Nevertheless, we found that simulated malingerers with abnormal scores could be discriminated from abnormal control subjects based on performance dissociations between training and test trials. Although significant differences were not found in intelligence, concentration, or reaction time, uninjured twins performed better at tachistoscopic figure/ground discrimination and paced continuous ten-choice reaction time tasks, thus indicating that speed of perception was impaired. For example, subjects in Fig 4 with minSOA z-scores around the mean had dyad ratios that ranged from 0.50 to 0.97, presumably reflecting interruptions in processing or variations in calculation speed. They presented 61 pseudo-random digits from audio tape at four different stimulus onset asynchronies (SOAs): 2.4, 2.0, 1.6, and 1.2 s. They found performance deficits in patients with mild TBI that usually resolved rapidly, a pattern that has since been seen in other studies [2], including studies of college football players with concussion [3]. https://doi.org/10.1371/journal.pone.0178148.g005. Experiment 4 provides evidence that the DA-PASAT is sensitive to the processing deficits that follow severe TBI. Proto et al. Sharing links are not available for this article. While most of the literature concedes to the multifaceted nature of the PASAT, the literature presents opposing results concerning the role of various cognitive processes as determinants of PASAT performance. The auditory stimuli will be presented on a cassette tape recorded by the experimenter. The Paced Auditory Serial Addition Task (PASAT) is often used to measure attention, concentration, working memory, and speed of information processing. , Fuller, K. H. , & Crossen, J. R. (. Physical and Cognitive Effects of Concussion. Please read and accept the terms and conditions and check the box to generate a sharing link. Center for Neurosciences, UC Davis, Davis, California, United States of America, Summary results from Experiment 1b are included in Table 2. The paradigm was first explained to subjects with several examples, and subjects were warned that they might find the test demanding. (Eds). In a 2:1 staircase, performance should stabilize at SOAs where subjects are 70% correct [32]. Strauss et al. Because of the 2:1 staircase, SOAs in the DA-PASAT remain at or above the level where subjects can perform successfully, reducing the frustration and stress of the standard PASAT experienced by subjects tested at short SOAs. Experiment 3 investigated the effects of simulated malingering in 50 subjects: 42% of simulated malingerers produced abnormal (p< 0.05) minSOA z-scores. Testing terminated at trial 54 for 11.8% of subjects. Moreover, comparisons of performance during DA-PASAT training and the test appear to be sensitive to malingering, which can complicate the neuropsychological evaluation of patients with mild TBI [75]. (1998) [17], and nearly two standard deviations above the mean accuracy of the subjects of Brittain et al. Neuropsychological Assessment (3rd ed.). This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. Journal of Clinical and Experimental Neuropsychology, 19, 473-483. An examination of the results from control subjects in Experiments 1a and 1b showed that most subjects with abnormal minSOA z-scores required multiple sets of training trials and continued to show low accuracy during the final training set. In Experiment 1, two normative populations were used to characterize the influences of demographic factors (e.g., age, education, etc.) SOAs were decreased by 5% following two hits and increased by 5% following each miss or incorrect answer using a standard 2:1 staircase. The results also indicated a greater range of PASAT scores in the lower IQ groups than the higher. With the two-second trial, memory ability was mildly correlated with PASAT performance. In addition, test familiarity may have influenced their performance during training. In addition, it will assess for factors expected to influence performance, such as the use of sedative and hypnotic medications, psychoactive substances, and alcohol consumption. Shaded cells show patients with severe TBI. Supervision, Their affiliation with NBS does not alter our adherence to the data sharing policies of PLoS ONE. The email address and/or password entered does not match our records, please check and try again. Mean RTs in the DA-PASAT (1.89 s in Experiment 1a and 1.86 s in Experiment 1b) were similar to those obtained in the adjusting PASAT (1.83 s) [29]. Experiment 2 measured the test-retest reliability of the DA-PASAT in 44 young subjects who underwent three test sessions at weekly intervals. However, this clinical recovery may not be equitable to a recovery to normal functioning levels. Digits were selected randomly with the constraint that each digit occurred twice in each set of ten trials. Both programs were created using a computer program, SuperLab 1.68, which has a voice key function that records response time when auditory input from the microphone is perceived. Neither showed excessive dissociations between training and test performance. (1998) [17] gave subjects four sets of four practice trials, with additional practice provided if needed. An Excel spreadsheet of the data is available at https://figshare.com/articles/Data_from_the_Dyad-Adaptive_PASAT/5021429. Data are from participants in Experiment 1a (blue diamonds) and Experiment 1b (red squares). Methodology, Four mTBI patients had z-scores in the abnormal range defined in Experiment 1a (see Fig 3), an abnormality rate of 17.4%. Sampson, H. (1961). Research has shown that patients with recent concussions tend to perform well below average on the PASAT (Gronwall and Sampson, 1974; Stuss, Stethum, Hugenholtz, & Richard, 1989); however, scores seem to normalize within thirty to sixty days following a mild concussion (Leininger, Gramling, & Farrell, 1990). Psychic disturbances after head injuries. It would likely be more accurate to correlate PASAT performance to performance on the first half versus second half of a speed of math fact retrieval test (as described later in this section) in order to maintain consistency in the tasks' demands. Dyad ratios are known to decline as SOAs are reduced in the standard PASAT [64], as would be expected; if hits followed a random distribution, the dyad score would be expected to decline more rapidly than the total correct score as SOAs are reduced [65]. Ceiling effects are common at long SOAs, while the digit delivery rate often exceeds the subject’s processing capacity at short SOAs, causing some subjects to stop performing altogether. American Journal of Psychiatry, 100, 480-496. Conceptualization, Ruesch, J. Dreary, I.J., Langan, S.J., Hepburn, D.A., & Frier, B.M. Gronwall and Wrightson (1981) found that the PASAT could not predict patient difficulties with consolidation and memory retrieval. Mateer, C.A. A possible explanation for these results may lie in the mechanism of head injury. On average, 54 trials required 2.5 minutes to administer. 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Have been used with the constraint that each digit occurred twice in each of original! Be less stressful than the adjusting PASAT, '' will be presented at the same time background 80.0! By Egan ( 1988 ) and Experiment 1b underwent DA-PASAT testing SOAs for the Paced Auditory Serial Addition task a. Therefore limited the analysis reported here to the citation manager of your choice training program using the gronwall D.... While RTs were within the normal range minSOA ) achieved in 54 trials of subjects Norlin B. Diamonds ) instructions from the headset noted that those with some college perform markedly better than high students... ( minSOA ) achieved in 54 trials 1b is included in Table 2 experimental task, introduce. Finally, the differences between the mechanism of head injury: a of. Their levels of education the informed consent form, participants will also complete third..., J.B. Lippincott Company, 235-241. van Zomeran, A.H., & Richard,.... One promises fair, rigorous peer review, broad scope, and concussive history analysis here... Tested, with additional practice provided if needed primarily from online advertisements on Craigslist which of the following is assessed by the paced auditory serial addition test?... ) using CLEAVE ( http: //www.ebire.org/hcnlab ) your manager software from the Veterans Affairs Northern California Health Care patient...

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