TY - JOUR
T1 - Reliable Digit Span
T2 - Does it Adequately Measure Suboptimal Effort in an Adult Epilepsy Population?
AU - Maiman, Moshe
AU - Del Bene, Victor A.
AU - MacAllister, William S.
AU - Sheldon, Sloane
AU - Farrell, Eileen
AU - Arce Rentería, Miguel
AU - Slugh, Mitchell
AU - Nadkarni, Siddhartha S.
AU - Barr, William B.
N1 - Publisher Copyright:
© 2018 The Author(s). All rights reserved.
PY - 2018/3/28
Y1 - 2018/3/28
N2 - Objective: Assessment of performance validity is a necessary component of any neuropsychological evaluation. Prior research has shown that cutoff scores of ≤6 or ≤7 on Reliable Digit Span (RDS) can detect suboptimal effort across numerous adult clinical populations; however, these scores have not been validated for that purpose in an adult epilepsy population. This investigation aims to determine whether these previously established RDS cutoff scores could detect suboptimal effort in adults with epilepsy. Method: Sixty-three clinically referred adults with a diagnosis of epilepsy or suspected seizures were administered the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS-III or WAIS-IV). Most participants (98%) passed Trial 2 of the Test of Memory Malingering (TOMM), achieving a score of ≥45. Results: Previously established cutoff scores of ≤6 and ≤7 on RDS yielded a specificity rate of 85% and 77% respectively. Findings also revealed that RDS scores were positively related to attention and intellectual functioning. Given the less than ideal specificity rate associated with each of these cutoff scores, together with their strong association to cognitive factors, secondary analyses were conducted to identify more optimal cutoff scores. Preliminary results suggest that an RDS cutoff score of ≤4 may be more appropriate in a clinically referred adult epilepsy population with a low average IQ or lower. Conclusions: Preliminary findings indicate that cutoff scores of ≤6 and ≤7 on RDS are not appropriate in adults with epilepsy, especially in individuals with low average IQ or below.
AB - Objective: Assessment of performance validity is a necessary component of any neuropsychological evaluation. Prior research has shown that cutoff scores of ≤6 or ≤7 on Reliable Digit Span (RDS) can detect suboptimal effort across numerous adult clinical populations; however, these scores have not been validated for that purpose in an adult epilepsy population. This investigation aims to determine whether these previously established RDS cutoff scores could detect suboptimal effort in adults with epilepsy. Method: Sixty-three clinically referred adults with a diagnosis of epilepsy or suspected seizures were administered the Digit Span subtest of the Wechsler Adult Intelligence Scale (WAIS-III or WAIS-IV). Most participants (98%) passed Trial 2 of the Test of Memory Malingering (TOMM), achieving a score of ≥45. Results: Previously established cutoff scores of ≤6 and ≤7 on RDS yielded a specificity rate of 85% and 77% respectively. Findings also revealed that RDS scores were positively related to attention and intellectual functioning. Given the less than ideal specificity rate associated with each of these cutoff scores, together with their strong association to cognitive factors, secondary analyses were conducted to identify more optimal cutoff scores. Preliminary results suggest that an RDS cutoff score of ≤4 may be more appropriate in a clinically referred adult epilepsy population with a low average IQ or lower. Conclusions: Preliminary findings indicate that cutoff scores of ≤6 and ≤7 on RDS are not appropriate in adults with epilepsy, especially in individuals with low average IQ or below.
KW - Epilepsy
KW - Performance validity test
KW - Reliable digit span
KW - Suboptimal effort
KW - Test of Memory Malingering
UR - http://www.scopus.com/inward/record.url?scp=85059316911&partnerID=8YFLogxK
U2 - 10.1093/arclin/acy027
DO - 10.1093/arclin/acy027
M3 - Article
C2 - 29659666
AN - SCOPUS:85059316911
SN - 0887-6177
VL - 34
SP - 259
EP - 267
JO - Archives of Clinical Neuropsychology
JF - Archives of Clinical Neuropsychology
IS - 2
ER -