The consequence of many psychiatric and neurodegenerative disorders, such as Parkinson's disease and schizophrenia, is an impairment in ‘executive functioning'; an umbrella term for several cognitive processes, including the focussing and shifting of attention and the inhibition of responding. The ability to form an ‘attentional set' involves learning to discriminate qualities of a multidimensional cue, and to subsequently learn which quality is relevant, and therefore predictive of reward. According to recent research, the subthalamic nucleus (STN) and possibly the adjacent zona incerta (ZI) may mediate the formation of attentional set. Dysregulation of the STN as a result of Parkinson's disease contributes to characteristic motor symptoms, and whilst deep-brain stimulation of this region may treat gross motor impairments, it may also impair cognition. The work in this thesis aimed to expand our understanding of the mechanisms of attentional set-formation, and the role of the STN in this process. This thesis evaluates new methods for examining set-formation in the attentional set-shifting task; rather than inferring this behaviour solely from the cost of shifting set, modifications to the task design in Chapters 3 & 4 explored several hypotheses designed to exploit a deficit in this behaviour. Chapter 6 revealed that inhibition of this region with designer receptors leads to a disruption in attentional selectivity, which compromises the ability to form an attentional set. This manifested as an inability to parse relevant information from irrelevant, and instead, animals learned the stimuli holistically. The findings in this thesis also suggested that reversal and attentional shifting processes do not operate independently, but rather in a hierarchy, and that consequently, the STN is a region that may be crucial in selecting appropriate responses during associative learning that leads to the formation of an attentional set.

abstract: ABSTRACT Post-Traumatic Stress Disorder (PTSD), depression, and insomnia are prevalent among United States (US) military veterans. This study investigates whether Brain Boosters, a new cognitive enhancement group therapy, improves symptoms of PTSD, depression, and insomnia among veterans completing the groups. The study population includes 64 US military veterans treated in the setting of the Veterans Affairs (VA) Health Care System in Phoenix, AZ. Group members were US military veterans, age 22 to 87 (mean age=53.47), who had served in or after World War II (WWII), who sought mental health care at the Phoenix VA from 2007 through 2011. Participants were treated with Brain Boosters therapy. They completed measures of mental-health related symptoms before and after this therapy. Participants were assessed pre and post group with the PTSD Checklist for military personnel (PCL-M), the Patient Health Questionnaire (PHQ-9; a measure of depression symptoms), and the Insomnia Severity Index (ISI). Statistical analyses were done with paired samples t-tests and McNemar's tests, using SPSS. The hypotheses were that symptoms of PTSD, depression, and insomnia would show statistically significant improvement with Brain Boosters therapy. Results supported the hypotheses that symptoms of PTSD and depression would improve significantly. Insomnia did not show significant improvement. The results showed the mean PCL-M score was 54.84 before Brain Boosters therapy and 51.35 after (p= 0.008). The mean PHQ-9 score was 15.21 before Brain Boosters therapy and 13.05 after (p= 0.002). The mean ISI score was 15.98 before Brain Boosters Therapy and 14.46 after (p= 0.056). Although this is a nonrandom, uncontrolled trial, findings nevertheless suggest that Brain Boosters may be an effective therapy to reduce PTSD symptom severity and depression symptom severity. This may be especially important for veterans seeking alternatives to pharmacological intervention or traditional therapeutic interventions. / Dissertation/Thesis / M.S. Psychology 2012

