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Article ; Online: Clinical utility of the Saint Louis University Mental Status Examination (SLUMS) in a mixed neurological sample: Proposed revised cutoff scores for normal cognition, mild cognitive impairment, and dementia.

Merz, Zachary C / Lace, John W

2022 , Page(s) 1–8

Abstract: Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University ... ...

Abstract	Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (
Language	English
Publishing date	2022-08-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2673736-X
ISSN	2327-9109 ; 2327-9095
ISSN (online)	2327-9109
ISSN	2327-9095
DOI	10.1080/23279095.2022.2106572
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Article ; Online: High elevation rates of the Structured Inventory of Malingered Symptomatology (SIMS) in neuropsychological patients.

Harris, Matthew / Merz, Zachary C

Applied neuropsychology. Adult

2021 Volume 29, Issue 6, Page(s) 1344–1351

Abstract: The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified ...

Abstract	The current study examined characteristics of the Structured Inventory of Malingered Symptomatology (SIMS) in a sample of 110 patients at an adult neuropsychology clinic. Subjects with especially high or low suspicion of invalid reporting were identified based on clinician-completed questions. SIMS elevation rates were examined at different cutoffs and between these groups and were correlated with other indicators of validity. High rates of SIMS elevations were found at the standard cutoff (>14) for the total sample (45.5%), low suspicion cases (24.4%), and high suspicion cases (95.7%). Other indicators of invalidity were low (secondary gain = 8.5%, clinical suspicion of exaggeration in interview M = 2.37/5, medical records concerning for invalidity = 2.4%, mixed/poor performance validity = 6.1%). Elevations correlated with clinician concern for over-reporting in interview, subject-reported cognitive concern (
MeSH term(s)	Adult ; Humans ; Malingering/diagnosis ; Malingering/psychology ; Neuropsychological Tests ; Reproducibility of Results
Language	English
Publishing date	2021-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2673736-X
ISSN	2327-9109 ; 2327-9095
ISSN (online)	2327-9109
ISSN	2327-9095
DOI	10.1080/23279095.2021.1875227
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Article ; Online: High-School Football and Midlife Brain Health Problems.

Iverson, Grant L / Merz, Zachary C / Terry, Douglas P

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2022 Volume 32, Issue 2, Page(s) 86–94

Abstract: Objective: To examine whether middle-aged men who played high-school football experience worse mental health or cognitive functioning than men who did not play high-school football.: Design: Cross-sectional cohort study.: Setting: Online survey ... ...

Abstract	Objective: To examine whether middle-aged men who played high-school football experience worse mental health or cognitive functioning than men who did not play high-school football. Design: Cross-sectional cohort study. Setting: Online survey completed remotely. Participants: A total of 435 men between the ages of 35 and 55 completed the study, of whom 407 were included in the analyses after excluding participants who answered embedded validity items incorrectly (n = 16), played semiprofessional football (n = 2), or experienced a recent concussion (n = 10). Assessment of risk factors: Self-reported high school football participation, compared with those who played contact sports, noncontact sports, and no sports. Main outcome measures: A lifetime history of depression or anxiety; mental health or cognitive problems in the past year; current depression symptoms, and post-concussion-like symptoms. Results: Middle-aged men who played high-school football did not have a higher prevalence of being prescribed medication for anxiety or depression or receiving treatment from a mental health professional. Similarly, there were no significant differences between groups on the rates in which they endorsed depression, anxiety, anger, concentration problems, memory problems, headaches, migraines, neck or back pain, or chronic pain over the past year. A greater proportion of those who played football reported sleep problems over the past year and reported being prescribed medication for chronic pain and for headaches. Conclusions: Men who played high-school football did not report worse brain health compared with those who played other contact sports, noncontact sports, or did not participate in sports during high school.
MeSH term(s)	Adult ; Athletic Injuries/epidemiology ; Brain ; Brain Concussion/diagnosis ; Chronic Pain ; Cross-Sectional Studies ; Female ; Football ; Headache ; Humans ; Male ; Middle Aged ; Schools
Language	English
Publishing date	2022-01-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000000898
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Article: Examining the Research Criteria for Traumatic Encephalopathy Syndrome in Middle-Aged Men From the General Population Who Played Contact Sports in High School.

