Academic journal article The Psychological Record

Validation of the Immediate and Delayed Memory Tasks in Hospitalized Adolescents with Disruptive Behavior Disorders

Academic journal article The Psychological Record

Validation of the Immediate and Delayed Memory Tasks in Hospitalized Adolescents with Disruptive Behavior Disorders

Article excerpt

Impulsivity, "a predisposition toward rapid unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to themselves or others," is a core component of many psychiatric disorders (Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001, p. 1784), such as personality disorders (Blaszczynski, Steel, & McConaghy, 1997; Steinberg et al., 1997), substance abuse (Allen, Moeller, Rhoades, & Cherek, 1998; Bickel, Odum, & Madden, 1999), intermittent explosive disorder (Virkkunen & Linnoila, 1993), and disruptive behavioral disorders of adolescence (Allen et al., 1998; Dougherty, Bjork, Marsh, & Moeller, 2000). Accurate measurement of impulsive behavior could improve treatment for those experiencing these disorders.

In the past, self-report measures have been the primary, and frequently the only, method for the assessment of impulsivity within a given protocol; however, the use of any single measure does not suitably account for all the variance inherent in a complex construct like impulsivity (Block, Block, & Harrington, 1974). Thus, other modes of measurement are continuing to be developed to supplement self-report measures of impulsive behavior. Behavioral measures have excellent potential for this purpose because they measure aspects of impulsivity that are partially independent from aspects assessed through self-report (Barratt & Patton, 1983). While self-report instruments typically offer information regarding performance in "real world" situations over a broad time period, behavioral measures are objective and also sensitive to state-dependent changes in impulsivity. Clinically objective state-sensitive measures of impulsive behavior, therefore, could prove to be a useful addition to diagnostic batteries and assessments of medication efficacy.

Recently, attention has focused on objective computerized tasks developed to assess the severity of behavioral impairments, including behavioral dyscontrol in children (for a review, see Frick & Loney, 2000). Clinicians and researchers alike have acknowledged the potential value of computer-based technological developments in these populations. For example, after reviewing some of these procedures Frick and Loney concluded, "several of these techniques have the potential for assessing clinically important processes that may be involved in the development and maintenance of conduct problems in youth ... [and] ... could contribute to the development of individualized treatment plans for children and adolescents with CDs [conduct disorder]" (p. 553).

Despite the apparent need for further development of these technologies, and the common tendency to interpret the results of these types of measures as representing impulsivity, relatively little research has been conducted to validate these kinds of tests as impulsivity measures. One example of this kind of technology is the Continuous Performance Test (CPT) that typically yields commission errors (responses made to stimuli other than the designated target stimulus), which are frequently interpreted as impulsive (Halperin, Wolf, Greenblatt, & Young, 1991; Halperin et al., 1988; O'Dougherty, Nuechterlein, & Drew, 1984; Riccio, Reynolds, & Lowe, 2001; Sostek, Buchsbaum, & Rapoport, 1980; Sykes, Douglas, & Morgenstern, 1973; Sykes, Douglas, Weiss, & Minde, 1971; Wohlberg & Kornetsky, 1973). Validation studies of this type of CPT performance have generally focused on very young children or severely impaired patients, while studies testing higher functioning groups have commonly failed to find differences in commission error rates. This suggests that these measures may not be sufficiently difficult and are therefore insensitive to individual impulsivity differences in higher functioning samples (Cornblatt & Keilp, 1994; Dougherty, Moeller, et al., 1999). There remains a need for studies examining differences in response characteristics using methodologies sensitive to older or higher functioning groups. …

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