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PubMed2004

Correlation between cognitive impairment and the Rey auditory-verbal learning test in a population with Alzheimer disease.

Patients affected by Alzheimer disease (AD) need an accurate diagnosis, to the extent allowing us to find the best therapy or polytherapy, in order to take under control their cognitive impairment. In our Alzheimer Evaluation Units (from the Italian name abbreviated: UVA), the patients undergo a multidimensional evaluation, which can address us towards a proper diagnosis and of other weakening, or even dementia-related diseases. The patients are also subject to neuropsychometric and neuropsychological evaluations, allowing a more focused analysis on cognitive impairments. Among the tests, we use the Rey auditory-verbal learning test (RAVLT), evaluating the patient's verbal memory. A list of 15 words is read to each patient. N the first part of the test, the clinician repeats 5 times such a list. the patient is hen asked, at the end of every repetition, to tell all words he/she remembers. This part is useful to evaluate the immediate recall (IR) ability. The score, i.e., the total number of recalled words, ranges from 0 to 75. After 15 minutes, the delayed recall (DR) ability is evaluated: the patient is newly asked to repeat as many words as he can recall from the list. The score for this part ranges from 0 to 15 minutes. The score is corrected of rage and education, with a cut-off of 28.5 for IR and 4.7 for DR. We made a survey with the purpose of deciding if there was a correlation between cognitive impairment and verbal memory lack, whose deficiency appears earlier in AD. To this aim, we selected several patients with AD, diagnosed during the period between September 2002 and February 2003. We only considered those patients whose AD was not associated with other weakening diseases, and whose clinical dementia rating scale (CDR) score was between 0.5-2.0. A sample of 35 individuals (11 men and 24 women) could be obtained. A meaningful correlation was observed between CDR and IR (r = -0.725, p < 0.01), as well as between CDR and DR (r = -0.470; p < 0.05). Such a result confirms the importance of evaluating immediate and long-term memories, for the early diagnosis of AD, because it is the only symptom of clinically not yet diagnosed dementia, as proven also by other studies.

Aged↗
PubMed1994

Test-retest reliability of a new form of the auditory verbal learning test (AVLT).

The equivalence between the original form (Form 1) of the Auditory Verbal Learning Test (AVLT), and a new form (Form 4) was examined in 51 normal adult subjects (20-67 years) of average estimated intelligence who were assessed in two separate sessions. Performance on the new form was equivalent to that on the original and most measures on the two tests showed significant positive correlations. Test-retest reliability of AVLT scores between sessions was also assessed, both globally and separately for Form 1 followed by Form 4 and for the reverse order. The most reliable measures on the AVLT were the total number of words learned over the five learning trials, (r =.77), and performance on the retention trial of the learning list following the presentation and performance of the distractor list (r =.70). These measures are sufficiently robust for use in clinical serial assessments.

Journal Article↗
PubMed2005

Discrepancies between the California Verbal Learning Test: Children's Version and the Children's Category Test after pediatric traumatic brain injury.

One hundred 9-16-year-old children with traumatic brain injury (TBI) completed the California Verbal Learning Test-Children's Version (CVLT-C) and the Children's Category Test (CCT) within 1 year after injury. Performance contrasts between these two instruments that were unusually large (> 16 T score points) were about as common in this clinical sample as in the standardization sample of both instruments. However, relatively poor performance on the CVLT-C as compared to the CCT was associated with prolonged coma and lower scores on the Processing Speed index of the Wechsler Intelligence Scale for Children-Third Edition. It is concluded that a relative weakness on the CVLT-C is more likely to reflect cerebral compromise after pediatric TBI than is a relative weakness on the CCT.

Adolescent↗
PubMed2000

California Verbal Learning Test indicators of suboptimal performance in a sample of head-injury litigants.

