Santana et al.

Avaliação Psicológica, 2022, 21(2) Avaliação Psicológica

http://dx.doi.org/10.15689/ap.2022.2102.20888.10 ISSN 2175-3431 (versão on-line)

Validity evidence for the Neuropsychological

Test for the Assessment of Visuospatial
Binding: a working memory test
Yuri E. G. Santana , Jonatas R. Bessa , Marian A. A. Abbas
Universidade Federal da Bahia, Salvador-BA, Brasil
Camilla O. S. Barretto , Milena F. Ramos
Centro Universitário Uninassau, Salvador-BA, Brasil
Neander Abreu1
Universidade Federal da Bahia, Salvador-BA, Brasil
ABSTRACT
The Neuropsychological Test for the Assessment of Visuospatial Binding (TNABV) was developed to measure the Working
Memory binding for object-location features. This study aimed to provide validity evidence related to the content and internal
structure of the TNABV. To investigate the evidence based on internal structure, the sample was composed of 1173 people.
Participants were between 18 and 95 years of age. In order to investigate the content-related validity evidence, a judgment was
performed through the analysis of seven experts. The data analysis was carried out through exploratory factor analysis, the Internal
Consistency Content Validity Index (CVI). The result suggested a one-dimensional model with an explained variation of 41.78%
and Cronbach's alpha of .82. The total CVI showed an agreement of .98. The findings indicated that the psychometric properties
evaluated in the TNABV are adequate.
Keywords: working memory; neuropsychological assessment; test validity; factor analysis; test reliability.

RESUMO – Evidências de Validade do Teste Neuropsicológico para Avaliação do Binding Visuoespacial: Um Teste
de Memória Operacional
O Teste Neuropsicológico para Avaliação do Binding Visuoespacial (TNABV) foi desenvolvido para avaliar o binding da memória operacional
para os recursos de objeto-localização. Este estudo investigou as evidências de validade relacionadas ao conteúdo e estrutura interna do
TNABV. Para realizar as evidências baseadas na estrutura interna, a amostra foi composta por 1173 pessoas. Os participantes tinham entre 18 e
95 anos. Para investigar a validade das evidências baseadas no conteúdo, foi realizado um julgamento pela análise de sete especialistas. A análise
dos dados foi realizada por meio de análise fatorial exploratória, Índice de Confiabilidade e Validade de Conteúdo (IVC). O resultado sugeriu
um modelo unidimensional com uma variação explicada de 41,78% e o alfa de Cronbach de 0,82. O IVC total mostrou uma concordância de
0,98. Os achados indicaram que as propriedades psicométricas avaliadas no TNABV são adequadas.
Palavras-chave: memória operacional; avaliação neuropsicológica; validade de teste; análise fatorial; confiabilidade de teste.

RESUMEN – Evidencias de validez del Test Neuropsicológico para la Evaluación de Binding Visuoespacial: un test de
memoria operativa
El Test Neuropsicológico para la Evaluación de Binding Visuoespacial (TNABV) se desarrolló para evaluar el binding de la memoria
operativa para los recursos de objeto-localización. Este estudio investigó las evidencias de validez relacionadas con el contenido
y la estructura interna del TNABV. Para explorar las evidencias basadas en la estructura interna, la muestra se compuso por 1173
personas. Los participantes tenían entre 18 y 95 años. Para investigar la validez de las evidencias basadas en el contenido se realizó
un juicio mediante la revisión de siete expertos. El análisis de los datos se ejecutó utilizando el análisis factorial exploratorio,
el Índice de Confiabilidad y la Validez de Contenido (CVI). El resultado sugirió un modelo unidimensional con una variación
explicada del 41,78% y un alfa de Cronbach de 0.82. El CVI total mostró una concordancia de 0,98. Los hallazgos indicaron que las
propiedades psicométricas evaluadas en el TNABV son adecuadas.
Palabras clave: memoria operativa; evaluación neuropsicológica; validez del test; análisis factorial; confiabilidad del test.

