory-intact or memory-impaired. These findings suggested that Form C may be used for the assessment of persons with verbal mnemonic deficits with the same degree of confidence that has been attributed to Form A.

Journal Article↗
PubMed2005

Construct validity of the California Verbal Learning Test--Children's Version (CVLT-C) after pediatric traumatic brain injury.

The purpose of this study was to determine the latent structure of the California Verbal Learning Test--Children's Version (CVLT-C; D. Delis, J. Kramer, E. Kaplan, & B. Ober, 1994) in a sample of 175 children with traumatic brain injury (TBI). Maximum-likelihood confirmatory factor analyses were performed to test 6 competing hypothetical models for fit and parsimony. A 4-factor model consisting of Attention Span, Learning Efficiency, Delayed Recall, and Inaccurate Recall provided the best fit to the data. The results support the construct validity of the CVLT-C in children with TBI and suggest that a multifactorial interpretation of quantitative indexes from this instrument is appropriate for clinical practice.

Brain Injuries↗
PubMed2005

Further validation of the expanded auditory verbal learning test for detecting poor effort and response bias: data from temporal lobectomy candidates.

The present study aimed to further examine the specificity of the Exaggeration Index of the expanded Auditory Verbal Learning Test procedure for detecting inadequate effort or response bias in a nonlitigating sample with unequivocal brain damage. Data from 56 patients with intractable epilepsy undergoing presurgical evaluation for temporal lobectomy were analyzed. In this sample, specificity was excellent at the recommended cut-off (94%), and comparable to that of another well-researched instrument for detecting inadequate effort, the Recognition Memory Test. Findings strongly support the generalizability of the specificity estimates obtained by Barrash et al. and, more broadly, the clinical utility of the Exaggeration Index. To facilitate diagnostic decision-making, the probability of invalid performances associated with each score on the Exaggeration Index, based on all clinical cross-validation samples reported to date, is also presented.

Acoustic Stimulation↗
PubMed1999

California Verbal Learning Test practice effects in a schizophrenia sample.

Practice effects on the California Verbal Learning Test (CVLT; >Delis et al., 1987), a measure of new learning and memory, were evaluated in a sample of patients with schizophrenia who were administered the CVLT at baseline, week 10, and week 14 in the context of a study of the effects of a non-pharmacological intervention on psychiatric status. Large effects attributable to prior exposure to the test were evident at weeks 10 and 14. These effects indicate that caution must be exercised in interpreting serial performances on this commonly used test, whether in research or clinical circumstances. Additionally, although the exact nature of the learning involved is unclear, the influence of prior exposure on later performance reveals considerable retention over time of new information in this sample of persons with schizophrenia.

Adult↗
PubMed2006

Cluster subtypes on the California verbal learning test-children's version after pediatric traumatic brain injury.

The purpose of this study is to determine the presence of profile subtypes on the California Verbal Learning Test-Children's Version (CVLT-C; Delis, Kramer, Kaplan, and Ober, 1994) in 175 children with traumatic brain injury (TBI). Four key z score variables are used in a 2-stage cluster analysis that reveal 4 reliable subtypes. No meaningful differences among the clusters are found on demographic variables. In contrast, statistically significant differences among the 4 clusters in both level and pattern of performance are found on injury severity parameters and the 4 factor index scores from an independent measure of psychometric intelligence (Wechsler Intelligence Scale for Children-Third Edition; Wechsler, 1991). This study concludes that although no unique profile is found on the CVLT-C after TBI in children, performance on this test is affected strongly by injury severity, with a mediating contribution by speed of information processing.

Adolescent↗
PubMed2006

Detection of inadequate effort on the California Verbal Learning Test-Second edition: forced choice recognition and critical item analysis.

The Forced Choice Recognition (FCR) and the Critical Item Analysis (CIA) indices of the California Verbal Learning Test-II (CVLT-II) have been identified by the CVLT-II test developers as potentially useful, brief screening indicators of effort in neuropsychological assessment. This retrospective study analyzes performance on these measures in three groups: (1) clinically referred individuals; (2) forensically referred individuals not suspected of inadequate effort; and (3) forensically referred individuals whose performance on freestanding tests of effort suggested inadequate effort. Performances on FCR were analyzed for their relation to actual memory impairment and with regard to concrete and abstract distractor endorsement. FCR and CIA performances were analyzed for agreement with formal tests of inadequate effort and their test characteristics. Incremental validity was assessed by hierarchical logistic regression with previously identified indices for detection of inadequate effort on the CVLT. Results indicate that (1) FCR and CIA performances are not related to decreased memory performance; (2) FCR and CIA indices exhibit higher specificity and lower sensitivity, with higher positive predictive value than negative predictive value; and (3) FCR and CIA indices exhibit modest incremental validity with previously identified indices. Implications for use of FCR and CIA indices in inadequate effort detection are discussed

Adolescent↗
PubMed2006

[French adaptation of the Hopkins Verbal Learning Test].

INTRODUCTION: A number of tests are currently used in clinical and research settings for the assessment of patients with memory deficits. Among them, the Hopkins Verbal Learning Test (HVLT) is particularly appropriate for the longitudinal follow-up of patients with memory disorders because it exists in six parallel forms, and therefore avoids the risk of learning effect at retest. Since a test with these characteristics is not available in French, we decided to adapt a French version of the HVLT. METHODS: 180 normal subjects participated in the study. Their mean age was 41 years (SD=11), and they had had on average 12 years of schooling (SD=3). The subjects were randomly divided into 6 groups of 30 subjects. One of the six forms of the French version of the HVLT was administered orally to each group of subjects. Each form consisted of a list of 12 words belonging to 3 different semantic categories. For the construction of the French version of the HVLT, we adopted the same procedure as used in the original version of the test taking into account the French lexical and semantic characteristics of the items. In the first part of the test, the list was administered three times to the subjects. Following each administration, subjects were asked for an immediate free recall. Twenty minutes later, used for intercurrent tasks, subjects were asked for a delayed free recall, which was immediately followed by a recognition memory task. In this task, subjects listened to a list of 24 words, 12 belonging to the studied list and 12 were distractors; the subjects were asked to recognize the 12 studied words. RESULTS: The subjects' performance was equivalent in the six forms of the test, except for the immediate recall of Form 3 (which was excluded from the test). No significant difference emerged in free recall, delayed free recall, and recognition across the five remaining forms of the test. CONCLUSION: Our study provides a useful tool for the longitudinal evaluation of patients with memory impairment and may become the test of reference in European longitudinal clinical trials. The French adaptation of the HVLT represents only a first step, because it needs to be standardized, in order to provide norms, and validated, in order to provide values of sensitivity and specificity.

Adult↗
PubMed2004

Alternative forms of the Rey Auditory Verbal Learning Test: a review.

Practice effects in memory testing complicate the interpretation of score changes over repeated testings, particularly in clinical applications. Consequently, several alternative forms of the Auditory Verbal Learning Test (AVLT) have been developed. Studies of these typically indicate that the forms examined are equivalent. However, the implication that the forms in the literature are interchangeable must be tempered by several caveats. Few studies of equivalence have been undertaken; most are restricted to the comparison of single pairs of forms, and the pairings vary across studies. These limitations are exacerbated by the minimal overlapping across studies in variables reported, or in the analyses of equivalence undertaken. The data generated by these studies are nonetheless valuable, as significant practice effects result from serial use of the same form. The available data on alternative AVLT forms are summarized, and recommendations regarding form development and the determination of form equivalence are offered.

Humans↗