Submitted by JOANA SANTOS MONTALVÃO null (joana_mbj@hotmail.com) on 2018-08-09T17:28:07Z No. of bitstreams: 1 dissertação oficial eNVIAR.pdf: 1493305 bytes, checksum: 66f090ee5b1fa4de3165184ac6e1bff7 (MD5) / Approved for entry into archive by Minervina Teixeira Lopes null (vina_lopes@bauru.unesp.br) on 2018-08-09T20:20:25Z (GMT) No. of bitstreams: 1 montalvão_js_me_bauru.pdf: 1348149 bytes, checksum: 3ba8400d96ff8669298eb82346473103 (MD5) / Made available in DSpace on 2018-08-09T20:20:25Z (GMT). No. of bitstreams: 1 montalvão_js_me_bauru.pdf: 1348149 bytes, checksum: 3ba8400d96ff8669298eb82346473103 (MD5) Previous issue date: 2018-06-13 / A cirurgia bariátrica (CB) tem se tornado uma prática cada vez mais utilizada no tratamento da obesidade grau III, por auxiliar na redução do peso e eliminação ou diminuição das comorbidades. Por outro lado, pouco se sabe sobre seus efeitos com relação ao funcionamento biopsicossocial. A presente pesquisa consiste de um estudo prospectivo dos efeitos da redução de peso rápida (CB) ou lenta (dieta), nos aspectos emocionais, cognitivos, de autoeficácia e qualidade de vida, em pessoas com obesidade grau III avaliadas em dois momentos em um intervalo de três meses. Participaram do estudo 58 indivíduos com obesidade grau II e III, de ambos os sexos, com idade superior a 20 e inferior a 60 anos, avaliados quantos aos sintomas depressivos e ansiosos, funções executivas, autoeficácia geral, autoeficácia para regular hábitos alimentares e qualidade de vida. No estudo transversal a amostra total (n=58) foi dividida em dois grupos, GJ (Grupo Jovem) e GM (Grupo Maduro) para análise da influência da idade sobre as variáveis. No estudo prospectivo os pacientes participantes foram divididos em dois grupos CB (tratados por cirurgia bariátrica) e o NCB (tratados por dieta). O estudo transversal indicou que o GJ apresentou um melhor desempenho na memória operacional no subsistema visuoespacial quando comparado ao GM, não houve diferenças nos demais quesitos. O estudo prospectivo revelou que os pacientes do grupo CB apresentaram melhoras nos sintomas depressivos e de ansiedade, assim como apresentaram escores mais positivos com relação à avaliação da qualidade de vida e melhoras na memória operacional, assim como, na avaliação da autoeficácia quando comparados aos pacientes do grupo NCB. A melhora do grupo NCB foi restrita à autoeficácia para regular hábitos alimentares. Em conclusão a obesidade grau III parece contribuir para o prejuízo na memória operacional a partir dos 40 anos. A redução de peso rápida tende a reduzir os sintomas ansiosos e depressivos, bem como melhora a autoeficácia para regular hábitos alimentares, a percepção da qualidade de vida, e a memória operacional. O tratamento dietético parece ser responsável pela melhora na autoeficácia para regular hábitos alimentares em indivíduos que esperavam pela cirurgia bariátrica. / Bariatriac surgery (BS) has become an increasingly used procedure in the treatment of class III obesity, as this surgery helps to lose weight while eliminate or reduce comorbidities. On the other hand, little is known about its effects on an individual's biopsychosocial functioning. The present research contrasts fast weight loss (BS) and slow weight loss (diet) effects in emotional, cognitive, self-efficacy and life quality aspects in people with morbid obesity assessed in two moments over a three-month interval. Participants were 58 individuals from both genders, aged 20 to 60 years, with class II and III obesity assessed regarding depression and anxiety symptoms, executive functions, general self-efficacy, self-efficacy to regulate eating habits and quality of life. In the cross-sectional study, the sample was divided into two groups, YG (Young Group) and MG (Mature Group), for age analysis over the variables. In the prospective study, the patients were divided into two groups: BS (treated by bariatic surgery) and NBS (treated by diet). The cross-sectional study indicated that MG had better performance in working memory in the visuospatial subsystem when compared to MG – no differences were found in other inquiries. The prospective study revealed that BS patients had improvements in depression and anxiety symptoms, more positive scores regarding quality oflife, improvements in working memory and self-efficacy assessment when compared to NBS patients. Benefits in NBS group were restrict to self-efficacy to regulate eating habits. Thus, morbid obesity seems to contribute to harm in working memory of 40 year-old people and older. Fast weight loss reduces anxiety and depressive symptoms, as well as enhances self-efficacy to regulate eating habits, life quality perception and visuospatial memory. Dietetic treatment seems to be responsible for improvement in self-efficacy to regulate eating habits in individuals waiting to undergo bariatric surgery.

