Bradley Axelrod

U.S. Department of Veterans Affairs | VA · Mental Health Services

Introduction Cognitive impairment in older Veterans is an independent predictor of subsequent mortality and disability. Pilot data indicate that patients with OSA-COPD Overlap Syndrome (OVS) have reduced sleep quality and quality of life (QoL). However, there are no prior systematic studies evaluating treatment paradigms in patients with OVS. Our o...

Introduction “Post-acute sequelae of SARS-COV-2 infection (PASC)” is a condition with a wide range of physical and mental health consequences that are present or persist four or more weeks after SARS-COV-2 infection. Fatigue is one of the most common PASC symptoms. It is not known whether underlying OSA and sleep disturbances may influence the pers...

Previous research on the rates of juvenile re‐offending have been found to be as high as 66% when measuring recidivism by rearrest and as high as 33% when measuring re‐offending by reconvictions within one to three years of release. However, accurately estimating a national juvenile recidivism rate is problematic. This is even more complicated when...

Introduction Cognitive impairment in older Veterans is an independent predictor of subsequent mortality and disability. Pilot data indicate that patients with OSA-COPD Overlap Syndrome (OVS) may have reduced sleep quality, cognitive function and quality of life (QoL). However, there are no prior systematic studies evaluating treatment paradigms in...

Introduction OSA coexisting with COPD, also known as “Overlap Syndrome” (OVS), occurs in 14% of the general adult population and is associated with grave consequences, including increased cardiovascular events, mortality and hospital admissions. However, the effect of OVS on neurocognitive function, exercise tolerance and quality of life (QoL) is n...

Aims: In neuropsychological evaluations, it is often difficult to ascertain whether poor performance on measures of validity is due to poor effort or malingering, or whether there is genuine cognitive impairment. Dunham and Denney [1] created an algorithm to assess this question using the Medical Symptom Validity Test (MSVT). We assessed the abilit...

Objective: Latent Class Analysis (LCA) was used to classify a heterogeneous sample of neuropsychology data. In particular, we used measures of performance validity, symptom validity, cognition, and emotional functioning to assess and describe latent groups of functioning in these areas. Method: A data-set of 680 neuropsychological evaluation pro...

Objective: The influence of demographic variables on the Trail Making Test (TMT) performance in older individuals and empirical findings on clinical validity in predementia states, such as Parkinson's disease mild cognitive impairment (PD-MCI), are limited. The principal aim of this study was to add normative data for the Czech population of older...

Introduction OSA coexisting with Chronic Obstructive Pulmonary Disease (COPD), also known as the “Overlap Syndrome”, is estimated to occur in 14% of the general adult population. Whether patients with Overlap Syndrome suffer from worse clinical outcomes is not known. We investigated the associations between clinical and neurocognitive outcomes in b...

Objective: The present study evaluated strategies used by healthy adults coached to simulate traumatic brain injury (TBI) during neuropsychological evaluation. Method: Healthy adults (n = 58) were coached to simulate TBI while completing a test battery consisting of multiple performance validity tests (PVTs), neuropsychological tests, a self-rep...

Objective: This study explored the utility of combining data from measures of performance validity and symptom validity among Veterans undergoing neuropsychological evaluation for mild traumatic brain injury (mTBI). Background: Persistent cognitive impairments following mTBI are often reported by returning combat veterans. However, objectively-m...

The aim of this study was to test whether a Czech version of the Trail Making Test (TMT) yields normative data scores that approximate those based on English (North American) and Spanish normative samples. In all samples, TMT Parts A and B were administered according to the guidelines. Completion times for healthy adults from the Czech Republic (n...

Introduction: The Mild Brain Injury Atypical Symptoms (mBIAS) scale was developed as a symptom validity test (SVT) for use with patients following mild traumatic brain injury. This study was the first to examine the clinical utility of the mBIAS in a mixed clinical sample presenting to a Department of Veterans Affairs (VA) neuropsychology clinic....

The purpose of the current study was to compare three potential profiles of the Medical Symptom Validity Test (MSVT; Pass, Genuine Memory Impairment Profile [GMIP], and Fail) on other freestanding and embedded performance validity tests (PVTs). Notably, a quantitatively computed version of the GMIP was utilized in this investigation. Data obtained...

The aim of this study was to provide normative data for older and very old Czech adults on the Prague Stroop Test (PST) and to test its discriminative validity in individuals with Parkinson's disease mild cognitive impairment (PD-MCI). The construction of the PST was modeled after the Victoria Stroop Test. We examined 539 participants aged 60-96 th...

