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Article ; Online: The Importance of the Morel Emotional Numbing Test Instructions: A Diagnosis Threat Induction Study.

Williamson, Emily S / Arentsen, Timothy J / Roper, Brad L / Pedersen, Heather A / Shultz, Laura A / Crouse, Ellen M

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

2023 Volume 39, Issue 1, Page(s) 35–50

Abstract: Objective: Marketed as a validity test that detects feigning of posttraumatic stress disorder (PTSD), the Morel Emotional Numbing Test for PTSD (MENT) instructs examinees that PTSD may negatively affect performance on the measure. This study explored ... ...

Abstract	Objective: Marketed as a validity test that detects feigning of posttraumatic stress disorder (PTSD), the Morel Emotional Numbing Test for PTSD (MENT) instructs examinees that PTSD may negatively affect performance on the measure. This study explored the potential that MENT performance depends on inclusion of "PTSD" in its instructions and the nature of the MENT as a performance validity versus a symptom validity test (PVT/SVT). Method: 358 participants completed the MENT as a part of a clinical neuropsychological evaluation. Participants were either administered the MENT with the standard instructions (SIs) that referenced "PTSD" or revised instructions (RIs) that did not. Others were administered instructions that referenced "ADHD" rather than PTSD (AI). Comparisons were conducted on those who presented with concerns for potential traumatic-stress related symptoms (SI vs. RI-1) or attention deficit (AI vs. RI-2). Results: Participants in either the SI or AI condition produced more MENT errors than those in their respective RI conditions. The relationship between MENT errors and other S/PVTs was significantly stronger in the SI: RI-1 comparison, such that errors correlated with self-reported trauma-related symptoms in the SI but not RI-1 condition. MENT failure also predicted PVT failure at nearly four times the rate of SVT failure. Conclusions: Findings suggest that the MENT relies on overt reference to PTSD in its instructions, which is linked to the growing body of literature on "diagnosis threat" effects. The MENT may be considered a measure of suggestibility. Ethical considerations are discussed, as are the construct(s) measured by PVTs versus SVTs.
MeSH term(s)	Humans ; Neuropsychological Tests ; Malingering/diagnosis ; Malingering/psychology ; Emotions ; Stress Disorders, Post-Traumatic/diagnosis ; Stress Disorders, Post-Traumatic/psychology
Language	English
Publishing date	2023-07-14
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/acad048
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Article ; Online: The relationship of the clinician-rated Functional Status Interview with executive functioning.

Arentsen, Timothy J / Stubbs, Whitney J / Lease, Suzanne H / Adler, Marcy C / Ovrebo, Elin / Jacobson, Jennifer L

Applied neuropsychology. Adult

2022 , Page(s) 1–13

Abstract: Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning ( ...

Abstract	Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning (EF) contributes significantly to functional independence, and the validity of functional status measures has been examined through its relationship to EF scores. The current study used a clinical sample of older U.S. Veterans who completed a neurocognitive evaluation (
Language	English
Publishing date	2022-06-11
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	10.1080/23279095.2022.2084619
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Article ; Online: The Behavior Rating Inventory of Executive Function®-Adult Version is Related to Emotional Distress, Not Executive Dysfunction, in a Veteran Sample.

Shwartz, Susan K / Roper, Brad L / Arentsen, Timothy J / Crouse, Ellen M / Adler, Marcy C

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

2020 Volume 35, Issue 6, Page(s) 701–716

Abstract: Objective: In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self- ... ...

