Objetivos: avaliar a atenção e a memória de doentes com dor pélvica crônica (DPC) ou com síndrome complexa de dor regional (SCDR) e correlacionar os resultados à duração e intensidade da dor, à presença de transtornos do humor e à qualidade do sono comparando esses resultados aos do grupo controle composto por indivíduos sem dor. Métodos: sessenta indivíduos, de ambos os sexos, com idade variando de 18 a 60 anos e com escolaridade maior ou igual a quatro anos foram avaliados através de uma bateria neuropsicológica para avaliação de atenção e memória, escala para avaliação da intensidade da dor, do humor, e qualidade do sono. Os indivíduos foram organizados em três grupos. O grupo DPC, foi constituído de 20 doentes com dor pélvica; o grupo SCDR, de 20 doentes com síndrome complexa de dor regional; e o grupo controle foi constituído de 20 indivíduos sem dor. Resultados: prevaleceram indivíduos com idade entre 29 e 50 anos, casados, com atividade profissional regular e registrada e com escolaridade de nove a 12 anos. 65% eram mulheres. A maioria dos doentes apresentou dor de moderada a intensa com duração de seis a 15 anos e nenhum com duração de menos de cinco anos. Os doentes com dor apresentaram qualidade do sono pior que os indivíduos sem dor (p < 0,001), mais transtorno depressivo maior avaliado pelo PRIME-MD (p = 0,013) e mais alterações no MEEM (p = 0,001). Ocorreu maior número de doentes com DPC e SCDR com déficit na fluência verbal (p = 0,031), atenção concentrada abaixo da média (p = 0,027), e piores resultados no teste RAVLT quando comparados aos indivíduos sem dor. Os indivíduos com dores de moderada a intensa avaliada pela EAVN apresentaram piores escores nos testes de fluência verbal, DSI e teste de atenção concentrada. Neste estudo, o transtorno depressivo maior parece interferir na fluência verbal, na atenção e na memória. Os indivíduos com qualidade de sono ruim apresentaram piores escores nos testes cognitivos, com diferença estatística significativa em relação a população sem dor para os testes DSD, DSI, teste de atenção concentrada, fluência verbal e MEEM. Conclusão: os doentes com dor apresentaram maior déficit de acordo com os testes MEEM, FV, RAVLT e TAC, mais transtorno depressivo maior e qualidade do sono pior em relação à população sem dor. Indivíduos com dores de moderada à intensa avaliados pela EAVN apresentaram os piores escores nos testes de fluência verbal, atenção concentrada e DSI. O Transtorno depressivo maior parece interferir na fluência verbal, na atenção e na memória. Indivíduos com má qualidade de sono apresentaram os piores escores nos testes cognitivos, diferença esta estatisticamente significativa em relação à população sem dor quando avaliados com os testes de atenção concentrada, fluência verbal, MEEM, DSD e DSI . / Objectives: to assess attention and memory of patients who are chronic pelvic pain holders (CPP) and/or Complex Regional Pain Syndrome (CRPS) holders, and to correlate the results to the characteristics of the duration and intensity of the pain, and to the mood and to the sleep pattern disorders, by comparing such results to the control group of pain-free individuals. Methods: 35% male and 65% female individuals, 18 to 60 years old, with schooling higher or equal to four years, were evaluated through a series of neuropsychological tests directed to assess the attention and memory, pain intensity, mood, and sleep quality. They were organized in three groups: 20 Pelvic Pain Patients (CPP Group); 20 Complex Regional Pain Syndrome patients (CRPS Group); 20 pain-free individuals (Control Group). Results: there was prevalence of 29 to 50 year-old individuals with regular and formal professional activity and schooling of 9 to12 years. Most of them presented moderate to severe pain during the last 6 to 15 years (none of them during less than five years). Pain patients presented lower quality sleep than individuals pain free (p < 0, 001), more Major Depression Disorder assessed by PRIME-MD (p = 0, 013) and more changes in MEEM (p = 0, 001). There was more Verbal Fluency Deficit (p = 0,031), average Attention (p = 0,027) and lower scores in RAVLT test in CPP and CRPS groups than in non-pain individuals. The scores in the tests of Verbal Fluency, DSI and Attention were lower in patients with moderate to severe pain. Major Depression Disorder was related to Verbal Fluency, Attention and Memory impairment. The cognitive tests were significantly different in individuals with low-quality sleep than in the normal population. Conclusion: Pain patients showed greater deficit in the MEEM, Verbal Fluency Test, RAVLT, and in the Attention Test, and also Major Depression Disorder and lower quality of sleep when compared to the non-pain individuals. The Verbal Fluency, DSI and Attention scores were lower in patients with moderate to severe pain. Major Depression Disorder seems to interfere with Verbal Fluency, Attention and Memory. The cognitive function evaluated with DSD, DSI, Concentrated Attention, Verbal Fluency and MEEM tests score lower in individuals with low-quality sleep, and the difference was statistically significant to the normal population