[pt] O declínio no funcionamento cognitivo e a queixa de sintomas de ansiedade são frequentes no processo de envelhecimento. Esta dissertação tem como objetivo explorar a relação entre os sintomas de ansiedade com o desempenho cognitivo de indivíduos com idade acima de 55 anos. Está dividida em dois estudos em etapas progressivas. O primeiro estudo é uma revisão sistemática e o segundo estudo é uma pesquisa exploratória com protocolo de 73 testes cognitivos e 6 escalas de ansiedade. A amostra foi composta por 26 indivíduos idade acima de 55 anos, sendo 20 mulheres (76,92 por cento) e 6 homens (23,07 por cento), com idade média de 70,96 (mais ou menos 8,42) anos e escolaridade média de 16,23 ( mais ou menos 3,68) anos de escolaridade. Calcularam-se coeficientes de correlação e, para as correlações com efeito médio ou grande, foi feita análise de regressão linear. Em seguida, repetiu-se a análise em uma subamostra, considerando-se apenas os participantes com ansiedade acima do ponto de corte em pelo menos uma escala de ansiedade. Observaram-se mais correlações com efeito de tamanho médio ou grande na análise da subamostra. Em cada análise foram observadas 11 correlações significativas com efeito de tamanho médio ou grande, apontando associação entre ansiedade e funções cognitivas. A regressão linear destas correlações apontou que o aumento do nível de ansiedade reduz o desempenho em tarefas cognitivas. Conclui-se que os resultados apontam dissociação nos diferentes sistemas de ansiedade: (1) estado de ansiedade afetando memória de trabalho; (2) traço de ansiedade afetando memória episódica e velocidade de processamento; e (3) os sintomas fisiológicos da ansiedade afetando o controle inibitório. / [en] The decline in cognitive functioning and the complaint of anxiety symptoms are frequent in the aging process. This dissertation aimed to explore the relationship between anxiety symptoms and the cognitive performance of individuals aged over 55 years. It is divided into two studies in progressive stages. The first study is a systematic review and the second study is an exploratory research with protocol of 73 cognitive tests and 6 anxiety scales. The sample consisted of 26 individuals aged over 55 years, 20 women (76.92 percent) and 6 men (23.07 percent), with a mean age of 70.96 (plus or minus 8.42) years and average schooling of 16.23 (plus or minus 3.68) years of schooling. Correlation coefficients were calculated and, for correlations with medium or large effect, linear regression analysis was performed. Thereafter, the analysis was repeated in a subsample, considering only participants with anxiety above the cutoff point on at least one anxiety scale. There were more correlations with medium or large size effect in the subsample analysis. In each analysis, 11 significant correlations were observed with medium or large size effect, indicating an association between anxiety and cognitive functions. The linear regression of these correlations pointed out that the increase of the level of anxiety reduces the performance in cognitive tasks. We conclude that the results point to dissociation in the different anxiety systems: (1) anxiety state affecting working memory; (2) anxiety trait affecting episodic memory and processing speed; and (3) the physiological symptoms of anxiety affecting the inhibitory control.

Le but de la thèse était d’avancer les connaissances sur les procédures diagnostiques ayant pour objectif  la latéralisation des déficits de la mémoire visuelle, ainsi que d’étudier la perception dans l´épilepsie du lobe temporal (ELT). La première étude a examiné l’aptitude de quatre tests de mémoire visuo-spatiale, comme méthode d´identification des dysfonctions du lobe temporal médial droit. Des méthodes statistiques variées, illustrent la capacité limitée de ces tests à latéraliser la zone dysfonctionnelle, même lorsque les facteurs cliniques liées à l’épilepsie ainsi que d’autres facteurs cognitives étaient contrôlés. La deuxième étude est fondé sur la première, et à pour but de valider un nouveau paradigme. Ainsi, nous avons examiné des patients avec ELT en préopératoire avec le Delayed Matching to Sample (DMS-48) test et en postopératoire avec deux versions parallèles que nous avions développées et standardisées auprès des sujets contrôles sains. Nos