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Comparing a Computerized Digit Symbol Test to a Pen-and-Paper Classic
Danielle N Pratt1, Lauren Luther2, Kyle S Kinney3
1Department of Psychology, Northwestern University, Evanston, IL, USA.
Schizophrenia Bulletin Open
|October 23, 2023
Summary
Computerized and paper processing speed tests correlate, but the paper version detects impairment in more clinical high-risk (CHR) individuals. The computerized test is better for identifying progressive CHR psychosis cases.
Area of Science:
- Cognitive Neuroscience
- Psychiatry
- Neuropsychology
Background:
- Processing speed dysfunction is a key indicator of psychosis and predicts conversion in individuals at clinical high risk (CHR).
- Traditional pen-and-paper assessments are being supplemented by computerized tasks for remote evaluation needs.
- This study investigates the relationship between traditional and digital processing speed measures in CHR individuals.
Purpose of the Study:
- To assess the correlation between traditional (pen-and-paper) and computerized processing speed measurements.
- To compare the effect sizes of processing speed impairment in progressive versus persistent CHR subgroups.
- To explore factors influencing performance differences between the two assessment types.
Main Methods:
- 92 CHR individuals and 60 healthy controls participated.
- Assessments included clinical interviews, the Brief Assessment of Cognition in Schizophrenia Symbol Coding test (paper), and the TestMyBrain Digit Symbol Matching Test (computerized).
- Data analysis involved correlations, Hedges' g effect sizes, and linear models.
Main Results:
- A strong correlation (r=0.505) was found between paper and computerized processing speed tasks.
- Both progressive and persistent CHR subgroups showed similar impairment on the paper task.
- The computerized task identified impairment only in the progressive CHR subgroup, while the persistent group performed similarly to controls.
Conclusions:
- The paper symbol coding task captures processing speed deficits across the CHR spectrum.
- The computerized digit symbol task may be more sensitive to processing speed impairments in individuals with worsening psychosis symptoms.
- Observed differences could stem from task sensitivity, subgroup characteristics, or underlying cognitive mechanisms.