Older bilingual adults typically perform better than monolinguals in tasks of executive control, and are diagnosed later with dementia. Studies have also shown structural and functional brain differences between bilinguals and monolinguals. However, it remains poorly understood how language history influences the functional organization of the aging brain. The current study investigated; 1) differences in resting-state functional connectivity between monolinguals and bilinguals in the Default Mode Network (DMN), Frontoparietal Network (FPN), Executive Control Network (ECN), Language Network (LANG), and a network consisting of structures associated with tasks of executive control coined the Bilingual Control Network (BCN); 2) the relationship of cognitive performance with functional connectivity of the BCN; and 3) whether proficiency, age of second language acquisition, degree of second language exposure, and frequency of language use predicts the network’s functional connectivity. Healthy older bilinguals (N=10) were matched pairwise for age, sex and education to healthy older monolinguals (N=10). All participants completed a battery of cognitive tests, a language history questionnaire, and a 6-minute functional scan during rest. Results showed that groups did not differ in cognitive performance, or in the functional connectivity of the FPN, ECN, LANG, or BCN. However, monolinguals had significantly stronger functional connectivity in the DMN compared to bilinguals. Later age of second language acquisition and lower proficiency were also associated with greater DMN functional connectivity. None of these variables predicted BCN’s functional connectivity. However, bilinguals showed stronger functional connectivity with other structures outside of the canonical networks compared to monolinguals. Finally, vocabulary scores, local switch cost accuracy and reaction time were negatively correlated with BCN’s functional connectivity. Overall, these findings illustrate differences in functional brain organization associated with language experience in the DMN, while challenging the “bilingual advantage” hypothesis. The results also suggest a possible neural mechanism by which bilingualism might mediate cognitive reserve.

Nearly 13.8 million Hispanics in the United States speak English "less than very well." This has important implications for the field of clinical neuropsychology. Patients who do not speak English fluently are being increasingly referred for neuropsychological services, and many of these individuals are assessed with the aid of language interpreters. However, whether or how the use of an interpreter has an effect on neuropsychological test scores is not known. For lack of a better alternative, it generally is assumed that the test data obtained through an interpreter are a valid indication of the patient's cognitive functioning, but with almost no empirical support, this assumption appears tenuous at best. The effect of an interpreter, in fact, could be substantial, making this issue all the more deserving of rigorous investigation. The primary objective of the current study was to determine whether using an interpreter to conduct neuropsychological testing of monolingual Spanish speakers had an effect on the neuropsychological test scores. Participants included 40 neurologically normal Spanish-speakers with limited English proficiency, ages 18-65 years, (M= 39.65, SD =13.91) who completed a 2-hour battery of verbal and nonverbal neuropsychological tests both with and without an interpreter. The condition of test administration was counterbalanced across participants and test score differences between the two conditions were compared. Results indicated that use of an interpreter significantly affected mean scores for some neuropsychological tests from the verbal modality. Also, variability in test scores generally was higher when an interpreter was used, significantly so for one verbal test. Results of this study contribute to the extant literature concerning the use of interpreters to facilitate neuropsychological testing of individuals with limited English proficiency. Specifically, they indicate that neuropsychologists should avoid interpreter use and refer patients to bilingual clinicians whenever possible. For situations in which this may not be a viable option, neuropsychologists should limit their test batteries to measures that require minimal reliance on the interpreter. Tests that rely almost entirely on interpreter skills for administration and scoring - such as the Vocabulary and Similarities subtests of the Wechsler Adult Intelligence Scale (WAIS) - should probably not be used. Larger confidence intervals should be used when interpreting observed scores from interpreter-mediated neuropsychological tests.

Word-retrieval and rapid naming abilities play an important role in language processing and cognitive development. Researchers have demonstrated that early language difficulties may lead to later reading impairments and several decades of research has convincingly demonstrated that rapid automatized naming is a powerful predictor of concurrent and future reading development. As a result, researchers have argued that naming and reading tasks involve some shared cognitive processes. Language and reading deficits have implications for academic success and self-esteem, particularly during childhood. Hence, the identification of children at-risk for developing reading impairments is an important task for educators and clinicians. Debates still exist about whether rapid naming difficulties reflect simple delays in language acquisition resulting from processing speed and/or attention problems or are suggestive of abnormalities in underlying cognitive processes. While the co-occurrence of rapid naming deficits and reading impairments is well established in the literature, few studies have explored the presence of Dysnomia without reading impairment. The current study examined the nature of expressive language deficits for Dysnomic children with and without impaired reading by incorporating multiple neuropsychological measures. In a sample of children (N=104) between the ages of 6 and 12 years, performance differences were specifically investigated on measures of verbal fluency, confrontation naming, and rapid naming, as well as visual and verbal sequential memory. The impact of a concurrent diagnosis of a primary attention deficit was also examined within the context of cognitive performances. Results of the current study indicated that a concurrent diagnosis of AD/HD significantly impacted performance on measures of verbal fluency and confrontation naming. When comparing the neurocognitive profiles of these children, those with Dysnomia performed significantly better on reading-related tasks and worse on a measure of visual sequential memory. No significant differences were found between groups on other neuropsychological measures, yet performances were consistently below average for children in both groups. Overall, findings revealed that children in both groups displayed similar neurocognitive profiles. However, children diagnosed only with Dysnomia were significantly younger than children with both Dysnomia and Dyslexia. Findings from this study have implications for research and intervention with school-aged children. Treatment approaches targeting reading fluency and automaticity may be particularly helpful for children with Dysnomia, in addition to intervention programs which integrate fluency-based with phonological-based treatment.