Abstract	Objective: In three studies, we explore the impact of response bias, symptom validity, and psychological factors on the self-report form of the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the relationship between self-reported executive functioning (EF) and objective performance. Method: Each study pulled from a sample of 123 veterans who were administered a BRIEF-A and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) during a neuropsychological evaluation. Participants were primarily middle-aged, and half carried a mood disorder diagnosis. Study 1 examined group differences in BRIEF-A ratings among valid, invalid, and indeterminate MMPI-2 responders. Analyses were conducted to determine the optimal cut-score for the BRIEF-A Negativity Validity scale. In Study 2, relationships were explored among MMPI-2-RF (restructured form) Restructured Clinical (RC) scales, somatic/cognitive scales, and the BRIEF-A Metacognition Index (MI); hierarchical analyses were performed to predict MI using MMPI-2-RF Demoralization (RCd) and specific RC scales. Study 3 correlated BRIEF-A clinical scales and indices with RCd and an EF composite score from neuropsychological testing. Hierarchical analyses were conducted to predict BRIEF-A clinical scales. Results: Invalid performance on the MMPI-2 resulted in significantly elevated scores on the BRIEF-A compared to those with valid responding. A more stringent cut-score of ≥4 for the BRIEF-A Negativity scale is more effective at identifying invalid symptom reporting. The BRIEF-A MI is most strongly correlated with demoralization. BRIEF-A indices and scales are largely unrelated to objective EF performance. Conclusions: In a veteran sample, responses on the BRIEF-A are most representative of generalized emotional distress and response bias, not actual EF abilities.
MeSH term(s)	Adult ; Executive Function ; Humans ; MMPI ; Middle Aged ; Neuropsychological Tests ; Psychological Distress ; Reproducibility of Results ; Veterans/psychology
Language	English
Publishing date	2020-05-04
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/acaa024
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Article ; Online: Validity testing and neuropsychology practice in the VA healthcare system: results from recent practitioner survey (.).

Young, J Christopher / Roper, Brad L / Arentsen, Timothy J

The Clinical neuropsychologist

2016 Volume 30, Issue 4, Page(s) 497–514

Abstract: Objective: A survey of neuropsychologists in the Veterans Health Administration examined symptom/performance validity test (SPVT) practices and estimated base rates for patient response bias.: Method: Invitations were emailed to 387 psychologists ... ...

Abstract	Objective: A survey of neuropsychologists in the Veterans Health Administration examined symptom/performance validity test (SPVT) practices and estimated base rates for patient response bias. Method: Invitations were emailed to 387 psychologists employed within the Veterans Affairs (VA), identified as likely practicing neuropsychologists, resulting in 172 respondents (44.4% response rate). Practice areas varied, with 72% at least partially practicing in general neuropsychology clinics and 43% conducting VA disability exams. Results: Mean estimated failure rates were 23.0% for clinical outpatient, 12.9% for inpatient, and 39.4% for disability exams. Failure rates were the highest for mTBI and PTSD referrals. Failure rates were positively correlated with the number of cases seen and frequency and number of SPVT use. Respondents disagreed regarding whether one (45%) or two (47%) failures are required to establish patient response bias, with those administering more measures employing the more stringent criterion. Frequency of the use of specific SPVTs is reported. Conclusions: Base rate estimates for SPVT failure in VA disability exams are comparable to those in other medicolegal settings. However, failure in routine clinical exams is much higher in the VA than in other settings, possibly reflecting the hybrid nature of the VA's role in both healthcare and disability determination. Generally speaking, VA neuropsychologists use SPVTs frequently and eschew pejorative terms to describe their failure. Practitioners who require only one SPVT failure to establish response bias may overclassify patients. Those who use few or no SPVTs may fail to identify response bias. Additional clinical and theoretical implications are discussed.
MeSH term(s)	Disability Evaluation ; Female ; Humans ; Inpatients/statistics & numerical data ; Male ; Mental Disorders/diagnosis ; Mental Disorders/psychology ; Middle Aged ; Neuropsychological Tests/standards ; Neuropsychology/standards ; Outpatients/statistics & numerical data ; Psychology ; Regression Analysis ; Reproducibility of Results ; Surveys and Questionnaires ; Symptom Assessment/standards ; Treatment Failure ; United States ; United States Department of Veterans Affairs/standards ; Veterans
Language	English
Publishing date	2016
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	639080-8
ISSN	1744-4144 ; 0920-1637 ; 1385-4046
ISSN (online)	1744-4144
ISSN	0920-1637 ; 1385-4046
DOI	10.1080/13854046.2016.1159730
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Article ; Online: Memory modulation in the classroom: selective enhancement of college examination performance by arousal induced after lecture.

