VERBAL AND VISUAL-MOTOR DIGIT SPAN

IN NEWLY INPATIENT FEMALE ALCOHOLICS:

CORRELATIONS WITH THE AGE

AND THE LENGTH OF ALCOHOL ABUSE

R. COCCHI, D. AGOSTINI, D. DONNINI, F. ALIOTTA


(Italian translation) 

Summary

Forty-six female alcoholic patients (age 28-66, average 44.83; 2-27 years of alcohol abuse, average 11.2) were given verbal and visual-motor digit spans during the clinical examination each of them underwent at the entrance, or in first days of inpatient staying. The results revealed an average reduction of more than 2 digits both in Verbal Digit Span and in Visual-motor Digit Span; a very significant difference between the two Digit Spans (0.0009); no significant correlations between age, or years of alcoholic abuse, and the two Digit Spans. The results suggest a gender difference, because we found in a previous research age and years of abuse of males always highly correlated with both digit spans. (Cocchi, Agostini & Donnini, 1993).

Key words: Verbal Digit Span; Visual-motor Digit Span; female alcoholics; age; length of abuse; gender difference.


Theoretcal and research bases

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In a previous research on verbal and visual-motor Digit Span in newly admitted alcoholics (Cocchi, Agostini and Donnini, 1993), the spread out for sex showed a gender difference. The small number of female alcoholics suggested doubts that these differences could only be done to the poor representability of the female sample.

The greater amount of tested females we gained forced us to redo this investigation for either to confirm or not such gender difference in the Digit Span at admission.

We recall here that the Digit Span test (DS) with direct digits repetition is administered according to WAIS rules. It mainly explores a share of short term acoustical memory, the acoustical-verbal intermodal transfer and the normal ability to form the verbal production.

By maintaining the acoustical input, it is even possible to elicit a visual-motor replay. The tested person has to point eared digits with the non-dominant hand in tables where the nine digits were random printed, having one different table for each reply.

In this way we can evaluate an actual difference, if any, between the verbal and the acoustical-motor answer. We previously made it when investigating people with various forms of dementia, as compared with a control group (Cocchi, Sellerini and Pola, 1987; Cocchi, Pola, Rossetti and Pala, 1987; Cocchi, Zerbi and Savoldi, 1988; Cocchi, Rossetti and Pola, 1990) and then a mixed sample of alcoholics (Cocchi, Agostini and Donnini, 1993).

In account of it we could suggest that a visual-motor answer of the DS, elicited by the non-dominant hand, has more facility to explore acoustical areas, associating acoustical-visual-motor areas and motor areas of the non-dominant half-brain.

In this investigation, as for female inpatients alcoholics, we aimed to verify both DS answers, given when they entered the hospital or during first days of inpatient stay. Then we correlated them with patients' age and years of abuse.

 

Subjects, materials and methods.

Forty-six female alcoholics newly inpatients in our hospital had their verbal Digit Span (VDS) and visual-motor Digit Span tested. This people make a consecutive, gender selected sub-series coming from a consecutive non selected series. Who entered twice during our investigation did not have a second count. Of these cases we used only digit span scores of first entry.

From every subject we collected age and years of abuse, during the admission visit.

Testing and scoring was made according to WAIS norms.

As the tool to elicit both digit spans we used the double series of digits the WAIS proposes for a similar purpose, but without any reverse repetition. In facts we used the first series of digits to elicit the verbal response, and the second series of digits to elicit the visual-motor response.

We obtained the visual-motor answer having the subject to immediately point the heard digits, in the same order, on the submitted table, with the non-dominmant hand. In these tables the nine digits were written in a random way.

We used each special table only once in the same subject under the test. Before starting the V-MDS test we told the subject not to say the numbers shown or pointed, even to him/herself at a whisper.

Statistics: Chi Square and simple correlation

 

Results.

These are features of our sample:

No.of Ss: 46, all females.

Age at admission: range 28-66 years, average 44;10 +/- 10.22 years.

Length of alcohol abuse: range 2-27 years, average 11:2 +/- 6.05 years.

We reported other results on tables 1-4.

 

Table 1: Detailed casuistry.

No of Ss.

 

Age at the admission

Years

of abuse

Verbal Digit

Span

Visual-motor

Digit Span

1

31

7

5

4

2

54

27

4

4

3

28

2

7

7

4

48

15

6

6

5

52

3

5

4

6

45

12

6

6

7

57

5

5

4

8

58

22

5

4

9

39

13

4

4

10

39

16

4

4

11

37

10

4

4

12

36

10

4

4

13

57

20

6

4

14

40

10

6

5

15

48

6

6

5

16

32

7

5

5

17

33

8

5

4

18

30

15

3

5

19

38

10

4

4

20

54

15

4

4

21

63

10

6

4

22

40

15

6

5

23

41

15

5

5

24

31

10

6

5

25

58

8

3

4

26

48

20

6

7

27

52

7

5

5

28

58

23

3

4

29

42

7

6

6

30

35

3

5

5

31

41

9

4

5

32

66

5

5

5

33

45

3

5

6

34

43

6

5

5

35

42

15

6

6

26

54

13

4

4

37

31

11

6

5

38

50

5

5

6

39

48

8

4

5

40

30

6

6

6

41

30

3

5

5

42

47

10

4

4

43

39

22

6

6

44

61

21

4

5

45

57

15

6

6

46

51

8

4

4

Average

44.83

11.20

4.98

4.91

SD

11.22

6.05

0.98

0.89

As you can see, both VDS and V-MDS score average 5 +/- 1 SD, wich clairly differs, by lowering, from the normal average 7 +/- 2 found by Milner for the VDS.

