The Booklet Category Test (BCT) is a modified, highly portable version of the Halstead Category Test that has been shown to be very sensitive to brain damage. The BCT is commonly used in neuropsychological assessment in Western countries, however, no information on psychometric properties of the BCT had been report in the Chinese population thus far. This is a single-center, hospital-based, prospective, case-controlled cognitive instrument validation study. The study objective is to examine the criterion, convergent and divergent validity, test-retest reliability, internal consistency and ease of administration of the BCT in Chinese. Ten healthy controls, 12 patients with focal frontal contusions and ten patients with non-frontal contusions were recruited. The Chinese BCT did not differentiate between patients with cerebral contusions from controls, or between patients with focal frontal contusions from those with non-frontal contusions using receiver operating curve analyses. However, it showed good convergent validity with tests of spatial reasoning and had acceptable divergent validity, excellent internal consistency (Cronbach’s ss= .928) and test-retest reliability (ICC = .982, p < .982) and was generally well accepted by local participants. These results showed that the BCT is a valid and reliable clinical measure of spatial reasoning applicable to the Chinese population. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Eighty-eight (N = 88) non-brain-injured adults were tested with one of two versions of the Booklet Category Test (BCT). Forty-four (N = 44) individuals were tested with the standard version of the BCT, and forty-four (N = 44) were tested with a revised BCT in which between-subtest cueing was removed, called the Noncued Category Test (NCT). The results of this study indicate that removal of cueing instructions changes the Category test significantly. Subjects administered the NCT scored significantly more errors than those who were administered the standard Category test. While BCT scores correlated significantly with nonverbal intelligence scores, NCT scores did not. However, the difference in these correlations was not significant, indicating that the intelligence aspect measured in the two versions is not different. Neither the BCT nor the NCT correlated significantly with the Wisconsin Card Sort, Word Fluency, Stroop, or Trail Making Test. It is recommended that the NCT be administered to circumscribed clinical populations in order to best utilize present findings.

The capacity of Raven's Standard Progressive Matrices (SPM) and the Booklet Category Test (BCT) to discriminate between groups of brain-injured, simulated malingering, and normal participants was investigated in this study. Exploratory analyses were also conducted to examine the differences between groups categorized as sophisticated and naive fakers. Clinical decision rules and discriminant function analyses were utilized to identify malingerers. Clinical decision rules ranged in hit rates from 41% to 78%, in sensitivity from 2% to 100%, and in specificity from 86% to 100%. Discriminant functions ranged in hit rates from 81% to 86%, in sensitivity from 68% to 73% and in specificity from 82% to 87%. Overall, the least helpful detection method examined was below chance responding on either measure, while the most efficient was gross errors for SPM.

Modified administration techniques that relied on patient verbalization of reasoning on each item were devised. For the WCST, verbalized scores correlated highly with conventional scores. However, patterns of age, education, and IQ covariates for each scoring condition were very different, raising questions concerning what such verbalized scores measured. Further research based upon a prospective research design was suggested to address this question. Factor analysis of WCST scores for each scoring condition resulted in almost identical three-factor solutions in each case: (a) ineffective, perseverative responding; (b) nonperseverative number errors; and (c) Maintaining Set. A three-part hierarchy of response determinants for the CT was utilized, consisting of (a) concrete perceptual attributes; (b) cognitive organization of perceptual attributes into abstract patterns; and (c) relating abstract patterns to the corresponding number responses. Decision trees were devised to prescribe a set of rules for coding each score. Utilization of this approach yielded adequate test-retest reliability for recoding responses. Sets of variables for each subtest were factor analyzed, with second order factor analysis of all factors from each subtest in order to determine if common cognitive process scores on each subtest described cognitive process scores on other subtests. Results revealed similar factor solutions for each subtest, but subtest-specific factors were not predictive of similar factor scores on other subtests, except for Subtests V and VI, which are based upon the same principle. Factors related to Maintaining Set predicted most of the variance in subtest error scores. Factor scores related to Determinant Shifting were predictive of error scores to a much lesser degree than Maintaining Set factor scores. Determinant Shifting factor scores appeared to be independent of Maintaining Set factor scores, and also showed much more independence from age, education, and IQ covariates. The relationship between CT and WCST factor scores was slightly lower than the relationship between CT error scores and WCST summary scores. Suggestions for further research were discussed.