MATRICS and is in support of improving cognition

MATRICS Consensus
Cognitive Batter (MCCB) Test Critique

The
MATRICS Consensus Cognitive Battery (MCCB) was developed by pharmacological associates and originally developed to be an
endpoint for cognitive enhancement clinical trials, in hopes to better develop cognition in schizophrenia.
(Nuechterlein et
al., 2008, Kern et al., 2008).
To date, there is limited data concerning the clinical and cognitive correlates
of the battery. Three recent studies demonstrate the sensitivity of the battery
to the general severity and pattern of cognitive impairments expected in people
with schizophrenia 

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Today, the Measurement and Treatment
Research to Improve Cognition in Schizophrenia (MAATRICS) is a standardized
test used for adults who suffer with schizophrenia or other disorders which are
related and is in support of improving cognition in schizophrenia. The battery
test has also been looked at to use in clinical trials with patients with
bipolar who show cognitive deficits.  The
test provides Evidence revealing that
cognitive shortfalls are primary features of schizophrenia, increasing
relationship support between cognition and function outcome and has been
increased regarding the basic studies of neuropharmacology and cognition. 

The MCCB complete
kit includes Manual, 25 MCCB Administrator’s Forms, 25 MCCB Respondent’s
Booklets, 2 Software Disks in plastic sleeves (one with the CPT-IP and the
second with the MSCEIT™ and MCCB Scoring Programs, 1 Scoring Template for the
BACS Symbol Coding Task, 1 WMS-III™ Spatial Span Board, 25 HVLT-R Test
Booklets–Form 1, 1 BVMT-R Recall Stimulus Booklet, 25 Executive Functions Module
Response Booklets–Form 1, and 25 NAB Mazes Test Record Forms–Form 1, in an MCCB
box.  There are several retest kits
available depending on the need of the administrator.  Each kit costs $550.00.

The MCCB Battery test is in hard-copy form.  Completion of this test on-line is not an
option, it is not available.  The test
can be administered in individuals 18 years of age and older and administration
of the test takes approximately 60-90 minutes from start to finish.  Once the test is administered, the scoring of
the battery test is initially hand-scored to obtain raw scores.  Once hand-scored the raw scores are entered into
the computer program.  Once that is completed,
T- Scores and Percentiles are generated and seven cognitive domains result in
graphic profile when then Produces a data file for export. 

The Measurement and Treatment Research to Improve Cognition in
Schizophrenia (MAATRICS), Consensus Cognitive Battery test was originally
presented in a Journal in 2008 in three separate articles.  Since those articles were published the MCCB
has been evaluated and scrutinized in a way that most other test battery
assessments have been.  However, over
time the strengths of the MCCB have increased according to (Keefe, RS, 2011)

Test
Description

The Measurement and Treatment Research to Improve Cognition in
Schizophrenia (MAATRICS), Consensus Cognitive Battery test initially was
designed to develop a pathway for drug approval.  The FDA would not approve any type of drug to
enhance cognition in an individual with schizophrenia because they demanded a
consensus on domains, measurement and study design (Green et.al., 2011). 

The components of the MCCB i.e., raw scores, T-scores and
percentiles were selected through both consensus and data collection.  Coming to an agreement on the cognitive
domains was the first step to be presented in the schizophrenia trials.  Once that step was established and domains
agreed upon the next step was to select a test based on prior criteria of
domain level. L 

The Measurement and Treatment Research to Improve Cognition in
Schizophrenia (MAATRICS), Consensus Cognitive Battery test is a standardized
test used for adults who suffer with schizophrenia or other disorders which are
related and is in support of improving cognition in schizophrenia. As mentioned
above the battery test has also been looked at to use in clinical trials with
patients with bipolar who show cognitive deficits.  The test focuses on and produces scores on Seven cognitive domains;

1)  Speed of processing using the Assessment in Cognition
(BACS) Symbol Coding;

2)  Attention/Vigilance, using continuous
performance Identical Pairs (CPT-IP);

3)  Working Memory/Verbal using Westler Memory
Scale – 3rd Ed.;

4)  Verbal Learning using the Hopkins Verbal
Learning;

5)  Working Memory/Non-verbal using Spatial Span
Letter-Number Span;

6)  Social Cognition, using Mayer-Salovey-Caruso
Emotional Intelligence Test 

            (MSCEIT):  Managing
Emotions

7)  Reasoning and Problem Solving, using
Neuropsychological Assessment Battery (NAB) Mazes

 

 

The Speed of Processing cognitive domain
is a paper and pencil test and is timed. 

The correction key is used to identify symbols of
nonsense.  The oral test required the
test-taker name as many animals as they can in a one minute timeframe.  The last portion of the Speed of Processing
the test-taker uses a pencil and paper to draw a line to connect consecutive
numbered circles placed randomly on the sheet of paper.

The Attention/Vigilance cognitive domain
is a computer administered test where the test-taker presses a computerized
button for matching numbers consecutively.

Working Memory, the Non-Verbal Cognitive
Domain consist of 10 cubes that are placed randomly.  The object is for the test-taker to tap the
cubes in the same order that the administrator taps the cubes.  When orally administered, the test-taker
mentally records strings of numbers and letters then repeats back to the
administrator (Tomida, 2010).

Verbal Learning cognitive domain is
comprised of 12 words from three taxonomic categories.  The 12 words are presented to the test-take
and the test-taker recalls as many of the words as possible after the learning
trial of each of the three.

Visual Learning cognitive domain consists
of the test-taker reproducing six geometric figures from memory his or her
memory.

Reason and Problem Solving cognitive
domain is completed with paper and pencil and is timed.  The test-taker completes a series of seven
mazes with each of the seven increasing in difficulty.  This test has been proven to help to see
foresight and planning.

