The Relationships among Gender, Handedness, GPA, Depression and Visual Memory in the ROCF Test in University Students

Ochilbek Rakhmanov¹ and Senol Dane^2*

^*Correspondence: Senol Dane, Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria, Email:

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Introduction

The Rey-Osterrieth Complex Figure (ROCF) test was developed by Rey in 1941 [1] and standardized by Osterrieth in 1944 [2]. It is a nonverbal neuropsychological test and is used for the evaluation of visuospatial and visual memory [3]. The ROCF is also a useful test for measuring executive functions of the prefrontal lobe. The ROCF consists of three test conditions: Copy, immediate recall, and delayed recall. The results include scores related to location, accuracy, and organization. The copy trial is used to assess the perceptual analytic process or strategy a subject used to complete the copy and the recall trial is used to assess the accuracy in visual memory [4].

In a recent review article, it has been reported the importance of visuospatial measures in the diagnosis and prognosis of Alzheimer’s disease. Block Design and Clock Drawing Tests, Rey-Osterrieth Complex Figure recall and topographical tasks showed the greatest diagnostic potential in dementia. The Benton visual retention, doors and people, and topographical memory tests showed potential as prognostic markers [5]. It has been reported that men had higher scores than females in the ROCF test [6,7]. However, some studies reported that gender-related effects were negligible [8,9]. As such, the potential for gender to have a clinically meaningful impact on test performance remains unclear.

Also, it has been reported that left-handed people had the better performance on a test of mental rotation of 3-D patterns than right-preferent individuals [10], that left-handed persons have some advantage over right-handed subjects in imagining the rotations of figures [11]. Also, sex and handedness differences in eye-hand visual reaction times in handball players were reported in which men and left-handed people had the advantage in visual reaction time [12]. It has been suggested that left-handed subjects have probably an intrinsic neurological advantage and therefore the left-handed athletes seem to have some superiority for success and performance compared to right-handed athletes [12,13].

Also, a recent study reported the relationships between depression and visual memory in patients with epilepsy. Persons with lower levels of depression achieved better scores in the Immediate (short-term visual memory) and Delayed recall (long-term visual memory) subtests of the ROCF [14]. This study was conducted to explore the effects of gender; handedness and depression on immediate recall (short-term visual memory) and Delayed recall (long-term visual memory) subtests of the ROCF in university students.

Methods

Participants

Students (One hundred thirty-eight) who had classes at the time of the study were approached and requested to participate in the study. All of them accepted to participate in this study (66 men, average age=21.12 years, standard deviation, SD=2.02; 72 women, average age=21.35, SD=1.81). They were students of the two different faculties (Faculty of Natural and Applied Sciences, College of Health Sciences) at Nile University of Nigeria, private tertiary institution in Abuja, Nigeria. The age of the participants was not different statistically by sex.

Inclusion criteria

1. Willingness to participate.

2. Only students were allowed to participate.

3. Only undergraduate students studying were included in the study.

Exclusion criteria

1. The study excluded participants that were not willing to be involved.

2. Students with respiratory, metabolic, cardiac, psychiatric or central and autonomic nervous system disease that might change the depression and visual memory scores were not involved.

Procedure

The experimental protocol was by following international ethical standards. The study was performed per under the Helsinki Declaration (1975, revised in 1996-2013). It was a descriptive cross-sectional study. The aims and objectives of the study were explicitly explained to the participants before the commencement of the study. All participants voluntarily gave written informed consent to participate in the study. The study was anonymous. A paper and pencil based method of filling questionnaires was utilized. Participants were administered the Self Reporting Questionnaire (SRQ-20) to get a depression score. All questionnaires were distributed only among first-year students on the university campus. The study was made between September 2019 and November 2019.

Assessment of depression

TheEnglishversionofastructuredself-administered World Health Organization’s questionnaire (Self Reporting Questionnaire, SRQ-20) was used to collect the data on depression [14, 15]. The SRQ-20 was developed and validated for international use. Compared to other scales for analysis of depression, the SRQ-20 has better validity and is widely used to assess depression among University students [16,17]. The SRQ-20 scale includes 20 dichotomous (yes/no) questions asking whether participants experienced symptoms of anxiety, depression, or somatic symptoms during the last 30 days before the study [16,17].

Procedure for Rey–Osterrieth Complex Figure Test (ROCF)

The following instructions to conduct the ROCF test were followed [18].

1. All students were given 2 pieces of a blank sheet and were told they would be given a figure which they need to copy to blank paper in front of them. They were also informed that details are important rather than beauty and colorfulness of the picture. Finally, a copy of ROCF is given to everyone at the same time. The time limit was given as 3 minutes, but nearly everyone finished in 2 minutes time period.

2. All sketched papers and original ROCF papers were collected by the invigilator, which took approximately 2-3 minutes. So actually by the instructions of (Meyers & Meyers, 1995), a break of 3 minutes was given [3].

3. Once Step 2 is done, students were requested to sketch the figure from their memory on a 2^nd blank sheet. Time limit was given as 3 minutes again, and all figures were collected back once sketches are done. These sketches served as the Immediate Recall test.

4. Meyers, et al. suggested using 30-45 minutes time interval between the Immediate and Delay Recall test [3]. They also suggested using conducting some verbal tasks in between this interval. So we discussed with students about modern scientists and inventors and their impacts on modern technology. This process took between 32-37 minutes in our case.