Working Memory (WM) is the system responsible sketchpad, which performs the manipulation of visual in-
for storing, processing and manipulating information for a formation; and the episodic buffer. The episodic buffer is
limited time (Baddeley, 2012). This system is divided into characterized as a component with the ability to integrate
four subsystems: the central executive, responsible for at- information from different sources into multidimensional
tentional control; the phonological loop, involved in verbal codes from external stimuli and the information from
information maintenance during a task; the visuospatial long-term memory (Baddeley, 2012; Hitch et al., 2020).

1
Endereço para correspondência: Laboratório de Neuropsicologia Clínica e Cognitiva. Instituto de Psicologia. Rua Professor Aristídes Novis, 197, Federação, 40210-630,
Salvador - BA. Tel.: (71) 3283-6474. E-mail: [email protected]

Disponível em http://pepsic.bvsalud.org/scielo.php?script=sci_serial&pid=1677-0471 Avaliação Psicológica, 2022, 21(2), pp. 227-235 227

 Santana, Y. E. G., Bessa, J. R., Abbas, M. A. A., Barretto, C. O. S., Ramos, M. F., & Abreu, N.

The episodic buffer may play a role through a cog- it useful is also crucial to test its reliability. The TNABV
nitive process called binding (Baddeley, 2012; Hitch et is proposed to be a test with ecological characteristics,
al., 2020). Binding is the cognitive process of temporarily i.e., simulates a daily scene, which can bring more preci-
sustaining a connection between information of similar sion, presenting a measure closer to reality (Robertson &
or different features. It happens, for example, in every- Schmitter-Edgecombe, 2016). Another aspect to be stud-
day life when we need to remember where an object was ied is the possible proportional relations that the visuo-
stored or remember someone's name when we recognize spatial binding can have with other cognitive processes
his/her face or hear his/her voice. resulting from WM operation. This would help studies
Deficits in WM are common in clinical disorders, of the WM model, as well as the use of more efficient
which may imply functional impairments in daily life. neuropsychological interventions and rehabilitation pro-
Studies suggest that impairments in this function may be cesses.Despite the development of the software TNABV,
related to Alzheimer's disease and mild cognitive impair- this test had a lack of validity evidence based on its con-
ment (Goodman et al., 2018), schizophrenia, schizoaf- tent, internal structure and measures of reliability (Abreu
fective disorder, bipolar disorder (Gold et al., 2018), at- et al., 2018).
tention deficit hyperactivity disorder, specific learning The present study had the proposal to analyze evi-
disorders (Maehler & Schuchardt, 2016) and traumatic dence of validity of a test, which simulates a daily scene
brain injury (Dunning et al., 2016). that measures the visuospatial binding of WM. The
There are many tests and tasks which evaluate the Psychometric validity evidence based on content and in-
different processes of working memory. The majority of ternal structure of the TNABV were verified, using ex-
them are focused specifically on visual-spatial sketchpad pert judgments and an exploratory factor analysis. The
and phonological loop, as example: corsi tapping blocks results of expert judgments were then analyzed using the
task, digit span task, letter-number sequencing, arithmet- Content Validity Index. This is one measurement model
ics (Lezak, 2014). The international literature presents a in which a group of experts agrees on the relevance of
limitation of a clinical test which assesses this binding items making up a measure. In this study, the CVI was
process, because it is more common to develop an ex- calculated as an item-level content validity index and a
periment task without the investigation of the validity scale-level content validity index. The second aim was
evidence (Abreu et al., 2018). However, there are some to observe the factor structure of the instrument, analyz-
binding tasks to evaluate this process, such as: memory ing whether there is a structure based on the theoreti-
binding test - MBT (Gramunt, 2016), which presented cal model, the reliability of the instrument and whether
a reliability range from .64 to .76, and visual short-term there is any problematic item that needs to be excluded.
memory binding test - VSTMB, with 77% sensitivity and
83% specificity to identify cases of Alzheimer's disease. Method
(Parra et al., 2010). However, these tests do not simulate
a daily scene in its execution. Similarly, in Brazilian con- Type of the Study
text, there are still no validated and reliable clinical in- This is an exploratory and psychometric study con-
struments for assessing the visuospatial WM binding of ducted in brazilian sample and it was divided in two parts
object-location, which brings relevance to studies of psy- intending to provide evidence of validity based on con-
chometric validity and standardization for the Brazilian tent and internal structure and reliability of the TNABV.
population (satepsi.cfp.org.br). In view of this gap and The study 1, relating to the validity evidence based on
the need for a better understanding of the functioning the content of the test, had a sample composed by seven
of the visuospatial WM binding object-location, we de- expert participants (n=7). Further, the study 2 had 1173
veloped the software of the Neuropsychological Test for participants on a sample, allowing the investigation of
the Assessment of Visuospatial Binding (TNABV). The the internal structure and reliability of the test.
TNABV is a computerized task and has the proposal of
evaluating the visuospatial binding process that occurred Participants
in the WM episodic buffer, more specifically, it was made
to evaluate the binding of the visual component (objects) Study 1: Evidence based on test content
and spatial (location) information simulating a daily To investigate the validity evidence based on the
scene and its execution (Abreu et al., 2018). The use of content, we selected experts' judgment procedures.
instruments with ecological characteristics can contrib- Seven Brazilian participants with expertise in the area of
ute to the neuropsychological assessment. Robert and neuropsychology, with a minimum of five years of ex-
Schmitter-Edgecombe (2016) suggest that the individu- perience, were invited to be part of this study. It should
al's performance assessed under these conditions may be be noted that everyone accepted the invitation and this
closer to reality. The development of an instrument that sample was selected for convenience. All members have
measures visuospatial bindings aims to contribute to the been involved in the development of neuropsychological
neuropsychological clinic and research settings. To make tests and research in the field of cognition. This choice

