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ARMY PROJECT ORDER NO: 84PP4806

TITLE: DEVELOPMENT AND EVALUATION OF A HUMAN PERFORMANCE

ASSESSMENT BATTERY

PRINCIPAL INVESTIGATOR: John Schrot

CONTRACTING ORGANIZATION: Naval Medical Research andDevelopment Command

Naval Medical Research InstituteBethesda, Maryland 20814-5055

REPORT DATE: September 1, 1990

TYPE OF REPORT: Final Report

PREPARED FOR: U.S. ARMY MEDICAL RESEARCH AND DEVELOPMENT COMMANDFort Detrick, Frederick, Maryland 21702-5012

DISTRIBUTION STATEMENT: Approved for public release;distribution unlimited

The findings in this report are not to be construed as anofficial Department of the Army position unless so designated by

other authorized documents.

91-03204

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Development CommandI6C. ADDRESS XCty, Staff, .and ZIP Code) 7b A30FIESS City, Stale, an~d ZIP COde)

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Research & Development Command j________ Army Project Order No. 34PP4806

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Frederick, Maryland 21702-5012 80A 60793011

1 1 TITLE (In~fc~ei Sec~jrry CIaification)

Development and Evaluation of a Human Performance Assessment Battery

12 PERSONAL ATl-4OR(S)

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FOREWORD

For the protection of human subjects, the investigator(s)have adhered to policies of applicable Federal Law 45CFR56.

Citations of commercial organizations and trade names inthis report do not constitute an official Department of the Armyendorsement or a-roval of the products or services of theseorganizations.

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SUMMARY

The Environmental Medicine Department (EMD) at the NavalMedical Research Institute (NMRI) joined the JWGD3 MILPERFprogram in 1984. The primary mission was to develop and evaluatea human performance assessment battery. The battery was toconsist of a Level I Neurophysiological screen and a Level IIPerformance Assessment Battery (PAB).

The EMD mission with JWGD3 MILPERF has been successfullycompleted and this laboratory continues to support and contributeto the efforts of the Office of Military Performance AssessmentTechnologies (OMPAT), which succeeded the JWGD3 MILPERF.

A brief list of EMD's accomplishments are listed here and

are elaborated in the YEARLY HIGHLIGHTS section below.

* Authored a performance assessment battery.

* Developed a neurophysiological performance assessmentbattery.

* Validated the batteries in a study of humanperformance during cold exposure.

* Employed the batteries as part of the JWGD3 MILPERFantihistamine validation effort.

* Transferred the PAB technology to JWGD3 MILPERFmember laboratories and a number of universities.

* Participated in the Beta testing of the Unified Tri-Service Performance Assessment Battery (UTC-PAB)software system.

* Participated in the effort to generate standard testparameters for the individual tests of the TC-PAB.

* Contributed two unque tes's to the UTC-PAB libraryof tests.

* Participated in the generation of standard testpara u, 7!L chb *.L igicd± test battery.

k Developed a model of pulmonary functioning under

stress using the MicroSAINT modeling environment.

* Enhanced the MicroSAINT modeling environment bydeveloping procedures for the solution ofdifferential equations.

* Monitored a contract effort to provide a taskanalysis of combat critical shipboard personneloccupational specialties.

YEARLY HIGHLIGHTS

FY 1984 (April 1984 - September 1984)

Progress consisted of (a) facilities/equipment, (b) testbattery development, and (c) initiation of task analytic studies.

(a) Facilities/Equipment: With the acceptance of a new laboratoryfacility and computerized heat/cold environmental chamber and thepurchase of ancillary test equipment, we developed the capabilityof conducting performance and physiological studies of thermalstress. The 15x15 ft programmable heat/cold chamber provided thecapability of performing a full range of laboratory evaluationsof behavioral and physiological performance.

(b) Test Battery Development: A neurocognitive/psychomotorassessment battery consisting of 31 repeated measures tests (with15 alternate forms each) was developed and studies were initiatedto establish standardized norms. Thirty subjects completed eachof the tests, and normative data on acquisition, stability, andreliability were collected. This test battery was intended toallow a comprehensive evaluation of cognitive and psychomotorperformance of individuals performing under potential stressesimposed by CW antidote/pretreatment agents.

