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Discrepancy analysis and Australian norms for the Trail Making Test.

Graeme Senior1, Adina Piovesana2, Patricia Beaumont3

  • 1a Centre for Psychological Assessment , University Southern Queensland , Ipswich , Australia.

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|July 29, 2017
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Summary

Discrepancy analysis of the Trail Making Test (TMT) using Trails A performance levels enhances differentiation between perceptual-motor speed and mental flexibility deficits. This method improves understanding of cognitive processing in clinical populations.

Keywords:
Discrepancy analysisTrail Making Testneuropsychologynorms

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Area of Science:

  • Neuropsychology
  • Cognitive Psychology
  • Clinical Psychology

Background:

  • Discrepancy analyses compare two measures within an individual, often using tests like the Trail Making Test (TMT).
  • TMT Trails A and B are frequently compared, but analyses often neglect the impact of Trails A performance level.
  • Existing methods may not fully account for differential vulnerability to pathology or performance variability.

Purpose of the Study:

  • To investigate the utility of TMT discrepancy analysis stratified by Trails A performance levels.
  • To differentiate between slowed visual scanning/graphomotor speed and reduced mental flexibility.
  • To provide a more nuanced understanding of cognitive performance in clinical cases.

Main Methods:

  • Utilized a normative sample of 647 Australians and a clinical sample of 2,292 Australians and U.S. participants.
  • Employed discrepancy analysis comparing TMT Trails A and TMT Trails B.
  • Stratified analyses based on the performance level of TMT Trails A.

Main Results:

  • Demonstrated the ability to differentiate between perceptual-motor speed and mental flexibility deficits by stratifying TMT discrepancies.
  • Highlighted the importance of considering Trails A performance variability in discrepancy score interpretation.
  • Applied normative data to clinical cases, revealing distinct patterns of impairment.

Conclusions:

  • A simple, efficient approach for analyzing TMT-A and TMT-B differences is presented.
  • This method allows for examination of the relative contributions of perceptual/motor abilities and mental flexibility.
  • Stratifying by Trails A performance enhances the diagnostic utility of TMT discrepancy analysis.