Background: Maintaining independence in instrumental activities of daily living (IADL) is crucial for older adults. This study explored the association between cognitive and functional performance in general and in single IADL domains. Also, risk factors for developing IADL impairment were assessed. Methods: Here, 3,215 patients aged 75–98 years were included. Data were collected during home visits. Results: Cognitive functioning was associated with IADL both cross-sectionally and longitudinally. Regarding the single IADL domains cross-sectionally, executive functioning was especially associated with shopping, while episodic memory was associated with responsibility for own medication. Conclusion: Reduced performance in neuropsychological tests is associated with a greater risk of current and subsequent functional impairment. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: Maintaining independence in instrumental activities of daily living (IADL) is crucial for older adults. This study explored the association between cognitive and functional performance in general and in single IADL domains. Also, risk factors for developing IADL impairment were assessed. Methods: Here, 3,215 patients aged 75–98 years were included. Data were collected during home visits. Results: Cognitive functioning was associated with IADL both cross-sectionally and longitudinally. Regarding the single IADL domains cross-sectionally, executive functioning was especially associated with shopping, while episodic memory was associated with responsibility for own medication. Conclusion: Reduced performance in neuropsychological tests is associated with a greater risk of current and subsequent functional impairment. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background. Within the South African context there is a large body of research regarding the associations between maternal gestational drinking and diagnosable child FASDs. However, there remains a paucity of local research regarding the impacts of other kinds of maternal drinking behaviours (e.g. past and present maternal drinking) and related socio-demographic factors on developmentally sensitive areas of child neurocognitive functioning, such as executive functioning (EF). Methods. This study was cross-sectional in design, utilising a gender balanced sample of N=464 children between the ages of 9.00 and 15.12 (year.months) in three rural areas within the Western Cape. Information regarding maternal drinking behaviours (before, during and after pregnancy) and related socio-demographic factors was collected via structured interviews with mothers or proxy respondents. Six subtests from the Cambridge Automated Neuropsychological Battery (CANTAB), were used to assess three aspects of child EF namely: (1) processing speed, assessed by the MOT and RTI subtests, (2) attention, assessed by the MTT and RVP subtests and (3) memory, assessed by the SWM and PAL subtests. Findings. For all three maternal alcohol use behaviours examined, there was an apparent non-significant trend whereby children of mothers who reported alcohol use (before, during and after pregnancy) performed worse (on average) than children of mothers reporting non-alcohol use on the EF subtests. Several of the socio-demographic factors were found to act as significant predictors of subtest specific EF performance including child sex (RTI: B=.46, p<. 01; MTT: B=.05, p<.05), child age (RTI: B=.27, p<.05; MTT: B=.11, p<.01), home language (MOT: B=- .13, p<.05), maternal employment (MTT: B=-.04, p<.05) and household size (SWM: B=-1.29, p<.05). Conclusions. These study findings provide initial insights into the impacts of different types of maternal drinking behaviours and related socio-demographic factors on child EF outcomes within the context of an LMIC, South Africa.

Background: Maintaining independence in instrumental activities of daily living (IADL) is crucial for older adults. This study explored the association between cognitive and functional performance in general and in single IADL domains. Also, risk factors for developing IADL impairment were assessed. Methods: Here, 3,215 patients aged 75–98 years were included. Data were collected during home visits. Results: Cognitive functioning was associated with IADL both cross-sectionally and longitudinally. Regarding the single IADL domains cross-sectionally, executive functioning was especially associated with shopping, while episodic memory was associated with responsibility for own medication. Conclusion: Reduced performance in neuropsychological tests is associated with a greater risk of current and subsequent functional impairment.

Objective: Lack of insight into illness is common in patients with schizophrenia diagnoses. It is supposed to reflect deficits of executive functioning that are frequently assessed with the Wisconsin Card Sorting Test. Studies on the remediability of WCST deficits in schizophrenia, however, raise doubts about its construct validity and suggest the use of a dynamic pretest-training-posttest paradigm (WCSTdyn) and single-case analysis (Reliable Change Index, RCI) in studies on insight. Moreover, a multifactorial etiology with neurocognitive and motivational factors, as suggested by Startup's (1996) model, has to be taken into consideration. The model hypothesizes a quadratic function of the relationship between insight and cognition, which means that both cognitively impaired and cognitively intact patients with low insight are to be expected. Method: Three interrelated studies on WCSTdyn and insight were conducted. In study 1, the split-half reliability of the WCST-128 was investigated in a non-psychiatric sample (N = 110). Study 2 compared different RCI single-case tests of significance of intraindividual change on data from N = 400 patients with schizophrenia diagnoses. Furthermore, a typology with three homogenous subgroups was developed and first steps toward an external validation were taken. In study 3, the three types of test-takers were compared on two measures of insight (Item G12 of the Positive and Negative Syndrome Scale [PANSS]; Osnabrueck Scale of Therapeutic Attitudes and Identification of Psychological Problems in Schizophrenia [OSSTI]). The model by STARTUP (1996) was tested by means of regression and cluster analyses including scales on coping (Freiburg Questionnaire of Coping with Illness, FKV: MUTHNY, 1989) and defensiveness (Eppendorf Schizophrenia Inventory, ESI-FR: MAß, 2001; N = 85). Results: The WCST-64 was sufficiently stable (r_tt = .70 [Total Number Correct]). Concordances of different RCI methods were high (kappa = .72 - .90). 45 % of the sample consisted of high scorers, in 43 % a low initial score could be normalized by a short training intervention (learners), and in only 12 % of the sample the WCST deficits were not amenable to training (nonlearners). Insight of nonlearners was significantly reduced (G12: g = 0,45). Finally, three clusters were identified with configurations of insight and WCSTdyn scores consistent with the prediction by STARTUP (1996). Patients with intact neurocognition but low insight responded in a significantly more defensive manner (g = 0,38). They did not differ in self-rated coping, however. A quadratic relationship could not be confirmed. Conclusion: The RCI-based performance typology developed in studies 1 and 2 is a universally applicable analytic tool for future studies on insight-limiting neurocognitive deficits with the WCSTdyn. Results from study 3 point in the direction of a multifactorial etiology of lack of insight in schizophrenia with differential contributions of neurocognitive deficits (e.g., interference control) and defensiveness.