Nielson, Kristy A / Arentsen, Timothy J

Neurobiology of learning and memory

2012 Volume 98, Issue 1, Page(s) 12–16

Abstract: Laboratory studies examining moderate physiological or emotional arousal induced after learning indicate that it enhances memory consolidation. Yet, no studies have yet examined this effect in an applied context. As such, arousal was induced after a ... ...

Abstract	Laboratory studies examining moderate physiological or emotional arousal induced after learning indicate that it enhances memory consolidation. Yet, no studies have yet examined this effect in an applied context. As such, arousal was induced after a college lecture and its selective effects were examined on later exam performance. Participants were divided into two groups who either watched a neutral video clip (n=66) or an arousing video clip (n=70) after lecture in a psychology course. The final examination occurred two weeks after the experimental manipulation. Only performance on the group of final exam items that covered material from the manipulated lecture were significantly different between groups. Other metrics, such as the midterm examination and the total final examination score, did not differ between groups. The results indicate that post-lecture arousal selectively increased the later retrieval of lecture material, despite the availability of the material for study before and after the manipulation. The results reinforce the role of post-learning arousal on memory consolidation processes, expanding the literature to include a real-world learning context.
MeSH term(s)	Achievement ; Adult ; Arousal/physiology ; Emotions/physiology ; Female ; Humans ; Male ; Memory/physiology ; Retention (Psychology)/physiology ; Students ; Universities
Language	English
Publishing date	2012-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1223366-3
ISSN	1095-9564 ; 1074-7427
ISSN (online)	1095-9564
ISSN	1074-7427
DOI	10.1016/j.nlm.2012.04.002
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Article ; Online: Muscle tension induced after learning enhances long-term narrative and visual memory in healthy older adults.

Nielson, Kristy A / Wulff, Laura L / Arentsen, Timothy J

Neurobiology of learning and memory

2014 Volume 109, Page(s) 144–150

Abstract: Arousing events are better remembered than mundane events. Indeed, manipulation of arousal, such as by muscle tension, can influence memory even when it occurs shortly after learning. Indeed, our founding study showed this approach can raise delayed ... ...

Abstract	Arousing events are better remembered than mundane events. Indeed, manipulation of arousal, such as by muscle tension, can influence memory even when it occurs shortly after learning. Indeed, our founding study showed this approach can raise delayed memory performance in older adults to a level comparable to that of unaided young adults. Yet, systematic studies, especially those investigating different modalities or types of memory, have not been done. This study investigated the effects of a brief bout of isometric exercise via handgrip on narrative and visuospatial episodic memory in healthy elders. Forty-seven participants completed the Logical Memory subtest of the Wechsler Memory Scales III (LM) and the Benton Visual Retention Test (BVRT), followed alternately by no treatment and by moderately squeezing a sand-filled latex ball for 1-min (counterbalanced order and test forms). Isometric exercise significantly increased both positive and negative affect ratings. Retention was tested 2 weeks later. Delayed recall and recognition of LM was enhanced by arousal relative to control, as was recognition of the BVRT. The results extend past findings that muscle tension induced after learning modulates memory consolidation, extending findings in elders to suggest that a simple form of isometric exercise can have practical effects, such as aiding memory for stories and images.
MeSH term(s)	Age Factors ; Aged ; Arousal ; Exercise/psychology ; Female ; Humans ; Male ; Memory, Episodic ; Muscle Tonus ; Visual Perception/physiology
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223366-3
ISSN	1095-9564 ; 1074-7427
ISSN (online)	1095-9564
ISSN	1074-7427
DOI	10.1016/j.nlm.2014.01.008
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Article ; Online: Increased Suicidal Ideation in Patients with Co-Occurring Bipolar Disorder and Post-Traumatic Stress Disorder.

