Figure - uploaded by Laszlo A Erdodi
Content may be subject to copyright.
-KEFS Stroop Age-Corrected Scaled Scores Across the Four Trials for the Entire Sample (N 132)

-KEFS Stroop Age-Corrected Scaled Scores Across the Four Trials for the Entire Sample (N 132)

Source publication
Article
Full-text available
This study was designed to develop performance validity indicators embedded within the Delis-Kaplan Executive Function Systems (D-KEFS) version of the Stroop task. Archival data from a mixed clinical sample of 132 patients (50% male; MAge= 43.4; MEducation= 14.1) clinically referred for neuropsychological assessment were analyzed. Criterion measure...

Context in source publication

Context 1
... they were significantly below the nominal mean of 10, with small to medium effect sizes (Cohen's d: .25-.44). Skew and kurtosis were well within 1.0 (see Table 7). However, visual inspection revealed bimodal distributions with one peak in the impaired range and another in the average-to-high average range. ...

Similar publications

Article
Full-text available
Objective: Determine whether preinjury concussion symptom factors predict postinjury concussion symptom factors. Setting: Community concussion surveillance program between 2008 and 2017. Participants: A total of 290 high school and collegiate-aged athletes (n = 168, aged 14-17 years; n = 122, aged 18-21 years, respectively). Design: Retrospe...

Citations

... Research over the last decades considered a large number of validity measures, so-called performance validity tests (PVTs), that can be classified into stand-alone (freestanding) validity tests and validity indicators embedded within routine measures of neuropsychological functions (for an overview, see Boone, 2021). While stand-alone PVTs are considered the gold standard for producing high diagnostic accuracy in distinguishing credible and noncredible cognitive performance, embedded PVTs have certain advantages over stand-alone PVTs Erdodi et al., 2014Erdodi et al., , 2018. Empirical evidence and current practice standards recommend the use of multiple PVTs to assess validity and stress the need to sample validity continuously throughout the assessment and across cognitive domains (e.g., Rhoads et al., 2021;Soble, 2021;Sweet et al., 2021). ...
... As a major limitation of the present study, it must be noted that only one PVT (i.e., the WMT) was used as the criterion to determine noncredible cognitive performance. The use of a single criterion PVT has been shown to distort accuracy estimates of the predictor PVT, especially when high congruence between predictor and criterion is given (see domain-specificity hypothesis, Erdodi et al., 2018). In favor of the present study, the congruence between the cognitive domains of the predictor PVT (COG as an attention test) and criterion PVT (WMT as a verbal memory test) was low, and the WMT is presumably one of the best studied PVTs and de facto gold standard in clinic and research. ...
Article
Full-text available
The assessment of performance validity is essential in any neuropsychological evaluation. However, relatively few measures exist that are based on attention performance embedded within routine cognitive tasks. The present study explores the potential value of a computerized attention test, the Cognitrone, as an embedded validity indicator in the neuropsychological assessment of early retirement claimants. Two hundred and sixty-five early retirement claimants were assessed with the Word Memory Test (WMT) and the Cognitrone. WMT scores were used as the independent criterion to determine performance validity. Speed and accuracy measures of the Cognitrone were analyzed in receiver operating characteristics (ROC) to classify group membership. The Cognitrone was sensitive in revealing attention deficits in early retirement claimants. Further, 54% (n = 143) of the individuals showed noncredible cognitive performance, whereas 46% (n = 122) showed credible cognitive performance. Individuals failing the performance validity assessment showed slower (AUC = 79.1%) and more inaccurate (AUC = 79.5%) attention performance than those passing the performance validity assessment. A compound score integrating speed and accuracy revealed incremental value as indicated by AUC = 87.9%. Various cut scores are suggested, resulting in equal rates of 80% sensitivity and specificity (cut score = 1.297) or 69% sensitivity with 90% specificity (cut score = 0.734). The present study supports the sensitivity of the Cognitrone for the assessment of attention deficits in early retirement claimants and its potential value as an embedded validity indicator. Further research on different samples and with multidimensional criteria for determining invalid performance are required before clinical application can be suggested.
