DOI QR코드

DOI QR Code

Clinical Characteristics of Patients with Major Depressive Disorder on Military Service and Conscription Issues Using K-WAIS-IV : A Retrospective Study

한국판 성인용 웩슬러 지능검사 4판(K-WAIS-IV)으로 살펴본 병무용 진단서 대상 주요우울장애 환자의 특성 : 후향적 연구

  • Kim, Jiyoung (Department of Psychiatry, Hallym Sacred Heart Hospital) ;
  • Park, Eunhee (Department of Psychiatry, Hallym Sacred Heart Hospital)
  • 김지영 (한림대학교 성심병원 정신건강의학과) ;
  • 박은희 (한림대학교 성심병원 정신건강의학과)
  • Received : 2019.09.19
  • Accepted : 2020.01.16
  • Published : 2020.04.30

Abstract

Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

Keywords

References

  1. Vandenberg RJ, Seo JH. Placing recruiting effectiveness in perspective: A cognitive explication of the job-choice and organizational-entry period. Hum Resour Manag Rev 1992;2:239-273. https://doi.org/10.1016/1053-4822(92)90001-7
  2. Song BH. The Study on the Military Organization Maladjustment Prediction. Kor Public Secur Adm 2013;22:188-223.
  3. Sung GH, Park JH, Kim KH, Lee SH, Park EH, Choi JY. Clinical Characteristics of Psychiatric Patients with Military Issues Using MMPI-2-RF. Korean J Psychosom Med 2017;25:33. https://doi.org/10.22722/KJPM.2017.25.1.033
  4. Ministry of National Defense. Defense White Papaer. Seoul: Ministry of National Defense;2012.
  5. Bush SS, Ruff RM, Troster AI, Barth JT, Koffler SP, Pliskin NH, et al. Symptom validity assessment: Practice issues and medical necessity NAN policy & planning committee. Arch Clin Neuropsychol 2005;20:419-426. https://doi.org/10.1016/j.acn.2005.02.002
  6. Jasinski LJ, Berry DT, Shandera AL, Clark JA. Use of the Wechsler Adult Intelligence Scale Digit Span subtest for malingering detection: A meta-analytic review. J Clin Exp Neuropsychol 2011;33:300-314. https://doi.org/10.1080/13803395.2010.516743
  7. Wechsler D. Weschsler adult intelligence scale-III. TX: The Psychological Corporation;1997.
  8. Wechsler D. Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). TX: NCS Pearson;2008. p.498.
  9. Wechsler D, De Lemos MM. Wechsler adult intelligence scale-revised: Orlando: Harcourt Brace Jovanovich;1981.
  10. Baddeley A, Warrington E. Amnesia and the distinction between long-and shortterm memory. J Verbal Learn Verbal Behav 1970;9:176-189. https://doi.org/10.1016/S0022-5371(70)80048-2
  11. Cermak LS, Butters N. The role of interference and encoding in the short-term memory deficits of Korsakoff patients. Neuropsychologia 1972;10:89-95. https://doi.org/10.1016/0028-3932(72)90045-0
  12. Iverson GL, Franzen MD. The recognition memory test, digit span, and knox cube test as markers of malingered memory impairment. Assessment 1994;1:323-334. https://doi.org/10.1177/107319119400100401
  13. Mittenberg W, Theroux-Fichera S, Zielinski R, Heilbronner RL. Identification of malingered head injury on the Wechsler Adult Intelligence Scale-Revised. Prof Psychol Res Pr 1995;26:491. https://doi.org/10.1037/0735-7028.26.5.491
  14. Trueblood W. Qualitative and quantitative characteristics of malingered and other invalid WAIS-R and clinical memory data. J Clin Exp Neuropsychol 1994;16:597-607. https://doi.org/10.1080/01688639408402671
  15. Hunter B, Calloway J, Perkins S, Denney R. C-92 detecting malingered cognitive impairment with WAIS-IV Digit Span variables in a clinical outpatient setting. Arch Clin Neuropsychol 2014;29:607-607. https://doi.org/10.1093/arclin/acu038.273
  16. Curtis KL, Greve KW, Bianchini KJ. The Wechsler Adult Intelligence Scale-III and Malingering in Traumatic Brain Injury: Classification Accuracy in Known Groups. Assessment 2009;16:401-414. https://doi.org/10.1177/1073191109338161
  17. Etherton JL, Bianchini KJ, Ciota MA, Heinly MT, Greve KW. Pain, malingering and the WAIS-III working memory index. Spine J 2006;6:61-71. https://doi.org/10.1016/j.spinee.2005.05.382
  18. Greve KW, Ord J, Curtis KL, Bianchini KJ, Brennan A. Detecting malingering in traumatic brain injury and chronic pain: A comparison of three forced-choice symptom validity tests. Clin Neuropsychol 2008;22:896-918. https://doi.org/10.1080/13854040701565208
  19. Kokcu AT, Kurt E. General practitioners' approach to malingering in basic military training centres. J R Army Med Corps 2017;163:119-123. https://doi.org/10.1136/jramc-2015-000591
  20. Straud CL, Siev J, Messer S, Zalta AK. Examining military population and trauma type as moderators of treatment outcome for firstline psychotherapies for PTSD: a meta-analysis. J Anxiety Disord 2019; 102133.
  21. Shin MO. An Analytic Study of Psychosocial Anxiety of Replacement Training Center Recruit [dissertation]. Seoul: Ewha Womans University;2000.
  22. Kim NY. Detection of the Faking Bad Response on the M-FAST and MMPI-2 in the Young Males on Military Conscription [dissertation]. Gyeongbuk: Daegu University;2017.
