Ruff 27, WFOT 2018

海報的文字內容，暫時先貼這樣。

等下，我再把table 1 及table 2寄給你。完成後，先把海報寄給我看一下。

BA plots，再提醒我。
再加入BA plots的內文描述。
BA plots等寫文章時，再寫進去。異質性甚麼的及r>0.3。

Title: The test-retest reliability and practice effects of the Ruff 2 & 7 Selective Attention Test in patients with schizophrenia

Introduction: Sustained attention is referred to individuals to maintain concentration at a cognitive activity with repeat stimuli; selective attention is the ability to focus something particular while neglecting distractors in activity context. Attention deficits are a crucial feature of cognitive impairments in patients with schizophrenia. All impaired sustained or selective attention will affect the daily performance of schizophrenia. The Ruff 2 & 7 Selective Attention Test (2 & 7 Test) assesses sustained and selective attention with automatic detection (AD) and controlled search (CS) trials. However, test-retest reliability and practice effects of the 2 & 7 Test are unknown in patients with schizophrenia. The test-retest reliability of the 2 & 7 Test is helpful to determine whether repeated measures are reproducible.

Objectives: The aim of the study was to assess the test-retest reliability and practice effects between two successive assessments of the 2 & 7 Test in patients with schizophrenia.

Method: Inpatients with schizophrenia at chronic wards of a psychiatric hospital were recruited in the test-retest design study with a 2-week interval. Intraclass correlation coefficient was used for test-retest reliability. Paired t test was used for significance of practice effects; Cohen’s d for the magnitude of practice effects.

Results: Sixty-two inpatients with schizophrenia participated in our study and most of the 62 participants were male (59.7%). The duration of onset was about 24 on average (mean ± SD = 23.8 ± 10.2). Table 1 shows further characteristics of the participants. For sustained attention, the test-retest correlations of the total speed and accuracy scores were 0.95 and 0.84, respectively. For selective attention, the test-retest correlations of the speed/accuracy of AD and CS were 0.91/0.82 and 0.93/0.86, respectively. The paired t test of most mean scores were significant, except for AD accuracy; Cohen’s d ranged from 0.10 to 0.36 for all scores.

Conclusion: In general, the 2 & 7 Test showed good test-retest reliability and acceptable random measurement error. Small practice effects occurred across two successive tests. Practice effects must be taken into consideration for interpretation an individual change of a 2-week interval in clinical settings. 

Keywords: Attention; Practice effects; Schizophrenia; Cognition

Introduction of Ruff 2 & 7 selective test

Introduction

Attention deficit is one of common cognitive impairments in patients with schizophrenia. (Bortolato, F Carvalho, & S McIntyre, 2014). Attention is a specific mental function including focused attention, sustain attention, selective attention, alertness, and divided attention (AOTA, 2014; Golisz & Toglia, 2003; Yu et al., 2015). Among them, selective attention is the ability to focus something particular while neglecting distractors in activity context (Ettinger et al., 2015); and sustain attention is refer to individuals to maintain concentration at cognitive activity with repeat stimuli (Sarter, Givens, & Bruno, 2001). All impaired selective attention or sustain attention will affect daily performance of schizophrenia (Shi K. Liu et al., 2002). Thus, attention measurements used in schizophrenia evaluation accurately is important in screening referral, planning intervention, monitoring progress, and so on.

The Ruff 2 & 7 Selective Attention Test (2 & 7 test) (Ronald M Ruff & Allen, 1996) was developed to assess selective attention and sustain attention in adolescents and adults (16-70yrs). The 2 & 7 test, a kind of paper-and-pencil cancellation test, consists a series of 20 sets: 10 Automatic Detection (AD) trials and 10 Controlled Search (CS) trials. Each trial take individual 15 seconds and the total administration time is 5 minutes per test. After finishing the 2 & 7 test, the administrator has to count the raw sore, including the hits and errors of 20 trials, and then tabulates these scores to speed and accuracy score. In clinical practice, some literature indicate that the 2 & 7 test is ideal tool to be used in quick bedside evaluation because of its convenience and low cost (R. Ruff, 2017).

The 2 & 7 test has good psychometric properties in normal population (Messinis et al., 2007; R. Ruff, 2017; Ronald M Ruff & Allen, 1996). In addition, there are also different clinical populations evaluated by the 2 & 7 test in some research literatures (Lan, Tsai, & Tan, 2011; R. Ruff, 2017; Ronald M. Ruff, 1994; Ronald M. Ruff, Niemann, Allen, Farrow, & Wylie, 1992). However, the test-retest reliability and practice effects of the 2 & 7 test are still unknown in patients with schizophrenia so that the assessment results will affect clinical intervention. Thus, we aim to assess the test-rest reliability and practice effect of the 2 & 7 test in schizophrenia.

AOTA. (2014). Occupational Therapy Practice Framework: Domain and Process (3rd Edition). American Journal of Occupational Therapy, 68(Supplement_1), S1-S48. Retrieved from http://dx.doi.org/10.5014/ajot.2014.682006 doi:10.5014/ajot.2014.682006

Bortolato, B., F Carvalho, A., & S McIntyre, R. (2014). Cognitive dysfunction in major depressive disorder: a state-of-the-art clinical review. CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders), 13, 1804-1818.