... Stroop test (ST). An experimental trial-by trial version of the ST (Erdodi et al., 2018;Jensen, 1965) was employed. Stimuli consisted of 48 congruent and incongruent colored (green, yellow, and blue) words. ...
Article
Almost 30% of ADHD adults do not respond to standard pharmaceuticals. Transcranial direct current stimulation (tDCS) is a method for modulation of cortical excitability. On the other hand, dialectical behavioral therapy (DBT) is a cognitive-behavioral approach that might be utilized for adults with ADHD. The effects of integration of these interventions are only beginning to be explored. In the present work, we used both subjective and objective measures to investigate the effects of tDCS, DBT, and the integration of the two in treating adult ADHD symptoms. A total of 80 adults with ADHD (63 females, 17 males) participated in the study and were grouped into control, DBT, tDCS, and combined groups. Based on the observed results, the combination of DBT and tDCS was significantly effective in improving the mentioned variables compared to administration of each method in isolation. The results are discussed in terms of neurophysiological and psychological aspects of treatment methods.
... The EFT is widely used to measure inhibition ability and selective attention [47]. The ST is commonly used to measure the inhibition of cognitive interference, processing speed, cognitive flexibility, and executive function [48]. The RVIPT was used to assess target sensitivity, decision-making, and sustained attention and alertness [49]. ...
Article
Full-text available
This study aimed to investigate the effects of caffeine on performances of simulated match, Wingate Anaerobic Test (WAnT), and cognitive function test of elite taekwondo athletes. Ten elite taekwondo athletes in Hong Kong volunteered to participate in two main trials in a randomized double-blinded crossover design. In each main trial, 1 h after consuming a drink with caffeine (CAF) or a placebo drink without caffeine (PLA), the participants completed two simulated taekwondo match sessions followed by the WAnT. The participants were instructed to complete three cognitive function tests, namely the Eriksen Flanker Test (EFT), Stroop Test, and Rapid Visual Information Processing Test, at baseline, before exercise, and immediately after the simulated matches. They were also required to wear functional near-infrared spectroscopy equipment during these tests. Before exercise, the reaction time in the EFT was shorter in the CAF trial than in the PLA trial (PLA: 494.9 ± 49.2 ms vs. CAF: 467.9 ± 38.0 ms, p = 0.035). In the WAnT, caffeine intake increased the peak power and mean power per unit of body weight (by approximately 13% and 6%, respectively, p = 0.018 & 0.042). The performance in the simulated matches was not affected by caffeine intake (p = 0.168). In conclusion, caffeine intake enhances anaerobic power and may improve certain cognitive functions of elite taekwondo athletes in Hong Kong. However, this may not be enough to improve the simulated match performance.
... In a mixed clinical sample of 234 adults referred for neuropsychological assessment, the Borderline range was significantly different from both Pass (i.e., stronger evidence of non-credible responding) and Fail (i.e., weaker evidence of non-credible responding). These findings are consistent with the results of previous (Erdodi & Rai, 2017;Erdodi, Sagar, et al., 2018;Erdodi, Seke, et al., 2017) and subsequent Cutler et al., 2021;Dunn et al., 2021;Erdodi, Hurtubise, et al., 2020) investigations. ...
Article
Full-text available
This study was designed to examine the classification accuracy of the Erdodi Index (EI-5), a novel method for aggregating validity indicators that takes into account both the number and extent of performance validity test (PVT) failures. Archival data were collected from a mixed clinical/forensic sample of 452 adults referred for neuropsychological assessment. The classification accuracy of the EI-5 was evaluated against established free-standing PVTs. The EI-5 achieved a good combination of sensitivity (.65) and specificity (.97), correctly classifying 92% of the sample. Its classification accuracy was comparable to that of another free-standing PVT. An indeterminate range between Pass and Fail emerged as a legitimate third outcome of performance validity assessment, indicating that the underlying construct is an inherently continuous variable. Results support the use of the EI-model as a practical and psychometrically sound method of aggregating multiple embedded PVTs into a single-number summary of performance validity. Combining free-standing PVTs with the EI-5 resulted in a better separation between credible and non-credible profiles, demonstrating incremental validity. Findings are consistent with recent endorsements of a three-way outcome for PVTs (Pass, Borderline and Fail).
