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Validity of Self-Reported Concentration and Memory Problems: Relationship with Neuropsychological Assessment and Depression
Bowler, R., S. Adams, R. Schwarzer, V. Gocheva, H. Roels, Y. Kim, C. Kircos, C. Wright, M. Colledge, G. Bollweg, AND D. Lobdell. Validity of Self-Reported Concentration and Memory Problems: Relationship with Neuropsychological Assessment and Depression. Journal of Clinical and Experimental Neuropsychology. Swets & Zeitlinger, Lisse, 39(10):1026-1036, (2017).
This study addresses research questions under Sustainable and Healthy Communities (2.62 Community Public Health and Wellbeing). The present study reports findings of a study investigating the validity of self-reported concentration problems (CP) and memory problems (MP) in adult residents environmentally exposed to manganese (Mn) living in two Ohio towns. The study was conducted through the Regional Applied Research Effort which is a joint effort between Region 5 and ORD Scientists. The findings for this first environmental study of air-Mn exposed U.S. adults indicates that self-reported CP/MP in Mn-exposed residents appear to be invalid when compared to neuropsychological test performance. Clinical neuropsychological testing is recommended over self-report in environmental epidemiological studies examining neuropsychological outcomes.
Background: This study investigated the validity of self-reported concentration and memory problems (CMP) in residents environmentally exposed to manganese (Mn). Method: Self-report of CMP from a health questionnaire (HQ) and the Symptoms Checklist-90-Revised (SCL-90-R) was compared to neuropsychological assessment (Trails A&B, Digit Span, Digit Symbol, Similarities, ACT, NAB-Memory, Rey-Osterrieth, Rey-O Delayed). Participants were 146 residents from Ohio exposed to air-manganese (Mn), with modeled average concentration of 0.55 µg/m3 (range: 0.01-4.58). Results: Residents were primarily white (94.5%), aged 30-64 years (M=51.24), with a minimum of 10 years of residence (range: 10-64). Ninety-four (65.3%) participants reported concentration problems CP and 107 residents (73.3%) reported memory problems MP. More participants endorsed CMP on the SCL-90-R than on the HQ. The prevalence of self-reported CMP was higher for women than for men (88.4% vs. 68.3%). After neuropsychological test scores were adjusted for age and education, participants who reported CP/MP on the HQ and SCL-90-R did not perform significantly worse on any of the neuropsychological tests than those who reported not having these problems. Point-biserial and Pearson’s correlations between self-reported CMP and neuropsychological test scores were nonsiginificant and weak for both the HQ (rpb=-0.20 to rpb=0.04) and SCL-90-R (r=-0.12 to r=0.007). Education was the best predictor of neuropsychological test performance. Greater levels of depression, anxiety, and female sex predicted having more self-reported CMP on both the HQ and SCL-90-R. Air-Mn- and blood-Mn- were not associated with self-reported CMP. Residential distance from the Mn source accounted for a small proportion of variance (sr2=0.04), although depression remained the largest predictor (sr2=0.21). Conclusion: These results indicate that self-report of CMP in Mn-exposed residents appear to be invalid when compared to neuropsychological test scores. The participants’ misperception of having CMP is associated with less education and higher levels of depression. Neuropsychological assessment is recommended to attain valid results.