Choose a suitable test to assess frontal lobe functions in a man suffering from head injury:
C. The Wisconsin Card Sorting Test (WCST) is used to test set-shifting ability, which is thought to be a function of the frontal lobe. In Rey Osterreith Complex Figure Test (ROCFT) a complicated figure is presented and the subject is required to copy it. The original and copy are then removed and the subject is asked to draw the figure again from memory, after varying delay intervals. This is not specific for frontal lobe functions. Stanford Binet Scale measures general intelligence. Mini Mental State Examination (MMSE) is a test of general cognition. In fact, it does not include any specific tests for frontal lobe function.
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Among the WAIS subtests, performance on which of the following is relatively resistant to decline with ageing?
E. Tests on WAIS are either ‘hold’ or ‘no hold’. The so called ‘hold tests’ in WAIS are thought to reflect the use of old knowledge and are relatively resistant to the effects of brain damage and aging. These include vocabulary, information, object assembly, and picture completion. ‘No hold’ tests require speed of response, working memory, or the creation of new relations between unrelated items. These are more likely to show early decline with aging and cognitive impairment. These include digit symbol, digit span, similarities, and block design. This is the reason why WAIS is not the best test to measure premorbid intelligence.
Which of the following is NOT a bedside cognitive test?
A. The Halstead Reitan Battery is composed of seven to ten tests. The battery can differentiate those who are brain damaged from neurologically intact persons. It usually needs to be administered by a trained neuropsychologist and is time consuming. Frontal Assessment Battery is a battery of six tests used to test frontal lobe function at the bedside. It includes verbal fluency, similarities, Luria three-step test, go–no go tests, and a test of environmental autonomy. In category test the subject must discover the common theme in a set of pictures presented. Category test measures concept formation and abstract reasoning. It is one of the tests included in the Halstead Reitan Battery. Verbal fluency is measured using the FAS test.
Which of the following scales used in antidepressant trials is most sensitive to detect any change in the severity of depression?
B. The Hamilton Rating Scale for Depression (HAM-D) and the Montgomery-Åsberg Depression Rating Scale (MADRS) are two widely used depression scales. HAM-D is relatively limited in measures of sensitivity and multidimensionality but it is very popular. The MADRS (10 items), designed to be sensitive to treatment changes, is briefer and more uniform. A limitation of the MADRS is the lack of a structured interview, which may affect reliability. The HAM-D and the MADRS are often used conjointly as endpoints in depression trials. There are various versions of the HAM-D, ranging from 17 to 31 items. The Brief Psychiatric Rating Scale (BPRS) comprises 16 items rated from 0 (not present) to 6 (extremely severe) and includes symptoms such as somatic concern, anxiety, depressive mood, hostility, and hallucinations. The scale was developed essentially for psychosis but also includes symptoms of depression. Positive and Negative Symptoms Scale (PANSS) is not a scale to measure depressive symptoms. It is used to measure the severity of psychotic symptoms. The Beck Depression Inventory (BDI) is a 21 question, self-report inventory. It is not a very useful measure of change in severity of depression with treatment.
While using a diagnostic rating scale, a psychologist tries to fi nd the degree of correlation between one test item and the other items in the scale.
What is he trying to measure?
A. Internal consistency is the degree to which one test item correlates with all other test items. Reliability is the consistency of a measuring instrument or the repeatability of a test. Inter-rater reliability is the likelihood that two raters will rate the same answer in the same way. Test–retest reliability is the degree to which a test will give the same result on two different occasions, separated in time. Parallel-form reliability is the extent to which two comparable versions of a test give the same result. Split-half reliability is when a test is notionally split in two and the two halves correlated with each other.
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