... In the Stroop test [31,32] (duration: 2 min), the words "RED" or "GREEN" appeared in the central area of the screen, randomly shown in red or green. The participants were asked to press the "Z" button when the color of the word was red, and to press the "/" button when the color of the word was green, regardless of the meaning of the words. ...
Article
Full-text available
Fifteen participants were exposed in an enclosed environmental chamber to investigate the effects of elevated carbon dioxide (CO2) concentration on their cognitive abilities. Three CO2 conditions (1500, 3500, and 5000 ppm) were achieved by constant air supply and additional ultrapure CO2. All participants received the same exposure under each condition, during which they performed six cognitive tests evaluating human perception, attention, short-term working memory, risky decision-making, and executive ability. Generalized additive mixed effects model (GAMM) results showed no statistically significant differences in performance on the reaction time (RT) tests, the speed perception test, and the 2-back test. This suggests that elevated CO2 concentrations below 5000 ppm did not affect participants’ perception and short-term working memory. However, a significant increase in response time was observed in the visual search (VS) test, the balloon simulation risk test (BART), and the Stroop test at 5000 ppm compared to lower exposure concentrations. The slower responses reflected the detrimental effects of elevated CO2 concentrations on visual attention, risky decision-making, and executive ability. The findings suggest that the control level of CO2 concentrations should be tighter in enclosed workplaces where rapid response and operational safety are required.
... Of note, embedded validity indicators have also been derived from and validated using other Stroop paradigms, including the Comalli version(Arentsen et al., 2013) and Delis-Kaplan Executive Function System Color-Word Interference(Eglit et al., 2020;Erdodi et al., 2018), but these will not be reviewed here given the focus of our article is the traditional SCWT. 2 KHAN ET AL. ...
Article
This study investigated the utility of four Stroop Color and Word Test (SCWT) indices, including the raw score and T score for the word reading (WR) and color naming (CN) trials, as embedded performance validity tests (PVTs) within a sample referred for evaluation of suspected or known attention-deficit/hyperactivity disorder (ADHD). Data were analyzed from a final sample of 317 patients consecutively referred for ADHD evaluation, which was divided into groups with invalid (n = 43; 14%) and valid neuropsychological test performance (n = 274; 86%). A subset of the valid group with confirmed ADHD diagnoses (n = 226; 71%) were also analyzed separately. Classification accuracy for the overall valid sample was in the acceptable range (AUCs = .757-.794), with optimal cut scores of WR raw ≤75 (54% sensitivity/90% specificity), WR T score ≤ 28 (54% sensitivity/88% specificity), CN raw ≤57 (42% sensitivity/90% specificity), and CN T score ≤ 30 (40% sensitivity/90% specificity). Classification accuracy was also in the acceptable range for the ADHD-confirmed subgroup (AUCs = .750-.790), with optimal cut scores of WR Raw ≤ 75 (54% sensitivity/89% specificity), WR T score ≤ 28 (54% sensitivity/87% specificity), CN Raw ≤ 57 (42% sensitivity/90% specificity), and CN T score ≤ 30 (40% sensitivity/90% specificity). These findings indicate that embedded PVTs derived from the SCWT, particularly those derived from the WR trial, are effective measures for determining validity status in samples with suspected or confirmed ADHD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... The Stroop task is one of the most favorable neuropsychological tests to investigate the cognitive impairments in attention and inhibition control. 31,[60][61][62] The behavioral results in this paper confirm the claim that both the reaction times and accuracy rates are statistically different between healthy controls and patients with neuropsychiatric diseases as seen in Tables 3 and 4 and in Figs. 4(a)-4(d). ...
