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Use of the modified WAIS-R with psychiatric inpatients: a caution
1Trenton Psychiatric Hospital, NJ 08628.
Abstract:
Use of the Modified WAIS-R described by Cella in 1984 with psychiatric inpatients was criticized on several grounds. First, the modification did not accurately identify areas of relative cognitive strength and weakness. An accuracy rate of 49% was considered unacceptable for interpretation of individual profiles, the task the WAIS-RM was originally designed to perform. Second, use of the WAIS-RM does not significantly reduce total administration time. For the majority of 70 psychiatric inpatients, at least 80% of the WAIS-R items would be administered, resulting in saving just fifteen minutes. Finally, an inpatient's confidence and motivation to perform well could be compromised by skipping earlier, easier items. Administration of the full WAIS-R battery is recommended if a discussion of relative strengths and weaknesses is desired.
Insights
The Modified Wechsler Adult Intelligence Scale-Revised (WAIS-R) is not recommended for psychiatric inpatients due to poor accuracy in identifying cognitive strengths and weaknesses. The full WAIS-R is advised for comprehensive cognitive assessments.
Area of Science:
- Neuropsychology
- Clinical Psychology
- Psychiatry
Background:
- The Modified Wechsler Adult Intelligence Scale-Revised (WAIS-R) was developed to assess cognitive abilities in psychiatric inpatients.
- Previous use of the WAIS-R in this population has faced criticism regarding its efficacy and efficiency.
Purpose of the Study:
- To evaluate the validity and utility of the Modified WAIS-R (WAIS-RM) for assessing cognitive profiles in psychiatric inpatients.
- To determine if the WAIS-RM accurately identifies cognitive strengths and weaknesses and reduces administration time.
Main Methods:
- The study critically reviewed the methodology and findings associated with the WAIS-RM's application in psychiatric inpatient settings.
- Analysis focused on the accuracy of cognitive profile interpretation and the extent of time savings compared to the full WAIS-R.
Main Results:
- The WAIS-RM demonstrated a low accuracy rate of 49% in identifying individual cognitive strengths and weaknesses, deemed unacceptable for clinical interpretation.
- Significant reductions in administration time were minimal, with most patients receiving over 80% of the full WAIS-R items, saving only approximately fifteen minutes.
- Potential negative impacts on patient confidence and motivation due to item skipping were noted.
Conclusions:
- The Modified WAIS-R is not a reliable tool for assessing cognitive profiles in psychiatric inpatients.
- The full WAIS-R battery is recommended for accurate and comprehensive evaluation of cognitive strengths and weaknesses in this patient group.