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Objectives: The aim of this study was to demonstrate the utility of an evidence-based assessment (EBA) model to establish a multimodal set of tools for identifying students at risk for perceived post-injury academic problems. Methods: Participants included 142 students diagnosed with concussion (age: M=14.95; SD=1.80; 59% male), evaluated within 4 weeks of injury (median=16 days). Demographics, pre-injury history, self- and parent-report measures assessing symptom severity and executive functions, and cognitive test performance were examined as predictors of self-reported post-injury academic problems. Results: Latent class analysis categorized participants into “high” (44%) and “low” (56%) levels of self-reported academic problems. Receiver operating characteristic analyses revealed significant discriminative validity for self- and parent-reported symptom severity and executive dysfunction and self-reported exertional response for identifying students reporting low versus high academic problems. Parent-reported symptom ratings [area under the receiver operating characteristic curve (AUC)=.79] and executive dysfunction (AUC=.74), and self-reported ratings of executive dysfunction (AUC=.84), symptoms (AUC=.80), and exertional response (AUC=.70) each classified students significantly better than chance (ps<.001). Hierarchical logistic regression indicated that, of the above, self-reported symptoms and executive dysfunction accounted for the most variance in the prediction of self-reported academic problems. Conclusions: Post-concussion symptom severity and executive dysfunction significantly predict perceived post-injury academic problems. EBA modeling identified the strongest set of predictors of academic challenges, offering an important perspective in the management of concussion by applying traditional strengths of neuropsychological assessment to clinical decision making. (JINS, 2016, 22, 1038–1049)
The goal of this paper is to review assessment research of bipolar
disorder in children and adolescents. The review addresses numerous
themes: the benefits and costs of involving clinical judgment in the
diagnostic process, particularly with regard to diagnosis and mood
severity ratings; the validity of parent, teacher, and youth self-report
of manic symptoms; how much cross-situational consistency is typically
shown in mood and behavior; the extent to which a parent's mental
health status influences their report of child behavior; how different
measures compare in terms of detecting bipolar disorder, the challenges in
comparing the performance of measures across research groups, and the
leading candidates for research or clinical use; evidence-based strategies
for interpreting measures as diagnostic aids; how test performance changes
when a test is used in a new setting and what implications this has for
research samples as well as clinical practice; the role of family history
of mood disorder within an assessment framework; and the implications of
assessment research for the understanding of phenomenology of bipolar
disorder from a developmental framework.We
thank the families who participated in this program of research. This work
was supported in part by NIMH R01 MH066647, as well as a Center Grant from
the Stanley Medical Research Institute.
Ipsative approaches to neuropsychological assessment typically
involve interpreting difference scores between individual test scores.
The utility of these methods is limited by the reliability of
neuropsychological difference scores and the number of comparisons
between scores. The present study evaluated the utility of difference
scores using factor analytic methods, including reliable components
analysis (RCA), equally weighted composites and individual
neuropsychological measures. Data from 1,364 individuals referred for
neuropsychological assessment were factor analyzed and the resulting
solutions were used to compute composite scores. Reliabilities and
confidence intervals were derived for each method. Results indicated
that RCA outperformed other factor analytic methods, but produced a
slightly different factor structure. Difference scores derived using
orthogonal solutions were slightly more reliable than oblique methods,
and both were more reliable than those from equally weighted composites
and individual measures. Confidence intervals for difference scores
were considerably smaller for factor methods relative to those for
individual test comparisons, due to the greater reliability of factor
based difference scores and the smaller number of comparisons required.
These findings suggest that difference scores derived from orthogonal
factor solutions, particularly RCA solutions, may improve reliability
for clinical assessment purposes. (JINS, 2004, 10,
We examined the relations of verbal ability and self-regulation in preschool to emotion
knowledge in first grade, and concurrent relations between emotion knowledge and indexes of
social functioning in 143 children from low-income families. After controlling for children's
verbal ability in preschool, teacher reports of attentional control and caregiver reports of
behavioral control in preschool predicted children's emotion expression knowledge and
emotion situation knowledge 2 years later. After controlling for verbal ability and attentional and
behavioral control, children's emotion knowledge predicted concurrent teacher-reported
social problems and social withdrawal. Results suggest that low levels of emotion knowledge
co-occur with many important aspects of children's early social adaptation.
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