(c) Task Analysis: A major portion of this work unit dealt withidentifying ratings/jobs of shipboard personnel consideredcritical to combat mission accomplishment and who would beexposed to the contaminated environment during a CW attack.

Initial progress was as follows: Job task inventories ofNavy ratings were acquired from the Navy Occupational Develcpmentand Analysis Center (NODAC). This information was furtherseparated according to ship classification (e.g. DD vs CVN).Preliminary findings indicate that the following ratings arecritical among combatant ships: Fire Control Technician (FT),Boatswain's Mate (BM), Gunner's Mate (GM), Signalman (SM),Missile Technici-n IMT), 11azt-r-at-ALi11 4.iA, Quartermaster ,),and Hull Maintenance Technician (HT).

FY 1985

Task Analysis: A formal contract package was constructed,delivered to the Office of Naval Research, and final negotiationswere completed. Dr. Edwin Fleishmen and his associates from theAdvanced Research Resources Organization (ARRO) have beenselected to provide the required extramural suppurt.

Level I (Neuropsychological Task Area Group) activities: Theassociate investigator (AI) was selected as Chairman for theLevel I TAG, and through collaborative efforts within the TAG,major components for the standardized level I screen weredesigned, and prototypes produced. This included selected evokedpotential paradigms and a section of automatic psychomotor tests.In addition, the AI has provided consulting services as a memberof the review board assigned (by the JWGD3) to establishextramural support for the development of an automatedneuropsychological assessment battery.

Level Ila (Cognitive Performance Task Area Group)activities: In cooperation with other TAG members a 25 testUnified Tri-Service Cognitive Performance Assessment Battery(UTC-PAB) was designed, and prototype components developed. Inaddition to the battery contents, a standardized hardware andoperating system was developed for JWGD3 standardization.

Level Ilb (Performance Physiology Task Area Group)activities: In collaboration with other members of the Level IlbTAG, a formal performance physiology battery was constructed. Inaddition, collaborative efforts with USUHS are underway todevelop a mobile field laboratory to provide support for theinitial residential screen to be conducted at ARC.

Progress from this work unit will be formally presented atthe 1985 American Psychological Association convention (LosAngeles, CA) in the form of two poster presentations, and apresentation.

FY 1986

Task Analysis: A formal contract package was constructed,delivered to the Office of Naval Research, and final negotiationshave been completed. Dr. Edwin Fleishmen and his associates fromthe Advanced Research Resources Organization (ARRO) providing therequired extramural support and progress includes a specialforces and shipboard task analysis.

Level I (Neuropsychological Task Area Group) activities:Through collaborative efforts within the TAG, major componentsfor the standardized level I screen were designed, and prototypesproduced. This included selected evoked potential paradigms and asection of automatic psychomotor tests (e.g. Zita and intentionaltremor device). Tn addition, ESPC provided consulting servicesfor the source selection board assigned (by the JWGD3) toestablish extramural support for development of an automated

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neuropsychological assessmsnt battery.

Level Ila (Cognitive Performance Task Area Group)activities: In cooperation with other TAG members a 25 testUnified Tri-Service Cognitive Performance Assessment Battery(UTC-PAB) was designed, and a subset of prototype componentsdeveloped. In addition to the battery contents, a hardware systemwas dpveloned for JWGD3 standardization, and is currently beinginstalled.

A subset of the UTC-PAB consisting of eight tasks, six ofwhich were translated from existing cognitive performance PABS,and two of which were generated at NMRI was created. This subsetis referred to as the NMRI-PAB. One of the tasks generated atNMRI (matching-to-sample) has been incorporated into thedevelopment of the UTC-PAB, the other task (repeated acquisition)is being submitted for consideration by the JWGD3 joint workinggroup chairman for inclusion in the UTC-PAB. An "executive"program for controlling the NMRI PAB administration was alsocompleted. The NMRI PAB was used to collect baseline data andestimates of the sensitivity of its constituent tasks wasevaluated by manipulating task parameters.

Level Ilb (Performance Physiology Task Area Group)activities: In collaboration with other members of the Level IlbTAG, a formal performance physiology battery was constructed. Inaddition, collaborative efforts with USUHS are underway todevelop a performance physiology laboratory to provide supportfor the initial residential screen to be conducted at ARC.Additionally, the anticholinergic-autonomic tone review ofliterature was completed.