228 Avaliação Psicológica, 2022, 21(2), pp. 227-235

 Validity evidence for the Neuropsychological Test

procedure is in accordance with the guidelines suggested by pressing the "start" button, after reading the initial in-
in the literature (Alexandre & Coluci 2011). All of the ex- structions: "Pay attention to this object and which door
perts were certified with an academic level graduate title. it goes in. You have to remember which object and door
Two of them had a doctorate; two had a master's degree; it goes in". At the beginning of the test, objects related
and three had a postgraduate degree in Neuropsychology to the environment (food and cooking utensils) are pre-
or Neuroscience. sented in sequence in the center of the screen, and these
are subsequently stored in one of the cabinet doors. The
Study 2: Evidence base on internal structure objects and their respective locations must be memorized
To perform the exploratory factor analysis, a non- and subsequently evoked (Figure 1). After a one-second
probabilistic sample of 1173 people residents in the state interval with a blank screen, the image of the kitchen is
of Bahia-Brazil was recruited, 720 were female (61.38%). again presented with some objects in the center of the
Participants were selected from universities, churches screen. The examinee must select the previously pre-
and community centers for convenience. The sample sented objects and allocate them in the previously estab-
showed an age range between 18 and 95 years (M=41.95 lished locations (doors) – there is no limited time for this
years; SD=20.05). The inclusion criterion was to be at evocation process.
least 18 years old and have no history of neurological The objects are presented in three sequences of 3, 4
disorder. and 5 items. The objects in the center of the screen are
always twice the number of objects allocated.
Instruments The first sequence has three objects that are placed
Content Validity Index Scale. For the expert's into the doorsand and, after the first second interval, six
judgment procedure, a content validity question- objects are displayed to the examiner (Figure 1). Then,
naire was developed and sent to the experts. After they the examinee should choose the cabinet door and place
answered, we calculated the agreement coefficient. the object there. In the remaining sequences, four allo-
This scale had five objective statements for which cated objects are shown and eight are displayed in the
the answers followed a Likert scale of 4 points, being: center of the screen, and subsequently, five objects are
1. I do not agree, 2. Indifferent, 3. I partially agree, and allocated and 10 are displayed in the post-allocation.
4. I strongly agree. The five objective statements were: The TNABV generates an efficacy index of visuo-
(a) the TNABV assesses visuospatial memory; (b) the spatial bindings for 3, 4 and 5 trials. The TNABV’s ef-
test assesses the visuospatial WM; (c) based on the ficacy index is calculated by the span of the sequence
Baddeley and Hitch (1974) Multicomponent Model trial times the total of correct bindings by span sequence.
of Operational Memory and its revision in 2000 the All instructions from TNABV are presented in the test,
test evaluates the visuospatial sketchpad component; which may be self-administered or can be guided by the
(d) based on Baddeley's Multicomponent Operating examiner.
Memory Model (2012), the test evaluates the binding In this study, the examiners guided all tests, since
in visuospatial memory; and (e) the test presents items some participants declared they were not familiar with
(figures) that are easily recognized for adults and elderly computers. Therefore, we decided to standardize the
examinees. Below each statement, there was a space for examiner's assistance through the manipulation of the
writing suggestions and observations about the test or mouse, as soon as the participant chose the objects and
changes that should be made due to difficulties in one or doors where they should be placed. An exploratory
more items required to be analyzed. This questionnaire factor analysis was performed with the results of this
aimed to assess the adequacy of the test to the theoretical instrument.
model and the test format/design.
The Neuropsychological Test for the Procedures
Assessment of Visuospatial Binding. The TNABV is With the approval of the Research Ethics
a computerized test and was developed to be self-applied, Committee of the Institute of Psychology (CAAE:
simulating the context of a kitchen, in which there are 89544618.7.0000.5686), of the Federal University of
16 cabinet doors, four doors at each end of the screen Bahia (UFBA), the study was completed in accordance
(Abreu et al., 2018). The individual must start the test with the Helsinki Declaration.