  23. Hwang ST, Kim JH, Park KB, Choi JY, Hong SH. Korean Wechsler Adult Intelligence Scale-IV. Daegu: Korea Psychol Inc;2012.
  24. Holdnack JA, Weiss LG. Demographic Adjustments to WAIS-IV/WMS-IV Norms. In WAIS-IV, WMS-IV, and ACS. CA: Acad Press; 2013.
  25. American Psychiatric Association. DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. VA: American Psychiatric Publication;1993.
  26. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59:22-33.
  27. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatr 1960;23:56. https://doi.org/10.1136/jnnp.23.1.56
  28. Yoo SW, Kim YS, Noh JS, Oh KS, Kim CH, NamKoong K, et al. Validity of Korean version of the mini-international neuropsychiatric interview. Anxiety and Mood 2006;2:50-55.
  29. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and Reliability of the Korean Version of the Hamilton Depression Rating Scale(K-HDRS). J. Kor Neuropsychiatr Assoc 2005;44:456-465.
  30. Spielberg CD, Gorsuch RL, Lushene RD. Test Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press;1970.
  31. Hahn DW. Korean adaptation of Spielberger's STAI (K-STAI). Kor J Health Psychol 1966;1:1-14.
  32. Cohen J. The effect size index: d. Statistical power analysis for the behavioral sciences, NJ: Lawrence Erlbaum Associates;1988. p.284-288.
  33. Webber TA, Soble JR. Utility of various WAIS-IV Digit Span indices for identifying noncredible performance validity among cognitively impaired and unimpaired examinees. Clin Neuropsychol 2018;32:657-670. https://doi.org/10.1080/13854046.2017.1415374
  34. Erdodi LA, Abeare CA, Lichtenstein JD, Tyson BT, Kucharski B, Zuccato BG, et al. Wechsler Adult Intelligence Scale-(WAIS-IV) processing speed scores as measures of noncredible responding: The third generation of embedded performance validity indicators. Psychol Assess 2019;29:148.
  35. Etherton JL, Bianchini KJ, Heinly MT, Greve KW. Pain, malingering, and performance on the WAIS-III Processing Speed Index. J Clin Exp Neuropsychol 2006;28:1218-1237. https://doi.org/10.1080/13803390500346595
  36. Boone KB. Clinical practice of forensic neuropsychology. New York, NY: Guilford;2013.
  37. Kennedy JE, Clement PF, Curtiss G. WAIS-III processing speed index scores after TBI: the influence of working memory, psychomotor speed and perceptual processing. Clin Neuropsychol 2003;17:303-307. https://doi.org/10.1076/clin.17.3.303.18091
  38. Den Hartog H, Derix M, Van Bemmel A, Kremer B, Jolles J. Cognitive functioning in young and middle-aged unmedicated out-patients with major depression: testing the effort and cognitive speed hypotheses. Psychol Med 2003;33:1443-1451. https://doi.org/10.1017/S003329170300833X
  39. Madigan NK, DeLuca J, Diamond BJ, Tramontano G, Averill A. Speed of information processing in traumatic brain injury: Modality-specific factors. J Head Trauma Rehabil 2000;15:943-956. https://doi.org/10.1097/00001199-200006000-00007
  40. Strauss GP, Morra LF, Sullivan SK, Gold JM. The role of low cognitive effort and negative symptoms in neuropsychological impairment in schizophrenia. Neuropsychology 2015;29:282. https://doi.org/10.1037/neu0000113
  41. Daseking M, Petermann F, Waldmann, HC. Sex differences in cognitive abilities: Analyses for the German WAIS-IV. Personality and Individual Differences 2017;114:145-150. https://doi.org/10.1016/j.paid.2017.04.003
  42. Camarata S, Woodcock R. Sex differences in processing speed: Developmental effects in males and females. Intelligence 2006;34:231-252. https://doi.org/10.1016/j.intell.2005.12.001
  43. Park EH. The Effect of Cognitive Deficits on the Adaptive Functioning in Patients with Major Depressive Disorder [dissertation]. Seoul: Seoul National University;2019.
  44. Scheiber C, Chen H, Kaufman AS, Weiss LG. How Much Does WAIS-IV Perceptual Reasoning Decline Across the 20 to 90-Year Lifespan When Processing Speed is Controlled?. Appl Neuropsych-Adul 2017;24:116-131. https://doi.org/10.1080/23279095.2015.1107564
  45. Hyde JS, Linn MC. Gender differences in verbal ability: A metaanalysis. Psychol Bull 1988;104:53. https://doi.org/10.1037/0033-2909.104.1.53
  46. McKelvie SJ, Standing L, Jean DS, Law J. Gender differences in recognition memory for faces and cars: Evidence for the interest hypothesis. Bull Psychon Soc 1993;31:447-448. https://doi.org/10.3758/BF03334958
  47. Lichtenberger EO, Kaufman AS. Essentials of WAIS-IV assessment (Vol. 96). NJ: John Wiley & Sons;2012.
  48. Lemke M, Puhl P, Koethe N, Winkler T. Psychomotor retardation and anhedonia in depression. Acta Psychiatrica Scandinavica 1999;99:252-256. https://doi.org/10.1111/j.1600-0447.1999.tb07221.x
  49. American Psychiatric Association. Diagnostic and statistical manual of mental disorders(DSM-5(R)). VA: American Psychiatric Association Publishing;2013.