Table Of ContentReliability and Validity
in Neuropsychological
Assessment
Second Edition
CRITICAL ISSUES IN NEUROPSYCHOLOGY
Series Editors
Antonio E. Puente Cecil R. Reynolds
University of North Carolina at Wilmington Texas A&M University
and Bastrop Mental Health Associates
Current Volumes in this Series
CONTEMPORARY APPROACHES TO NEUROPSYCHOLOGICAL ASSESSMENT
Edited by Gerald Goldstein and Theresa M. Incagnoli
DETECTION OF MALINGERING DURING HEAD INJURY LmGATION
Edited by Cecil R. Reynolds
HANDBOOK OF CLINICAL CHll..D NEUROPSYCHOLOGY, Second Edition
Edited by Cecil R. Reynolds and Elaine Fletcher-Janzen
HANDBOOK OF CROSS-CULTURAL NEUROPSYCHOLOGY
Edited by Elaine Fletcher-Janzen, Tony L. Strickland, and Cecil R. Reynolds
HANDBOOK OF NEUROPSYCHOLOGY AND AGING
Edited by Paul David Nussbaum
INTERNATIONAL HANDBOOK OF NEUROPSYCHOLOGICAL REHABILITATION
Edited by Anne-Lise Christensen and B. P. Uzzell
MEDICAL NEUROPSYCHOLOGY, Second Edition
Edited by Ralph E. Tarter, Meryl Butters, and Sue R. Beers
NEUROPSYCHOLOGICAL INTERPRETATION OF OBJECTIVE PSYCHOLOGICAL TESTS
Charles J. Golden, Patricia Espe-Pfeifer, and Jana Wachsler-Felder
NEUROPSYCHOTHERAPY AND COMMUNITY INTEGRATION
Brain lllness, Emotions, and Behavior
Tedd Judd
PRACTITIONER'S GUIDE TO EVALUATING CHANGE WITH INTELLECTUAL
ASSESSMENT INSTRUMENTS
Edited by Robert J. McCaffrey, Kevin Duff, and Holly J. Westervelt
PRACTITIONER'S GUIDE TO EVALUATING CHANGE WITH NEUROPSYCHOLOGICAL
ASSESSMENT INSTRUMENTS
Edited by Robert J. McCaffrey, Kevin Duff, and Holly 1. Westervelt
RELIABILITY AND VALIDITY IN NEUROPSYCHOLOGICAL ASSESSMENT,
Second Edition
Michael D. Franzen
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Reliability and Validity
in Neuropsychological
Assessment
Second Edition
Michael D. Franzen
Allegheny General Hospital
and Medical College of PennsylvanialHahnemann University
Pittsburgh. Pennsylvania
Springer Science+Business Media, LLC
Library of Congress Cataloging-in-Publication Data
Franzen, Michael D., 1954-
Reliability and validity in neuropsychological assessmentlMichael D. Franzen-2nd ed.
p. ; cm. - (Critical issues in neuropsychology)
Includes bibliographical references and index.
I. Neuropsychological tests-Evaluation. 2. Neuropsychological tests-Validity. I.
TItle. II. Series.
[DNLM: I. Neuropsychological Tests. 2. Neuropsychology-methods. 3.
Psychometrics-methods. 4. Reproducibility of Results. 5. Sensitivity and Specificity.
WL 141 F837r 2000]
RC386.6.N48 F73 2000
152-dc21
00-028725
ISBN 978-1-4419-3341-6 ISBN 978-1-4757-3224-5 (eBook)
DOl 10.1007/978-1-4757-3224-5
© 2002 Springer Science+Business Media New York
Originally published by Kluwer Academic 1 Plenum Publishers, New York in 2002.
Softcover reprint of the hardcover 2nd edition 2002
http://www.wkap.nU
ill 9 8 7 654 3 2 1
A C.l.P. record for this book is available from the Library of Congress
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,
electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the
Publisher
Preface
Much has happened since the publication of the first edition of this book. Little of what
has happened could have been predicted. The one accurate prediction was that clinical
neuropsychology would continue to grow in terms of methods and knowledge as well as in
importance in health care overall. The impact of managed care was not in the crystal ball.
The rise in interest in the detection of response bias or in premorbid estimates was not
seen in 1989. Both of those activities were viewed as being secondary and subsidiary to
the "actual" testing. I did not foresee the rise in interest and sophistication in psycho
metric issues among clinical neuropsychologists, although certainly I am gratified by this
development.
When I began my career, I had a great deal of difficulty trying to publish papers that
were studies of reliability and validity, although certainly validity studies had a better shot
at being accepted. Today, psychometrically based studies are routinely published in a newer
journal, The Clinical Neuropsychologist, and to a somewhat lesser extent in other journals
such as Archives of Clinical Neuropsychology, Journal of Experimental and Clinical
Neuropsychology, and Psychological Assessment. Clinical neuropsychologists are more
sophisticated in discussing issues of sensitivity, specificity, advanced concepts in re
liability, and confirmatory factor analysis.
Writing the second edition of this book was a much more labor-intensive effort than
the first edition. The names of certain of my colleagues would pop up time after time in my
reviews of the journals. In fact, during some late nights I would silently curse the produc
tivity of some of these colleagues whose output was slowing the completion of the book.