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 Santana, Y. E. G., Bessa, J. R., Abbas, M. A. A., Barretto, C. O. S., Ramos, M. F., & Abreu, N.

Study 1 and is performed when the survey is done quantita-

For the expert judgment stage, seven participants tively (Alexandre & Coluci, 2011). The literature sug-
were chosen and invited by electronic message to par- gests that the CVI measures the agreement of judges
ticipate in the content validity of the TNABV. After ac- regarding the items in relation to the content stud-
ceptance, the TNABV was sent electronically. It is note- ied (Tibúrcio et al., 2014). According to Alexandre &
worthy that the judges had not had previous access to the Coluci (2011), with the CVI, it is possible to analyze
test, and along with it, the content validity scale was sent each item individually and, then, the instrument as a
to calculate the Content Validity Index (CVI). whole. The total agreement value can vary from 0 to 1.
The parameter adopted for the TNABV content valid-
Study 2 ity was 0.80 minimum agreement between experts, as
The participants were invited, for convenience, suggested by other studies (Alexandre & Coluci, 2011).
to, voluntarily, participate in the research, signing the To obtain the CVI by items of the TNABV, the sum of
consent form, which explained the research procedures the values marked by the judges who rated the specific
and objectives. After this stage, the application of the item as “3” (partially agree) and “4” (strongly agree) was
TNABV was performed. The application was carried out divided by the maximum possible value of the item. In
collectively and individually, in computer laboratories of order to obtain the total CVI, the sum of all CVI of the
the institutions that participated in the study, or in the items calculated separately was performed, divided by
researchers' notebooks, in places that did not provide the number of items on the scale. Both formulas can be
computers. Although the form of application occurred viewed in Figure 2 (Alexandre & Coluci, 2011, Tibúrcio
in different ways, using desktops and notebooks, collec- et al., 2014).
tively or individually, the researchers actively participated
in all the applications, reading the instructions automati- Study 2
cally given by the instrument and solving doubts before For the analysis, the statistical analysis was per-
performing the test. The total duration of the applica- formed on software Factor programming, version
tion was, approximately, 20 minutes. Data collection oc- 11.04.02 x664bits (Ferrando & Lorenzo-Seva, 2017) and
curred during the period from 2018 to 2020. R programming, version 4.0.3 (R Core Team, 2020). To
Data analysis investigate the possibility of factoring the data matrix,
the Kaiser-Meyer Olkin Measure (KMO) of sampling
Study 1 adequacy and Bartlett's test was performed. The KMO
The experts' judgment was performed by the CVI presented a value of 0.90 (BC 95% C.I=0.90 - 0.91),
parameter with the seven separate experts for the ques- which indicates excellent values (Damásio, 2012).
tionnaire. This method is widely used in the health area Bartlett's test showed a value <0.001, indicating that