Cutoff scores suggested by Millis, Putnam, Adams, and Ricker (1995) for detecting suboptimal performance on indices from the California Verbal Learning Test (CVLT) were evaluated using data from 193 compensation-seeking participants. All participants claimed to have suffered a blow to the head in an accident causing subsequent deterioration in cognitive function. The participants were divided into those with negligible or possible mild brain injuries and those with clear evidence of moderate to severe brain injuries. In addition to the CVLT, all participants were administered the Computerized Assessment of Response Bias (CARB), a two-alternative forced choice test of recognition memory that is used to detect feigned cognitive impairment. For all CVLT indices, the distributions of outcome (valid vs. suboptimal performance) was unrelated to age and brain injury severity, and only weakly associated with education. However, a significantly higher proportion of males than females obtained scores in the suboptimal performance range. The CVLT indices were not fully redundant with each other with respect to binary participant classifications; substantial disagreement between pairwise classifications was found among those participants who obtained at least one score in the suboptimal performance range. CVLT index classifications were also found to be non-redundant with classifications based on CARB scores. The CVLT may thus add useful data over and above that obtained from symptom validity testing. However, the data suggest that the use of the strategy where any one or more below-cutoff CVLT scores are considered a positive indicator of suboptimal performance may be associated with a higher than acceptable false-positive error rate.

Adolescent↗
PubMed2004

Performance discrepancies on the California Verbal Learning Test-Children's Version (CVLT-C) in children with traumatic brain injury.

One hundred sixty-seven children with traumatic brain injury (TBI), selected from an 8-year series of consecutive referrals to a Midwestern rehabilitation hospital, completed the California Verbal Learning Test-Children's Version (CVLT-C) and the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) within 1 year after injury. A large proactive interference (PI) effect, defined as performance on the second list that was at least 1.5 standard deviations below that on the 1st one, was statistically significantly more common in this clinical sample (21%) than in the CVLT-C standardization sample (11%). Other performance discrepancies, including retroactive interference, rapid forgetting, and retrieval problems, occurred at approximately the same rate in the clinical and standardization samples. Children with anterior cerebral lesions were about 3 times less likely to have a large PI effect than children without such lesions, but the former group performed worse on the first CVLT-C list. The impact of pediatric TBI on a wide range of CVLT-C quantitative variables was mediated by speed of information processing, as assessed by the WISC-III Processing Speed factor index. It is concluded that failure to release from PI is somewhat common, although certainly not universal, in children with TBI. Unlike with adults, anterior cerebral lesions are not associated selectively with an increased risk for PI after pediatric TBI but rather with a reduced efficiency of allocation of cognitive resources. Deficits in speed of information processing appear to be primarily responsible for the learning deficits on the CVLT-C after pediatric TBI.

Adolescent↗
PubMed2000

Edouard Claparède and the auditory verbal learning test.

This paper describes the role of the Swiss psychologist Edouard Claparède (1873-1940) in developing the Test de mémoire des mots (Test of Memory for Words), a test consisting of one free-recall trial of a 15-word list that is the antecedent of the auditory verbal learning tests (AVLT) of Rey and others. The fact that Claparède's test has survived in modified form for 80 years makes it one of the oldest mental tests in continuous use. In addition to developing the AVLT, Claparède's pioneering contributions to neuropsychology include forensic assessment of cognitive deficits and research on implicit learning in amnesia.

Auditory Perception↗
PubMed2000

Accuracy of metamemory after traumatic brain injury: predictions during verbal learning.