 

Table 2: Distribution by subjects of VDS and V-MDS scores

Score

Verbal Digit Span

Visual-motor Digit Span

 

No. of Ss

Total score

No. of Ss

Total score

3

3

9

0

0

4

12

48

18

72

5

15

75

16

80

6

15

90

10

60

7

1

7

2

14

Totali

46

229

46

226

Chi Square = 22,276 with 4 df and p = 0.0009

As you can see, there is a very significan difference as for VDS and V-MDS distribution. This strongly suggest that the two Digit Spans are the result of the evaluation ofdifferent bran structures or mechanisms

 

Table 3: Comparison of the two Digit Spans scores

Comparison direction

No. of Ss

%

DSV > DSVM

13

28.26

DSV < DSVM

10

21.73

DSV = DSVM

23

50.00

 

Same score Digit Spans account for 50%, while in the remaining cases we can find either a better score in the VDS either in the V-MDS.

.Table 4: correlations.

---------------------------------------------------------------------------------------------------------------------.

Age vs DSV: r = - 0,206; t = - 1,396 with 44 df, and p = 0.170 N.S

Age vs DSVM: r = - 0,269; t = - 1,853, with 44 GL, and p = 0.071 N.S.

Years of Abuse vs DSV: r = - 0,183; t = - 1,235, with 44 GL, and p = 0.223 N.S.

Years of abuso vs DSVM: r = - 1,121; t = - 0,807; with 44 GL, and p = 0.424 N.S.

---------------------------------------------------------------------------------------------------------------------.

No significant correlations, differently to what we found in male alcoholics. (Cocchi. Agostini and Donnini, 1993).

 

Discussion.

We found a very significant difference between the two Digit Spans, which again confirms the hypothesis that VDS and V-MDS measure different functional abilities. In our sample of alcoholic females they do no overlap in 50% of cases.

To find the same results in 50% of subjects, could even suggest that there be an equally spread reduction, if any.

On the other hand, the average diminution of more than two points, compared to the normal average, clearly drives to think a pathological reduction in female alcoholics too.

Moreover we can think so, by the fact that we did not find any Digit Span score larger than seven, a very improbable result in normal people. In a series of 46 VDS and a series of 46 V-MDS we should have to get at least about ten scores larger than seven for each series.

This investigation, aiming to discover real gender differences in alcoholic female at hospital admittance, confirmed what we brought to light in the reduced sub-sample of the previous research. (Cocchi, Agostini and Donnini, 1993).

There are no correlations between the two Digit Spans and age or years of alcohol abuse. This happens for a sample fairly paired for age and years of abuse to that of the previous research, where i. Even now the scores distribution of the two Digit Spans is always significantly different; ii. The direction of the comparison between the two Digit Spans nearly overlaps that same rate comparison in the previous research.

As for the link between age and Digit Spans, anyhow the whole sample shows a marked correlation trend vs. the V-MDS as found in the previous research, although it has a negative - the span decreases as the age grows - non significant correlation vs. both Digit Spans.

Age was reported as a significant variable in a research of Digit Spans in demented people (Cocchi, Zerbi and Savoldi, 1988). Its role in alcoholics surely deserves a deeper investigation. Why this gender difference is, at the moment, a thing without a possible explanation, because many variables could have been involved

 

Conclusion.

Verbal and visual-motor digit spans, as given to a consecutive series 46 female alcoholic inpatients during the clinical examination each of them underwent at the entrance, or in first days of inpatient staying, confirmed what we discerned in the previous research.

We found two points average reduction of both Digit Spans; A very significant difference between the two; No correlations between age, or years of abuse, and any of them. The last datum does not match what happened in male alcoholics where age and years of abuse very significantly correlate with both Digit Spans.

 

References.

Cocchi R. Agostini D. Donnini D.: Digit span verbale e visivo motorio in etilisti nuovi ricoverati: Correlazioni con sesso, eta’ e durata dell’abuso alcolico. Riv. Ital. Disturbo Intellet. 1993, 6: 91-103

Cocchi R., Sellerini M., Pola A.: Ricerche sulla validita‘ del Digit Span nei test di memoria. In: Pavoni E., Saraceni F. (a cura di): Atti del I Congresso Nazionale SIPG. Vol. II. Idelson, Napoli 1986: 535-539.

Cocchi R., Pola A., Rossetti R., Pala P.: Digit Span verbale e visivo-motorio in dementi e in soggetti di controllo: tre sottogruppi di risposte. In: Pavoni E., Saraceni F. (a cura di): Atti del II Congresso Nazionale della SIPG. Vol. I. Idelson, Napoli 1987: 153-156.

Cocchi R., Rossetti R., Pola A.: Digit span verbale e visivo-motorio in 12 casi di incerta diagnosi tra demenza e pseudodemenza. In: Pavoni E., Saraceni F. (a cura di): Atti del III congresso nazionale della SIPG. Idelson, Napoli 1990: 223-227.

Cocchi R., Zerbi F., Savoldi F.: Verbal and visuo-motor digit span in demented inpatients: A controlled study. Ital. J. Intellect. Impair. 1988, 1: 133-140.

Milner G.A.: The "magical" number 7, plus or minus two: Some limits on our capacity for processing information. Psychol. Rev. 1956, 63: 81-97.

 

Printed in Italian on Riv. It. Disturbo Intellet. 1993, 6: 163-268.

First English translation on Internet, January 2002

 

 Author's address: dr Renato COCCHI Via Rabbeno, 3

42100 Reggio Emilia (Italy).

renatococchi@libero.it

 

Italian translation 

Theoretical and research bases

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