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PART III
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INTEGRATION AND APPLICATION OF WAIS-III RESEARCH
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Education Level and V P for Brain-Damaged Samples
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Table 8.22 summarizes all of the studies in Tables 8.1 8.3 that provided education information for the students unilateral brain-damaged samples. The studies are grouped by mean education levels, cutting across other variables such as type of lesion, instrument used for assessment, gender, and so forth. The resultant composite samples range in size from 119 to 426, encompassing five levels of education: less than 10 years, 10 years, 11 years, 12 years, and 13 14 years. These data show that the mean P > V profile that is anticipated for patients with left lesions is about 6 7 points for those samples that averaged 10 years of education or less, but is notably smaller (about 1 4 points) for those averaging 11 or more years of schooling. For patients with right-hemisphere lesions, the expected V > P profile is substantial (about 7 11 points) for patient samples averaging 12 or less years of schooling, but is only about 3 points for samples that averaged 1 or 2 years of college. Indeed, the latter sample is the only education group that tended not to show the characteristic pattern for either lesion group. However, the predicted patterns for each type of lesion resulted for the least educated samples, those with 0 9 years of schooling and those with 10 years. Consequently, based on these data: TABLE 8.22
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(1) for patients with 0 10 years of schooling, expect a loss of verbal function for patients with left lesions and a loss in nonverbal function for those with right lesions; (2) for patients with 11 12 years of schooling, anticipate a nonverbal loss for those with right lesions, but don t expect P > V patterns for patients with left lesions; and (3) for patients with some college, do not expect either predicted profile to occur. However, the data in Table 8.22, and the guidelines derived from these data, are tentative because the education groups are not matched on gender, ethnicity, Wechsler scale, or type of lesion. Nonetheless, the overview shown in Table 8.22 for patient samples, when coupled with the education data for normal individuals presented in Table 8.21, indicates the importance of interpreting the results of a V P IQ comparison in the context of the person s (or group s) level of formal education. Herring and Reitan (1986) also noted the same type of relationship between level of education and V P discrepancy indicated in Table 8.22 for patients with left lesions, based on unpublished studies in their laboratory: [P]ersons with lower educational levels and left cerebral hemisphere lesions had relatively low VIQ compared with PIQ, whereas VIQs were only slightly lower than PIQs for persons with left cerebral hemisphere lesions when educational levels were higher (p. 540).
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The relationship of mean education of brain-damaged sample to size of V P IQ discrepancy for patients with left hemisphere and right hemisphere lesions Left Lesion Mean Education Level of Sample (Years of School Completed) <10 years 10 years 11 years 12 years 13 14 years N 119 184 426 218 129 V P Diff 7.2 5.6 3.7 1.1 3.8 Right Lesion N 130 199 423 168 128 V P Diff +9.1 +11.1 +6.5 +10.2 +2.8
NOTE: These data are from all studies in Tables 8.1, 8.2, and 8.3 that indicated mean education level of the sample. However, like Tables 8.1, 8.2, and 8.3, overlapping samples are excluded. V P Diff. Equals minus P IQ.
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V P IQ DISCREPANCIES: A NEUROPSYCHOLOGICAL APPROACH
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Education as a Variable for Normal versus Brain-Damaged People
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Reitan and Wolfson (1996a, 1996b) systematically investigated the role of education level on the intellectual and neuropsychological test performance of 50 patients with brain damage and 50 control subjects who were matched on age (36.5 years) and education (12.8 years). Although Reitan and Wolfson used the old WAIS and did not examine the side of the lesion as a variable (nor did they limit the study to those with unilateral damage), the results are instructive. Reitan and Wolfson s (1996a, 1996b) main findings were that higher-educated subjects performed better on all IQs, but the finding was more consistent among controls than among subjects with brain damage and was not significant for the P-IQ within the patient sample. The correlations between education and each IQ distribution were significantly higher for the controls (rs of .66 .79) than for the patients with brain damage (rs of .35 .54). Reitan and Wolfson (1996b) identified an interesting interaction in the relationship of IQ and education, as shown in Table 8.23. Each sample (patients with brain damage, controls) was divided in half, based on educational attainment, and correlations were computed for each mini-sample. Dividing the control sample in half had no real influence on
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the relationships of education to IQ, but splitting the sample of patients with brain damage had a striking effect. For control subjects in both halves of the sample, and for the high-education patient sample, IQ correlated substantially with V-IQ and FS-IQ (.64 .71) and moderately with P-IQ (.39 .57). However, correlations were nonsignificant and trivial ( .11 .26) for the loweducation patient sample. The diminished role in the ability of educational attainment to predict IQ for relatively poorly educated patient samples suggests that, for such samples, the brain damage itself has a more potent effect on a patient s IQ than does his or her educational attainment. Reitan and Wolfson (1996a) also looked at individual WAIS scaled scores to examine the effect of education on cognitive performance for patients with brain damage and for control subjects. Like the global results described above, level of education had a strong effect on subtest scores in the control group and a much lesser effect on scores in the patient group (see Table 8.24). In the group with brain damage, only three subtests produced significant differences (p < .05) between the high and low education subgroups (Information, Comprehension, and Vocabulary); however, in the control group, all subtests but two (Picture Completion and Object Assembly) had significant differences between the high and low education subgroups (p < .05). Likewise, correlations between education and subtest scores were larger
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TABLE 8.23 Coefficients of correlation for education vs. V-IQ, P-IQ,
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and FS-IQ for patients with brain damage and control group, each subdivided at the median for education Group Controls (N = 50) Education: Upper 50% Education: Lower 50% Brain-Damaged (N = 50) Education: Upper 50% Education: Lower 50% .66* .26* .57* .11* .64* .07* .71* .64* .39* .55* .66* .67* V-IQ P-IQ FS-IQ
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*p < .01 NOTE: Data are from Reitan and Wolfson (1996b).
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