230 Avaliação Psicológica, 2022, 21(2), pp. 227-235

 Validity evidence for the Neuropsychological Test

the matrix is favorable. These results indicate that it is Lorenzo-Seva, 2011). In addition, the construct repli-
possible to do the factoring of the data matrix (Damásio, cability was measured by Generalized H Index (G-H)
2012). To investigate the psychometric properties of the which values above .80 suggest a well-defined latent
TNABV based on the internal structure, an exploratory variable of the model (Hancock & Mueller (2000) and
factor analysis was performed in order to verify the qual- the closeness to unidimensionality assessment was ana-
ity of the items and the model adjustment indexes. The lyzed by Unidimensional Congruence (UniCo>.95),
exploratory factor analysis was performed using the fol- Explained Common Variance (ECV>.85) and Mean of
lowing criteria: (a) it was computed a bootstrap sample Item Residual Absolute Loadings (Mireal<.30) indexes
(Number of BC=500) to normalize the non-paramet- to evaluate if the data of the test suggests a unidimen-
ric distribution of data; (b) the estimation method used sional model (Ferrando & Lorenzo-Seva, 2018).
was Exploratory Robust Maximum Likelihood (RML), Furthermore, to measure the reliability and in-
because of the continuous nature of the variables used ternal consistency of the items, Cronbach's alpha was
(Morata-Ramirez & Holgado-Tello, 2013); (c) the corre- performed. Values above .80 suggest adequate internal
lation method used to among the items was the Pearson consistency (Damasio, 2012). The correctness of the
correlation, because of the nature of the variables se- object-location was considered as the item of the in-
lected (Morata-Ramirez & Holgado-Tello, 2013); (d) a strument, indicating the participant's WM binding per-
direct oblimin was the rotation method chosen to this formance. This study was performed using the standard
analysis (Damásio, 2012); and (e) the number of fac- of Bentler and Chou (1987), who suggest a minimum
tors was defined by a parallel analysis (Timmerman & of five participants for each item.

Results was evaluated. The items “a” to “d” of the scale refer
to the adequacy of the test to the proposed construct
Study 1 and to the assessment measures, while item “e” con-
For the expert judgment, an analysis of the con- cerns the understanding of images by adults and the
cordance on the statements of each item of the scale elderly (Table 1).

Table 1
Values for the Content Validity Index and Scale Items
CVI CVI
Scale
Item Total
a) the TNABV assesses visuospatial memory 1

b) the test assesses visuospatial working memory 1

c) based on the Baddeley and Hitch (1974) Multicomponent Model of Operational Memory 1
and its revision in (2000) the test evaluates the visuospatial sketchpad component .98
d) based on Baddeley’s Multicomponent Operating Memory Model (2012) the test evaluates 1
the binding in visuospatial memory

e) the test presents items (figures) that are easily visualized for adults and the elderly .93

All items from “a” to “d” showed a concordance to the proposed model (items “a”, “b”, “c” and “d”). On
of 1, that is, 100% – therefore, all experts marked that the other hand, in the item “e”, which assesses wheth-
they “strongly agree” (4) in the adequacy of the items er the stimuli (figures) are visually easy to identify for

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 Santana, Y. E. G., Bessa, J. R., Abbas, M. A. A., Barretto, C. O. S., Ramos, M. F., & Abreu, N.