analyses démontrent que le DMS-48 et ces versions parallèles ont pu latéraliser la zone épileptogène avant et après l´intervention chirurgicale. La troisième partie comprime une expansion de la mémoire visuelle à la perception visuelle. Une étude de cas unique suggère que la reconnaissance de l´objet et l´imagerie mentale sont soutenues par des régions corticales proches, situées en contiguïté de la voie temporo-occipitale. De plus, la perception et l´imagerie de l´espace sont rendues possibles par des mécanismes en dehors de la voie ventrale. En outre, ces résultats semblent indiquer que des dysfonctions chroniques du système visuel peuvent être réversibles avec un contrôle des crises effectif. / The aim of the present thesis was to advance the knowledge of diagnostic procedures for lateralizing visual memory deficits and to study the characteristics of perception in temporal lobe epilepsy (TLE). The first study examined the appropriateness of four routinely used learning and reproduction visuo-spatial memory tests as an identification method for right mesial temporal lobe dysfunctions. Various statistical methods illustrate the tests poor capacity to lateralize the functional deficit zone, even when epilepsy-related clinical and other cognitive factors were controlled. The second study is built upon the results of the first, aiming to validate a new test paradigm for lateralizing right hippocampal dysfunctions. Thus we assessed mesial TLE patients preoperatively with the Delayed Matching to Sample (DMS-48) task and postoperatively with two parallel versions that we had developed and standardized in healthy controls. Our analysis suggests that the DMS-48 and its parallel versions were able to lateralize the epileptic onset zone pre- and postsurgically. The third part consists of an expansion from visual memory to visual perception. A study of single case suggests that visual object recognition and visual imagery are sustained by cortical areas located in proximity to the temporo-occipital ventral pathway and that perception and imagery for space is subserved by mechanisms, which are close anatomically, and outside the ventral path. Furthermore, the results seem to indicate that nonlesional paroxysmal activity in the posterior temporal lobe can cause chronic dysfunctions of the visual system, which may be reversible with effective seizure control.

Essa dissertação teve como objetivo investigar as funções executivas em crianças e adolescentes com Transtorno do Espectro do Autismo (TEA). No primeiro estudo, foi feita uma revisão sistemática de publicações de 2001 a 2011, que avaliaram as funções executivas nessa amostra. No segundo estudo, foi feita uma comparação de desempenho de dois grupos de crianças e adolescentes, um grupo com diagnóstico de TEA (n=11) e um grupo controle com desenvolvimento típico (n=19), em tarefas de funções executivas e memória de trabalho. Concluiu-se que, embora o estudo de revisão tenha encontrado evidências de componentes executivos intactos (resolução de problemas, memória de trabalho) e disfuncionais (planejamento, flexibilidade, fluência verbal, inibição) nas amostras com TEA, o estudo empírico indicou desempenho inferior do grupo TEA em todas as tarefas de funções executivas e memória de trabalho, envolvendo componentes do controle inibitório, da flexibilidade cognitiva, do planejamento, de memória de trabalho e de fluência verbal. / This dissertation aimed to investigate executive function in children and adolescents with Autism Spectrum Disorders (ASD). In the first study, we performed a systematic review of publications from 2001 to 2011, which assessed executive function in this sample. In the second study, was done a performance comparison of two groups of children and adolescents, a group with ASD (n=11) and a control group with typical development (n=19), in tasks of executive function and working memory. It was concluded that, although the review study has found evidence of intact (problem-solving, working memory) and dysfunctional (planning, flexibility, verbal fluency, inhibition) executive components in samples with ASD, the empirical study indicated lower performance of executive function in ASD group, involving components of inhibitory control, cognitive flexibility, planning, working memory and verbal fluency.

