PART III in .NET

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PART III
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INTEGRATION AND APPLICATION OF WAIS-III RESEARCH
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Regardless of the patients difficulties with nonverbal and sequential tasks, they clearly do best on skills that have been overlearned, like reading, writing, and Wechsler s Verbal Comprehension subtests (Lezak, 1995). WAIS-III data on a small sample of 15 subjects with Huntington s Disease (33% male, mean age = 44.7 years) comes from the WAIS-III/ WMS-III Technical Manual (Psychological Corporation, 1997). The group showed a striking 12.7-point V > P IQ profile. When examining the mean indexes, a similar pattern emerged (VCI > POI by 13.5 points), but the real story was the VCI > PSI discrepancy of 29.9 points (means of 98.4 and 69.3), demonstrating the degree to which the index profile shows enormous potential for neuropsychological assessment. The group earned similar means on the POI (84.0) and WMI (81.7). Thus, this sample showed relatively intact verbal abilities (although perhaps even lower than premorbid abilities), but severely affected visual motor and processing speed skills, as well as deficits in visual spatial ability, and either short-term memory or sequential processing skills. Performance Deficits in Parkinson s Disease The Psychological Corporation (1997) also reported WAIS-III data for a small sample of 10 patients with Parkinson s disease (mean age = 71.2, 80% male, 80% Caucasian), a disease of involuntary movement characterized by resting tremors, reduced initiation of voluntary movements, shuffling gait, plastic rigidity, and impaired posture (p. 152). Like MS, one would hypothesize V > P profiles for patients with Parkinson s disease, and, indeed, they had a 12.3-point discrepancy. Their index profile, though not as extreme as the MS sample concerning the PSI, was as follows: VCI (96.9) > WMI (89.6) > POI (84.7) > PSI (81.7). In addition to studying Huntington s patients (and patients with Alzheimer s disease), Randolph et al. (1993) obtained WAIS-R data on 59 patients with Parkinson s Disease (mean age 46), demonstrating a V > P IQ discrepancy of
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14.9 points, similar to the value reported for the small WAIS-III sample of patients with Parkinson s disease.
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Alzheimer s-Type Dementia
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General intellectual deterioration is one of the hallmarks of individuals with Alzheimer s disease, but the cognitive deficiencies are complex. Memory impairment (both in learning new information and recalling old information) is part of the diagnostic criteria (American Psychiatric Association, 1994). Nonverbal measures appear to be affected to a greater extent than are verbal measures, commonly leading to a Wechsler profile of V > P. The V > P Profile Fuld (1984) was able to obtain valid WAIS data for 46 Alzheimer s patients; based on IQs prorated from four Verbal and three Performance subtests, she observed V > P profiles of 15 or more points in 24 (52%) of these patients. Intriguingly, Fuld also obtained dramatic V > P findings for 20 normal graduate and undergraduate students who were given drugs to induce experimentally the impaired cholinergic neurotransmitter functioning believed to characterize Alzheimer s patients. All 20 subjects demonstrated V > P patterns, with 15 (75%) showing differences of at least 15 points. To ensure that the V > P profile did not merely reflect the high educational attainment of the sample, Fuld administered placebos to a control group of 22 medical and undergraduate students. This group also tended to have higher Verbal IQs (16 individuals, or 73%, had V > P), but only 18% of the control subjects had a Verbal superiority by 15 or more points. Brinkman and Braun (1984) also identified a WAIS V > P pattern in their sample of 23 adults suspected of Alzheimer s-type dementia. This group scored 7 points higher on the Verbal Scale (IQs of 97 and 90). However, it is unclear whether the V > P pattern that seems to be associated with Alzheimer s disease is useful in differentiating Alzheimer s patients from those with
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