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Oldwine, new skins: MMPI alcoholism screening through logistic regression
182
Abstracts of 10th Annual Meeting
especially since CID is a potentially precautions.
transmissible
disease and requires
special
15. Colis, M. J., Zillmer, E. A., & Fowler, P. C. Neuropsychology Program, Drexel University & University of Virginia Health Sciences Center MMPI and Neuropsychological Relationships in Psychiatric Patients. The present study examined the complex relationship between the degree of psychiatric disturbance and the level of impairment on neuropsychological variables. The subjects were 139 hospitalized psychiatric patients who, in addition to the MMPI were administered a comprehensive neuropsychological test battery (viz., WAIS-R, HRNB, WMS, PIAT, and WRAT). The composite MMPI profile for this sample was a common one with scales 8 and 6 as high-points. After reducing the neuropsychological measures to five composite indices by factor analysis, MANOVA procedures revealed a statistically significant relationship between simple-weighted factor scores and F-scale as well as Goldberg Index elevations (Wilks’ lambda = .77, p < .OOl). The parallel univariate ANOVA’s revealed significant effects involving factors Verbal-Comprehension [F (2, 137) = 17.6, p < .OOOl], Perceptual-Organization [F (2, 137) = 3.2, p -C .05], and Sensory-Attention [F (2, 137) = 10.0, p -C .OOl]. Neither the F-scale nor the Goldberg Index were significantly related to factor indices representing Primary-Motor skills or Tactile-Spatial abilities. Higher cortical functions, specifically those involving more complex abilities, may be less robust in the face of severe emotional problems. Results from both the MMPI and neuropsychological procedures, may however, when appropriately used, generate important complementary data about the patient’s overall adjustment. This seems of particular importance in applied neuropsychology and neuropsychiatric settings were patients commonly manifest both, emotional maladjustment and neuropsychological disorders. Theoretical issues and practical implications regarding the neuropsychological and emotional assessment of psychiatric patients are discussed.
16. Colligan, R. C., Davis, L. J., Offord, K. P., & Morse, R. M. Mayo Clinic Old Wine, New Skins: MMPI Alcoholism Screening Through logistic Regression. Evaluation of seven MMPI alcoholism scales found classification was more accurate for medical patients with MMPI #215 (I have used alcohol excessively.) alone than with any of the seven scales. Since a single-item “scale” is insufficient for screening, it was decided to develop a new MMPI alcoholism scale specifically for medical patients. The criterion group consisted of 211 female and 525 male alcoholic patients diagnosed by DSM-III criteria and hospitalized on an alcoholism treatment unit. Three contrast samples included 2446 female and 2418 male medical outpatients administered the MMPI according to a research protocol - and excluding those referred for psychiatric evaluation - and 4146 female and 2702 male
Session 1
183
medical outpatients administered the MMPI at physician request. Patients with alcoholism or alcohol-related diseases were excluded. A third contrast sample consisted of 762 female and 646 male normal adult subjects not under the care of a physician for any mentally or physically handicapping condition. Chi Square procedures have traditionally been used for MMPI scale construction. However, in this study, logistic regression was applied to the criterion and contrast samples to select 33, differentially weighted, items applicable to both sexes. With sensitively (the proportion of alcoholics in the criterion sample correctly identified) set at 90%, specificity (the proportion of the non-alcoholic samples correctly identified) ranged from 82-96%. Cross-validation was carried out with a new sample of 485 alcoholic patients, also diagnosed by DSM-III criteria. No detectable shrinkage in accurate classification was found. Thus the scale appears ready for clinical trials. 17. Costa, P. T., Jr., Kawas, C. H., Zonderman, A. B. Gerontology Research Center, National Institute on Aging NIH Impairment in Recognition Memory Performance as a Correlate of Cognitive Status in the Baltimore Longitudinal Study of Aging. One view of normal cognitive aging holds that age declines in memory perfor-
mance are due to declines in central processing resources. Because they require fewer processing resources, recognition memory tasks would thus not be sensitive indicators of age effects. Impairments in recognition memory after multiple exposures, however, may be sensitive to cognitive impairments that are not characteristic of normal aging. In this study we examined the relationship between recognition memory performance in the Grober-Buschke Enhanced Cued Recall test with two measures of cognitive status, the Mini-Mental Status Examination (MMSE) and the Blessed Mental Status Test (BMST). Subjects were 336 male and female participants in the Baltimore Longitudinal Study of Aging who received an extensive neuropsychological battery as part of a research program on early markers of Alzheimers Disease. 169 of them had taken an Army Alpha IQ and verbal fluency tests an average of 23 years prior to the MMSe and BMST tests. Recognition accounted for 47% and 48% of the variation in the concurrent MMSE and BMST, Recognition also accounted for 33% and 34% of the variation in MMSE and BMST after removing 24% and 21% of the variation due to the age, education, gender, vocabulary, IQ and fluency tests. Deficits in recognition memory performance are independent indictors of mental status. Implications of these findings for neuropsychological assessment and diagnosis of cognitive aging and brain disease will be discussed. 18. Cullum, C. M., Thompson, L. L., & Smernoff, E. N. University of Colorado School of Medicine Three Word Recall as a Measure of Memory: How Valid is it?