One of the consequences of traumatic brain injury is the postconcussion syndrome. The symptoms in this syndrome include headache, dizziness, poor memory, poor concentration, easy fatigue, drowsiness, irritability, sensitivity to light, sensitivity to noise, low alcohol tolerance, visual problems, auditory problems, nausea, vomiting, anxiety, and depression. Several factor analytic studies have shown that these symptoms load onto cognitive and noncognitive factors (Bohnen, Twijnstra, & Jolles, 1992). The aim of this study was to determine whether patients who report different symptoms also evidence differences in cognitive deficits, as indexed by reaction time. For this purpose 106 subjects (mean age 25.92 years; SD=6.05) of both sexes were tested on 8 reaction time tasks adapted from Shum, McFarland, Bain, and Humphreys (1990). There were 54 traumatic brain injury patients (mean age 26.40 years; SD=6.23) drawn from three Pretoria hospitals. They were heterogeneous with respect to diagnosis and severity of injury. For the controls (N=52), the mean age was 25.43 years (SD=5.88). The eight reaction time tasks constituted 4 task variables, each with 21evels. From these tasks, 36 reaction time indexes were derived. The indexes were classified into 4 groups, viz., reaction time (RT), movement time (MT), total reaction time (TT), and subtraction scores (SB, the difference between the 2 levels for each task variable). RT reflects the decision component and MT reflects the response execution component of reaction time. Partial correlation coefficients for all symptoms (p0,01) showed that some symptoms were most frequently associated with RT whilst others were most frequently associated with MT. On factor analysis with varimax rotation, symptoms loaded predominantly with SB scores. Symptoms also loaded with different task variablseuiggesting that they correlated with deficits on different stages of information processing. Taking into account possible methodological constraints that were discussed, these results confirm that different symptoms within the postconcussion syndrome correlate with different cognitive deficits. The correlations between symptoms and indices of reaction time are moderated by the characteristics of the symptoms (frequency & intensity), and the duration since injury. These findings have significance for understanding the aetiology of the postconcussion symptoms and for planning treatment. / Psychology / Ph. D. (Psychology)

The present study aimed at investigating the neuropsychological sequelae of transient ischaemic attacks. Transient ischaemic attacks are defined as those neurological disorders in which there is complete resolution of neurological symptoms within twenty·four hours. Transient ischaemic attacks may or may not reveal evidence of brain infarcts on imaging studies. In the present study, the neuropsychological sequelae of transient ischaemic attacks in the carotid circulation were investigated since, within the perspective of cognitive neuropsychology, it was assumed that localized changes in cognitive functions could be demonstrated.Since several psychological, medical and neurological factors are known to influence scores·on neuropsychological tests, regression analyses were performed to determine which factors contributed significantly to the variance of scores on neuropsychological tests in the transient ischaemic attack and control groups. Two transient ischaemic attack groups, each comprising forty left and forty right hemisphere involvement patients, were then compared with each other and with a control group of forty general medical patients. Stenosis of the carotid artery formed a significant predictor of test scores in the combined transient ischaemic attack group. When the groups were·analyzed independently, in the left transient ischaemic attack group stenosis predicted performance on the same tests reaching significance for the combined group, and for the Wisconsin Card Sorting Test (Perseverative Score). In the right transient ischaemic attack group, stenosis significantly predicted performance on Digits Forward, Backward and Total, the PASAT (2.4 seconds) and Trails B. On the other hand, education formed a significant predictor of performance on Digits Forward, Digits Backward and Digits Total and the PASAT (all levels) in the control group. Multivariate comparisons revealed that the left and right transient ischaemic attack groups performed worse than the controls on tests of attention, concentration and conceptual flexibi1ity. The left transient ischaemic attack group performed worse than the right transient ischaemic attack group on all tests of attention and concentration, but there was a significantly better performance of the former group on the Rey Auditory Verbal Learning Test (Trial 1), Block Designs and Verbal Fluency. The findings on the PASAT that left transient ischaemic attack patients performed significantly worse than the right hemisphere group ·were considered to be relatively unreported previously in the literature on transient ischaemic attacks. The findings obtained are discussed from a neurocognitive perspective of neuropsychological functioning in transient ischaemic attacks. / Psychology / Ph. D. (Psychology)

