Publication Abstract Display
Type: Published Abstract
Title: Investigation of failed Hiscock Digit Memory Test performance in adults in rural China.
Authors: Gupta S, Woods SP, Cysique L, Grant I, Heaton RK
Year: 2009
Publication: Journal of the International Neuropsychological Society
Volume: 15 Issue: Suppl. 1 Pages: 23
Abstract:Rationale The Hiscock Digit Memory Test (HDMT) was designed to detect suboptimal effort during Neuropsychological (NP) testing. Non-compensation seeking demented subjects in the U.S. obtain ≥ 90% accuracy scores. A given subject’s effort is considered suboptimal if performance on the HDMT ≤ 90%. However, it is unknown whether similar are generalizable to non-US populations with very different cultural/educational backgrounds. Woods et al. (2003) were the first to report base rates for HDMT failure in a U.S. sample with HIV-associated neurocognitive disorders. 2% of their noncompensation seeking HIV+ sample failed (HDMT ≤ 90%) the effort measure. The primary aims of the current study are: 1) to evaluate base rates of HDMT <90% in a rural Chinese longitudinal sample and 2) to use available neurocognitive, neuromedical and demographic data in an attempt understand reasons for HDMT failure in this population. Conclusions The HDMT failure base rate in our Chinese HIV/HCV infected group was comparable to that found in the previous U.S. HIV+ sample (1.5% vs. 2%, respectively). HDMT overall shows good specificity, even in a context of medical illness, low education and SES in a developing country. We cannot definitively rule out the possibility of suboptimal effort in these 4 subjects, however the level of the HDMT failure does not suggest intentional malingering (all scores well above chance). The HDMT failers’ stable NP performance over time, as well as practice effect comparable to controls, argue against invalid performance from poor effort. The most likely explanation for HDMT failure may be substantial real NP impairment in people with low cognitive reserve (low education and SES).

return to publications listing