adults and elderly people, five experts marked that they need to use actions to deal with missings or outliers, as
“strongly agree” (4) and two experts marked that “par- these situations were not observed in the data set. For the
tially agree” (3), obtaining the CVI value for item “e” of investigation of the factor model, a parallel analysis, fol-
.93. From the results obtained by the item CVI, the to- lowed by an exploratory factor analysis were performed,
tal CVI was performed, obtaining a value of .98, which which resulted in a unifactorial model (Figure 3). This
can be seen in Table 3. It is important to note that, even one factor suggestion to the test’s model is corroborated
though a space was provided for suggestions and possible by the unidimensionality indexes of UniCo, EVC and
adjustments to the TNABV, the experts did not present MIREAL tested (Table 3). The results suggested an ex-
any written consideration. Therefore, it was not possible plained variance of 41,78% to a unidimensional model.
to make a qualitative analysis. The exploratory factor analysis was performed with the
items related to the visuospatial binding process of the
Study 2 test, i.e., the quantity of correct answers of bindings be-
With the exploratory data analysis, it was possible to tween the object and the location. These items provide
identify that the data set has a normal distribution, with the measure of binding of object-location information
a mean of 16.8, standard deviation of 7.44. There was no answered by the participants.

According to the results expressed in Table 2, effect, the coefficient presented a value equal to .82
it seems that the factor loadings exhibit a coeffi- (CI-95%=.81 to .84). According to Table 2, if any item
cient value above .40, which means an acceptable in- of the binding effect was dropped, Cronbach's α would
dex. According to Wang and Wang (2019), the value not undergo significant changes in its value. This result
of .40 is considered an acceptable conservative limit suggests adequacy of the internal consistency, because
of the variable in the creation of the factor, avoiding it is above the cut-off criteria established to this study
the problem of the indeterminacy of the relationship (Damasio, 2012).
between variables and factors. Regarding the item- Table 3 shows the fit indices of the tested model.
rest correlation, results show a value above .30, sug- Regarding RMSEA, which estimates the average diffe-
gesting a medium effect of correlation between the rence between the observed covariance and that of the
items with binding effect and the overall score of the model, their values were interpreted using the criteria of
TNABV (Field, 2018). Wang and Wang (2019): 0=perfect fit; <.05=close fit;
Cronbach's alpha (α) was calculated in order to .05 to .08=fair fit; .08 to .10=mediocre fit; and >.10
measure the internal consistency of the object-loca- =poor fit. For GFI, which corresponds to the observed
tion items. For the nine items that present the binding covariance proportion that is explained by the model's

232 Avaliação Psicológica, 2022, 21(2), pp. 227-235

 Validity evidence for the Neuropsychological Test

covariance, Hoyle (2012) suggests that GFI values >.95 that CFI values >.90 as the cutoff point. For TLI, which
indicate an adjustment considered acceptable. Regarding corresponds to a measure that compares the lack of fit of
the CFI, which compares the fit of the specified model a model with the lack of fit of the null model, Wang and
with the null model that assumes zero covariance betwe- Wang (2019) suggest TLI values >.90 as the cutoff value,
en the observed variables, Wang and Wang (2019) suggest as can be seen in Table 3.

Table 2
Psychometric Properties of the TNABV Binding Items
Cronbach’s α if item
Item Factor loading Communality Item-rest correlation
dropped
S1_3_OL .49 .24 .43 .82
S2_3_OL .58 .33 .51 .81
S3_3_OL .63 .39 .56 .80
S1_4_OL .61 .36 .54 .80
S2_4_OL .65 .42 .57 .80
S3_4_OL .65 .42 .58 .80
S1_5_OL .56 .31 .51 .81
S2_5_OL .57 .32 .52 .81
S3_5_OL .54 .29 .49 .81
Note. S1=Sequence 1; S2=Sequence 2; S3=Sequence 3; OL=Object-location binding. e.g.=S1_3_OL: Binding from the first sequence
with 3 stimulus of object/location

Table 3
Fit Indices for the Tested Model of the TNABV
Indexes of the tested model Value Bootstrap 95% Confidence Intervals
GFI .996 0.995 - 0.997
CFI .992 .989 - .993
TLI .989 .986 - .991
RMSEA .037 .034 - .038
G-H Index .829 .812 - .840
UniCo .991 .989 - .994
ECV .911 .901 - .927
MIREAL .158 .119 - .172
Note. GFI=goodness-of-fit index; CFI=comparative fit index; TLI=Tucker-Lewis index; RMSEA=root mean square error of approxi-
mation; G - H index=generalized h index to construct replicability; UniCo=unidimensional congruence; ECV=explained common
variance; MIREAL=mean of item residual aboslute loadings

