Neuropsychologists looking to improve the validity of cognitive assessment may be one step closer thanks to Sarah Patrick, a doctoral student in clinical psychology in the Wayne State University College of Liberal Arts and Studies. 

Patrick recently received a Blue Ribbon Award for excellence in research from the American Psychological Association (APA) and Society for Clinical Neuropsychology for her submission, “Something old, something new: Pupillary response in performance validity testing.” She was invited to present her research in a symposium at the upcoming national convention of the APA in Washington, DC, in August 2020. Due to coronavirus, the convention will take place online Aug. 6-8 and the symposium of talks has been converted to posters, which can be viewed on the convention website for the duration of the event.

The study examines how biometric measures, such as pupillometry—the measurement of pupil size and reactivity—can improve the diagnostic accuracy of cognitive assessment. 

“Pupillometry provides information relating to psychological and cognitive processes related to effort and deception,” Patrick said. “For example, pupils dilate when we think hard and when we recognize familiar items. Importantly, pupil reactivity is not something examinees can directly control.”

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Current methods of cognitive assessment rely heavily on self-reporting of symptoms and performance (e.g., accuracy) on cognitive tests. These methods are susceptible to feigned impairment, Patrick said, because examinees have conscious control over such behavioral responses.

“If someone does not give their best effort during a cognitive evaluation, they might appear to be a lot more impaired than they actually are,” Patrick said. “The accurate diagnosis of true versus feigned cognitive impairment is crucial, because invalid assessment results can lead to incorrect diagnoses, ineffective treatment plans, and the inappropriate allocation of resources.”

Shifting focus to rely more heavily on responses that examinees cannot control could change that.

Her research on cognitive assessment is in part funded by a grant from Blue Cross Blue Shield of Michigan. She and her mentor Professor Lisa Rapport, Ph.D., are also recipients of a 2020-2021 Graduate School Competitive Graduate Student Assistantship. The award will allow Patrick to focus on her research full-time and take part in more training opportunities, such as her upcoming placement with the Michigan Center for Forensic Psychiatry.

Following her graduation from Wayne State, Patrick aspires to become a certified neuropsychologist and gain a position in the psychiatry or neurology department of an academic medical center or veterans hospital.

Written by Kristy Case