Iverson, Grant L / Merz, Zachary C / Terry, Douglas P

Frontiers in neurology

2021 Volume 12, Page(s) 632618

Abstract: Objective: ...

Abstract	Objective:
Language	English
Publishing date	2021-04-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2021.632618
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Article ; Online: DSM-5 Level 1 cross-cutting measure in an online sample: evaluating its latent dimensionality and utility detecting nonspecific psychological distress.

Lace, John W / Merz, Zachary C

Psychiatry research

2020 Volume 294, Page(s) 113529

Abstract: Included in the most recent Diagnostic and Statistical Manual of Mental Disorders is the Level 1 Cross-Cutting Symptom Measure (CCSM), a self-report checklist with 23 items assessing 13 major psychiatric symptom clusters. To date, minimal literature has ... ...

Abstract	Included in the most recent Diagnostic and Statistical Manual of Mental Disorders is the Level 1 Cross-Cutting Symptom Measure (CCSM), a self-report checklist with 23 items assessing 13 major psychiatric symptom clusters. To date, minimal literature has examined the factor structure of the CCSM and its utility identifying significant psychological distress, and existing studies pose notable limitations. Four hundred (400) American adults (M age = 34.13; 50.2% female) participated online via Amazon Mechanical Turk as part of a larger study, which included the CCSM. The sample was randomly split to conduct exploratory and confirmatory factor analyses (EFAs and CFAs). EFAs revealed structures with one (general psychopathology) and two (externalizing/serious mental illness and internalizing/affective) factors accounting for 67.3% and 73.7% of the variance, respectively. CFAs indicated good fit for both models, though statistical comparison of the models via χ
MeSH term(s)	Adolescent ; Adult ; Aged ; Checklist/methods ; Diagnosis, Computer-Assisted/methods ; Diagnosis, Computer-Assisted/psychology ; Diagnostic and Statistical Manual of Mental Disorders ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Mental Disorders/diagnosis ; Mental Disorders/psychology ; Middle Aged ; Models, Psychological ; Psychological Distress ; Self Report ; Young Adult
Language	English
Publishing date	2020-10-23
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	445361-x
ISSN	1872-7123 ; 1872-7506 ; 0925-4927 ; 0165-1781
ISSN (online)	1872-7123 ; 1872-7506
ISSN	0925-4927 ; 0165-1781
DOI	10.1016/j.psychres.2020.113529
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Zs.A 1541: Show issues

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Article: Examining the Clinical Utility of Selected Memory-Based Embedded Performance Validity Tests in Neuropsychological Assessment of Patients with Multiple Sclerosis.

Lace, John W / Merz, Zachary C / Galioto, Rachel

Neurology international

2021 Volume 13, Issue 4, Page(s) 477–486

Abstract: Within the neuropsychological assessment, clinicians are responsible for ensuring the validity of obtained cognitive data. As such, increased attention is being paid to performance validity in patients with multiple sclerosis (pwMS). Experts have ... ...

Abstract	Within the neuropsychological assessment, clinicians are responsible for ensuring the validity of obtained cognitive data. As such, increased attention is being paid to performance validity in patients with multiple sclerosis (pwMS). Experts have proposed batteries of neuropsychological tests for use in this population, though none contain recommendations for standalone performance validity tests (PVTs). The California Verbal Learning Test, Second Edition (CVLT-II) and Brief Visuospatial Memory Test, Revised (BVMT-R)-both of which are included in the aforementioned recommended neuropsychological batteries-include previously validated embedded PVTs (which offer some advantages, including expedience and reduced costs), with no prior work exploring their utility in pwMS. The purpose of the present study was to determine the potential clinical utility of embedded PVTs to detect the signal of non-credibility as operationally defined by below criterion standalone PVT performance. One hundred thirty-three (133) patients (
Language	English
Publishing date	2021-09-23
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2514727-4
ISSN	2035-8377 ; 2035-8385
ISSN (online)	2035-8377
ISSN	2035-8385
DOI	10.3390/neurolint13040047
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Article ; Online: Nonmemory Composite Embedded Performance Validity Formulas in Patients with Multiple Sclerosis.