Ettinger, U., Mohr, C., Gooding, D. C., Cohen, A. S., Rapp, A., Haenschel, C., & Park, S. (2015). Cognition and Brain Function in Schizotypy: A Selective Review. Schizophrenia Bulletin, 41, S417-S426. doi:10.1093/schbul/sbu190

Golisz, K. M., & Toglia, J. P. (2003). Section II: Perception and Cognition. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard & Spackman's Occupation Therapy (tenth ed., pp. 402-403). Philadephia: Lippincott, Williams & Wilkins.

Lan, C.-M., Tsai, P.-C., & Tan, M.-Y. (2011). Validation of the Ruff 2 and 7 Selective Attention Test for Outpatients with Schizophrenia. [羅夫2與7選擇性注意力測驗於精神分裂症門診病患的效度研究]. Journal of Occupational Therapy Association R.O.C., 29, 28-45. doi:10.6594/jtota.2011.29(1).02

Messinis, L., Kosmidis, M. H., Tsakona, I., Georgiou, V., Aretouli, E., & Papathanasopoulos, P. (2007). Ruff 2 and 7 Selective Attention Test: Normative data, discriminant validity and test–retest reliability in Greek adults. Archives of Clinical Neuropsychology, 22, 773-785. doi:https://doi.org/10.1016/j.acn.2007.06.005

Ruff, R. (2017). Ruff 2 and 7 Selective Attention Test. In J. Kreutzer, J. DeLuca, & B. Caplan (Eds.), Encyclopedia of Clinical Neuropsychology (pp. 1-3). Cham: Springer International Publishing.

Ruff, R. M. (1994). What Role Does Depression Play on the Performance of the Ruff 2 and 7 Selective Attention Test? Perceptual and Motor Skills, 78, 63-66. doi:10.2466/pms.1994.78.1.63

Ruff, R. M., & Allen, C. C. (1996). Ruff 2 & 7 selective attention test: professional manual: Psychological Assessment Resources.

Ruff, R. M., Niemann, H., Allen, C. C., Farrow, C. E., & Wylie, T. (1992). The Ruff 2 and 7 Selective Attention Test: A Neuropsychological Application. Perceptual and Motor Skills, 75, 1311-1319. doi:10.2466/pms.1992.75.3f.1311

Sarter, M., Givens, B., & Bruno, J. P. (2001). The cognitive neuroscience of sustained attention: where top-down meets bottom-up. Brain Research Reviews, 35, 146-160. doi:https://doi.org/10.1016/S0165-0173(01)00044-3

Shi K. Liu, Chia-Hui Chiu, Ching-Jui Chang, Tzung-Jeng Hwang, Hai-Gwo Hwu, & Wei J. Chen. (2002). Deficits in Sustained Attention in Schizophrenia and Affective Disorders: Stable Versus State-Dependent Markers. American Journal of Psychiatry, 159, 975-982. doi:10.1176/appi.ajp.159.6.975

Yu, W. H., Chiu, E. C., Lin, G. H., Lin, H. Y., Hsueh, I. P., & Hsieh, C.-L. (2015). Test-retest Agreement, Random Measurement Error and Practice Effect of the Attention Scale for Elementary School Children. [Test-retest Agreement, Random Measurement Error and Practice Effect of the Attention Scale for Elementary School Children]. Journal of Occupational Therapy Association R.O.C., 33, 25-44. doi:10.6594/jtota.2015.33(1).02

CSFS-27, introduction

DSM 5, social function, schizophrenia
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5), the lifetime prevalence of schizophrenia is approximately 0.3%-0.7%. 

1. Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care.

schizophrenia, social dysfunction

Schizophrenia is characterized by delusions, hallucinations, disorganized speech and behavior, and other symptoms that cause social or occupational dysfunction.

schizophrenia, delete subtype

 The DSM-5 has added the word, “spectrum” to the title. The same basic diagnoses are still available in the DSM-5. Some symptom criteria were changed to make diagnosis more accurate and precise.

Perhaps the most substantial change to this category of disorders is the elimination of subtypes (paranoid, disorganized, catatonic, undifferentiated, and residual). The rationale for doing away with these subtypes is they are not stable conditions and have not afforded significant clinical utility nor scientific validity and reliability.

2018/4/29
Progress in developing effective interventions to ameliorate these problems has been slowed by the absence of reliable and valid measures that are suitable for use in clinical trials. 
Bellack, Alan S., et al. "Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop." Schizophrenia bulletin 33.3 (2006): 805-822.

Ruff 2 & 7 table 1

Table 1. Demographic characteristics of the participants (n=62) excluding non data and bipolar

Variable	Mean	SD
Age	49.08	9.51
Onset	24.45	8.53
Duration of illness	24.63	10.32
Variable	n	(%)
Gender
Male	37	59.68
Female	25	40.32
Education
£12years	55	88.71
13-16years	6	9.68
³17years	1	1.61
Severity
Mild	1	1.61
Moderate	47	75.81
Severe	4	6.45
unknown	10	16.13
Marital status
Single	49	79.03
Married	6	9.68
Divorced	7	11.29
CGI-S scores (pre-test)
2 (borderline)	1	1.61
3 (mildly ill)	22	35.48
4 (moderately ill)	37	59.68
5 (markedly ill)	1	1.61
CGI-S scores (post-test)
2 (borderline)	1	1.61
3 (mildly ill)	22	35.48
4 (moderately ill)	37	59.68
5 (markedly ill)	1	1.61

Notes: SD = standard deviation; CGI-S = Clinical Global Impression-Severity.