Conners’ CPT II
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Transcript Conners’ CPT II
Auditory & Visual Attention:
New Developments in
Assessment Using CPTs
C. K. Conners, Ph.D.
Conners’ CPT II
Continuous Performance
Test II
Conners’ CPT II
Development &
Standardization
Normative Data
Nonclinical
N = 1920
• N = 812 Epidemiological Study
• N = 1108 Multi-Site Study
ADHD
N = 378
Neurological
(Adults)
N = 223
Gender Composition of the
CPT II Nonclinical Sample
Age Group
Males
Females
Under 18
52.5%
47.5%
18+
28.8%
71.2%
Overall
47.2%
52.8%
Ethnic Composition of the
CPT II Nonclinical Sample
Ethnic Group
Count
% of Sample
% not including
“Other”
White
904
47.0
59.9
Black
518
27.0
34.3
Asian
88
4.6
5.8
Other*
410
21.4
—
*Note: The epidemiological sample classified individuals as “African American” or “Other,” producing a large
percentage of “Other” classifications.
Diagnostic Breakdown
of Neurological Sample
Diagnostic Category
% Occurrence as Primary or
Secondary Diagnosis
Post-concussive (310.2)
29
Other Organic Brain Syndrome (310.8)
21
Concussion with brief loss of consciousness (850.1)
6
Variants of migraine (346.2)
Frontal Lobe Syndrome (310.0)
Headaches (784.0)
Dementia (290.13, 290.43, 294.1)
6
5
5
5
Pain disorder associated with psychological and medical
conditions (307.89)
5
Late effects of cerebrovascular disease: Cognitive deficits
(438.0)
Cortical contusion with loss of consciousness (851.02)
3
Disorder of written expression (315.2)
Other
2
11
2
Conners’ CPT II
Developmental Trends
(Nonclinical Norm Data)
Hit Reaction Time (HRT)
Standard Error (SE)
Commissions
Omissions
Test-Retest Correlation Coefficients
for the CPT II (n = 23)
Omissions
.84**
Perseverations
.43*
Commissions
.65**
Hit RT Block Change
.28
Hit RT
.55*
Hit SE Block Change
.08
Hit RT Std Error
.65**
Hit RT ISI Change
.51*
Variability
.60*
Hit SE ISI Change
.05
Detectability
(d prime)
Response Style
(Beta)
.76**
Confidence Index (ADHD)
.89**
.62*
Confidence Index (Neuro.)
.92**
*
**
p < .05
p < .01
CPT II
Discrimination of Clinical
and Nonclinical Groups
ANCOVA Results
Summary
ADHD, Neuro., and Nonclinical
groups compared across
measures controlling for Age
and Gender
The clinical groups (ADHD &
Neuro.) scored significantly
higher (p < .001) than
nonclinical on ALL measures
ANCOVA Results
Summary (continued)
Also, relative to the ADHD
group, the Neuro. Group
• made more omission errors
(p < .001)
• had slower RTs (p < .001)
• had more variable responses
(p < .001)
• responded less consistently by ISI
(p < .001)
Discriminant Functions
Used to identify best predictors for
differentiating between groups
Different Functions used for
child/adult, ADHD/Neuro assessment
Used to determine classification
accuracy rates
ADHD vs. Nonclinical, Ages 6-17:
Contribution of Measures to
Discriminant Function
ADHD vs. Nonclinical, Ages 18+:
Contribution of Measures to
Discriminant Function
Neurological Impairment vs.