Carter, Julia M / Arentsen, Timothy J / Cordova, Matthew J / Ruzek, Josef / Reiser, Robert / Suppes, Trisha / Ostacher, Michael J

Archives of suicide research : official journal of the International Academy for Suicide Research

2017 Volume 21, Issue 4, Page(s) 621–632

Abstract: Suicide risk increases for those with Bipolar Disorder or PTSD, however little research has focused on risk for co-occurring Bipolar Disorder and PTSD. The aim of this article was to evaluate increased suicide risk in co-occurring disorders, and ... ...

Abstract	Suicide risk increases for those with Bipolar Disorder or PTSD, however little research has focused on risk for co-occurring Bipolar Disorder and PTSD. The aim of this article was to evaluate increased suicide risk in co-occurring disorders, and differences in suicide risk for patients with Bipolar I versus Bipolar II. This study evaluated suicide risk in patients with co-occurring PTSD and Bipolar Disorder (n = 3,158), using the MADRS and Suicide Questionnaire. Those with history of PTSD had significantly higher suicidal ideation than those without (U = 1063375.00, p < .0001). Those with Bipolar I had higher risk than those with Bipolar II. Patients with Bipolar I and PTSD were at higher risk for suicidal ideation, implying the importance of diagnosis and risk assessment.
MeSH term(s)	Adult ; Bipolar Disorder/epidemiology ; Bipolar Disorder/psychology ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/psychology ; Suicidal Ideation ; Surveys and Questionnaires
Language	English
Publishing date	2017-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1283671-0
ISSN	1543-6136 ; 1381-1118
ISSN (online)	1543-6136
ISSN	1381-1118
DOI	10.1080/13811118.2016.1199986
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Article ; Online: Detecting coached neuropsychological dysfunction: a simulation experiment regarding mild traumatic brain injury.

Lau, Lily / Basso, Michael R / Estevis, Eduardo / Miller, Ashley / Whiteside, Douglas M / Combs, Dennis / Arentsen, Timothy J

The Clinical neuropsychologist

2017 Volume 31, Issue 8, Page(s) 1412–1431

Abstract: Objective: Performance validity tests (PVTs) and symptom validity tests (SVTs) are often administered during neuropsychological evaluations. Examinees may be coached to avoid detection by measures of response validity. Relatively little research has ... ...

Abstract	Objective: Performance validity tests (PVTs) and symptom validity tests (SVTs) are often administered during neuropsychological evaluations. Examinees may be coached to avoid detection by measures of response validity. Relatively little research has evaluated whether graduated levels of coaching has differential effects upon PVT and SVT performance. Accordingly, the present experiment evaluated the effect of graduated levels of coaching upon the classification accuracy of commonly used PVTs and SVTs and the currently accepted criterion of failing two or more PVTs or SVTs. Method: Participants simulated symptoms associated with mild traumatic brain injury (TBI). One group was provided superficial information concerning cognitive, emotional, and physical symptoms. Another group was provided detailed information about such symptoms. A third group was provided detailed information about symptoms and guidance how to evade detection by PVTs. These groups were compared to an honest-responding group. Extending prior experiments, stand-alone and embedded PVT measures were administered in addition to SVTs. Results: The three simulator groups were readily identified by PVTs and SVTs, but a meaningful minority of those provided test-taking strategies eluded detection. The Word Memory Test emerged as the most sensitive indicator of simulated mild TBI symptoms. PVTs achieved more sensitive detection of simulated head injury status than SVTs. Conclusions: Individuals coached to modify test-taking performance were marginally more successful in eluding detection by PVTs and SVTs than those coached with respect to TBI symptoms only. When the criterion of failing two or more PVTs or SVTs was applied, only 5% eluded detection.
Language	English
Publishing date	2017-11
Publishing country	England
Document type	Journal Article
ZDB-ID	639080-8
ISSN	1744-4144 ; 0920-1637 ; 1385-4046
ISSN (online)	1744-4144
ISSN	0920-1637 ; 1385-4046
DOI	10.1080/13854046.2017.1318954
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Article: Psychosocial Correlates of Medication Adherence among HIV-Positive, Cognitively Impaired Individuals.

