Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)
May 9–10
Live and Online
Offered by Academy, Shirley Ryan AbilityLab
30 characteristics are assessed in the ISPC, the participant is asked to rate both the extent to which the behavior is present and degree of change from baseline.
30
30-60 minutes
Adult
18 - 64
yearsElderly Adult
65 +
yearsThe ISPC may be particularly sensitive to assessing acquired sociopathy in patients with ventromedial prefrontal damage.
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Parkinson's: (Houeto et al, 2001; n = 16; patients successfully treated by bilateral subthalamic stimulation, assessed by the patients spouse before and 6 months after surgery)
Changes in IRSPC scores in patients treated by continuous bilateral STN stimulation:
Test-Retest >10* | Test-Retest <10* | |
Mean (SD) | Mean (SD) | |
Dimension | n = 8 | n = 8 |
Irritability | -0.8 (2.0) | 1.7 (1.4) |
Lack of initiative | -2.8 (2.0) | 2.6 (1.7) |
Perseveration | -3.4 (1.8) | 1.8 (1.3) |
Depression | -2.9 (1.8) | 1.3 (2.0) |
Impulsivity | -0.5 (0.9) | 1.2 (1.6) |
Obsessiveness | 0.5 (2.3) | -0.1 (1.8) |
Lability/moodiness | 0.0 (1.8) | 1.1 (1.0) |
Lack of persistence | -3.1 (2.0) | 2.5 (1.5) |
Lack of stamina | -2.4 (0.7) | 1.0 (3.7) |
Lack of planning | -2.0 (2.1) | 2.4 (1.9) |
Inflexibility | -1.1 (1.5) | 1.4 (1.2) |
Poor judgment | -1.0 (1.5) | 1.3 (1.2) |
Anxiety | -0.9 (1.0) | 0.8 (3.0) |
Insensitivity | -0.4 (1.1) | 1.4 (0.9) |
Social inappropriateness | -0.4 (1.1) | 0.6 (1.4) |
Dependency | -2.0 (2.1) | 1.0 (1.9) |
Impatience | -1.2 (2.1) | 1.3 (1.0) |
Type A behaviour | -0.9 (2.0) | -0.6 (1.4) |
Blunted affect/unemotional | -0.6 (1.2) | 0.6 (2.1) |
Social withdrawal | -2.4 (2.4) | 0.9 (2.0) |
Aggression | -0.2 (0.7) | 1.4 (1.6) |
Indecisiveness | -0.7 (1.2) | 1.6 (1.8) |
Vanity | 0.2 (0.7) | 0.1 (1.1) |
Suspiciousness | -0.1 (0.8) | 1.2 (1.9) |
Apathy | -1.9 (1.6) | 2.0 (1.5) |
Frugality | -0.1 (0.3) | -0.8 (2.6) |
Inappropriate affect/emotion | -0.3 (0.7) | 1.1 (1.6) |
Manipulativeness | 0.3 (0.7) | 0.4 (0.5) |
Vulnerability to pressure | -1.0 (1.1) | 2.3 (1.6) |
Lack of insight | -0.4 (1.1) | 0.6 (1.4) |
Total | -32.6 (16.8) | 33.5 (14.1) |
*Mean (SD) |
No studies have been published assessing IRSPC norms with control subjects (Malloy and Grace 2005)
Bilateral Ventromedial Prefrontal Damage: (Barrash et al, 2000; n = 57; mean ages for the three groups ranged from 54 to 59 years; informants (close others) knew the patient, on average, more than 30 years)
IRSPC Ratings of Severity and Change: |
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| Level Ratings |
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Scale | PF–BVM | PF–NBVM | NPF | PF–BVM | PF–NBVM | NPF |
Lack of insight | 6.4 (1.0) | 2.9 (1.5) | 2.9 (1.6***) | 2.4 (0.5) | 0.3 (1.2) | 0.1 (0.8***) |
Lack of initiative | 6.6 (0.8) | 3.4 (1.7) | 3.2 (1.4***) | 2.6 (0.5) | 1.0 (1.1) | 0.5 (0.9***) |
Irritability | 6.1 (0.9) | 4.4 (1.4) | 3.7 (1.5***) | 2.1 (0.4) | 1.4 (1.0) | 0.6 (0.9***) |