The primary intent of this study was to investigate the metamemory monitoring abilities of adult survivors of at least moderate traumatic brain injury (TBI) during a verbal-learning activity. Eighteen survivors and 18 non-injured control participants made judgment-of-learning (JOL) predictions of their recall ability immediately after studying 3 lists of noun-pairs or after a slight delay. A secondary intent of this study was to determine if verbal retrieval attempts would enhance predictive accuracy. One half of participants made retrieval attempts during the second and third list-learning task, and the other half made retrieval attempts during the third list-learning task only. Measures of the correlation between JOL predictions and recall accuracy revealed that survivors were as accurate as controls when making delayed predictions and were less accurate when making immediate predictions. This occurred regardless of retrieval attempts. Absolute measures that compared mean JOL ratings to overall recall revealed that the survivor group was well-calibrated when making delayed JOL predictions but overestimated when making immediate JOL predictions. The non-injured control group underestimated when making both types of predictions. However, within-group variability was high. These findings are compared to those from studies that investigated metamemory beliefs in which survivors' ratings were compared to family-member ratings. Clinical implications for basing executive decisions about compensatory strategies on delayed and immediate predictions of future recall are discussed. Additionally, a rationale is provided for the use of both relative and absolute measures of predictive accuracy in metamemory studies involving neurological clinical populations.

Adult↗
PubMed2000

Further investigation of traumatic brain injury versus insufficient effort with the California Verbal Learning Test.

The present study replicates and attempts to extend previous research using the California Verbal Learning Test (CVLT) to identify malingerers. Documented moderate and severe traumatic brain injury patients (n = 42) were compared with clinical malingerers identified by criteria other than the CVLT (n = 21), malingering simulators instructed in realistic potential injury sequelae (n = 25), and normal controls (n = 21). Results of discriminant function analyses for high and low base rates are reported, showing similar results. Also, the four individual cutoff scores (Recognition Hits, Discriminability, Total Words Recalled, Long Delay Cued Recall) from Millis, Putnam, Adams, and Ricker (1995) were evaluated with these groups. Similar specificity rates were found with all four variables, while sensitivity rates were slightly lower than that of Millis. Adjusted cutoffs derived from the new samples resulted in slightly improved overall classification rates. Overall, present findings support those of Millis et al. (1995) with regard to the use of the CVLT in detection of malingering. Exploratory use of Total Intrusions and Recognition Hits Compared to Long Delay Free Recall was not promising. Simulators were found to be fairly comparable in performance to actual malingerers, affirming their use in malingering research.

Journal Article↗
PubMed1995

Differential response characteristics in nonepileptic and epileptic seizure patients on a test of verbal learning and memory.

Investigators have found it difficult to separate patients with nonepileptic seizures (NES) from those with true epileptic seizures (ES) using quantitative measures of neuropsychological test performance. We examined qualitative response characteristics on the California Verbal Learning Test of 41 patients undergoing continuous video/audio-EEG monitoring in an effort to distinguish these patient groups (12 patients with left temporal [LT] foci, 11 with right temporal [RT] foci, and 18 with NES). NES patients explicitly recognized fewer target words compared with ES patients. In addition, NES patients rarely made false-positive errors, which resulted in failure to endorse a significant number of items on the recognition list. This response tendency is called a negative response bias. In contrast, LT patients endorsed a high number of items on the recognition test, which resulted in a positive response bias. RT patients demonstrated no consistent response tendency. In our sample, a negative response bias index (ie, a cutoff score < 0) showed a sensitivity of 61% and a specificity of 91%. We propose that failure to explicitly recognize words following repeated exposure may reflect aspects of psychological denial in NES patients. Response bias indices may thus help identify patients with NES and may begin to explain the psychological mechanisms underlying this complex disorder.

Adult↗
PubMed1997

Verbal learning in amnesic anterior communicating artery aneurysm patients and in patients with multiple sclerosis.

The California Verbal Learning Test (CVLT) was used to examine the qualitative, and quantitative aspects of memory in patients with amnesic anterior communicating artery aneurysm (ACoA) and in patients with multiple sclerosis (MS). The results show that both groups were impaired relative to control participants with respect to acquisition of verbal material. The participants with A CoA exhibited a profound loss of information and emitted a significantly greater number of intrusions and false positives than either control participants or participants with MS. The advantages of using both quantitative and qualitative measures of memory in differentiating various clinical populations are discussed.

Journal Article↗
PubMed2005

Ineffectiveness of an Italian NART-equivalent for the estimation of verbal learning ability in normal elderly.