Nonclinical: Contribution of
Measures to Discriminant Function
CPT II Confidence
Indexes
Based on Discriminant Function Analysis
Provides a Classification Prediction
• Index > 50 (Prediction: Clinical)
• Index < 50 (Prediction: Nonclinical)
Exact value of index indicates the
“probability” associated with the
prediction
Incorrect to use index as the sole criterion
for CPT II assessment
Group Differences for
6-17 Year Olds,
ADHD vs. Nonclinical
0 = Nonclinical
1 = ADHD
Group Differences for
18+ Year Olds,
ADHD vs. Nonclinical
0 = Nonclinical
1 = ADHD
Group Differences for
18+ Year Olds,
Neuro. vs. Nonclinical
0 = Nonclinical
2 = Neurological
Classification Accuracy and
Error Rates
Specificity
(False Positives)
Sensitivity
(False Negatives)
ADHD vs. Nonclinical
Under 18
83% (17%)
82% (18%)
ADHD vs. Nonclinical
18 Years & Above
87% (13%)
88% (12%)
Neuro. vs. Nonclinical
18 Years & Above
92% (8%)
85% (15%)
Reduce False Positives
(Option)
Adjusts for Base Rates
Increases certainty of need for
follow-up (i.e., helps avoid “false
alarms”)
Classification Accuracy
(Reduce False Positives Option Used)
Specificity
(False Positives)
Sensitivity
(False Negatives)
ADHD vs. Nonclinical
Under 18
95% (5%)
55% (45%)
ADHD vs. Nonclinical
18 Years & Above
98% (2%)
71% (29%)
Neuro. vs. Nonclinical
18 Years & Above
98% (2%)
68% (32%)
Minimize False
Negatives (Option)
In clinical settings, may be used
to adjust for Base Rates
Useful Option when focus is on
corroboration of Dx
Classification Accuracy
(Reduce False Negatives Option Used)
Specificity
(False Positives)
Sensitivity
(False Negatives)
ADHD vs. Nonclinical
Under 18
57% (43%)
95% (5%)
ADHD vs. Nonclinical
18 Years & Above
63% (37%)
96% (4%)
Neuro. vs. Nonclinical
18 Years & Above
77% (23%)
93% (7%)
Conners’ CPT II
Features of the Software
Single Administration
Report Options
Multiple Administration
Report Options
Multi-Admin Comparison
Graph
Multi-Admin
Interpretation Text
Progressive Analysis
Second Administration (Aug 09, 2000) vs. Third Administration (Aug 16,2000)
There was a substantial change in the Confidence Index between these two administrations. The
decrease in the Confidence Index was sufficient to produce a nonclinical classification on the third
administration while the second administration suggested a clinical classification. The change was
statistically significant based on the Jacobson-Truax assessment procedure.
First Administration (Aug 02, 2000) vs. Second Administration (Aug 09, 2000)
There was a substantial change in the Confidence Index between these two administrations. The
change was statistically significant based on the Jacobson-Truax assessment procedure. In both
administrations, but especially in the first, the Confidence Index favored a clinical classification.
Current Performance vs. First Administration
First Administration (Aug 02, 2000) vs. Third Administration (Aug 16, 2000)
There was a substantial change in the Confidence Index between these two administrations. The
decrease in the Confidence Index was sufficient to produce a nonclinical classification on the third
administration while the first administration suggested a clinical classification. The change was
statistically significant based on the Jacobson-Truax assessment procedure.
CPT II Preference
Options
CPT II Medication List
C-DATA
Why do we need an auditory CPT?
What is the goal of this project?
C-DATA
Development of Auditory Attention
LD, ADHD, CAPD
C-DATA
Paradigm
• Likely need to diverge from visual CPT
type paradigms
C-DATA
Paradigm Criteria
• Applicable to wide age range
• Measure ability to direct attention to
one channel or the other
• Competing sounds included
• Include consonant-vowel (CV) elements
• Verbal and non-Verbal
C-DATA
Paradigm Criteria (Continued)
•
•
•
•
•
•
Measure lateral preference
Mobility of Attention measured
Signal Detection Theory/Response bias
Stimulus onset asynchrony varied
Inter-Stimulus Interval varied
Vigilance measured
C-DATA
Paradigms
• Tone condition
• Dichotic Condition
C-DATA
Statistics
•
•
•
•
•
•
•
Hits to targets
False alarms to warnings
Omissions to targets
Delayed responses
Mobility
REA
Laterality