FY 1987

During FY87 this laboratory evaluated three separaterevisions of Version 1 of the UTC-PAB software system. Thisrequired construction of a sample task in the configurationsystem and implementing its execution with the runtime system. Ateach stage in the configuration and runtime process the testconstructors noted inaccuracies, inefficiencies, and failures insystem operations. These findings were then incorporated intowritten reports which were forwarded to the Director, JWGD3MILPERF for forwarding to the software contractor.

The NMRI-PAB was used to evaluate human performance in a Navyfunded study evaluating the effects of acute cold exposure.Subjects were exposed to a temperature of 4 degrees C for aperiod of 90 minutes. Throughout the 90 minute period bloodsamples were taken. At minute 45 of the session the NMRI-PAB wasstarted and the subjects performed on the PAB for approximatelythe next 30 minutes. The results indicated that for most subjectscore temperature remained stable throughout the sessions. PABperformance however showed changes in accuracy and latency during

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the exposures. In general, newly acquired behavior was moredisrupted than well learned behavior and affected responselatencies tended to be shorter. Measures of peripheral bloodlevels of epinephrine and norepinephrine were elevated in thecold but also showed an interactive effort with PAB performancein which the levels were significantly higher than they werepreceding PAB performance.

Neuropsychology and PAB. The ability to simultaneouslymeasure evoked potentials and performance on one task of theNMRI-PAB has been completed. By tying the evoked potential signalaveraging equipment to the microcomputers used to manage PABstimulus production and data acquisition, it is now possible toquantify cognitive evoked potentials relative to performance on aspecific PAB task. With the use of 18 channel topographicalanalysis of cortical excitation, it appears that differentstimulus conditions within the task produce evoked potentialswith different scalp distributions.

FY 1988

During the reporting period this laboratory providedtechnology transfer and implementation support of the NMRI-PABsubset of the UTC-PA3 to the Naval Aerospace Medical ResearchLaboratory, Walter Reed Army Institute of Research, GeorgetownUniversity, the United States Army Aerospace Medical ResearchLaboratory, Diving Medicine Department - Naval Medical ResearchInstitute, the University of Southern Mississippi, and theUniversity of Massachusetts - Amherst.

The MicroSaint modeling environment was used to generate amodel of cold exposure and physical stress effects on pulmonaryfunctioning. The MicroSAINT system was also enhanced by thedevelopment of procedures for the solution of differentialequations within the system.

A Performance version of the Repeated Acquisition test wasdeveloped for inclusion in the NMRI-PAB. Repeated Acquisitiontests a subjects' ability to learn a new extended responsesequence. The Performance version of this test evaluates asubjects ability to accurately repeat the same sequence ofresponses on numerous occasions for extended time periods.

The expanded version of the NMRI-PAB was used in a Navyfunded study of cold exposure effects on human behavior andphysiology. This study also included the use of Level 1procedures to evaluate the effects of cold exposure on evokedpotential latencies. The preliminary data from this studyindicates a shortening of evoked potential latencies in the coldas compared to ambient temperature levels.

Evoked potential topographical mapping procedures were used

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to evaluate the distribution of pattern reversal evokedpotentials over the occipital pole. The distributions were foundto be asymmetric for visual patterns nf fine sDacial structure.Papers have been submitted for publication from both of theevoked potential studies.

FY 1989

During the reporting period a study comparing the effects ofantihistamine administration on the sensitivity of nineperformance assessment battery tasks was undertaken andcompleted.

Objective:This study was designed to provide experimental data

validating a nine test subset of the UTC-PAB library of tests, aswell as auditory and visual evoked potential tests from the NP-PAB library of tests. The evaluation was performed byadministering therapeutic doses of diphenhydramine (Benadryl) orterfenadine (Seldane) prior to PAB administration.Diphenhydramine was chosen because of its purported centralnervous system (sedative) effects, while terfenadine was chosenbecause of its purported lack of similar effects. The widespreaduse of antihistamines in military environments makes thesecompounds ideal candidates for the testing and evaluation of amilitarily relevant performance assessment system.

Method:The subjects were six adult males between the ages of 19 and

36 years. The subjects were medically pre-screened and werejudged by a physician to be in good health. Following selectionfor the study the subjects were briefed on the experimentalprotocol by the Principal Investigator and given a copy of theinformed consent form to read and sign. Each subjects bloodpressure and heart was monitored following each experimentalsession and the subjects were not allowed to leave the premisesuntil these measurements were within normal range. All subjectswere compensated for their participation in the study.