Arentsen, Timothy J / Panos, Stella / Thames, April D / Arbid, J Natalie / Castellon, Steven A / Hinkin, Charles H

Journal of HIV/AIDS & social services

2016 Volume 15, Issue 4, Page(s) 404–416

Abstract: Although cognitive impairment has been shown to adversely affect antiviral medication adherence, a subset of cognitively impaired adults nonetheless are able to adequately adhere to their medication regimen. However, little is known about factors that ... ...

Abstract	Although cognitive impairment has been shown to adversely affect antiviral medication adherence, a subset of cognitively impaired adults nonetheless are able to adequately adhere to their medication regimen. However, little is known about factors that serve as buffers against suboptimal adherence among the cognitively impaired. This study consisted of 160 HIV-positive, cognitively impaired adults (Global Deficit Score ≥ 0.50) whose medication adherence was monitored over 6-months using an electronic monitoring device (MEMS caps). Logistic regressions were run to determine psychosocial variables associated with medication adherence. Higher self-efficacy and treatment related support, a stable medication regimen, stable stress levels, and absence of current stimulant use were predictive of optimal adherence. A distinct array of psychosocial factors was found that buffer against the adverse effects of cognitive impairment on medication adherence. Assessment and interventions targeting these factors may improve adherence rates among cognitively impaired adults.
Language	English
Publishing date	2016-09-23
Publishing country	United States
Document type	Journal Article
ISSN	1538-1501
ISSN	1538-1501
DOI	10.1080/15381501.2016.1228309
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Article ; Online: Effectiveness of the Comalli Stroop Test as a measure of negative response bias.

Arentsen, Timothy J / Boone, Kyle Brauer / Lo, Tracy T Y / Goldberg, Hope E / Cottingham, Maria E / Victor, Tara L / Ziegler, Elizabeth / Zeller, Michelle A

The Clinical neuropsychologist

2013 Volume 27, Issue 6, Page(s) 1060–1076

Abstract: Practice guidelines recommend the use of multiple performance validity tests (PVTs) to detect noncredible performance during neuropsychological evaluations, and PVTs embedded in standard cognitive tests achieve this goal most efficiently. The present ... ...

Abstract	Practice guidelines recommend the use of multiple performance validity tests (PVTs) to detect noncredible performance during neuropsychological evaluations, and PVTs embedded in standard cognitive tests achieve this goal most efficiently. The present study examined the utility of the Comalli version of the Stroop Test as a measure of response bias in a large sample of "real world" noncredible patients (n = 129) as compared with credible neuropsychology clinic patients (n=233). The credible group performed significantly better than the noncredible group on all trials, but particularly on word-reading (Stroop A) and color-naming (Stroop B); cut-scores for Stroop A and Stroop B trials were associated with moderate sensitivity (49-53%) as compared to the low sensitivity found for the color interference trial (29%). Some types of diagnoses (including learning disability, severe traumatic brain injury, psychosis, and depression), very advanced age (⩾80), and lowered IQ were associated with increased rates of false positive identifications, suggesting the need for some adjustments to cut-offs in these subgroups. Despite some previous reports of an inverted Stroop effect (i.e., color-naming worse than color interference) in noncredible subjects, individual Stroop word reading and color naming trials were much more effective in identifying response bias.
MeSH term(s)	Adult ; Color Perception ; Female ; Humans ; Male ; Middle Aged ; Neuropsychological Tests ; Predictive Value of Tests ; Sensitivity and Specificity ; Stroop Test
Language	English
Publishing date	2013
Publishing country	England
Document type	Journal Article
ZDB-ID	639080-8
ISSN	1744-4144 ; 0920-1637 ; 1385-4046
ISSN (online)	1744-4144
ISSN	0920-1637 ; 1385-4046
DOI	10.1080/13854046.2013.803603
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