Theses and Dissertations

Date of Award

2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

College of Psychology

First Advisor

Charles J. Golden

Second Advisor

Lisa Lashley

Third Advisor

Mark Sobell

Fourth Advisor

Ryan Black

Keywords

assessment, battery, neuropsychology, teleneuropsychology

Abstract

This study compared the factor structures of a traditional neuropsychological battery, administered in-person, and a teleneuropsychological battery, administered remotely. Participants were divided into two groups dependent on test condition (i.e., in- person or remote). Individuals in the in-person test condition group (n = 100) were selected from a sample of individuals who were assessed in-person in a previous archival study, and individuals in the remote testing condition group (n = 100) were assessed via teleneuropsychology in their home environment.

Two Exploratory Factor Analyses (EFA) using Principal Component Analysis (PCA) method were conducted on the T-scores and scaled scores of each subtest to compare the internal factor structures of the two neuropsychological batteries. For hypothesis one, it was hypothesized an EFA using PCA method of the subtests from the in-person neuropsychological battery would reveal three primary factors: general intelligence, auditory memory, and verbal comprehension. The Parallel Analysis recommended a three-factor solution for the in-person neuropsychological battery, and the factors extracted were labeled as general intelligence, general memory, and processing speed. For hypothesis two, it was hypothesized an EFA using PCA method of the subtests from the teleneuropsychological battery would reveal three primary factors:general intelligence, attention/ working memory, and verbal comprehension. The Parallel Analysis also recommended a three-factor solution for the teleneuropsychological battery, and the factors extracted were labeled as general memory, attention, and verbal comprehension.

Results of the two EFAs using PCA method revealed both similarities and differences between the two factor structures. Both batteries extracted a memory factor. However, although the teleneuropsychological battery was designed to measure the same cognitive constructs as a traditional neuropsychological battery, there were more differences than there were similarities. The in-person battery extracted general intelligence and processing speed factors, which were not captured in the teleneuropsychological battery. The teleneuropsychological battery extracted attention and verbal comprehension factors, which were not found to be primary factors in the in- person battery. Altogether, results of the two factor analyses do not indicate the batteries measured the same underlying cognitive skills. This suggests different cognitive skills are utilized when some measures, traditionally administered in person, are administered virtually.

These findings have several implications on the use of teleneuropsychology. The interpretation of results obtained from testing using virtual platforms must be altered as it cannot be assumed that virtual assessments measure the same cognitive domains as tests administered in-person. It is essential for clinicians to be cognizant of the differences between virtual and in-person batteries and incorporate this knowledge while conceptualizing an individual’s performance. Clinicians should openly acknowledge this limitation and be cautious in their ability to form definitive conclusions from virtual testing.

Results of the present study also illuminate the potential benefits of teleneuropsychological testing and extending neuropsychological services to patients in their home environment. Though the interpretation of results of remote testing must be altered and require further understanding, this study showed valuable information can still be acquired regarding an individual’s cognitive abilities through virtual testing. Implementing teleneuropsychological testing can help reduce numerous barriers for patients who would not otherwise have access to healthcare, particularly during a global pandemic which has limited the use of in-person neuropsychological testing.

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