Abstracts of 10th Annual Meeting
especially since CID is a potentially precautions.
transmissible
disease and requires
special
15. Colis, M. J., Zillmer, E. A., & Fowler, P. C. Neuropsychology Program, Drexel University & University of Virginia Health Sciences Center MMPI and Neuropsychological Relationships in Psychiatric Patients. The present study examined the complex relationship between the degree of psychiatric disturbance and the level of impairment on neuropsychological variables. The subjects were 139 hospitalized psychiatric patients who, in addition to the MMPI were administered a comprehensive neuropsychological test battery (viz., WAIS-R, HRNB, WMS, PIAT, and WRAT). The composite MMPI profile for this sample was a common one with scales 8 and 6 as high-points. After reducing the neuropsychological measures to five composite indices by factor analysis, MANOVA procedures revealed a statistically significant relationship between simple-weighted factor scores and F-scale as well as Goldberg Index elevations (Wilks’ lambda = .77, p < .OOl). The parallel univariate ANOVA’s revealed significant effects involving factors Verbal-Comprehension [F (2, 137) = 17.6, p < .OOOl], Perceptual-Organization [F (2, 137) = 3.2, p -C .05], and Sensory-Attention [F (2, 137) = 10.0, p -C .OOl]. Neither the F-scale nor the Goldberg Index were significantly related to factor indices representing Primary-Motor skills or Tactile-Spatial abilities. Higher cortical functions, specifically those involving more complex abilities, may be less robust in the face of severe emotional problems. Results from both the MMPI and neuropsychological procedures, may however, when appropriately used, generate important complementary data about the patient’s overall adjustment. This seems of particular importance in applied neuropsychology and neuropsychiatric settings were patients commonly manifest both, emotional maladjustment and neuropsychological disorders. Theoretical issues and practical implications regarding the neuropsychological and emotional assessment of psychiatric patients are discussed.
16. Colligan, R. C., Davis, L. J., Offord, K. P., & Morse, R. M. Mayo Clinic Old Wine, New Skins: MMPI Alcoholism Screening Through logistic Regression. Evaluation of seven MMPI alcoholism scales found classification was more accurate for medical patients with MMPI #215 (I have used alcohol excessively.) alone than with any of the seven scales. Since a single-item “scale” is insufficient for screening, it was decided to develop a new MMPI alcoholism scale specifically for medical patients. The criterion group consisted of 211 female and 525 male alcoholic patients diagnosed by DSM-III criteria and hospitalized on an alcoholism treatment unit. Three contrast samples included 2446 female and 2418 male medical outpatients administered the MMPI according to a research protocol - and excluding those referred for psychiatric evaluation - and 4146 female and 2702 male
Session 1
183
medical outpatients administered the MMPI at physician request. Patients with alcoholism or alcohol-related diseases were excluded. A third contrast sample consisted of 762 female and 646 male normal adult subjects not under the care of a physician for any mentally or physically handicapping condition. Chi Square procedures have traditionally been used for MMPI scale construction. However, in this study, logistic regression was applied to the criterion and contrast samples to select 33, differentially weighted, items applicable to both sexes. With sensitively (the proportion of alcoholics in the criterion sample correctly identified) set at 90%, specificity (the proportion of the non-alcoholic samples correctly identified) ranged from 82-96%. Cross-validation was carried out with a new sample of 485 alcoholic patients, also diagnosed by DSM-III criteria. No detectable shrinkage in accurate classification was found. Thus the scale appears ready for clinical trials. 17. Costa, P. T., Jr., Kawas, C. H., Zonderman, A. B. Gerontology Research Center, National Institute on Aging NIH Impairment in Recognition Memory Performance as a Correlate of Cognitive Status in the Baltimore Longitudinal Study of Aging. One view of normal cognitive aging holds that age declines in memory perfor-
mance are due to declines in central processing resources. Because they require fewer processing resources, recognition memory tasks would thus not be sensitive indicators of age effects. Impairments in recognition memory after multiple exposures, however, may be sensitive to cognitive impairments that are not characteristic of normal aging. In this study we examined the relationship between recognition memory performance in the Grober-Buschke Enhanced Cued Recall test with two measures of cognitive status, the Mini-Mental Status Examination (MMSE) and the Blessed Mental Status Test (BMST). Subjects were 336 male and female participants in the Baltimore Longitudinal Study of Aging who received an extensive neuropsychological battery as part of a research program on early markers of Alzheimers Disease. 169 of them had taken an Army Alpha IQ and verbal fluency tests an average of 23 years prior to the MMSe and BMST tests. Recognition accounted for 47% and 48% of the variation in the concurrent MMSE and BMST, Recognition also accounted for 33% and 34% of the variation in MMSE and BMST after removing 24% and 21% of the variation due to the age, education, gender, vocabulary, IQ and fluency tests. Deficits in recognition memory performance are independent indictors of mental status. Implications of these findings for neuropsychological assessment and diagnosis of cognitive aging and brain disease will be discussed. 18. Cullum, C. M., Thompson, L. L., & Smernoff, E. N. University of Colorado School of Medicine Three Word Recall as a Measure of Memory: How Valid is it?