Social inappropriateness | 5.9 (1.5) | 2.8 (1.1) | 2.3 (1.4***) | 2.4 (0.8) | 0.4 (0.9) | 0.2 (0.7***) |
Poor judgment | 6.3 (0.9) | 3.6 (1.5) | 3.2 (1.3***) | 2.0 (1.4) | 0.7 (0.8) | 0.3 (0.7**) |
Lack of persistence | 5.4 (1.8) | 3.4 (0.9) | 2.6 (1.3***) | 2.0 (1.1) | 0.8 (0.9) | 0.2 (0.7***) |
Indecisiveness | 6.0 (1.5) | 3.0 (1.0) | 3.6 (1.3***) | 2.0 (1.0) | 0.4 (0.9) | 0.6 (0.9) |
Lability | 6.1 (1.2) | 3.7 (1.5) | 3.4 (1.4***) | 2.3 (0.8) | 0.9 (0.7) | 0.6 (0.8***) |
Blunted emotional experience | 4.9 (1.5) | 2.7 (1.5) | 2.8 (1.1*) | 1.6 (1.1) | –0.3 (0.7) | –0.3 (0.6***) |
Apathy | 4.9 (1.2) | 3.6 (1.1) | 3.3 (0.9*) | 1.6 (1.0) | 0.9 (0.9) | 0.5 (0.8) |
Inappropriate affect | 5.1 (1.3) | 2.9 (1.0) | 2.8 (1.6**) | 2.3 (0.8) | 0.3 (0.6) | 0.4 (0.7***) |
Lack of planning | 5.0 (2.3) | 4.1 (1.3) | 3.6 (1.3) | 1.6 (1.4) | 0.9 (1.1) | 0.4 (0.9) |
Poor frustration tolerance | 5.0 (1.0) | 4.5 (1.1) | 3.4 (1.5**) | 2.1 (0.9) | 1.6 (0.8) | 0.7 (1.0***) |
Inflexibility | 5.9 (1.2) | 4.1 (1.3) | 3.6 (1.5**) | 2.0 (1.1) | 0.7 (1.2) | 0.4 (0.8*) |
Behavioral rigidity | 5.6 (2.1) | 3.3 (1.3) | 3.6 (1.4) | 1.4 (1.5) | 0.6 (0.9) | 0.5 (0.7) |
Low emotional expressivity | 4.0 (1.7) | 2.7 (1.4) | 3.3 (1.6) | 1.3 (1.6) | –0.3 (0.8) | –0.2 (0.8) |
Insensitivity | 5.3 (1.9) | 3.7 (1.5) | 2.9 (1.5) | 1.4 (1.0) | 0.1 (1.1) | 0.2 (0.8*) |
Excitability | 3.6 (1.9) | 3.7 (1.3) | 3.3 (1.3) | 0.6 (1.3) | 0.6 (1.3) | 0.6 (0.9) |
Anxiety | 5.0 (2.0) | 5.0 (2.0) | 3.5 (1.5) | 1.6 (1.5) | 1.0 (0.9) | 0.6 (0.7) |
Impulsivity | 3.9 (1.9) | 3.5 (1.1) | 2.8 (1.4) | 1.1 (1.6) | 0.6 (0.9) | 0.2 (0.7) |
Self-absorption | 4.7 (1.9) | 3.5 (1.3) | 3.2 (1.2) | 1.0 (1.1) | 0.4 (0.9) | 0.3 (0.6) |
Obsessiveness | 4.1 (2.2) | 3.8 (1.3) | 3.7 (1.4) | 0.9 (1.9) | 0.1 (1.0) | 0.4 (0.7) |
Social withdrawal | 4.0 (2.4) | 3.1 (1.3) | 3.1 (1.4) | 0.7 (1.4) | 0.4 (0.7) | 0.3 (0.8) |
Disorganization | 3.4 (2.4) | 3.9 (1.0) | 3.2 (1.5) | 1.0 (1.7) | 1.3 (1.0) | 0.3 (0.9) |
Manipulativeness | 3.6 (2.2) | 2.5 (1.0) | 2.5 (1.3) | 0.9 (1.2) | 0.1 (0.7) | 0.0 (0.3) |
Dependency | 3.7 (1.8) | 2.9 (1.1) | 3.4 (1.5) | 1.0 (1.4) | 0.9 (0.6) | 0.6 (0.9) |
Depression | 3.9 (1.2) | 3.5 (0.8) | 3.4 (1.2) | 1.3 (1.1) | 0.8 (1.1) | 0.6 (0.8) |
Type A behavior | 2.0 (1.7) | 3.1 (1.7) | 2.7 (1.3) | 0.0 (1.4) | 0.0 (1.2) | –0.3 (0.7) |
Delusional thinking | 2.9 (1.7) | 1.9 (0.9) | 2.2 (1.2) | 0.9 (0.9) | 0.3 (0.5) | 0.1 (0.5) |
Frugality | 3.4 (2.8) | 2.9 (1.1) | 3.3 (1.1) | 1.0 (1.3) | –0.1 (0.8) | 0.3 (0.7) |
PF–BVM = participants with prefrontal lesions with bilateral involvement of the ventromedial region
PF–NBVM = prefrontal lesions without bilateral involvement of the ventromedial region
NPF = non-prefrontal lesions
Convergent validity: Brain Injury: (Barrash et al., 2022; n = 83, patients with ISPC ratings and available Minnesota Multiphasic Personality Inventory (MMPI) scores)
