A-168 Do Family Members’ Subjective Perceptions of Decline in Executive Functioning Skills Reflect Objective Cognitive Dysfunction?

Objective On behavior rating scales completed by family members, executive functioning is often operationalized in terms of subdomain abilities (e.g., problem-solving, multitasking, and organizing). It is unclear, however, how well collateral assessments of these abilities reflect patients’ actual executive functioning. The current study investigated the relationship between family members’ reported perceptions of change in patients’ problem-solving, multitasking, and organizing abilities and objective neuropsychological test findings. Method Patients undergoing dementia evaluations (n = 56, mean age = 71.4, mean education = 13.0 years) minimally completed subtests from the Delis-Kaplan Executive Function System (D-KEFS; Trail Making, Verbal Fluency, Color-Word, Tower) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Information from family members was obtained via a questionnaire asking about degrees of change (no change, mild change, moderate change, or severe change) in problem-solving, multitasking, and organizing. Spearman correlations were calculated between family members’ perceptions of change and cognitive dysfunction, as measured by D-KEFS (subtests and combined averaged scaled score) and RBANS index scores. Results Perceived changes in problem-solving, multitasking, and organizing did not significantly correlate at p < .05 with either D-KEFS subtest scores or the combined scaled score. Perceived changes significantly correlated with RBANS Immediate Memory (problem-solving: rs = −.338, p = .014; multitasking: rs = −.323, p = .017; organizing: rs = −.293, p = .028) and Language (problem-solving: rs = −.306, p = .027) indices. Conclusions Family members’ perceptions of change in problem-solving, multitasking, and organizing did not correspond with objective executive dysfunction observed on neuropsychological testing. Future research should attempt to cross-validate these findings. If cross-validated, results would suggest limited utility in using these terms to operationalize executive functioning on behavior rating scales.

A-177 Relationship Between Family Members’ Subjective Ratings of Memory Decline and Objective Neuropsychological Test Performance

Objective In cognitive domains such as memory, decline can manifest in several ways. The current study investigated how different memory changes reported by family members on a behavior rating scale were related to neuropsychological test performance. The study also examined if reported memory problems reflected memory impairment specifically, versus general cognitive dysfunction. Method Patients (n = 87, mean age = 73.0, mean education = 13.1 years) minimally completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) during dementia evaluations. Information from patients’ family members was obtained via a questionnaire asking about degrees of perceived change (no change, mild change, moderate change, or severe change) in “remembering conversations,” “repeating self,” and “misplacing items.” Spearman correlations were calculated between family members’ perceptions of change and cognitive dysfunction, measured by RBANS index scores. Results Perceived changes in misplacing items significantly correlated with RBANS Immediate Memory (rs = −.291, p = .008) and Delayed Memory (rs = −.261, p = .018) indices. The only other correlations that approached statistical significance were between remembering conversations and Immediate Memory (rs = −.209, p = .052) and repeating self and Delayed Memory (rs = −.208, p = .056). No correlations with other RBANS index scores approached statistical significance at p < .05. Conclusions While not all results were statistically significant, trends among correlations between RBANS index scores and family-reported changes in patients remembering conversations, repeating themselves, and misplacing items suggest that when these terms are utilized on behavior rating scales, they possess both convergent and discriminant validity. Since misplacing items significantly correlated with both immediate and delayed memory dysfunction, changes in this area might be the most useful to assess on behavior rating scales.

Appropriateness of various behavior rating scales used in pediatric dentistry: A Review

A youngster’s response to dental treatment may greatly facilitate or hinder the course and quality of treatment provided. Numerous children tend to experience various clinical levels of anxiety and some will go on to develop as an anxiety disorder. Estimates suggest that approximately 10–25% of the population may experience an anxiety disorder at some time. Without adequate tools to measure the levels of anxiety in children, it is not possible to isolate the problem and give them the early attention they need. Problems which have arisen in using rating scales typically involve difficulties related to reliability, validity, and measurement level. The major drawbacks of the rating system lie in possible undetected bias and misrepresentation of data. The scorer weighs the evidence on which the rating is based on a complex manner which is not easily specified, standardized, or objectified. The present review was carried out to understand the clinical significance of various behavior rating scales practiced over the years in pediatric practice.