Social Cognition cognitive domain is
completed with paper and pencil.  The
test is a series of multiple choice questions and assesses how an individual
manages emotions based on those multiple-choice questions. 

The above mentioned cognitive domain
testing processes are administered to individuals that are 18 years old and
older.  The test is a standardized test used for adults who suffer with
schizophrenia or other disorders which are related and is in support of
improving cognition in schizophrenia. As mentioned above the battery test has
also been looked at to use in clinical trials with patients with bipolar who
show cognitive deficits the series of tests are professionally administered and will
typically take anywhere from 60 minutes to 90 minutes to administer.  Once each of the separate tests are
completed, the results are hand scored and Software Administration scored,
meaning they are both manually and computer scored.  The computer scoring is the final of the two
scoring mechanisms and produces data files for export.  The administrator first inputs the raw scores
into the computer scoring program.  Once
entered, those raw scores are generated into T-Score percentiles.  At this point is where the seven cognitive
domains are created into a graphic profile and finally exported into other programs and/or
analysis.

Technical
Evaluation

The below seven properties
were decided by the Neurocognition Committee to be the most relevant
testing/assessing cognitive change with individuals diagnosed with
schizophrenia and similar disorders to include use
in clinical trials with patients with bipolar who show cognitive deficits.  Test-restest or short-term stability improved
to be the most beneficial and critical of the battery designed test because
it’s sensitive to cognitive change.  The
MCCB was measured over a four-week period along with Pearson Product.  The Pearson product revealed a measurement of
minimal stability at only .70.  Whereas
repeated testing measures of the MCCB revealed a small practice effect on the
test of the individual when administered four-weeks apart.  The seven properties of the MCCB test that
were recognized in support of Reliability and
Validity are below.

Scientifically validatedExtensive validity and reliability informationTest-retest reliabilityUsefulness as a repeated measureRelationship to functional outcomeTolerability to respondentsPracticality for test determination

According to Kern, RS,
2008, the individual neuropsychological tests that are included in the MCCB are
scientifically validated.   For more
information regarding the MCCB Technical manuals have been produced and are
available to the public.  These manuals
will provide extensive information regarding the validity and reliability of
the MCCB test.

In addition to the e seven properties Normative Data allows for
the MCCB to include corrections for age and gender; age, gender, and education;
or there may be no demographic correction. 
In any of the scenarios a T-score and percentile can be accessed.  Making for a flexible demographic
result.  The Normative Data that can
include corrections is Age/gender correction or; Age/gender/education correction or; No
demographic correction and; T-scores and percentiles are accessible

Practical
Evaluation

The MCCB Battery test is in hard-copy form the clarity and
comprehensiveness of instructions, directions and guidance that is provided, is
provided by and administered by a certified administrator.  Because the test is designed to be
administered to adults who suffer with schizophrenia or other disorders which
are related and is in support of improving cognition in schizophrenia as well
as clinical trials with patients with bipolar who show cognitive deficits the
test is not complex with a lot of graphic designs.  The presentation is clear and simple to
prevent the test-taker from becoming overwhelmed and frustrated before
beginning the test (Fiszdon, 2003). 

The test can be administered in individuals 18 years of age and
older and administration of the test takes approximately 60-90 minutes from
start to finish.  Once the test is administered,
the scoring of the battery test is initially hand-scored to obtain raw
scores.  Once hand-scored the raw scores are entered into
the computer program.  Once that is completed,
T- Scores and Percentiles are generated and seven cognitive domains result in
graphic profile when then Produces a data file for export. 

Summary
Evaluation and Critique

At one point the MCCB test was only available
in English which was a limitation, today the MCCB is professionally translated
and available commercially in over 20 languages.  In addition, representative normative data in
various key Countries has been collected and the data gathered is used to create
international scoring programs.  Although
MCCB has demonstrated impressive psychometrics there are some area s of
weakness or limitations. 

The MCCB does not provide an option for
social cognition composite since domain has only one test.  Therefore, leaving a gap because it is
unknown how the performance of the MCCB relates to such basic measures of
cognitive ability such as how the domain scores interact with each other and in
intelligence. 

On a positive note, the relationship between
MCCB performance and basic cognitive abilities has been investigated.  Now presenting data on the distributions
scores of MCCB to enhance clinical cognitive ability as well as use data on the
distributions of MCCB scores to enhance clinical interpretation of performance
and report on the relationship to symptomatic state, and the key outcome
dimensions of work and social functioning.

According to (Nuechterlein K, 2008), After
multi testing and clinical trials the MCCB is inspiring and validates
remarkable psychometrics.  The test has
shown understanding toward improvement from interventions, especially for
cognitive training interventions.

In summary, The
Measurement and Treatment Research to Improve Cognition in Schizophrenia
(MAATRICS), Consensus Cognitive Battery (MCCB) has shown positive results.  The test supports excellent reliability,
nominal practice effects, missing data is minimal and there are significant
relationships with functional measurements (Green, 2011, Nuechterlein,
2008).  However, the MATRICS Consensus
Cognitive Battery (MCCB) is developed and used only in clinical trials for
schizophrenia for adults ages 18 and older. 
I believe there is a dire need for development of testing norms for the
younger population.  Schizophrenia and
bipolar signs and symptoms can come on in early stages of life.  Neurocognitive impairments are a fundamental
problem, beginning as an adolescent during the premorbid period and continuing
throughout life with individuals with schizophrenia.  At present the only reliable and valid
testing assessment is designed for an older population, we are not meeting the
needs of our younger population.   There
is an entire world of 18-year-old and younger that also have the need and
rights for appropriate testing assessment.