5. Lastly, students were given a blank sheet and requested to draw ROCF again from their memory. These sketches were served as the Delay Recall test.

Scoring of ROCF test

A quantitative scoring system was used. In Rey’s scoring system, the ROCF stimulus is divided into 18 sections/units and each unit is scored separately in terms of both accuracy and placement. A standardized scoring system proposed by Meyers, et al. was presented in Table 1 [3]. The total score of every sketch may range from 0.0 to 36.0. The scoring of the pictures was done by researchers personally.

Table 1: Scoring of ROCF test.

Handedness

Handedness was ascertained by using the Edinburgh Handedness Scale [19]. This generated scores from 100 to -100. Participants having handedness scores from -100 to zero were considered to be left-handed and those with scores from zero to 100 were considered to be right-handed.

Statistical analysis

Measured values are given as a mean +/- standard deviation (SD). Statistical analysis was performed using SPSS for Windows version 18. The Student’s t-test was used to compare the depression scores in the participants. A p-value of less than 0.05 was considered statistically significant.

Results

In the total sample, there were significant positive Pearson correlations between Grade Point Average (GPA) and short-term (Immediate recall) (r=0.24, p=0.03) and long-term (Delayed recall) (r=0.26, p=0.03) visual memories in the ROCF test. Besides, there were significant negative Pearson correlations between depression score and short-term (r=-0.255, p=0.005) and longterm (r=-0.26, p=0.04) visual memories (Table 2).

Table 2: Correlation statistics (r and p) among age, GPA, depression score, short-term (Immediate Recall) and long-term (Delayed Recall) visual memories.

In male subjects, there was a significant negative Pearson correlation between GPA and depression score (r=-0.33, p=0.04). Also, there were significant positive Pearson correlations between GPA and long-term (r=0.29, p=0.04) visual memory (Table 2). In female subjects, unlike male subjects, there was a significant positive Pearson correlation between GPA and depression score (r=0.32, p=0.04). Also, there were significant negative Pearson correlations between depression and short-term (r=-0.35, p=0.03) and long-term (r=-0.4, p=0.001) visual memories (Table 2).

There were gender and handedness related differences in short-term and long-term visual memories in the ROCF test. Women had statistically significant higher short-term (t=3.64, p=0.00) and long-term (t=3.51, p=0.001) visual memories than men. Also, left-handed subjects statistically significant higher short-term (t=2.24, p=0.04) and long-term (t=2.32, p=0.04) visual memories than right-handed subjects (Table 3).

Table 3: Gender and handedness related differences in short-term (Immediate recall) and long-term (Delayed Recall) visual memories.

Discussion

Executive function is referred for the advanced mechanisms comprising many components of cognitive processes [20,21]. The executive function consists of several processes including working memory [22]. Executive dysfunction can cause impairments in planning, cognitive fluency, and judgment without lowering intelligence [23]. Also, executive dysfunction is taken into consideration as a basic mechanism of pervasive developmental disorders and attention-deficit/hyperactivity disorders [24,25]. ROCF has been used for the evaluation of visuo-constructional ability in copy condition and the evaluation of visual memory in recall condition [26]. It has been reported that patients with Parkinson’s disease [27], and obsessivecompulsive disorders [28] copied the ROCF using a less organized strategy. Therefore, it is accepted that ROCF reflects executive functions such as organization and planning. In the present study, there was a negative correlation between GPA and depression score in men and a positive correlation in women. This gender difference showed again that gender is a very important factor in behavioral studies including depression and school achievement. Previous studies reported the higher depression scores in female than in male subjects [29-31]. In the present study, a negative in men and a positive in women correlations between GPA and depression score may be related to the gender-related differences in depression.

Also, there were negative correlations between depression score and short-term and longterm visual memories in the total sample and women, but not in male students. These results suggest that high depression scores but in its normal range, especially in female university students, is an important factor to increase both GPA and short-term and long-term memories. In a lot of neuropsychological tests, there is a positive relationship between intelligence and performance on the ROCF (visual memory). The number of years’ education is often used to give an estimate of intelligence, and there is evidence to suggest that education may affect scores on the ROCF [20].

Additionally, women have higher short-term and long-term visual memories in the ROCF test than men in the present study. These results were not consistent with some previous studies in which men had higher scores than females in the ROCF test [6,7]. However, some studies reported that gender-related effects were negligible [8,9]. These results may result from racial or cultural diversities because the subjects were from Africa. Also, the left-handed university students had advantages in terms of short-term and long-term visual memories (ROCF test) than the righthanded ones. It has been known that left-handed people had the better performance on a test of mental rotation of 3-D patterns than rightpreferent individuals [10], that left-handed persons have some advantage over righthanded subjects in imagining the rotations of figures [11]. Also, sex and handedness differences in eye-hand visual reaction times in handball players were reported in which men and left-handed people had the advantage in visual reaction time [12]. It has been suggested that left-handed subjects have probably an intrinsic neurological advantage and therefore the left-handed athletes seem to have some superiority for success and performance compared to right-handed athletes [12, 13]. The advantage or superiority of left-handed athletes for success and performance or their intrinsic neurological advantage compared to right-handed athletes may result from their high scores in short-term and long-term visual memories in the ROCF test.

Conclusion

ROCF test can be accepted as an important and useful tool to assess and follow the achievement and some behavioral or neuropsychological factors in university students.

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