The PAB tests used in this study were written in theQuickBASIC 4.5 programming language. The documentation detailshave bcen previously reported (1, 2). Performance assessmentbattery administration was automated on a Zenith 150 series microcomputer system. Data were recorded for accuracy and latency ofresponding for each trial of the tests.

The evoked potential procedures evaluated were the patternreversal evoked potential and auditory event related potentialmeasurements.

Procedure:The study consisted of two phases, a training phase and an

experimental phase. During the training phase each subject was

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given one or two sessions of training with a demonstrationversion of the PAB. This version contains a screen ofinstructions that precedes each PAB test, the number of trials ineach test is reduced, the subject receives auditory feedback foreach correct response, and the transition from test to test isself-paced. No data were collected during these trainingsessions.

The next phase of training consisted of six to nine sessionswith a training version ot the PAB. During these sessions thefull number of trials for each test was employed, the subjectreceived feedback for correct responses, and the transition fromtest to test was machine controlled with a 20 second inter-test-interval between test presentations. These sessions requiredapproximately thirty minutes to complete, and subjects wererequired to perform the PAB two or three times each day. Datacollection was initiated during these sessions.

The final phase of training was identical to the experimentalphase of the study, excluding drug administration. During thisphase the subjects performed three PAB sessions, spaced at hourintervals, each day they visited the laboratory. The version ofthe PAB used did not include feedback for either correct orincorrect responses. This phase of training lasted until eachsubject achieved a criterion of 90% correct or better on eachtest for three sessions.

The experimental phase of the study consisted of ninesessions. Each subject was administered either 100 mg ofdiphenhydramine, 60 mg of terfenadine, or placebo three timeseach in a mixed order. Drug was administered and sessionsoccurred at 1 hour, 2 hours, and 3 hours post drugadministration. Evoked potential measurements were conductedbetween the second and third hour of PAB testing. Drugadministrations were spaced at least 48 hours apart. Allexperimental sessions took place between the hours of 0800 and1200. The subjects were alone and restricted to the testing roomfor the duration of the sessions but were allowed to read orlisten to a radio between sessions. T1e initiation of eachsession was controlled by an investigator.

Results:The data were analyzed for changes in both accuracy and

latency of responding. Data analysis indicated interactionsbetween treatment and hour of testing for accuracy of respondingduring the Chain Performance, Manikin, and Simultaneous PatternComparison tests of the PAB. An inspection of the data revealedthat accuracy of responding in the diphenhydramine condition wasreduced during these three tests. A level of significance of .01or better was obtained with these data. Analysis of the latencydata revealed changes with similar significance levels occ.-...ngduring the Repeated Acquisition test following diphenhydramineadministration. No consistent changes were observed in anycondition following terfenadine administration.

Analysis of the evoked potential data revealed greater intra-

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subject v:riability in both the pattern reversal evoked potentialand the auditory event related potential followingdiphenhylramine but not terfenadine administration. There wereno changes in either the latency or amplitude of the responsefollowing administration of either drug.

Conclusions:Three of the nine tests comprising the PAB proved to

sensitive to diphenhydramine but not to terfenadine when accuracyof responding was measured. One of the tests proved to besensitive to diphenhydramine but not to terfenadine when latencyof responding was measured. The majority of effects observedduring diphenhydramine administration occurred during the secondor third hour of testing. This is in conformance with thereported pharmacokinetics of diphe-nhydramine. Given orally thisdrug reaches maximal concentration in the blood in about twohours and remains at that level for another two hours.

During the reporting period this laboratory providedtechnology transfer and implementation support of the NYRI-PABsubset of the UTC-PAB to the Addiction Research Center, NIDA,Baltimore, MD, tlie Naval Submarine Medical Research Laboratory,Groton, CN, the University of Massachusetts - Amherst, and theARD Corporation, Columbia, MD.

PUBLICATIONS

1. Reeves, D. L., C. A. Shingledecker, D. R. Thorne, K. P.Wilson, C. E. Englund, and F. W. Hegge. The unified Tri-ServiceCognitive Performance Assessment Battery (UTC-PAB), abstract. APASymposiu-.- on Military Psychology, Anaheim, CA, August 23-27,1985.