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Brain Injury: (Barrash et al., 2022; n = 182, male = 96 (52.7%); mean age = 48.1 (14.4) years; interval of 5.2 (6.0) years (range = 4-360 months) between lesion acquisition and collection of personality data. patients with ISPC ratings and available Minnesota Multiphasic Personality Inventory (MMPI) scores)
Significant correlations between neuropsychological scores and personality disturbances1
Neuropsychological score | Dysexecutive (r) | Distress (r) |
FSIQ | -0.221** | -1.99* |
VCI | -0.067 | -0.144 |
POI | -0.183* | -0.143 |
WMS Gen Mem | -0.336 | -0.206* |
AVLT-DR | -0.286*** | -0.173* |
TMT-B (seconds)2 | 0;374*** | 0.124 |
BDI-II | 0.294*** | 0.338*** |
FSIQ = WAIS IV Full Scale IQ; VCI = WAIS IV Verbal Comprehension Index; POI = WAIS IV Perceptual-Organizational Index; WMS Gen Mem = Wechsler Memory Scales III General Memory Index; AVLT-DR = Auditory Verbal Learning Test-Delayed Recall; TMT-B = Trailmaking Test- Trail B; BDI-II = Beck Depression Inventory-II. 1Emotional/social disturbance and hypoemotional disturbance were not associated with cognitive performance. 2For the Trail Making Test- Trail B (seconds to completion), positive correlations indicate worse cognitive performance was related to increased personality disturbance. For the Beck Depression Inventory, positive correlations indicate higher levels of depression are related to increased personality disturbance. * = p < 0.05, ** = p < 0.01, *** = p < 0.001 |
Bilateral Ventromedial Prefrontal Damage: (Barrash et al, 2000)
The IRSPC was shown to discriminate between patients with Prefrontal lesions with bilateral involvement of the ventromedial region, Prefrontal lesions without bilateral involvement of the ventromedial region and non-prefrontal lesions (refer to the "IRSPC Ratings of Severity and Change" Table in the "normative data" section of this summary for details"
Ventromedial Prefrontal Damage: (Barrash, et al. 1997; n = 115)
Population Characteristics not Specified: (Barrash, et al 1997)
Barrash, J., Anderson, S., et al. (1997). "The Iowa rating scales of personality change: reliability and validity." Journal of the International Neuropsychological Society 3: 27-28.
Barrash, J., Tranel, D., et al. (2001). "Acquired personality disturbances associated with bilateral damage to the ventromedial prefrontal region." Developmental Neuropsychology. Find it on PubMed
Barrash. J., Bruss, J., et al. (2022). "Lesions in different prefontal sectors are associated with different type of acquired personality disturbances. Cortex, 147, 169-184. https://doi.org/10.1016/j.cortex.2021.12.004.
Houeto, J., Mesnage, V., et al. (2002). "Behavioural disorders, Parkinson's disease and subthalamic stimulation." Journal of Neurology, Neurosurgery & Psychiatry 72(6): 701. Find it on PubMed
Malloy, P. and Grace, J. (2005). "A Review of Rating Scales for Measuring Behavior Change Due to Frontal Systems Damage." Cognitive and behavioral neurology 18(1): 18-27. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.