The primary aim of the present study was to determine whether impairment on neuropsychological measures of decision making predicts increased alcohol use among college students. It was hypothesized that poorer performance on measures of decision making would predict linear increase on indicators of alcohol consumption across the first year of college. An additional aim was to assess whether established risk factors for college student drinking would moderate the association between decision making abilities and increased alcohol consumption, with the expectation that decision making would be more strongly associated with escalation in alcohol use for participants that are male, have a family history of alcohol abuse, report a longer history of pre-college alcohol use, hold more positive alcohol expectancies, and are more impulsive. Aims were pursued in a relatively homogeneous sample of first year college students (N = 136), using a prospective, longitudinal design in which decision making and drinking were assessed at three time-points during the first year of college. Participants additionally provided sociodemographic information and completed self-report impulsivity and alcohol expectancy questionnaires at each assessment. Results showed that drinking and associated negative consequences increased over time during the participants first year in college. However, there was generally little support for the hypotheses that poor decision making abilities are a risk factor for increased alcohol consumption, and that the association is moderated by established risk factors for drinking. Results suggest the need to consider whether drinking is indeed indicative of impaired decision making and underscore the importance of including other factors, especially perceived benefits and influence of social pressure, in models of decision making striving to predict drinking among college students.

Researchers have suggested there is a wide range of neuropsychological deficits individuals with anorexia nervosa (AN) possess, including impairments in nonverbal reasoning, attention and processing speed, memory, and executive functioning. While growing, examination of the neuropsychological functioning of children and adolescents with AN is quite sparse compared to the abundance of research on adults with AN, and the many conflicting findings have been attributed to inconsistent methodologies across studies. This study examined the neuropsychological functioning of children and adolescents with AN by conducting a quantitative study loosely based on Bayless et al. (2002) and Remberk, Namysłowska, Krempa-Kowalewska, Gadaś, and Skalska (2011). Results indicated verbal intellectual functioning was significantly higher than other intellectual domains, and verbal memory was almost significantly higher than nonverbal memory (p = .051). Negative correlations were found between individual subtests and clinical data (e.g., age of onset of AN and duration of AN) as well as the EDI-3 Personal Alienation scale and the BMI-for-age percentile. Clinical implications include providing treatment improving cognitive functioning and implementing a biopsychosocial model.

Much of the practice is clinical neuropsychology is performed in the role of consultant and although the neuropsychologist is dependent upon referrals made from outside sources, relatively little attention has been devoted to the investigation of the referral process. Surveys of clinicians and referral sources have reported breakdowns of referral sources by discipline and general topics of referral questions based on recollection, but direct analysis of referral patterns across the same period has not been undertaken. The purpose of the study is to document the advancement of neuropsychology from providing psychological testing to establishing itself as a multifaceted discipline with a significant diagnostic purview that is regularly relied upon to contribute to important decisions in the lives of patients. By examining the referral questions rather than neuropsychologists' or referral sources' recollection of referrals, this study expands what is known about referral content and patterns. In an effort to explain question content without relying upon recollection, a coding rubric was designed to capture the breadth of presenting problems and requests seen in the original referral questions. Two-thousand-six-hundred referral questions were selected from the odd year over the 25 year period from 1983 to 2007, yielding a total of 2600 referral questions. Cochran's Kappa was used to conduct interrater reliability analyses in three stages across the entire rating process. Content analysis showed that 79.1% of all questions had at more than minimal content. The most common request was for assistance with diagnostic considerations, which was present in 66.4% of all cases. Assistance with differential diagnoses was requested in 27.4% of all cases with the majority of these composed of requests for assistance in differentiating between psychiatric and neurological or other medical considerations. There was evidence for a trend over time in the gradual decline of requests for assistance with psychiatric differential diagnosis and requests for the MMPI from 1993 to the present. Memory problems and dementia are the most common presenting problems, although there is evidence of a slight decline in these evaluations beginning in 1997. Requests for specific recommendations, particularly those related to making recommendations regarding treatment planning were found to steadily increase across the sampling period. Limitations and implications for practice were discussed.

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"July 2002" Includes bibliographical references (leaves 324-342)

"July 2002" / Includes bibliographical references (leaves 324-342) / xiii, 342 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2002