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brain damage and controls, when IQs were compared, the older controls showed a tendency to perform better than younger controls on all IQs; also, the discrepancy between IQs of younger and older groups was even more pronounced in the patient sample. Educational attainment relates systematically to the size of a person s WAIS-III V P IQ discrepancy. Those with less than a high school education, on the average, score 1 2 points higher on the Performance Scale; those with college degrees or higher score 21 2 to 41 2 points higher on the Verbal Scale. These relationships have important clinical implications for individual neuropsychological assessment, and provide valuable baserate data for interpreting the results of V P analyses in neuropsychological research studies. When the samples of patients with left hemisphere lesions are grouped by their mean education level, the mean P > V profile that is predicted for patients with left lesions is about 6 7 points for samples averaging 10 years of education or less, but is smaller (about 1 4 points) for those with 11 or more years of schooling. For patients with right-hemisphere lesions, the expected V > P profile is about 7 to 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. In fact, the latter sample (the most educated) is the only education group that tended not to show the characteristic pattern for either lesion group.
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This chapter also discussed the clinical issues pertaining to individual neuropsychological assessment (as opposed to interpretation of research findings for groups of patients). When evaluating V P differences for individuals instead of groups, extreme caution must be exercised. What are large differences between groups of patients may not even be statistically significant for a given individual. In addition, individual interpretation demands understanding of clinical phenomena associated with lateralized lesions. For example, patients with left lesions prototypically demonstrate a profound depression known as a catastrophic reaction, while patients with right lesions are more prone to euphoria or indifference. These opposite reactions are likely to affect the observed V P discrepancy in different ways. Other behavioral observations must also be considered when evaluating V P differences. Fatigue, on the Wechsler-Bellevue or WAIS, for example, may have led to a depressed P-IQ because the six Verbal subtests are given first on those tests; the alternation of Verbal and Performance subtests on the WAIS-R and WAIS-III makes fatigue less of a problem for contemporary examiners interpretation of V P differences. Clinicians also need to understand sensory and attentional deficits associated with lesions in the left or right hemisphere to facilitate V P analysis.
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Verbal Performance IQ Discrepancies: A Clinical Approach
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This is the second of two chapters on V P IQ discrepancies. 8 explored Verbal Performance IQ discrepancies as related to brain damage. The patterns obtained by patients with left versus right lesions provided some insight into the greater sensitivity of the V P IQ difference for patients with right damage (V > P of 9 points) compared to those with left damage (P > V of only 31 2 points), and examined the relationship between patient variables and V P discrepancy in adults with brain damage. This chapter focuses on Verbal Performance discrepancies in various types of clinical profiles, such as learning disabilities, delinquency, bilingualism, autism, mental retardation, psychiatric disorders, alcoholism, multiple sclerosis, and dementia. The chapter will conclude with the presentation of clinical case reports that exemplify V P discrepancies within a profile.
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Individuals who obtain substantially higher Performance than Verbal IQs may do so because of strengths in fluid intelligence and visualization compared to weaknesses in crystallized intelligence and short-term memory (Horn, 1989; Horn & Cattell, 1967; Horn & Noll, 1997); strong Perceptual Organization skills in comparison with Verbal Comprehension abilities; a fieldindependent cognitive style (Goodenough & Karp, 1961); better developed simultaneous holistic than analytic sequential processing (Kaufman, 1994a); or for a number of other reasons. Some adolescent and adult groups who characteristically obtain P > V profiles, or, more
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