The goals of neuropsychological assessment include not only an accurate description of neurocognitive strengths and weaknesses, but also the reduction of misclassification rates. Despite the availability of tests with acceptable psychometric properties, the value of neuropsychological assessment may be undermined by the lack of clear guidelines on what constitutes impairment, and the use of inadequate normative data. These challenges to accurate neuropsychological assessment may result in both Type 1 and Type 2 diagnostic errors. In this study, the prevalence of impairment was examined in 20 neurologically intact individuals following administration of a small battery of commonly used neuropsychological tests. Results revealed an unacceptably high number of false positive cases. This finding questions the applicability of imported normative data for South African individuals, a dilemma which can only be remedied through the development of substantial data-collection projects.
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References
1.
AxelrodB. N.GoldmanR. S. (1996). Use of demographic corrections in neuropsychological interpretation: How standard are standard scores?The Clinical Neuropsychologist, 10, 159–162.
2.
BornsteinR. (1985). Normative data on selected neuropsychological measures from a nonclinical sample. Journal of Clinical Psychology, 41, 651–659.
3.
CiminoC. R. (2000). Principles of neuropsychological interpretation. In VanderploegR. D., (Ed.), Clinician's guide to neuropsychological assessment. (2nd ed.), (pp. 69–109). Mahwah, NJ: Lawrence Erlbaum Associates.
4.
DeLucaJ.JohnsonS. K.BeldowiczD.NatelsonB. H. (1995). Neuropsychological impairments in chronic fatigue syndrome, multiple sclerosis, and depression. Journal of Neurology, Neurosurgery, and Psychiatry, 58, 38–43.
5.
DerogatisL. R. (1983). SCL-90-R: Administration, scoring and procedures manual for the R(evised) version.Towson: Clinical Psychometric Research.
6.
ForresterG.GeffenG. (1991). Performance measures of 7- to 15-year-old children on the Auditory Verbal Learning Test. The Clinical Neuropsychologist, 5, 345–359.
7.
GronwallD. M. A. (1977). Paced Auditory Serial Addition Task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373.
8.
HinkinC. H.van GorpW. G.SatzP.WeismanJ. D.ThommesJ.BuckinghamS. (1992). Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. Journal of Clinical and Experimental Neuropsychology, 14, 289–297.
9.
IvnikR. J.MalecJ. F.SmithG. E.TangalosE. G.PetersenR. C. (1996). Neuropsychological tests' norms above age 55: COWAT, BNT, MAE Token, WRAT-R Reading, AMNART, STROOP, TMT, and JLO. The Clinical Neuropsychologist, 10, 262–278.
10.
KalechsteinA. D.Van GorpW. G.RapportL. J. (1998). Variability in clinical classification of raw test scores across normative data sets. The Clinical Neuropsychologist, 12, 339–347.
11.
KernsK.A.MateerC.A.BrousseauS. (1998). Computerizing the clinician: Internet resources for neuropsychology. The Clinical Neuropsychologist, 12, 217–230.
12.
KruppL. B.SliwinskiM.MasurD. M. (1994). Cognitive functioning and depression in patients with chronic fatigue syndrome and multiple sclerosis. Archives of Neurology, 51, 705–710.
13.
Lafayette Instrument® (undated) Test Manual for the Grooved Pegboard. Lafayette Instrument®, P. O. Box 5729, Lafayette, Illinois.
14.
LezakM. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.
15.
LezakM. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
16.
McCaffreyR.J.PuenteA.E. (1992). Overview, limitations, and directions. In PuenteA.E.McCaffreyR.J. (Eds.), Handbook of neuropsychological assessment: a biopsychosocial perspective. (pp. 511–520), New York: Plenum.
17.
MitrushinaM. N.BooneK. B.D'EliaL. F. (1999). Handbook of normative data for neuropsychological assessment.New York: Oxford University Press.
18.
NellV. (2000). Crosscultural neuropsychological assessment: theory and practice.Mahwah NJ: Lawrence Erlbaum Associates, Inc.
19.
OrsiniD.Van GorpW.BooneK. (1988). The neuropsychology casebook.New York: Springer-Verlag.
20.
RussellE.W. (2000). The cognitive-metric, fixed battery approach to neuropsychological assessment. In VanderploegR.D. (Ed.), Clinician's guide to neuropsychological assessment. (2nd ed.). (pp. 449–481), Mahwah, NJ: Lawrence Erlbaum Associates.
21.
SclafaniV. D.MackayR. D.MeyerhoffD. J.NormanD.WeinerM. W.FeinG. (1997). Brain atrophy in HIV infection is more strongly associated with CDC clinical stage than with cognitive impairment. Journal of the International Neuropsychological Society, 3, 276–287.
22.
SkoraszewskiJ. J.BallJ. D.MikulkaP. (1991). Neuropsychological functioning in HIV-infected males. Journal of Clinical and Experimental Neuropsychology, 13, 278–290.
23.
SmithA. (1982). Symbol Digit Modalities Test (SDMT). Manual (Revised). Los Angeles: Western Psychological Services.
24.
SpreenO.StraussE. (1991). A compendium of neuropsychological tests: administration, norms, and commentary.New York: Oxford University Press.
25.
SpreenO.StraussE. (1998). A compendium of neuropsychological tests: administration, norms, and commentary. (2nd ed.). New York: Oxford University Press.
26.
StussD. T.StethemL. L.PelchatG., (1988). Three tests of attention and rapid information processing: An extension. The Clinical Neuropsychologist, 2, 246–250.
27.
TierskyL. A.CiceroneK. D.NatelsonB. H.De LucaJ. (1998). Neuropsychological functioning in chronic fatigue syndrome and mild traumatic brain injury: A comparison. The Clinical Neuropsychlogist, 12, 503–512.
28.
TuokkaH.WoodwardT. S. (1996). Development and validation of a demographic correction system for neuropsychological measures used in the Canadian study of health and ageing. Journal of Clinical and Experimental Neuropsychology, 18, 479–616.
29.
VanderploegR.D. (2000). The interpretation process. In VanderploegR.D. (Ed.), Clinician's guide to neuropsychological assessment. (2nd ed.). (pp. 111–154), Mahwah, NJ: Lawrence Erlbaum Associates.
30.
VercoulenJ. H. M. M.BazelmansE.SwaninkC. M. A.GalamaJ. M. D.FennisJ. F. M.van der MeerJ. W. M.BleijenbergG. (1998). Evaluating neuropsychological impairment in chronic fatigue syndrome. Journal of Clinical and Experimental Neuropsychology, 20, 144–156.
31.
ViljoenG.TredouxC.LevettA.AndersonS. J., (1994). Using the Bender-Gestalt in South Africa: Some normative data for Zulu-speaking children. South African Journal of Psychology.24, 145–151.
32.
WalshK. (1992). Some gnomes worth knowing. The Clinical Neuropsychologist, 6, 119–133.
33.
YeudallL. T.FrommD.ReddonJ. R.StefanykW. O. (1986). Normative data stratified by age and sex for 12 neuropsychological tests. Journal of Clinical Psychology, 42, 918–945.