Catholic schools need to examine the barriers to, benefits of, and interventions needed when implementing inclusive practices into their institutions. Catholic schools are experiencing an increase in enrolled students identified with learning and behavioral needs; however, they frequently lack resources and expertise to provide the necessary support for these students and their families to succeed. Research studies identify teacher attitudes and perceptions regarding inclusive practices as vital factors to create successful culture change. A single group pretest-posttest design, incorporated into this action research study, measured the attitudes and stress of teachers before and after a 14-week long intervention for eight target students with ADHD. The Attitudes Toward Inclusive Education Scale (ATIES), adapted for this setting, was completed by 26 teachers. The Index of Teaching Stress (ITS) was completed by each teacher for each target student in their class for a total of 53 teacher-student dyads. Data analysis included two, one-tailed, paired-samples t-tests. A moderate effect (d= .471) that was statistically significant (p The implications of this study suggest the importance of providing appropriate interventions and accommodations to better support teacher-student relationships, and that a greater buy-in and understanding is needed by the teachers to change their overall attitudes toward inclusivity. Effective professional development is crucial for teachers and students alike to be better informed of the potential academic and social challenges of an ADHD diagnosis and how to best support these specific needs. Further, creating a more inclusive school environment requires stakeholders to develop clear mission statements, approve budgets that include wellness and resource programs, and design daily bell schedules that allocate time for support outside of the student’s normal classes. The limitations of this action research include generalization beyond a private high school setting, experimenter effect, teachers self-reporting, and not having a comparison or control group. Suggestions for further research include incorporating a qualitative component to better understand the effectiveness of an intervention, and running interventions for female groups, middle-school-aged students, and other specific diagnoses for comparative results.

This study investigates the nature of Asperger's Syndrome and specifically the social impairments experienced by learners affected by this syndrome. The incorrect social language, narrow interests and repetitive routines, and the deficits of theory of mind, central coherence and executive functioning of learners with Asperger's Syndrome are also outlined, and an attempt is made to relate these impairments to the social difficulties that learners with Asperger's Syndrome may experience in any inclusive setting. Chapters two and three comprise an in-depth literature study on this specific subject, thus forming a basis for the empirical research reported in chapter five. A qualitative research design is used, first to gain information about and understanding of the nature of the social impairments that afflict learners with Asperger's Syndrome, and secondly to gauge the effectiveness of using social stories as a means to assist the social development of affected learners. More specifically, an ethnographic research design has been chosen for its flexibility which readily permits last-minute adjustments to suit any design, and also because it helps to give meaning to personal encounters. The sensitive nature of the topic is another important reason for choosing this approach (ie. interaction with the researcher could be "fine-tuned" to achieve the ends of this adapted interview situation effectively, circumspectly and safely without undue upset for all concerned). The interview responses of two mothers of learners with Asperger's Syndrome, as well as the observation of these learners are reported. The results of the interviews and observations are checked against the literature study for corroboration in order to bring about a more positive awareness of the impairments experienced by these learners. The technique of social stories was investigated as a method of enhancing the social development of learners with Asperger's Syndrome. Three specific social stories were developed for this research in order to test the effectiveness of this method. Positive outcomes were achieved after implementation of the stories. Results of this study indicated that knowledge and understanding of Asperger's Syndrome, as well as positive attitudes, are critical to ensure the acceptance and accommodation of learners with Asperger's Syndrome in the school environment and in society as a whole. Also, the issue of accommodating learners with Asperger's Syndrome in an inclusive setting should receive concerted attention since it can have major implications for their educational prospects. / Educational Studies / Thesis (D. Ed.)