The purpose of this study was to determine how well scores from the Rey Complex Figure Test (RCFT) could serve as embedded measures of performance validity in a large, heterogeneous clinical sample at an urban-based Veterans' Affairs hospital. Participants were divided into credible performance (n = 244) and noncredible performance (n = 87) groups...

Researchers who have been responsible for developing test batteries have argued that competent practice requires the use of a “fixed battery” that is co-normed. We tested this assumption with three normative systems: co-normed (Heaton et al., 2004), meta-regressed norms (Mitrushina et al., 2005), and a hybrid of the two systems (Meyers, 2007). We a...

Performance validity testing (PVT) is a standard of practice in situations where there are prominent secondary gain issues; however, it is suggested that their use may benefit neuropsychological evaluations in clinical contexts, as engagement in neuropsychological evaluations can affect the validity of testing and can occur for a variety of reasons...

Effort assessment is a relevant area in neuropsychological assessment. There are well-established self-report measures, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) FBS Symptom Validity Scale (FBS; Lees-Haley, English & Glenn, Psychological Reports 68: 203-210, 1991) and MMPI-2 Response Bias Scale (RBS; Gervais, Ben-Porath, Wy...

ABSTRACT The present study provides normative data stratified by age for the Rey Auditory Verbal Learning test Czech version (RAVLT) derived from a sample of 306 cognitively normal subjects (20-85 years). Participants met strict inclusion criteria (absence of any active or past neurological or psychiatric disorder) and performed within normal limit...

All possible two-subtest combinations of the core Wechsler Adult Intelligence Scale-IV (WAIS-IV) subtests were evaluated as possible viable short forms for estimating full-scale IQ (FSIQ). Validity of the dyads was evaluated relative to FSIQ in a large clinical sample (N = 482) referred for neuropsychological assessment. Sample validity measures in...

Objective: Assessment of response validity is an integral part of forensic neuropsychological evaluations. The utility of performance validity measures (PVMs) in patients with potentially impaired cognitive functioning is less studied. The purpose of the current study was to compare the three potential profiles of the Medical Symptom Validity Test...

Objective: To determine whether scores from 2 commonly used cognitive screening tests can help predict general intellectual functioning in older adults. Background: Cutoff scores for determining cognitive impairment have been validated for both the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). However, less i...

Assessment of the validity of neuropsychological test data has become an ensconced aspect of the assessment process. Among the more popular free-standing performance validity measures (PVMs) is the Test of Memory Malingering (Tombaugh 1996). Given the popularity of this measure, a number of researchers (i.e., Trial 1 (Denning, 2012); TOMMe10 (Denni...

The objective of this study was to determine to what extent verbal fluency measures can be used as performance validity indicators during neuropsychological evaluation. Participants were clinically referred for neuropsychological evaluation in an urban-based Veteran's Affairs hospital. Participants were placed into 2 groups based on their objective...

A number of performance validity tests (PVTs) are used to assess memory complaints associated with traumatic brain injury (TBI); however, few studies examine the concordance and predictive accuracy of multiple PVTs, specifically in the context of combined models in known-group designs. The present study compared five widely used PVTs: the Test of M...

The Finger Tapping Test (FTT) has been presented as an embedded measure of performance validity in most standard neuropsychological evaluations. The present study evaluated the utility of three different scoring systems intended to detect invalid performance based on FTT. The scoring systems were evaluated in neuropsychology cases from clinical and...

Reliable Digit Span (RDS) is a measure of effort derived from the Digit Span subtest of the Wechsler intelligence scales. Some authors have suggested that the age-corrected scaled score provides a more accurate measure of effort than RDS. This study examined the relative diagnostic accuracy of the traditional RDS, an extended RDS including the new...

The current study aimed to clarify the relationship among the constructs involved in neuropsychological assessment, including cognitive performance, symptom self-report, performance validity, and symptom validity. Participants consisted of 120 consecutively evaluated individuals from a veteran's hospital with mixed referral sources. Measures includ...

This study examined embedded performance validity indicators (PVI) based on the number of impaired scores in an evaluation and the overall test battery mean (OTBM). Adult participants (N = 175) reporting traumatic brain injury were grouped using eight PVI. Participants who passed all PVI (n = 67) demonstrated fewer impaired scores and higher OTBM t...

The degree to which patients should be prompted to give their best effort has not been adequately addressed in the literature, nor has the issue of the extent to which they should be informed that measures of effort will be included in the assessment battery. Three groups of undergraduates were given three different instructional sets prior to comp...

The Montreal Cognitive Assessment (MoCA) is a brief yet comprehensive cognitive instrument used to assess level of impairment in neurological populations. The purpose of the present study was to assess the ability of the MoCA to detect cognitive impairment in a veteran patient population referred for neuropsychological testing and to determine opti...