Comparison between current and premorbid memory ability may be of help when trying to make a timely diagnosis of cognitive decline in questionable dementia. In the present study, we evaluated the possibility of estimating episodic verbal memory scores at the Rey Auditory Verbal Learning Test (RAVLT) from an irregular words reading task held to resist to deterioration, that is the Italian analogue of the NART, the TIB (Test d'Intelligenza Breve--brief intelligence test). A regression analysis was performed in a large sample of healthy elderly, using RAVLT scores as dependent variable and TIB score, MMSE score, age and education as predictors. We failed to find a relationship between the two tests that was strong enough for a reliable estimation of memory ability.

Aged↗
PubMed2004

Exaggeration index for an expanded version of the auditory verbal learning test: robustness to coaching.

Recent research suggests that effort detection measures based on patterns of neuropsychological performance may be more robust to coaching than traditional effort detection measures. In the present study, we evaluated the Exaggeration Index for an extended version of the Auditory Verbal Learning Test (EI-AVLTX), a recently developed effort detection instrument based on patterns of performance on the AVLT using a simulated malingering paradigm. In two independent samples, the EI-AVLTX was1 found to be relatively sensitive and specific to malingering, and robust to the effects of a warning about malingering detection.

Acoustic Stimulation↗
PubMed1996

Verbal learning and memory: does the modal model still work?

This chapter focuses on recent research concerning verbal learning and memory. A prominent guiding framework for research on this topic over the past three decades has been the modal model of memory, which postulates distinct sensory, primary, and secondary memory stores. Although this model continues to be popular, it has fostered much debate concerning its validity and specifically the need for its three separate memory stores. The chapter reviews research supporting and research contradicting the modal model, as well as alternative modern frameworks. Extensions of the modal model are discussed, including the search of associative memory model, the perturbation model, precategorical acoustic store, and permastore. Alternative approaches are discussed including working memory, conceptual short-term memory, long-term working memory, short-term activation and attention, processing streams, the feature model, distinctiveness, and procedural reinstatement.

Journal Article↗
PubMed2006

California verbal learning test indicators of Malingered Neurocognitive Dysfunction: sensitivity and specificity in traumatic brain injury.

The present study used well-defined traumatic brain injury (TBI) and mixed neurological (other than TBI) and psychiatric samples to examine the specificity and sensitivity to Malingered Neurocognitive Dysfunction (MND) of four individual California Verbal Learning Test (CVLT) variables and eight composite CVLT malingering indicators. Participants were 275 traumatic brain injury and 352 general clinical patients seen for neuropsychological evaluation. The TBI patients were assigned to one of five groups using the Slick, Sherman, and Iverson (1999) criteria: no incentive, incentive only, suspect, and malingering (both Probable MND and Definite MND). Within TBI, persons with the strongest evidence for malingering (Probable and Definite) had the most extreme scores. Good sensitivity (approximately 50%) in the context of excellent specificity (> 95%) was found in the TBI samples. Issues related to the appropriate clinical application of these data are discussed.

Brain Injuries↗
PubMed1991

Assessment of brain impairment with the Rey Auditory Verbal Learning Test: a comparison with other neuropsychological measures.

In this study the effectiveness of The Rey Auditory Verbal Learning Test (AVLT) at assessing patients with mixed brain impairment was compared with that of a number of other commonly used neuropsychological measures. Subjects were 50 patients with a mixture of medically confirmed neuropathologies, and 50 controls with no evidence of neurological history. Groups were equated for age, education, and sex. The AVLT was administered as pan of a full neuropsychological battery. Results indicated that all seven AVLT recall trials and the total of Trials I-V could significantly differentiate between the two groups (p <.001). The AVLT trial V score performed best (U = 457.5, p <.0001), correctly predicting group membership for 74% of the subjects. This hit-rate was better than any other single test on the Halstead-Reitan or Dodrill batteries, and was surpassed only by the Dodrill Discrimination Index. The potential usefulness of this test as part of a neuropsychological battery is discussed.

Journal Article↗