This study investigates the nature of Asperger's Syndrome and specifically the social impairments experienced by learners affected by this syndrome. The incorrect social language, narrow interests and repetitive routines, and the deficits of theory of mind, central coherence and executive functioning of learners with Asperger's Syndrome are also outlined, and an attempt is made to relate these impairments to the social difficulties that learners with Asperger's Syndrome may experience in any inclusive setting. Chapters two and three comprise an in-depth literature study on this specific subject, thus forming a basis for the empirical research reported in chapter five. A qualitative research design is used, first to gain information about and understanding of the nature of the social impairments that afflict learners with Asperger's Syndrome, and secondly to gauge the effectiveness of using social stories as a means to assist the social development of affected learners. More specifically, an ethnographic research design has been chosen for its flexibility which readily permits last-minute adjustments to suit any design, and also because it helps to give meaning to personal encounters. The sensitive nature of the topic is another important reason for choosing this approach (ie. interaction with the researcher could be "fine-tuned" to achieve the ends of this adapted interview situation effectively, circumspectly and safely without undue upset for all concerned). The interview responses of two mothers of learners with Asperger's Syndrome, as well as the observation of these learners are reported. The results of the interviews and observations are checked against the literature study for corroboration in order to bring about a more positive awareness of the impairments experienced by these learners. The technique of social stories was investigated as a method of enhancing the social development of learners with Asperger's Syndrome. Three specific social stories were developed for this research in order to test the effectiveness of this method. Positive outcomes were achieved after implementation of the stories. Results of this study indicated that knowledge and understanding of Asperger's Syndrome, as well as positive attitudes, are critical to ensure the acceptance and accommodation of learners with Asperger's Syndrome in the school environment and in society as a whole. Also, the issue of accommodating learners with Asperger's Syndrome in an inclusive setting should receive concerted attention since it can have major implications for their educational prospects. / Educational Studies / Thesis (D. Ed.)

Though a major illness in modern society, depression is still not completely understood. A number of empirical observations point to the importance of basic cognitive processes as well as personality variables as antecedents of a depressive disorder. In this work it is argued that “state orientation”, a personality style characterized by the inability to actively influence one’s focus of thought, plays an important role in the development of at least some forms of major depressive disorder. In the present work, it is suggested that (1) state-oriented cognitions are equivalent to sustained information processing, that (2) depressed individuals are characterized in particular by state-oriented cognitions related to prior failure experiences, that (3) sustained processing of affective information will interfere with normal executive cognitive functioning in depressed individuals resulting in impairments of normal behavior, and that (4) both sustained information processing and “affective interference” will be associated with specific dysfunctional patterns of brain activity in depressed individuals. In the first chapter of this thesis, theorizing pertaining to “action control” and the relationship between action control and state orientation are reviewed. After having established the potential functional significance of state-oriented cognitions, their possible link to depression is developed by introducing the “degenerated-intention hypothesis”. Afterwards, the role of state orientation in the advent of the depressive state is discussed against the background of the “functional helplessness” model of depression. Next, recent empirical findings related to executive dysfunction associated with state-oriented cognitions in major depressive disorder and related dysfunctional patterns of brain activity are reviewed. By considering evidence from studies on executive functioning, brain imaging, and neurophysiological studies, support is found for a possible frontocingulate dysfunction associated with a state-oriented cognitive style underlying a major depressive disorder. Consistent with the proposed link between depression and state orientation, in the second chapter of the thesis, Studies 1a – 1c demonstrate that subclinically and clinically depressed individuals are specifically characterized by failure-related state orientation. Moreover, the results of Study 2, described in Chapter 3, reveal that sustained processing of affectively valenced information may indeed interfere with subsequent executive cognitive functioning, especially in individuals demonstrating relatively high levels of depression. Finally, in line with the idea that sustained information processing and affective interference will be related to an individual’s level of state orientation and will be reflected in specific patterns of neural activity, Study 3, presented in Chapter 4, provides considerable evidence for disturbed brain function in clinically depressed individuals during processing of affective information as well as subsequent executive cognitive functioning and its relation to state-oriented thought. The current research supports the idea that state orientation, in particular its failure-focused form, is a crucial process involved in the development and maintenance of a depressive disorder. Specifically, the present findings suggest that certain forms of major depressive disorder are associated with sustained processing of affective information and with the resulting affective interference with executive cognitive functioning. Findings further suggest that sustained information processing is experienced by affected individuals as ruminative, state-oriented thought on past aversive experiences, and that both sustained information processing and affective interference are associated with distinct patterns of brain activity, which are related to early stimulus evaluation, conflict monitoring, and conflict resolution. The processes possibly underlying some forms of depression, as proposed in this thesis, comprise what may be called “the spinning mind”, whose important functional significance is to hinder an individual from adaptive behavior by impairing the ability to direct thought. Although state orientation may therefore appear to be maladaptive per se, it may be argued instead that this mode of action control is also an adaptive process as long as critical limits of certain parameters are met and the spinning mind is prevented. These and similar considerations are addressed in the concluding discussion in Chapter 5.