Cancer affects millions of people every year and survivorship has increased substantially recently. Two cancers that affect older adults is non-Hodgkin's lymphoma and breast cancer, yet very little research has focused on cancer and survivorship in late life. Emerging research has suggested that chemotherapy could have deleterious consequences on cognition, but few studies have considered the long-term neurocognitive sequelae of chemotherapy. Furthermore, social support and optimism have been independently examined as predictors of quality of life in cancer patients, but little research has considered the effects of these variables on other outcomes, such as cognition. The aim of this study was to gain a better understanding of the relationship between social support and optimism on cognition, specifically in non-Hodgkin's lymphoma (NHLS) and breast cancer survivors (BCS). It was hypothesized that social support and optimism would be positively related to cognition, and that social support would mediate the optimism-cognition relationship. Twenty-seven BCS (M age = 71.96), twenty-five female (M age = 69.76) and twenty-five male (M age = 65.28) NHLS groups were recruited. Each participant completed a three-hour standardized neuropsychological battery designed to evaluate a range of cognitive abilities involving attention, premorbid and current intellect, memory, language, visuospatial skills, and executive functioning, as well as self-report measures of mood, social support, and optimism. Performances on cognitive tests were within normal limits, but differences were found in aspects of executive functioning (p < .01) with the men outperforming women in the NHLS group. Women in the NHLS group performed better on a measure of executive functioning (p < .05) and visuospatial functioning (p < .01) than women in the BCS group. Women from both groups performed better than the male NHLS group on verbal learning and memory measures (all p's < .05). The groups did not differ on psychosocial variables. Correlations between psychosocial variables (i.e., social support and optimism) were variably related to cognitive measures in both groups. Social support did not mediate the optimism-cognition relationship. This is the first study to consider the relationship between social support, optimism, and cognition and early interventions to improve cognition in cancer survivors is discussed.

One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.

One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.

The 2002 Supreme Court decision (Atkins vs. Virginia, 536 U. S. 304), prohibiting the execution of mentally retarded persons, may potentially increase malingering of mental retardation (MR). There is limited research addressing the detection of feigned MR. The present study compared results from tests of intelligence, adaptive functioning, legal/courtroom knowledge, and psychiatric and neurocognitive feigning to determine how effectively these instruments discriminate between MR participants and community volunteers asked to either approach the test honestly (CVH group) or feign, or malinger, MR (CVM group). CVMs suppressed their IQ scores sufficiently to appear MR. CVMs overestimated deficits on individuals with genuine MR on tests of adaptive functioning and courtroom knowledge. Psychiatric feigning instruments did not discriminate between MR and CVM groups. Neurocognitive feigning instruments discriminated between groups, however specificity and Positive Predictive Power were unacceptably low. Revising cutting scores to hold specificity at .95 improved PPP significantly, suggesting the potential utility of these instruments to detect feigned mental retardation. Results from this study suggest that applying published decision rules to MR populations on tests commonly used in forensic neuropsychological evaluations will likely result in a high rate of false positive errors. Given the high stakes associated with classification errors in capital cases involving MR defendants, alternative cutting scores appropriate for this population should be determined.

One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.

One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.

The Luria-Nebraska Neuropsychological Battery (LNNB) was published in 1980 as an attempt to provide clinicians with a standardized version of the neuropsychological assessment and diagnostic procedures proposed by A. R. Luria and A, L. Christensen. Research on the LNNB included a series of factor analyses for each of eleven clinical scales. The analyses were completed on the combined scores obtained from a sample of normal, brain-damaged, and psychiatric populations. A second version of the LNNB was published in 1985 as a largely parallel version of Form I, but included changes in stimulus materials, administration procedures, and scoring procedures. The present study completed factor analyses on same eleven clinical scales using data generated with the newer LNNB Form II. The statistical procedures and criteria employed in the present investigation were identical to those used earlier on Form I to allow for comparisons between the two resulting sets of factor structures. The patient populations were different, however, in that all subjects in the current study were receiving inpatient care in a private psychiatric hospital which specializes in long-term treatment. Despite the changes in materials and procedures and the difference in subject parameters, the factors identified in the present investigation are similar to those seen in the Form I studies. However, two trends were observed when comparing the two sets of factor structures. First, in the present study several items were excluded from the statistical procedures because they were performed perfectly by almost everyone and the resulting scores lacked statistical variance. Second, more homogenous factors were obtained with the Form II analysis. That is, some of the complex LNNB Form I factors were reduced to two or more simpler factors. The results of the study lend support to Luna's conceptual model of higher cortical function and to the reliability of the LNNB as an assessment instrument.