2. Reeves, D.L. The Level I Screen: A clinicalneuropsychological/electrophysiological assessment, abstract. APASymposium on Military Pyschology, Anaheim, CA, August 23-27,1985.

3. Reeves, D. L. and S. L. Taube. Developments inneuropsychological and neurophysioloqical assessment: An overviewof progress and in products of the JWGD3 Level I neuropsychologytask area group. Report prepared for the rroceedings of the JWGD3MIL PERF Program Sub-element In Process Review. January 15-i 7 ,1986, Frederick, MD, 1987.

4. Reeves, D. L. and D. R. Thorne. A synopsis of UTC-PABDevelopment. Report prepared for the Proceedings of the JWGD3 MILPERF Program Sub-element In Process PRview, January 15-17 1986,Frederick, MD, 1987.

5. Englund, C. E., D. L. Reeves, C. A. Shing.edecker, D. R.

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Thorne, K. P. Wilson, and F. W. Hegge. The Unified Tri-ServiceCognitive Perfc-mance Assessment Battery I: Design andspecification of the battery. JWGD3 MIL PERF Report 86-1, AMRDCTechnical Report, 1987.

6. The Unified Tri-Service Cognitive Performance AssessmentBattery (UTC-PAB) II: Hardware/soft Pre design andspecifications. JWGD3 MIL PERF Report 86-2, AMRDC TechnicalReport, 1987.

7. J.R. Thomas and J.Schrot. Naval Medical Research InstitutePerformance Assessment Battery (NMRI PAB) Documentation. NMRI88-7, August, 1988.

8. J. Schrot ana J.R. Thomas. Naval Medical Research InstitutePerformance Assessment Battery Software. NMRI 88-8, August, 1988.

9. K. VanOrden and J.H. House. Assymmetry of the patternreversal visual evoked potential depends on stimulus spatialfrequency NMRI Technical Report, July 1989.

10. K.F. VanOrden, S.T. Ahiers, J.R. Thomas, J.F. House, and J.Schrot. Moderate cold exposure shortens evoked potentiallatencies in humans. Aviation, Space, and Environmental Medicine,61:63b-639, 1990.

MAJOR BRIEFINGS

1. D. L. Reeves, JWGD3 MZL PERF In Process Review, January 15-17,1986 fur AMRDC, Frederick, MD. Title: Overview of the LevelNeuropsychological Screen.

2. J. F. Schrot, JWGD3 MILPERF In Process Review, January 15-17,1986, Frederick, MD. Title: Animal Task Area Group Report.

3. D. L. Reeves, NMRI Program Review, March 18, 1986, at NMRI forNMRDC. Title: An overview of NMRI contributions to the YTGD3MILPERF Program.

4. J. R. Thomas, Joint Technical Coordinating Grcap, March, 1987,at NMRI, Title: Human performance assessment in the cold.

5. K. VanOrden and J.H. House. Asymmetry of the nattern reversalvisual evoked potential depends on stimulus spatial frequency.Eastern Psychological Association, Boston, MA, April 1989.

6. J. Schrot and J.R. Thomas. Third Quarterly Meeting, JWGD3

MITPERF, Dayton, OH, April 1989.

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7. J. Schrot. Individual performance variability resulting fromantihistamine administration. Fourth Quarterly Meeting; JWGD3MILPERF, Calverton, MD, July 1989.

8. J. Schrot, J.R. Thomas, and K.F. VanOrden. Effects ofantihistamine administration on cognitive performance. 1989Medical Defense Bioscience Review, U.S. Army Medical ResearchInstitute of Chemical Defense, Columbia, MD, August 1989.

9. K.F. VanOrden, J.R. Thomas, and J. Schrot. Development andvalidation of neurophysiological performance assessment batteryprotocols. 1989 U.S. Army Medical Research Institute of ChemicalDefense, Columbia, MD, August 1989.

10. J. Schrot and J.R. Thomas. Human performance followingantihistamine administration. Eastern Psychological Association,Philadelphia, Pa., April 1990.

11. J. Schrot, J.R. Thomas, K.F. VanOrden, and S. Lewis. Humanperformance assessment following antihistamine administration.FASEB, Washington, D.C., April 1990.

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