Lace, John W / Merz, Zachary C / Galioto, Rachel

Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists

2021 Volume 37, Issue 2, Page(s) 309–321

Abstract: Objective: Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited ... ...

Abstract	Objective: Research regarding performance validity tests (PVTs) in patients with multiple sclerosis (MS) is scant, with recommended batteries for neuropsychological evaluations in this population lacking suggestions to include PVTs. Moreover, limited work has examined embedded PVTs in this population. As previous investigations indicated that nonmemory-based embedded PVTs provide clinical utility in other populations, this study sought to determine if a logistic regression-derived PVT formula can be identified from selected nonmemory variables in a sample of patients with MS. Method: A total of 184 patients (M age = 48.45; 76.6% female) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into "credible" (n = 146) or "noncredible" (n = 38) groups according to performance on standalone PVT. Missing data were imputed with HOTDECK. Results: Classification statistics for a variety of embedded PVTs were examined, with none appearing psychometrically appropriate in isolation (areas under the curve [AUCs] = .48-.64). Four exponentiated equations were created via logistic regression. Six, five, and three predictor equations yielded acceptable discriminability (AUC = .71-.74) with modest sensitivity (.34-.39) while maintaining good specificity (≥.90). The two predictor equation appeared unacceptable (AUC = .67). Conclusions: Results suggest that multivariate combinations of embedded PVTs may provide some clinical utility while minimizing test burden in determining performance validity in patients with MS. Nonetheless, the authors recommend routine inclusion of several PVTs and utilization of comprehensive clinical judgment to maximize signal detection of noncredible performance and avoid incorrect conclusions. Clinical implications, limitations, and avenues for future research are discussed.
MeSH term(s)	Area Under Curve ; Female ; Humans ; Male ; Middle Aged ; Multiple Sclerosis/complications ; Neuropsychological Tests ; Reproducibility of Results
Language	English
Publishing date	2021-08-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	632972-x
ISSN	1873-5843 ; 0887-6177
ISSN (online)	1873-5843
ISSN	0887-6177
DOI	10.1093/arclin/acab066
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Zs.B 2993: Show issues

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Article ; Online: Methodological considerations of assessing meaningful/reliable change in computerized neurocognitive testing following sport-related concussion.

Merz, Zachary C / Lichtenstein, Jonathan D / Lace, John W

Applied neuropsychology. Child

2021 Volume 11, Issue 4, Page(s) 725–733

Abstract: Objective: Traditional reliable change index (RCI) methods may be psychometrically limited due to their inability to account for particularly high or low baseline performance and regression to the mean following serial testing. The current study sought ... ...

Abstract	Objective: Traditional reliable change index (RCI) methods may be psychometrically limited due to their inability to account for particularly high or low baseline performance and regression to the mean following serial testing. The current study sought to examine differences between RCI and standardized regression-based (RBz) methods in a cohort of adolescent athletes engaged in sport-related concussion recovery. Methods: Consultation records and results of computerized testing data via the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery were retrospectively reviewed among 240 adolescent athletes involved in return-to-play protocols following a sport-related concussion. Results: High concordance rates were found between RCI and RBz metrics across ImPACT composites, consistent with previous literature. However, especially for those with lower baseline performance, RBz scores tended to suggest cognitive performance not meeting or exceeding baseline scores despite RCI metrics being appropriate across speed-based ImPACT composites. In contrast, results revealed high rates of RCI scores suggesting continued cognitive difficulties despite RBz metrics being within normal limits, especially for adolescents with Conclusions: Results suggest value in interpreting RBz values in addition to RCI values as these allow for clinical interpretation more sensitive to statistical confounds, including baseline performance and regression to the mean.
MeSH term(s)	Adolescent ; Athletes/psychology ; Athletic Injuries/complications ; Athletic Injuries/diagnosis ; Athletic Injuries/psychology ; Brain Concussion/complications ; Brain Concussion/diagnosis ; Brain Concussion/psychology ; Humans ; Neuropsychological Tests ; Retrospective Studies ; Sports
Language	English
Publishing date	2021-07-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2673759-0
ISSN	2162-2973 ; 2162-2965
ISSN (online)	2162-2973
ISSN	2162-2965
DOI	10.1080/21622965.2021.1952413
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Article ; Online: Playing High School Football Is Not Associated With an Increased Risk for Suicidality in Early Adulthood.