No description available.

According to the biopsychosocial model of bulimia, neurobiological mechanisms called endophenotypes cause eating disordered behavior. Impulsivity has been identified as a possible endophenotype for bulimia nervosa, and individuals with bulimia who present with multiple forms of impulsive behavior are known to have worse prognoses. Executive dysfunction in impulse control purportedly manifests as behavioral under-regulation in binge-purge episodes. Neuropsychological assessments were used to analyze the relationship between impulsivity and symptoms of bulimia. Twenty-eight inpatient adolescent and young adult women with bulimia completed the D-KEFS Color Word Task, which is a version of the Stroop that contains four trials including the classic Stroop and a switching Stroop, as well as the age appropriate versions of the BRIEF rating scale and a Type-T Survey of thrill-seeking. Performance on these measures was correlated with measures of bulimia symptoms, including the EDI-3, EDE-Q, and variables of illness severity. Delay of gratification was assessed by offering subjects a choice of compensation that was either immediate and smaller or delayed and larger. Mixed results were found. The sample did not differ from the D-KEFS normative sample on total number of errors or on speed of task completion for the switching Stroop, and the sample demonstrated faster performance than the normative sample on the classic Stroop. However, a tendency to favor speed over accuracy of performance was identified. On the BRIEF rating scales, the sample self-reported significantly higher rates of executive dysfunction compared to the normative data. Additionally, some variables of impulsivity, including greater frequency of errors on cognitive tasks and self-reported deficits of executive functioning, were significantly correlated with variables of bulimia symptom severity, including self-reported bulimia symptomatology on the EDI-3 and frequency of bingeing and purgeing. Risk-taking was also found to be correlated with symptoms of bulimia. Differences were found between subjects who chose the immediate prize versus those who chose the delayed prize, including differences in cognitive task performance and symptom severity. Differences were also found for subjects with a comorbid disorder of impulse control, including bipolar disorders and substance abuse. In conclusion, a unilateral deficit of impulse control was not found to be characteristic of this sample; however, a multi-impulsive cohort was identified as having deficits of cognitive impulse control. / School Psychology

This dissertation focuses on available means of the assessment of cognitive functions in neurological patients in the Czech environment. The main goal was to verify the psychometric qualities and usability of the Czech version of the Neuropsychological Assessment Battery (NAB). NAB is a test battery that assesses attention, language, memory, and spatial and executive functions. The theoretical part of the dissertation introduces the basic cognitive functions and diagnostic tools for their assessment; the next chapter focuses on NAB and especially its psychometric characteristics. Third chapter describes specific diseases (epilepsy and psychogenic seizures), their manifestations and impact on cognition. Empirical part included participation in the adaptation of NAB to the Czech language. During the research, a group of healthy volunteers (n = 116) and patients from the Epilepsy Monitoring Unit (n = 60) were tested by the NAB Screening Module. To verify the convergent validity of NAB-SM we administered Repeatable Battery for the Assessment of Neuropsychological Status (including an Effort Index) to a part of the sample. Based on the results, we can conclude that NAB-SM appears to be a suitable method for the assessment of cognitive functions in patients with psychogenic non-epileptic seizures. The...