A Longitudinal Study Of Cognition In Adolescents At Risk For Substance Abuse

National Institute On Drug Abuse

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Abstract

Using data acquired from adolescents enrolled in this study, we evaluated the inter-rater reliability, internal consistency and/or temporal reliability of a number of the test instruments. We assessed the internal consistency and temporal stability of Conner's Continuous Performance Test (CCPT) as a clinical tool for the assessment of attention-deficit/hyperactivity disorder (ADHD) the CCPT in a sample of 51 adolescents, (19 with ADHD, 8 with ADHD and another disorder, and 24 controls). The CCPT has adequate split-half reliability, and performance was found to be moderately correlated over the span of 1.3 years. ADHD participants tended to perform worse than controls during the first, but not second, CCPT administration. The CCPT was found to be an insensitive indicator of diagnostic status and, while several CCPT performance measures correlated with parent ratings of ADHD symptomatology, the pattern of these correlations was largely independent of the interpretive guidelines provided in the test manual. We conclude that the poor diagnostic validity and the unclear functional relevance of CCPT scores might confound clinical interpretation of the CCPT. We assessed the inter-rater agreement and internal consistency of the Rey Complex Figure Test (RCFT) in a sample of adolescents enrolled in this study. We found each of the RCFT outcome measures to be associated with clinically acceptable inter-rater reliability estimates. Additionally, we found the copy and recall accuracy scores to be associated with clinically acceptable internal consistency. The organizational scoring method we evaluated, while associated with internal consistency that is acceptable for research purposes, was found to be somewhat below estimates associated with clinical acceptability. We assessed the short- and long-term stability of the Stroop Color and Word Test, a commercially-available version of Stroop s original task in 87 adolescents. Participants were tested an average of one month apart at baseline and twice more at approximately 15 month intervals. We found that all of the commonly used performance indices are associated with practice effects and that the three primary scores, but not the formula-derived interference score, were associated with acceptable reliability. [unreadable] Baseline data from participants in this longitudinal study were combined with data from other studies performed at NIMH on adolescents to examine whether face-emotion labeling deficits are illness-specific or an epiphenomenon of generalized impairment in pediatric psychiatric disorders involving mood and behavioral dysregulation. In total, data from two hundred fifty-two youths (718 years old) who had completed child and adult facial expression recognition subtests from the Diagnostic Analysis of Nonverbal Accuracy instrument were used. Forty-two participants had bipolar disorder, 39 had severe mood dysregulation (i.e., chronic irritability, hyperarousal without manic episodes), 44 had anxiety and/or major depressive disorders, 35 had attention-deficit/hyperactivity and/or conduct disorder, and 92 were controls. Dependent measures were number of errors labeling happy, angry, sad, or fearful emotions. We found that children with bipolar disorder and those with severe mood dysregulation made more errors than those presenting with anxiety and/or major depressive disorders, attention-deficit/hyperactivity and/or conduct disorder, or controls when labeling adult or child emotional expressions. Children with bipolar disorder and those with severe mood dysregulation did not differ in their emotion- labeling deficits. Therefore, we concluded that the face-emotion labeling deficits differentiate children with bipolar disorder and those with severe mood dysregulation from controls and those with anxiety and/or major depressive disorders or those with attention-deficit/hyperactivity and/or conduct disorder. The extent to which such deficits cause versus result from emotional dysregulation requires further study.