... In fact the classification accuracy of this metric between healthy controls and diseased subjects was 76.25% as seen in Fig. 8(a). In a study by Erdodi et al., 60 classification accuracy of inverted Stroop test metrics between healthy controls and patients that were clinically referred for neuropsychological assessment were found to be less sensitive (14% to 25%), but comparably specific (85% to 90%) while the findings in this study were contradictory with very high sensitivity (100%) but less specificity (77.6%) for this metric. Certainly there are many differences especially in the choice of subject groups, the Stroop test employed and the parameters used in the analysis of that study and this one, but it is evident that the behavioral parameters alone cannot yield high accuracies in classification for neuropsychological assessment. ...
Article
Significance: Clinical use of fNIRS-derived features has always suffered low sensitivity and specificity due to signal contamination from background systemic physiological fluctuations. We provide an algorithm to extract cognition-related features by eliminating the effect of background signal contamination, hence improving the classification accuracy. Aim: The aim in this study is to investigate the classification accuracy of an fNIRS-derived biomarker based on global efficiency (GE). To this end, fNIRS data were collected during a computerized Stroop task from healthy controls and patients with migraine, obsessive compulsive disorder, and schizophrenia. Approach: Functional connectivity (FC) maps were computed from [HbO] time series data for neutral (N), congruent (C), and incongruent (I) stimuli using the partial correlation approach. Reconstruction of FC matrices with optimal choice of principal components yielded two independent networks: cognitive mode network (CM) and default mode network (DM). Results: GE values computed for each FC matrix after applying principal component analysis (PCA) yielded strong statistical significance leading to a higher specificity and accuracy. A new index, neurocognitive ratio (NCR), was computed by multiplying the cognitive quotients (CQ) and ratio of GE of CM to GE of DM. When mean values of NCR ( N C R ¯ ) over all stimuli were computed, they showed high sensitivity (100%), specificity (95.5%), and accuracy (96.3%) for all subjects groups. Conclusions: N C R ¯ can reliable be used as a biomarker to improve the classification of healthy to neuropsychiatric patients.
... The stimuli for each condition were displayed on a 15-inch laptop screen, and the test length was approximately 8 to 10 min. The validity and reliability of the Stroop test has been extensively reported (Scarpina and Tagini, 2017;Erdodi et al., 2018). The Stroop test was chosen for the present study based on past evidence that it is both sensitive to the effects of exercise and provides a reliable measure of EF for healthy middle-aged adults (Chang and Etnier, 2009a). ...
Article
Full-text available
Sustained Effects of Acute Resistance Exercise on Executive Function in Healthy Middle-aged Adults The present study examined the sustained effects of acute resistance exercise on inhibitory function in healthy middle-aged adults. Seventy healthy middle-aged adults (mean age = 46.98 ± 5.70 years) were randomly assigned to exercise or control groups, and the Stroop test was administered before, immediately after, and 40 min after exercise. The resistance exercise protocol involved two sets of seven exercises performed for a maximum of 10 repetitions, with 60 s between sets and exercises. Acute resistance exercise resulted in higher Stroop test performance under the incongruent (inhibition) and interference conditions immediately post-exercise and 40 min post-exercise. Furthermore, the difference in scores after 40 min was significant. The findings indicate that a moderately-intensive acute resistance exercise could facilitate Stroop performance and has a more beneficial effect on sustaining of cognition that involves executive control at least 40 minutes. Keywords: inhibitory control; executive function; resistance exercise; sustained effect; middle age
... The main scoring variables are reading interference (the different reaction times between the reading interference condition and reading baseline) and naming interference (the difference in reaction times between the color naming interference condition and the color naming baseline). The validly and reliability of the Stroop test has been extensively reported in previous studies (Erdodi et al. 2018;Taheri et al. 2019b). ...
