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
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:
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
Theoretical and research bases
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