Discussion This suggests that there is a concordance among the ex-

perts on the adequacy of the TNABV to the proposed
This study aimed to verify the reliability and the evi- theoretical model. The item “e”, which addresses the
dence of validity based on content and internal structure ability of visual understanding of the figures for adults
of the TNABV, an instrument to evaluate WM visuospa- and the elderly, presented a concordance of .93, indi-
tial binding. It was found that the instrument presented cating a level within the recommended in the literatu-
adequate results related to its items and the content of re. Although the CVI result for this item is within the
the test, which provide a first evidence that the TNABV recommended range, it is important to emphasize that
is understandable and can measure what its propouses, the number of experts used for the analysis was seven,
i.e., visuospatial bindings of WM. which may not be considered a large sample for some
According to the concordance criterion adopted authors. Therefore, it is important to analyze the result
to CVI (CVI>.80) in this study of evidence validity of this item carefully. A possible measure to solve this
based on content (Alexandre & Coluci, 2011), it was question would be the use of a sample with similar cha-
possible to observe that the CVI for each item of the racteristics to this population, properly analyzing this
scale was in full agreement (1) for items “a” to “d”. information. For the total CVI, the value obtained was

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 Santana, Y. E. G., Bessa, J. R., Abbas, M. A. A., Barretto, C. O. S., Ramos, M. F., & Abreu, N.

0.98, indicating a degree of concordance above that su- no recommendations or revisions were made, and a quali-
ggested (Alexandre & Coluci, 2011). tative analysis was not possible to be done.
Although no qualitative considerations have been In summary, the present study evaluated the ade-
made about the disagreement of item “e”, some reasons quacy of the TNABV with the multicomponent WM
can be inferred. As mentioned in this study, the TNABV model, suggesting an acceptable agreement among ex-
presents items simulating a real situation, the selection perts on the ability to assess the binding effect by the test
of attention and the recognition of the stimulus item and the adequacy of the items to a unidimensional model.
(figure) can present emotional, motivational, compen- Which corroborates the theoretical model of object-loca-
satory strategies, relevant and/or personal experiences tion information integration of the visuospatial working
(Robertson & Schmitter-Edgecombe, 2016). It is impor- memory binding (Baddeley, 2012). The TNABV can
tant to highlight that the images presented in the instru- assist as a way of confirming the effectiveness of inter-
ment were taken from a study of standardization of figu- ventions in WM with subjects undergoing neuropsycho-
res for the Brazilian population (Pompéia et al., 2001). logical rehabilitation. In the context of neuropsycholo-
The development of tests with ecological characteristics gical assessment, more than one diagnostic resource to
is a challenge, due to the possibility of noise, i.e, varia- test WM is necessary. A more accurate assessment may
bles that are not controlled. Some people may experience contribute to a better intervention increasingly focused
more difficulty in recognizing certain figures. However, on the individual's needs. With the possibility of discove-
in instruments with ecological characteristics, the per- ring difficulties in WM as early as possible, it is possible
formance in the assessed competence may be closer to to enable a more accurate and effective rehabilitation to
reality (Robertson & Schmitter-Edgecombe, 2016). individuals with WM visuospatial binding impairments.
Another hypothesis for the lack of agreement pre-
sented in item “e”, which corresponds to the ease of un- Acknowledgments
derstanding of the figures for adults and the elderly, may We thank to the Clinical Cognitive Neuropsychology
be due to the gradual accumulation of error resulting Research Group (Neuroclic) and the Universidade
from noise in memory. It would be due to the presenta- Federal da Bahia our best regards for all the support gi-
tion of short sequences of exposures to multiple stimuli, ven to us to the development of this study.
which may indicate the difficulty in recognizing some
figures during the test (Ma et al., 2014). As the test pro- Financing
gresses, it is possible that the expert has encountered di- This work was based on an original study that
fficulties resulting from prolonged exposure to different was partially supported by Conselho Nacional de
complex stimuli, generating less recognition accuracy Desenvolvimento Científico e Tecnológico [grant num-
(Ma et al., 2014). ber 445857/2014-5].
In the exploratory factor analysis, since the items
presented factor loadings above .40, it was not necessary Author contributions
to exclude any item. The item-rest correlation showed We declare that all authors participated in the pre-
a result above .30, indicating a correlation of medium paration of the manuscript. Specifically, the authors Yuri
effect between the items and the overall score (Field, Santana, Jonatas Bessa e Neander Abreu participated in
2018). These results indicate how correlated the items the initial writing of the study – conceptualization, inves-
are with the factor, assuming that items with correlations tigation, visualization, the authors Yuri Santana, Jonatas
below this value should be excluded from the test. The Bessa e Neander Abreu participated in the data analy-
instrument had a Cronbach's α of .82. It is possible to su- sis, and the authors Yuri Santana, Jonatas Bessa, Marian
ggest that the internal consistency value of the measure Assolin, Camilla Barretto, Milena Ramos e Neander
is adequate, being within the acceptable parameter above Abreu participated in the final writing of the work – re-
.80 (Field, 2018). The adjustment indexes of the unifac- vision and editing.
torial model were considered within the ideal parameters
(Wang & Wang, 2019; Ferrando & Lorenzo-Seva, 2018), Availability of data and materials
suggesting that the instrument presents consistent values All data and syntax generated and analysed during this
that support the model. research will be treated with complete confidentiality due
Some limitations were presented in this study. to the requirements of the Ethics Committee for Research
The participants' only variables were gender and age. in Human Beings. However, the dataset and syntax that
Socioeconomic data and education are important and the support the conclusions of this article are available upon
literature indicates that socioeconomic factors have a posi- reasonable request to the main author of the study.
tive influence on performance in WM measures (Sbicigo
et al., 2013). The CVI scale presented objective assertions, Conflict of interests
aiming at calculating the index. However, even after pro- The authors declare that there are no conflicts of
viding the scale with the possibility of making suggestions, interest.

