The Pillbox Test: An Ecological Measure of Executive Functioning and Estimate of Medication Management Abilities
Abstract
Studies indicate that executive functioning (EF) is a strong predictor of everyday function. However, assessment can be problematic as no single standardized instrument is known to measure all EF domains simultaneously. Thus, the Pillbox Test was developed as a new measure tapping four EF factors through the real-time assessment of medication management, a complex instrumental activity of daily living. The Pillbox Test showed good criterion-related validity and was effective in differentiating graduated levels of executive dysfunction between a mixed neurological group, medical control group, and healthy community control group. This test also showed good convergent validity as it correlated significantly in expected directions with established EF measures in all four of selected EF domains and the Direct Assessment of Functional Status. Finally, a receiver operator characteristic curve found a sensitivity of 75% and specificity of 87.5%, suggesting that the Pillbox Test is a promising new ecological measure of EF.
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The conceptualization of EV has morphed over the years to confound EV with face validity.
“However, this conceptualization appears to have morphed over the years to confound EV with face validity.”
From Conceptualization of the term 'ecological validity' in neuropsychological research on executive function assessment: a systematic review and call to action (2024) · cites this paper as Zartman et al., 2013
The notion that highly naturalistic tests can be assumed to be ecologically valid has been repeatedly propagated in the literature.
“Indeed, as reviewed above, the notion that highly naturalistic tests can be assumed to be ecologically valid has been repeatedly propagated in the literature (Burgess et al., 1998; Zartman et al., 2013).”
From Conceptualization of the term 'ecological validity' in neuropsychological research on executive function assessment: a systematic review and call to action (2024) · cites this paper as Zartman et al., 2013
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- Authors
- Zartman, A. L., Hilsabeck, R. C., Guarnaccia, C. A., & Houtz, A.
- Affiliations
- University of North Texas (US)
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- Zartman, A. L.
- Venue
- Archives of Clinical Neuropsychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-03-15
- Volume
- 28
- Issue
- 4
- Pages
- 307-319
- ISSN
- 0887-6177 (ISSN-L)
- 1873-5843
- OpenAlex
- W2138876260
- Cited by
- 59
- References
- 63
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 16 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 5 · 2014: 2 · 2013: 1
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Clinical Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- executive function, medication management, instrumental activities of daily living, ecological assessment, executive dysfunction, criterion validity, convergent validity, neurological patients, medical patients, functional status
- MeSH terms
- Activities of Daily Living, Age Factors, Aged, Alzheimer Disease, Analysis of Variance, Cardiovascular Diseases, Cognition Disorders, Educational Status, Female, Humans, Male, Middle Aged, Neuropsychological Tests, ROC Curve, Dementia, Vascular, Reproducibility of Results, Chi-Square Distribution, Case-Control Studies, Stroke, Executive Function
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