Iverson, Grant L / Merz, Zachary C / Terry, Douglas P

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2021 Volume 31, Issue 6, Page(s) 469–474

Abstract: Objective: To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years.: Design: Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort ... ...

Abstract	Objective: To determine if playing high school football is associated with suicide ideation between the ages of 24 and 32 years. Design: Data were analyzed from the National Longitudinal Study of Adolescent to Adult Health. This prospective cohort study sampled nationally representative US participants at 4 time points from 1994 to 2008. Setting: In-home assessment. Participants: There were 3147 boys (age: median = 14.9, SD = 1.8) who participated during adolescence in 1994 to 1995 (wave I), of whom 2353 were reinterviewed in 2008 (wave IV, age: median = 29.1, SD = 1.8). Assessment of risk factors: Football participation, history of psychological counseling, suicide ideation, and a suicide attempt in the past year during high school. Main outcome measures: Lifetime history of depression, suicide ideation within the past year, and feeling depressed in the past 7 days at wave IV. Results: Men who played high school football, compared with those who did not, reported similar rates of lifetime diagnosis of depression, suicide ideation in the past year, and feeling depressed in the past 7 days. Those who played football reported similar rates of suicide ideation in the past year when they were in their early 20s. Individuals who underwent psychological counseling during adolescence were more likely to report a lifetime history of depression and suicide ideation in the past year. Conclusions: Young men who played high school football are not at an increased risk for suicide ideation during both their early 20s and late 20s. By contrast, those who experienced mental health problems in high school were much more likely to experience suicide ideation during their 20s.
MeSH term(s)	Adolescent ; Adult ; Football ; Humans ; Longitudinal Studies ; Male ; Prospective Studies ; Risk Factors ; Schools ; Suicide ; Young Adult
Language	English
Publishing date	2021-10-08
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000000890
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Zs.A 3120: Show issues

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Article ; Online: Examining the Clinical Utility of Selected Memory-Based Embedded Performance Validity Tests in Neuropsychological Assessment of Patients with Multiple Sclerosis

John W. Lace / Zachary C. Merz / Rachel Galioto

Neurology International, Vol 13, Iss 47, Pp 477-

2021 Volume 486

Abstract	Within the neuropsychological assessment, clinicians are responsible for ensuring the validity of obtained cognitive data. As such, increased attention is being paid to performance validity in patients with multiple sclerosis (pwMS). Experts have proposed batteries of neuropsychological tests for use in this population, though none contain recommendations for standalone performance validity tests (PVTs). The California Verbal Learning Test, Second Edition (CVLT-II) and Brief Visuospatial Memory Test, Revised (BVMT-R)—both of which are included in the aforementioned recommended neuropsychological batteries—include previously validated embedded PVTs (which offer some advantages, including expedience and reduced costs), with no prior work exploring their utility in pwMS. The purpose of the present study was to determine the potential clinical utility of embedded PVTs to detect the signal of non-credibility as operationally defined by below criterion standalone PVT performance. One hundred thirty-three (133) patients ( M age = 48.28; 76.7% women; 85.0% White) with MS were referred for neuropsychological assessment at a large, Midwestern academic medical center. Patients were placed into “credible” ( n = 100) or “noncredible” ( n = 33) groups based on a standalone PVT criterion. Classification statistics for four CVLT-II and BVMT-R PVTs of interest in isolation were poor (AUCs = 0.58–0.62). Several arithmetic and logistic regression-derived multivariate formulas were calculated, all of which similarly demonstrated poor discriminability (AUCs = 0.61–0.64). Although embedded PVTs may arguably maximize efficiency and minimize test burden in pwMS, common ones in the CVLT-II and BVMT-R may not be psychometrically appropriate, sufficiently sensitive, nor substitutable for standalone PVTs in this population. Clinical neuropsychologists who evaluate such patients are encouraged to include standalone PVTs in their assessment batteries to ensure that clinical care conclusions drawn from neuropsychological data are valid.
Keywords	multiple sclerosis ; neuropsychological assessment ; noncredible performance ; embedded performance validity tests ; Medicine ; R ; Internal medicine ; RC31-1245 ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571
Subject code	150
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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