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Discriminant function analysis with the NIMH AIDS brief neuropsychological battery in HIV research
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Abstracts from the 19th Annual Meeting
Duff, K., Westervelt, H. J., Haase, R. F., & McCaffrey, R. J. Discriminant Function Analysis with the NIMH AIDS Brief Neuropsychological Battery in HIV Research. In an attempt to assist researchers investigating the cognitive sequelae of HIV infection, an NIMH-sponsored workshop recommended an extended and brief neuropsychological battery for assessing the early detection of cognitive changes in H I V + asymptomatic individuals. Little empirical support for either battery has been published to date. In the present study, the discriminative abilities of the brief battery were assessed. Thirty-three H I V + asymptomatic subjects, 27 H I V + symptomatic subjects, and 30 HIV-controls were administered the NIMH AIDS Brief Neuropsychological Battery. Results of a discriminant analysis indicated that 57.8% of the subjects were correctly classified with the battery. Variables that contributed most to the classification were Hamilton Depression Rating Scale, Paced Auditory Serial Addition Test, State-Trait Anxiety Inventory State score, and California Verbal Learning Test Trials 1-5. Misclassifications were most common in the H I V + symptomatic group (with most misclassified as H I V + asymptomatic). The Brief Battery's utility as a screening tool, limitations of the present study, and future directions are discussed.
Navarrete, G., & Holliday, S. L. Ethnic Differences in Cognitive Function in Systemic Lupus Erythematosus. Neurocognitive deficits associated with SLE can vary from mild deficits to more severe deficits such as major strokes and delirium. However, research with neuropsychological measures and SLE patients is limited, and ecologically valid repeatable measures of cognitive function are lacking. Preliminary data from our group has shown that the computer-administered tests from the Automated Neuropsychological Assessment Metrics (ANAM) have potential for discriminating SLE patients and controls. A N A M was selected specifically for our predominantly Hispanic SLE population because it does not require English reading or verbal comprehension skills. The purpose of this study was to determine if two predominant ethnic groups in our sample would differ on ANAM tests. We studied 39 Hispanic and 18 European American SLE who met AAN Criteria for SLE and had no history of thrombo-occlusive events. A N A M subtests used included measures of simple reaction time, digit-symbol substitution with memory, simultaneous spatial processing, visuospatial matching to sample, digit span, continuous performance test, and a Sternberg working memory task. Separate t tests were conducted using ANAM test scores (averaged across all tests) of Lapses (response omissions), Reaction Time (in milliseconds), Accuracy (percent correct), and Throughput (correct responses/minute) as the primary measures of cognitive functioning. Additional exploratory t tests on basic demographic, psychiatric, and medical factors, which could affect ethnic differences in cognition were also conducted. Results indicate that ANAM Mean Reaction Time was slower (p = .014) and Throughput lower (p =- .015) among the Hispanic group. A N A M measures of Lapses and Accuracy failed to reach significance. Attributing these differences solely to ethnicity is complicated by the fact that the H A group was on average younger (p = .001) and less educated (p = .001) than the E A group. There were no differences noted in SLE disease activity/damage, autoantibody levels, Prednisone dose, or the psychiatric rating scales. Overall the results suggest that there might be a significant bias for ethnicity using ANAM tests and that specific ethnic norms may be needed for clinical interpretation.
Mungas, D., Gonzalez, H., Reed, B., & Haan, M. Psychometrically Matched English and Spanish Assessment Scales for Older Persons. There are significant limitations in neuropsychological tests for assessing older Englishspeaking persons, and even greater limitations for Spanish language assessment. The
Abstracts from the 19th Annual Meeting
Duff, K., Westervelt, H. J., Haase, R. F., & McCaffrey, R. J. Discriminant Function Analysis with the NIMH AIDS Brief Neuropsychological Battery in HIV Research. In an attempt to assist researchers investigating the cognitive sequelae of HIV infection, an NIMH-sponsored workshop recommended an extended and brief neuropsychological battery for assessing the early detection of cognitive changes in H I V + asymptomatic individuals. Little empirical support for either battery has been published to date. In the present study, the discriminative abilities of the brief battery were assessed. Thirty-three H I V + asymptomatic subjects, 27 H I V + symptomatic subjects, and 30 HIV-controls were administered the NIMH AIDS Brief Neuropsychological Battery. Results of a discriminant analysis indicated that 57.8% of the subjects were correctly classified with the battery. Variables that contributed most to the classification were Hamilton Depression Rating Scale, Paced Auditory Serial Addition Test, State-Trait Anxiety Inventory State score, and California Verbal Learning Test Trials 1-5. Misclassifications were most common in the H I V + symptomatic group (with most misclassified as H I V + asymptomatic). The Brief Battery's utility as a screening tool, limitations of the present study, and future directions are discussed.
Navarrete, G., & Holliday, S. L. Ethnic Differences in Cognitive Function in Systemic Lupus Erythematosus. Neurocognitive deficits associated with SLE can vary from mild deficits to more severe deficits such as major strokes and delirium. However, research with neuropsychological measures and SLE patients is limited, and ecologically valid repeatable measures of cognitive function are lacking. Preliminary data from our group has shown that the computer-administered tests from the Automated Neuropsychological Assessment Metrics (ANAM) have potential for discriminating SLE patients and controls. A N A M was selected specifically for our predominantly Hispanic SLE population because it does not require English reading or verbal comprehension skills. The purpose of this study was to determine if two predominant ethnic groups in our sample would differ on ANAM tests. We studied 39 Hispanic and 18 European American SLE who met AAN Criteria for SLE and had no history of thrombo-occlusive events. A N A M subtests used included measures of simple reaction time, digit-symbol substitution with memory, simultaneous spatial processing, visuospatial matching to sample, digit span, continuous performance test, and a Sternberg working memory task. Separate t tests were conducted using ANAM test scores (averaged across all tests) of Lapses (response omissions), Reaction Time (in milliseconds), Accuracy (percent correct), and Throughput (correct responses/minute) as the primary measures of cognitive functioning. Additional exploratory t tests on basic demographic, psychiatric, and medical factors, which could affect ethnic differences in cognition were also conducted. Results indicate that ANAM Mean Reaction Time was slower (p = .014) and Throughput lower (p =- .015) among the Hispanic group. A N A M measures of Lapses and Accuracy failed to reach significance. Attributing these differences solely to ethnicity is complicated by the fact that the H A group was on average younger (p = .001) and less educated (p = .001) than the E A group. There were no differences noted in SLE disease activity/damage, autoantibody levels, Prednisone dose, or the psychiatric rating scales. Overall the results suggest that there might be a significant bias for ethnicity using ANAM tests and that specific ethnic norms may be needed for clinical interpretation.
Mungas, D., Gonzalez, H., Reed, B., & Haan, M. Psychometrically Matched English and Spanish Assessment Scales for Older Persons. There are significant limitations in neuropsychological tests for assessing older Englishspeaking persons, and even greater limitations for Spanish language assessment. The