The Dyad-Adaptive Paced Auditory Serial Addition Test (DA-PASAT): Normative data and the effects of repeated testing, simulated malingering, and traumatic brain injury.
The Dyad-Adaptive Paced Auditory Serial Addition Test (DA-PASAT): Normative data and the effects of repeated testing, simulated malingering, and traumatic brain injury.
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DOI：
10.1371/journal.pone.0178148
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Reed B
中科院分区：
文献类型：
--
作者：
Woods DL;Wyma JM;Herron TJ;Yund EW;Reed B
起搏听觉序列加法测试（PASAT）广泛用于评估多发性硬化症、创伤性脑损伤和其他神经系统疾病患者的处理速度和执行功能。在PASAT测试中，受试者一边听数字序列，一边连续报告最后两位数字的总和。通常测试四种不同的刺激起始时间（SOA），随着SOA的减少，难度增加。天花板效应在长SOA中很常见，而数字传递率通常超过受试者在短SOA中的处理能力，导致一些受试者完全停止执行。此外，受试者可能会在短SOA时采用“交替回答”策略，这降低了测试对工作记忆和处理速度的要求。因此，研究表明，二元数（连续正确答案）是一个比正确总数更敏感的PASAT性能衡量标准。在这里，我们描述了一个2.5分钟的计算机化测试，二进制自适应PASAT（DA-PASAT），其中SOA调整2：1的楼梯，减少后，每对正确的反应和增加后错过。处理能力反映在54项试验达到的最低SOA（minSOA）中。实验1收集规范性数据在两个大的人群：1617名受试者在新西兰的年龄范围从18岁到65岁，和214名加州人的年龄范围从18岁到82岁。最低SOA受年龄、教育程度和每天使用计算机的时间的影响。在排除这些因素的影响后计算的最小SOA z分数在两个对照组中几乎相同，响应时间（RT）和二分体比率（二分体中发生的命中比例）也是如此。实验2测量的重测信度的DA-PASAT在44名年轻的受试者进行了三次测试，每周一次。minSOA（0.87）、响应时间（0.76）和二分体比（0.87）的组内相关系数（ICC）较高。在所有测量的测试会话中，性能都有所提高。实验3调查了50名受试者的模拟装病的影响：42%的模拟装病者产生了异常（p< 0.05）minSOA z分数。通过训练表现和实际测试之间的过度差异，以87%的灵敏度和69%的特异性将具有异常分数的模拟诈病者与具有异常分数的对照受试者区分开来。实验4研究了创伤性脑损伤（TBI）患者：轻度TBI患者的表现在正常范围内，而重度TBI患者则表现出缺陷。DA-PASAT减少了PASAT评估的时间和压力，同时收集了二分体处理的敏感措施，揭示了衰老，装病和创伤性脑损伤对性能的影响。
The Paced Auditory Serial Addition Test (PASAT) is widely used to evaluate processing speed and executive function in patients with multiple sclerosis, traumatic brain injury, and other neurological disorders. In the PASAT, subjects listen to sequences of digits while continuously reporting the sum of the last two digits presented. Four different stimulus onset asynchronies (SOAs) are usually tested, with difficulty increasing as SOAs are reduced. 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. In addition, subjects may adopt an “alternate answer” strategy at short SOAs, which reduces the test’s demands on working-memory and processing speed. Consequently, studies have shown that the number of dyads (consecutive correct answers) is a more sensitive measure of PASAT performance than the overall number of correct sums. Here, we describe a 2.5-minute computerized test, the Dyad-Adaptive PASAT (DA-PASAT), where SOAs are adjusted with a 2:1 staircase, decreasing after each pair of correct responses and increasing after misses. Processing capacity is reflected in the minimum SOA (minSOA) achieved in 54 trials. Experiment 1 gathered normative data in two large populations: 1617 subjects in New Zealand ranging in age from 18 to 65 years, and 214 Californians ranging in age from 18 to 82 years. Minimum SOAs were influenced by age, education, and daily hours of computer-use. Minimum SOA z-scores, calculated after factoring out the influence of these factors, were virtually identical in the two control groups, as were response times (RTs) and dyad ratios (the proportion of hits occurring in dyads). Experiment 2 measured the test-retest reliability of the DA-PASAT in 44 young subjects who underwent three test sessions at weekly intervals. High intraclass correlation coefficients (ICCs) were found for minSOAs (0.87), response times (0.76), and dyad ratios (0.87). Performance improved across test sessions for all measures. Experiment 3 investigated the effects of simulated malingering in 50 subjects: 42% of simulated malingerers produced abnormal (p< 0.05) minSOA z-scores. Simulated malingerers with abnormal scores were distinguished with 87% sensitivity and 69% specificity from control subjects with abnormal scores by excessive differences between training performance and the actual test. Experiment 4 investigated patients with traumatic brain injury (TBI): patients with mild TBI performed within the normal range while patients with severe TBI showed deficits. The DA-PASAT reduces the time and stress of PASAT assessment while gathering sensitive measures of dyad processing that reveal the effects of aging, malingering, and traumatic brain injury on performance.
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DOI：
10.1076/jcen.25.4.571.13876
发表时间：
2003-06-01
影响因子：
2.2
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2001-08-01
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Polman, CH
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影响因子：
3.8
作者：
Gonzalez, Raul;Miller, S. Walden;Heaton, Robert K.
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DOI：
10.1177/1352458506070933
发表时间：
2006-12-01
期刊：
MULTIPLE SCLEROSIS
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