Reliability and validity of a scoring system for measuring organizational approach in the Complex Figure Test

The Rey-Osterrieth Complex Figure Test (RCFT) is a widely-used measure of v isuospatial construction and nonverbal memory. One of the critical aspects of this test is that organizing the figure into meaningful perceptual units during copy enhances its subsequent free recall from memory. This study ex amined the psychometric properties of a new system for quantifying the orga nizational approach to the RCFT figure and compared it to another compatibl e scoring system. We investigated interrater reliability of both systems an d explored the influences of copy organization and copy accuracy on immedia te recall. Seventy-one participants meeting DSM-IV criteria for obsessive-c ompulsive disorder and 55 healthy control participants completed the copy a nd immediate free recall condition of the RCFT. Interrater reliability was evaluated by Kappa coefficients and Pearson correlations. The effects of co py organization and copy accuracy on immediate recall were evaluated using multiple regression analyses. Results indicated that the organizational app roach could be assessed with high reliability using both scoring systems. O rganization during copy was a strong predictor for subsequent free recall f rom memory using both approaches. Multiple regression analysis indicated th at all organizational elements were not equally predictive of memory perfor mance. This new system represents a very simple and reliable approach to sc oring organization on the RCFT, since it requires the identification of onl y 5 figure components. These characteristics should contribute to its clini cal utility.