The Italian telephone-based Verbal Fluency Battery (t-VFB): standardization and preliminary clinical usability evidence

Edoardo Nicolò Aiello; Alice Naomi Preti; Veronica Pucci; Lorenzo Diana; Alessia Corvaglia; Chiara Barattieri di San Pietro; Teresa Difonzo; Stefano Zago; Ildebrando Appollonio; Sara Mondini; Nadia Bolognini

doi:10.3389/fpsyg.2022.963164

The Italian telephone-based Verbal Fluency Battery (t-VFB): standardization and preliminary clinical usability evidence

Front Psychol. 2022 Aug 3:13:963164. doi: 10.3389/fpsyg.2022.963164. eCollection 2022.

Authors

Affiliations

¹ Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
² Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
³ Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padua, Italy.
⁴ Human Inspired Technology Research Centre, University of Padova, Padua, Italy.
⁵ Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy.
⁶ Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.
⁷ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁸ Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
⁹ Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
¹⁰ Department of Psychology, University of Milano-Bicocca, Milan, Italy.

Abstract

Background: This study aimed at standardizing and providing preliminary evidence on the clinical usability of the Italian telephone-based Verbal Fluency Battery (t-VFB), which includes phonemic (t-PVF), semantic (t-SVF) and alternate (t-AVF) verbal fluency tasks.

Methods: Three-hundred and thirty-five Italian healthy participants (HPs; 140 males; age range = 18-96 years; education range = 4-23 years) and 27 individuals with neurodegenerative or cerebrovascular diseases were administered the t-VFB. Switch number and cluster size were computed via latent semantic analyses. HPs underwent the telephone-based Mental State Examination (MMSE) and Backward Digit Span (BDS). Construct validity, factorial structure, internal consistency, test-retest and inter-rater reliability and equivalence with the in-person Verbal Fluency tasks were assessed. Norms were derived via Equivalent Scores. Diagnostic accuracy against clinical populations was assessed.

Results: The majority of t-VFB scores correlated among each other and with the BDS, but not with the MMSE. Switch number correlated with t-PVF, t-SVF, t-AVF scores, whilst cluster size with the t-SVF and t-AVF scores only. The t-VFB was underpinned by a mono-component structure and was internally consistent (Cronbach's α = 0.91). Test-retest (ICC = 0.69-0.95) and inter-rater reliability (ICC = 0.98-1) were optimal. Each t-VFB test was statistically equivalent to its in-person version (equivalence bounds yielding a p < 0.05). Education predicted all t-VFB scores, whereas age t-SVF and t-AVF scores and sex only some t-SVF scores. Diagnostic accuracy against clinical samples was optimal (AUC = 0.81-0.86).

Discussion: The t-VFB is a valid, reliable and normed telephone-based assessment tool for language and executive functioning, equivalent to the in-person version; results show promising evidence of its diagnostic accuracy in neurological populations.

Keywords: executive functioning; language; tele-neuropsychology; telephone-based; verbal fluency.