Article
Several studies report sleep deprivation negatively impacts post-cognitive and physical performance, and other functions. Recent findings indicate ingestion of melatonin prior to exercise enhances tolerance to training and improves competition. We investigated the effects of melatonin supplementation on psychomotor performance and selected physical fitness measures of collegiate student-athletes following 4 h and 24 h of sleep deprivation. The study employed a repeated-measures, double-blind, randomized controlled protocol with posttest control group design with six conditions [3 sleep conditions (without sleep deprivation, 4 h sleep deprivation (4SD) and 24 h sleep deprivation (24SD)) × 2 supplementation conditions (melatonin and placebo)]. Ten trained male collegiate student-athletes (mean ± SD; age: 20 ± 2 y) attended the laboratory on six occasions with 72 h between successive visits. Placebo or 6 mg of melatonin were administered orally in capsules 30 min before the tests of: static and dynamic balance, reaction time, and anaerobic power. Also, blood lactate was measured before and 3 min after the anaerobic power exercise. During the placebo session, the results indicated that 4SD and 24SD had negative effect on the measured parameters, with higher impacts of the 24SD condition. Compared to placebo and during both 4SD and 24SD conditions, melatonin had a positive effect on static and dynamic balance, anaerobic power, blood lactic acid, and reaction time (p < .05). However, 6 mg melatonin ingestion had no significant effect on all dependent variables in collegiate student-athletes after the night without a sleep deprivation (p > .05). In conclusion, 6 mg of melatonin may be used by student-athletes to improve balance and psychomotor and physical performances after 4 h or 24 h of sleep deprivation.
... Overall, a cutoff of 18 on the sum of age-corrected scaled scores on all four conditions exhibited the strongest classification accuracy. In contrast, previously proposed cutoffs (Erdodi et al., 2018) produced unacceptable false-positive rates within the TBI sample and generally a high rate of potential false positives in the normative age and clinical groups. Conclusion: Scoring 18 on the sum of all conditions on the CWIT appears to be an optimal cutoff for performance invalidity detection in non-demented samples. ...
... Recently, Erdodi et al. explored measures of performance validity within the D-KEFS CWIT (Erdodi et al., 2018). Erdodi et al.'s sample consisted of examinees with primary diagnoses of psychiatric, traumatic brain injury (TBI), neurological, or medical conditions. ...
... These new indices all relied on age-corrected timed scaled scores and were: (1) Color Naming þ Word Reading; (2) Inhibition þ Inhibition/ Switching; and (3) Color Naming þ Word Reading þ Inhibition þ Inhibition/Switching. The second set of measures consisted of indices previously proposed by Erdodi et al. (2018). These measures were age corrected timed scaled scores on individual trials of the CWIT (i.e., Color Naming, Word Reading, Inhibition, and Inhibition/Switching), and the inverted Stroop index. ...
Article
Full-text available
Objective: The D-KEFS Color Word Interference Test (CWIT) is among the most commonly administered measures of verbally mediated processing speed and executive functioning. Previous research suggests that this test may also be sensitive to performance invalidity. We sought to develop new embedded measures of performance invalidity based on multi-condition performance on the CWIT and to evaluate previously proposed embedded measures for performance invalidity on this test. Method: Newly developed and previously proposed embedded measures were evaluated in three samples: a traumatic brain injury (TBI) sample (N = 224) classified into psychometrically-defined performance-valid and performance-invalid subgroups; the D-KEFS normative sample (N = 1,735); and a Parkinson's disease sample (N = 166). To explore the resilience of CWIT cutoffs to the effects of age and neurocognitive impairment, the D-KEFS normative sample was stratified into age groups of 8-19, 20-69, and 70-89 and the Parkinson's disease sample into normal cognition, mild cognitive impairment, and dementia groups. Results: Our newly developed embedded measures derived from within the TBI sample were largely resilient to the effects of age and neurocognitive impairment other than dementia. Overall, a cutoff of ≤18 on the sum of age-corrected scaled scores on all four conditions exhibited the strongest classification accuracy. In contrast, previously proposed cutoffs (Erdodi et al., 2018 ) produced unacceptable false-positive rates within the TBI sample and generally a high rate of potential false positives in the normative age and clinical groups. Conclusion: Scoring ≤18 on the sum of all conditions on the CWIT appears to be an optimal cutoff for performance invalidity detection in non-demented samples.