Exploration of the Wechsler Memory Scale Fourth Edition (WMS-IV) Designs Content and Spatial Memory Scales

The Designs subtest was newly added as a measure of visual memory to the Wechsler Memory Scale, 4th edition (WMS-IV). This study examined this measure in a mixed clinical sample (n = 158). Specifically, the aim of the study was to evaluate the publishers’ claims that the Designs test assesses both visual content (“what”) and spatial (“where”) memory, as these functions are processed within distinct neurological systems. To date, no studies have specifically examined the individual Content and Spatial scores in relation to other neuropsychological variables. The purpose of this study was to gain a more comprehensive understanding of the Content and Spatial measures in order to aid clinicians in using the instrument for diagnostic purposes and to enhance the interpretation of results. The present study utilized hierarchical multiple regression analyses with each of the Designs subtest components as dependent variables, including Content I, Content II, Spatial I, and Spatial II, which encompass both immediate and delayed memory aspects of functioning. For each of these variables, neuropsychological variables were selected for comparison from domains of attention, visual-spatial skills, visual memory, and executive functioning, given the understanding of visual memory pathways in the brain and the confluence of these abilities on functioning. Age, education, and verbal intellectual functioning were controlled through the hierarchical multiple regression analyses. Study findings suggest that Content and Spatial scores may not be ideal for the measurement of both visual content and spatial memory. The results indicate that the combination of both constructs onto one measure may overwhelm participants’ cognitive capacity, leading them to favor one aspect over the other. Further studies may aim to explore these two constructs separately in the context of this paradigm to determine their clinical utility. This study highlights the importance of clinicians having an understanding of the literature associated with the measures administered to patients