Psychometric research is not sexy, but it has the potential to inform our clinical practice in
an enormous way. Therefore, these researchers deserve our thanks, and in the morning light
I would retract my nighttime curses. The first edition of this book did not initiate this wave
of psychometric sophistication, but it did ride the crest. Other books (e.g., Mitrushina,
Boone, & D'Elia, 1999; Spreen & Strauss, 1998) address the issues of normative informa
tion from a different perspective. The intent of this book is to review the extensive research
and hopefully provide a direction for additional investigation.
To evaluate the degree to which the numbers produced by assessment possessed the
characteristics of stability and meaningfulness, or of reliability and validity, experimental
and mathematical methods were applied that had been developed in other areas of psycho
metrics (literally, the measurement of psychological functions). But because clinical neuro
psychology still remained at least partly a medical endeavor, it was somewhat slower than
v
Vi PREFACE
some areas of psychological measurement to evaluate its instruments by psychometric
methods. There were even some individuals who totally eschewed the use of assessment
methods that produced numbers. That is not the case today. The practitioners who are most
closely identified with psychometric methods are those clinical neuropsychologists who
use a battery approach to assessment. But even those individuals who use a flexible
approach, sometimes called a process approach, rely on smaller tests that produce num
bers. It is difficult to find a contemporary clinical neuropsychologist who does not use at
least a few standardized tests in evaluating a patient. The evaluation of the psychometric
properties of clinical neuropsychological assessment instruments has assumed a more
prominent position and a higher priority than it held previously.
The psychometric evaluation of assessment instruments is a continual activity. This is
true, first of all, because psychometric theoreticians keep producing innovations. Second,
the psychometric properties of the instruments depend on the characteristics of the subject
populations. As individuals change or as different emphases develop for a population, the
instruments need to be reevaluated. This book should be seen as a takeoff rather than as a
summation point.
The purpose of this book is not to indict certain assessment instruments or to champion
other instruments. Rather, the purpose is to identify areas of needed research. Recommen
dations regarding clinical use are made in certain cases; however, if we were to use only
those instruments that have been completely evaluated and found to be completely satisfac
tory, our repertoire of assessment techniques would be very small indeed. This last state
ment is not meant to be a justification for the use of incompletely evaluated instruments or
for the use of instruments that have been evaluated and found to lack reasonable reliability
or to generate no valid interpretations. We have an obligation to choose the best instrument
or to develop a better one. Some instruments may be useful in some situations and useless in
others. We should use the results of research to guide our choice of assessment instruments.
It is hoped that this book will alert the clinical researcher to the need to conduct basic
research into the psychometric properties of neuropsychological instruments. It is further
hoped that clinicians will use the book to make decisions regarding the use of instruments
for particular patients in particular situations. It is also hoped that students will be able to
use this book to learn about instruments or to generate ideas for thesis or dissertation
research.
Acknowledgments
I'd like to thank the coauthors of the first edition of this book, Robert Sawicki and Doug
Robbins, who helped shape the initial manifestation. I'd like to acknowledge the enormous
contributions of my colleagues in clinical neuropsychology, without whose work this book
would not have been possible, or even necessary. I'd like to thank my editor, Mariclaire
Cloutier, who showed great patience in awaiting the completion of the manuscript. Most of
all I'd like to acknowledge Debbie, who showed great forbearance while I toiled, and Joe,
Tim, and Rose who accepted Dad's preoccupation and who learned to write at their
computers with professional journals propped open at the side.
vii
Contents
Chapter 1
Preliminary Measurement Considerations in Clinical Neuropsychological
Assessment .................................................. 1
Chapter 2
General and Theoretical Considerations in the Assessment of Reliability 7
Chapter 3
Practical and Methodological Considerations Regarding Reliability 15
Chapter 4
Elemental Considerations in Validity 27
Chapter 5
Validity as Applied to Neuropsychological Assessment 33
Chapter 6
The Wechsler Adult Intelligence Scale-Revised
and Wechsler Adult Intelligence Scale-III .......................... 55
Chapter 7
The Wechsler Intelligence Scales for Children-the WISC-R, WISC-III,
and WPPSI-R ................................................ 71
Chapter 8
Tests of General Intelligence 91
ix
x CONTENTS
Chapter 9
The Halstead-Reitan and Luria-Nebraska Neuropsychological Batteries 115
Chapter 10
Benton's Neuropsychological Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . 153
Chapter 11
The Minnesota Multiphasic Personality Inventory and
Personality Assessment Inventory ................................ 171
Chapter 12
The Rorschach Inkblots 193
Chapter 13
The Wechsler Memory Scale and its Revisions 203
Chapter 14
Tests of Memory 229
Chapter 15
Tests of Verbal Functions 255
Chapter 16
Tests of Visual and Construction Functions 267
Chapter 17
Tests of Higher Cognitive Function 283
Chapter 18
Screening Devices .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 299
Chapter 19
Tests of Achievement and Aptitude 319
Chapter 20
Methods for Evaluating the Validity of Test Scores 331
CONTENTS xi
Chapter 21
The Assessment of Child Neuropsychological Function . . . . . . . . . . . . . .. 349
Postscript-Future Directions ................................... 355
References ................................................... 357
Index ....................................................... 449