Establishing how cognitive abnormalities result in the signs and symptoms that define schizophrenia and anxiety disorders (and their co-morbidity) has become a prominent question in clinically, and sub-clinically, applied research. Abnormal performance in schizophrenia, schizotypy and anxiety has been observed in comparison to healthy individuals on a range of cognitive and behavioural tasks. For example, abnormal attention to irrelevant information has long been recognised by clinicians, which has since encouraged researchers to elucidate the nature of the relationship between schizophrenia, and anxiety more recently, with allocation of attention to stimuli in laboratory studies providing empirical evidence for an attentional view of these disorders. The pre-exposure effect (slower learning to a stimulus that has been rendered familiar by preexposure, relative to a novel cue), hereafter refered to as latent inhibition, has been shown to be inversely correlated with schizotypy, and abnormal in people with schizophrenia, but findings are inconsistent. One potential contributing factor to this inconsistency is that many tasks that purport to measure latent inhibition are confounded by alternative effects that also retard learning and co-vary with schizotypy, such as learned irrelevance (experience of a cue as irrelevant to the occurrence of an outcome due to inconsistent/uncorrelated presentations of a cue and a target). The general aim of this thesis is to address, or begin to address, some of the key questions and limitations with existing research that evaluate latent inhibition and learned irrelevance as potentially useful cognitive endophenotypes for schizophrenia and anxiety disorders. The current experiments separate out the effects of latent inhibition and learned irrelevance to assess the independent effects of these phenomena on schizotypy (and by extension schizophrenia) and anxiety. By teasing apart, the effects of latent inhibition and learned irrelevance the attempt is to disentangle, and improve understanding of attentional abnormalities observed in these sub-clinical traits and by extension, their related pathologies. Across Experiments 1-4, the purpose was two-fold. The first was to address the limitations of existing latent inhibition tasks by designing a paradigm that examines a purer effect of latent inhibition, by minimising the contribution of learned irrelevance, and assessing how this latent inhibition task co-varies with schizotypy and anxiety (Chapter 2: Experiments 1 and 2). The second was to examine the alternative, potentially less equivocal, learned attentional paradigm (learned irrelevance) and assess the relationship between this task with both schizotypy and anxiety (Chapter 3: Experiments 3 and 4). Based on the assumption that latent inhibition and learned irrelevance share similar psychological underpinnings (in this case, attentional), we anticipated the effect of schizotypy and anxiety to be comparable in the two types of attention tasks here. The results however indicate a double dissociation; an abnormally persistent latent inhibition effect in high positive schizotypy individuals (Experiments 1 and 2) and a reduced learned irrelevance effect in high state anxious individuals (Experiments 3 and 4). The possibility that latent inhibition is non-attentional and the implications of these findings for associative models of attention and learning are explored. The aim of Experiments 5 and 6 were to explore the causal relationship between induced variations in anxiety (stress, relaxation or neutral mood) and learned variations in attention, using a less ambiguous measure of attention (compared to latent inhibition): learned irrelevance. Based on the findings from Experiments 3 and 4, a reduced attentional bias towards previously established predictive cues was expected in individuals induced with an acute state of anxiousness, relative to individuals induced with either a relaxed or neutral mood state. This pattern of results was observed but to a weaker extent than the previous experiments, suggesting that induced variations in anxiety do not have the same relationship with learning as naturally occurring variations in anxiety, as observed in Experiments 3 and 4. Further analyses revealed that the relationship between reduced learned irrelevance and anxiety was mediated by individuals who were also characterised by high levels of schizotypy, and by extension vulnerability to schizophrenia. Given the potential common underlying cognitive processes to both anxiety and schizophrenia, it seems likely that therapies which target the symptoms of anxiety (e.g., Attentional Bias Modification Treatment; ABMT) would be beneficial to individuals who have also been diagnosed with a psychotic disorder. This work represents the first attempt to investigate the independent effects of latent inhibition and learned irrelevance on schizotypy and anxiety, using refined tasks that minimised the contribution of either learning phenomenon on each other. How these learning tasks co-vary in patients with schizophrenia and clinically diagnosed anxiety however remains for future research to determine . At this juncture, the current findings lend support to the potential cognitive endophenotype status of learned irrelevance (considering its status as a less ambiguous measure of attention) and its continued use to provide a base for the development of relevant attentional bias modification treatments.

[pt] O presente estudo teve como objetivo compreender como se dá a ontogênese das funções cognitivas no período entre o nascimento até o início da adolescência. A partir da perspectiva da neurociência e neuropsicologia cognitiva, questões como as influências biológicas e ambientais, a maturação cerebral e o processo de aprendizagem, assim como as bases neuroanatômicas e circuitos neurais serão discutidas. A ênfase será dada aos marcos mais relevantes no processo típico do desenvolvimento das principais funções cognitivas tais como a sensação, a percepção, a atenção, a memória, a linguagem, as habilidades visuoconstrutivas, e as funções executivas. / [en] This study aimed to understand how the ontogeny of cognitive functions during the period from birth to early adolescence. From the perspective of neuroscience and cognitive neuropsychology, issues such as biological and environmental influences, brain maturation and learning processes, as neuroanatomical bases and neural circuits will be discussed. Emphasis will be given to the most important milestones in the typical development of the main cognitive functions such as sensation, perception, attention, memory, language, visual-constructive skills and executive functions.