This study derived an embedded performance validity indicator for the Rey Auditory Verbal Learning Test (AVLT) using an archival dataset. Participants aged 20 to 65 (N = 167) who reported traumatic brain injury and completed at least two performance validity tests were included. The group who passed all performance validity measures (n = 68) demons...

The Trail Making Test (TMT) comprises two psychomotor tasks that measure a wide range of visual-perceptual and executive functions. The purpose of this study was to provide Czech normative data and to examine the relationship between derived TMT indices and demographic variables. The TMT was administered to 421 healthy adults. Two clinical groups (...

Objective: Presentation of an unusual case of amnesic syndrome following a suspected AVM. The subject was a 14-year-old female (N) who suffered a large right temporo-parietal intra-parenchymal hemorrhage with extension into the ventricular system requiring surgical evacuation. She presented with a significant anterograde amnesic disorder that was g...

The Postconcussive Symptom Questionnaire (PCSQ; Lees-Haley, 199217. Lees-Haley , PR . 1992. Neuropsychological complaint base rates of personal injury claimants. Forensic Reports, 5(4): 385–391. View all references) is purported to measure four constructs. These include psychological, cognitive, somatic, and infrequency (i.e., items intended to re...

This study examined the relationship of performance validity and neuropsychological outcomes in a sample of individuals referred for independent neuropsychological examination in the context of reported traumatic brain injury (82% mild). Archival data were examined on 175 participants aged 20 to 65 who were administered at least two performance val...

Most colorectal tumors develop from adenomatous polyps, which are detected by colonoscopy. African Americans (AAs) have higher incidence of colorectal cancer (CRC) and greater mortality from this disease than Caucasian Americans (CAs). We investigated whether differences in predisposition to CRC and its surrogate (colonic adenomas) between these et...

Two common measures used to evaluate verbal learning and memory are the Verbal Paired Associates (VPA) subtest from the Wechsler Memory Scales (WMS) and the second edition of the California Verbal Learning Test (CVLT-II). For the fourth edition of the WMS, scores from the CVLT-II can be substituted for VPA; the present study sought to examine the v...

Research on previous versions of the Wechsler Memory Scale (WMS) found that index scores could be predicted using a parsimonious selection of subtests (e.g., Axelrod & Woodard, 20001. Axelrod , B. N. and Woodard , J. L. 2000. Parsimonious prediction of Wechsler Memory Scale–III memory indices. Psychological Assessment, 12: 431–435. [CrossRef], [W...

The recent release of the Wechsler Memory Scale Fourth Edition contains many improvements from a theoretical and administration perspective, including demographic corrections using the Advanced Clinical Solutions. Although the administration time has been reduced from previous versions, a shortened version may be desirable in certain situations giv...

Picture Completion (PC) indices from the Wechsler Adult Intelligence Scale, Third Edition, were investigated as performance validity indicators (PVIs) in a sample referred for independent neuropsychological examination. Participants from an archival database were included in the study if they were between the ages of 18 and 65 and were administered...

Objective: The seminal paper on cerebellar cognitive affective syndrome by Schmahmann and Sherman (1998), and subsequent studies, has expanded our understanding of the role of the cerebellum beyond motor functioning to psychological and cognitive functioning. However, many of these studies have examined patients between 1 week and 5 years post-inju...

Assessment of effort on cognitive testing has become a suggested standard in both forensic and clinical neuropsychological assessment. Both stand-alone and empirically derived embedded measures have been developed, however guidelines for combining several measures are not always available. This study used logistic regression analysis to derive a mu...

The current study examines the differences in neuropsychological test performance between individuals who were referred for evaluation by either plaintiff or defense attorneys. Comparisons were made using a standardized battery of tests, with the same tests being administered to both groups of individuals along with the MMPI-2. The results of the s...

Forced-choice measures of recognition memory are used to assess the validity of an evaluation by using cutoff scores that discriminate individuals demonstrating good effort from those who are intentionally performing suboptimally. The current study evaluated three measures of motivation in a clinical sample of over 150 individuals. The Forced-Choic...

A sample of 314 consecutive clinical and forensic referrals with mild traumatic brain injury was evaluated using the Meyers Neuropsychological Battery (MNB). A comparison was made of the test performance and performance on the embedded Symptom Validity Tests (SVTs) with a control for multicolinearity utilized. Using the nine embedded SVTs in the MN...

Unique Application of Neuropsychology to Active Duty Service Members and Veterans - Military Neuropsychology. KennedyCarrie H. and MooreJeffrey L. (Eds.). (2010). New York: Springer Publishing Company, 432 pp., $85.00 HB. - Volume 17 Issue 1 - Bradley N. Axelrod