234 Avaliação Psicológica, 2022, 21(2), pp. 227-235

 Validity evidence for the Neuropsychological Test

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recebido em junho de 2020

aprovado em setembro de 2021
Sobre os autores

Yuri Eduardo Gomes de Santana é Psicólogo (UFBA), mestre em Psicologia do Desenvolvimento (UFBA). Atualmente, é
membro do Laboratório de Neuropsicologia Clínica e Cognitiva.
Jonatas Reis Bessa da Conceição é Psicólogo (UFBA), mestre em Psicologia do Desenvolvimento (UFBA). Atualmente, é
doutorando em Psicologia (UFBA) e membro e membro do Laboratório de Neuropsicologia Clínica e Cognitiva.
Marian Assolin Abou Abbas é Estudante de Psicologia (UFBA) e membro do Laboratório de Neuropsicologia Clínica e Cognitiva.
Camilla Oliveira dos Santos Barretto é Estudante de Psicologia no Centro Universitário Uninassau e membro do Laboratório
de Neuropsicologia Clínica e Cognitiva.
Milena Figueiredo Ramos é Estudante de Psicologia no Centro Universitário Uninassau e membro do Laboratório de
Neuropsicologia Clínica e Cognitiva.
Neander Abreu é Doutor em Neurociências e Comportamento (USP). Atualmente, é professor associado no Instituto de
Psicologia da Universidade Federal da Bahia e coordenador do Laboratório de Neuropsicologia Clínica e Cognitiva.

Como citar este artigo

Santana, Y. E. G., Bessa, J. R., Abbas, M. A. A., Barretto, C. O. S., Ramos, M. F., & Abreu, N. (2022). Validity evidence for the neuropsychology
test for the assessment of visuospatial binding: a working memory test. Avaliação Psicológica, 21(2), 227-235. http://dx.doi.org/10.15689/
ap.2022.2102.20888.10

Avaliação Psicológica, 2022, 21(2), pp. 227-235 235