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Computerized assessment of neurocognitive functioning of alcoholics in an inpatient addiction program
Abstracts from the 18th Annual Meeting
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subjects free of peripheral deficits affecting the ability to smell, low scores on the O D E may relate to brain damage. The O D E has been previously normed on a group of subjects who had experienced head trauma, and a group of normals, the latter study demonstrating a decrement in odor detection associated with aging. There has been no study examination the practice effects of the O D E in a short-term (1 week), test-retest situation. This study does so using 30 subjects who had been screened for peripheral impediments which would have disqualified them. All subjects were of similar educational backgrounds. The O D E consists of eight substances found in the American household. The format of the test dictates that in the first trial the subject is presented with the substances with instructions to smell the container and identify the substance. The container is masked so that visual identification is not possible. The second trial is a cued response with the containers again presented along with a sheet depicting possible responses. Subjects were given the test on two successive occasions, 1 week apart. Detected practice effects total 4.6 points out of a possible 24, a large relative number. This practice effect of 4.6 represents a range of 1.3 to 1.8 standard deviations depending on age group. Subjects who repeat the test are thus likely to significantly increase their scores. It is suspected that the cued part of the test, the second trial, is responsible for the large practice effect in that subjects are twice presented with materials helpful in influencing responses to presented odors. Researchers interested in conducting reliability studies of the O D E must consider this effect.
Doss, R. C., & Smigielski, J. S. Computerized Assessment of Neurocognitive Functioning of Alcoholics in an Inpatient Addiction Program. This study planned to evaluate neurocognitive functioning in a group of alcoholics undergoing inpatient substance abuse treatment using a computerized, self-administered screening instrument (MicroCog). MicroCog was administered to 121 patients (67 male, 64 female) who were consecutively admitted to an inpatient substance abuse treatment service. Following careful review of medical records, 66 (39 male, 27 female) patients with a primary diagnosis of alcohol dependence and/or abuse were studied. All subjects had completed acute detoxification and demonstrated no clinical signs of withdrawal prior to test administration. Subjects ranged in age from 18 to 78, with a mean of 41.83. Mean level of education for the group was 14.02 years, with a range of 10 to 21 years. We report descriptive statistics, which show mean test scores for the alcoholics to be generally lower, although within one standard deviation of the MicroCog age and educationcorrected standardization group means. One sample t-test comparing the alcoholics to the standardization group means revealed statistically significant differences for the General Cognitive Functioning (GCF), t(65) = -4.79, p < .001, and General Cognitive Proficiency (GCP), t(65) = -6.58, p < .001, index scores. Effect size statistics were calculated to determine the magnitude of the differences found in the above comparisons which yielded moderate effects for the GCF and GCP index scores, d = -.53 and -.71, respectively. We further report significant findings related to domain-specific neurocognitive functioning. Overall, the results suggest that alcoholics who are being treated in an inpatient setting demonstrate a significantly lower level of performance on computerized measures of global neurocognitive ability as compared to individuals of similar age and education. Characterization of cognitive ability in this population is important for setting individual program goals and discharge planning. Results suggest that MicroCog can be considered a useful, cost and time efficient instrument for such a purpose. Further study of these data will attempt to more specifically delineate the determinants of cognitive decline in this group of alcoholics.
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subjects free of peripheral deficits affecting the ability to smell, low scores on the O D E may relate to brain damage. The O D E has been previously normed on a group of subjects who had experienced head trauma, and a group of normals, the latter study demonstrating a decrement in odor detection associated with aging. There has been no study examination the practice effects of the O D E in a short-term (1 week), test-retest situation. This study does so using 30 subjects who had been screened for peripheral impediments which would have disqualified them. All subjects were of similar educational backgrounds. The O D E consists of eight substances found in the American household. The format of the test dictates that in the first trial the subject is presented with the substances with instructions to smell the container and identify the substance. The container is masked so that visual identification is not possible. The second trial is a cued response with the containers again presented along with a sheet depicting possible responses. Subjects were given the test on two successive occasions, 1 week apart. Detected practice effects total 4.6 points out of a possible 24, a large relative number. This practice effect of 4.6 represents a range of 1.3 to 1.8 standard deviations depending on age group. Subjects who repeat the test are thus likely to significantly increase their scores. It is suspected that the cued part of the test, the second trial, is responsible for the large practice effect in that subjects are twice presented with materials helpful in influencing responses to presented odors. Researchers interested in conducting reliability studies of the O D E must consider this effect.
Doss, R. C., & Smigielski, J. S. Computerized Assessment of Neurocognitive Functioning of Alcoholics in an Inpatient Addiction Program. This study planned to evaluate neurocognitive functioning in a group of alcoholics undergoing inpatient substance abuse treatment using a computerized, self-administered screening instrument (MicroCog). MicroCog was administered to 121 patients (67 male, 64 female) who were consecutively admitted to an inpatient substance abuse treatment service. Following careful review of medical records, 66 (39 male, 27 female) patients with a primary diagnosis of alcohol dependence and/or abuse were studied. All subjects had completed acute detoxification and demonstrated no clinical signs of withdrawal prior to test administration. Subjects ranged in age from 18 to 78, with a mean of 41.83. Mean level of education for the group was 14.02 years, with a range of 10 to 21 years. We report descriptive statistics, which show mean test scores for the alcoholics to be generally lower, although within one standard deviation of the MicroCog age and educationcorrected standardization group means. One sample t-test comparing the alcoholics to the standardization group means revealed statistically significant differences for the General Cognitive Functioning (GCF), t(65) = -4.79, p < .001, and General Cognitive Proficiency (GCP), t(65) = -6.58, p < .001, index scores. Effect size statistics were calculated to determine the magnitude of the differences found in the above comparisons which yielded moderate effects for the GCF and GCP index scores, d = -.53 and -.71, respectively. We further report significant findings related to domain-specific neurocognitive functioning. Overall, the results suggest that alcoholics who are being treated in an inpatient setting demonstrate a significantly lower level of performance on computerized measures of global neurocognitive ability as compared to individuals of similar age and education. Characterization of cognitive ability in this population is important for setting individual program goals and discharge planning. Results suggest that MicroCog can be considered a useful, cost and time efficient instrument for such a purpose. Further study of these data will attempt to more specifically delineate the determinants of cognitive decline in this group of alcoholics.