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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Associação entre função executiva e sintomas depressivos em pacientes com acidente  vascular cerebral isquêmico / Association between depressive symptoms and executive functions in ischemic stroke patients: a cross-sectional study

Sobreiro, Matildes de Freitas Menezes 29 May 2012 (has links)
INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associação entre função executiva e grupos de sintomas depressivos no primeiro mês após o acidente vascular cerebral isquêmico e como objetivo secundário investigar a associação entre função executiva e grupos de sintomas depressivos em adultos jovens. MÉTODOS: Foram triados consecutivamente 343 pacientes admitidos na enfermaria da neuroclínica do Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. Fizeram parte o estudo 87 pacientes que preencheram os critérios de inclusão e exclusão e foram incluídos no estudo. Eles foram submetidos aos testes neuropsicológicos que consistiu em: teste Fluência verbal fonêmica para as letras (F.A.S.), Dígitos Ordem Direta e Ordem Inversa, subteste da Escala Weschler de Inteligência para Adultos (WAIS-III-R) e as 03 partes do Stroop Teste. A avaliação psiquiátrica consistiu na entrevista estruturada para o diagnóstico pelo DSM-IV, no manual estruturado para entrevista da Escala Hamilton para Depressão, na versão 31 itens. Nós usamos o Índice de Barthel, para avaliar o comprometimento nas atividades de vida diária e o grau de gravidade do acidente vascular cerebral foi mensurado pela escala para acidente vascular cerebral do Natitonal Institutes of Health.A média do intervalo de tempo entre o AVC e as avaliações foi de 12,4; (dp±3,8) dias. Equações de regressão linear múltipla foram montadas usando os sete domínios dos sintomas depressivos da HAM-D-31 como variável independente e os testes neuropsicológicos como variável dependente. Os resultados foram ajustados para idade sexo e grau de instrução. RESULTADOS: Nós encontramos associação inversa entre o grupo de sintomas depressivos de retardo e o teste de fluência verbal (t=-3,46; p=0,001; IC 95% -4,46:-0,81), e associação positiva com as três partes do Stroop, SR (t=3,32; p=0,002; IC 95% 1,63:6,72), SP(t=3,05; p=0,004; IC 95% 1,68:8,21) e SC (t=3,01; p=0,005; IC 95% 3,22:16,39). Para a subamostra de pacientes com idade 60 anos foi encontrada associação inversa entre o teste de fluência verbal fonêmica (FAS) com o grupo de sintomas retardo ( t= -3,13; p= 0,003; IC 95% -4,72: -1,27). CONCLUSÃO: Nossos resultados suportam a hipótese que a disfunção executiva depressiva descrita para idosos pode ocorrer em pacientes com idade 60 anos e é uma associação específica da função executiva e o grupo de sintomas depressivos de retardo / BACKGROUD: The association between depressive symptoms and cognitive impairment after ischemic stroke has been described in several studies. Recently, studies have focused on the association of depressive symptoms and executive function. Actually, the hypothesis of a Depression Executive dysfunction in stroke patients has been investigated. However, it is not known whether such association occurs with any specific depressive group of symptoms and also if it occurs among the non elderly. Thus, the main objective this study is to investigate the association between executive function and domains of depressive symptoms in the first month after an ischemic stroke. As a secondary objective we investigated whether this association existed for those with below 60 years old. METHODS: We screened 343 patients consecutively admitted to the neurological unit of the Clinics Hospital of the University of São Paulo School of Medicine. Eight seven patients satisfied the inclusion and exclusion criteria and were included in the study. They were submitted to neuropsychological tests including the Phonemic Verbal Fluency for letters (F.A.S.); digits forwards and backwards, the subtest of the Weschler Adult Intelligence Scale (WAIS-III-R) and 3 parts of the Stroop Test. The psychiatric evaluation included the structured Clinical Interview for DSM-IV and the 31-item version of the Hamilton Rating Scale for Depression. We used the Barthel Indices to assess the impairment in activities of daily living and the severity of the stroke was assessed with the stroke Scale of the National Institutes of Health. The mean time interval between the stroke and the assessments were 12.4 (SD±38) days. Equations of multiple linear regression were performed using the seven domains of depressive symptoms of the HAM-D-31 as independent variable and the neuropsychological tests as the dependent variable. Results were adjusted for age, gender and educational level. RESULTS: We found an inverse association between the retardation domain of depressive symptoms and the verbal fluency test FAS (t = -3.46; p = 0.001; 95%CI -4.46, - 0.81) and a positive association with the three parts of the stroop test SR (t = 3.32; p= 0.002; 95%CI 1.63:6.72) SP (t = 3.05; p=0.004; 95% CI 1.68:8.21) and SC (t = 3.01; p = 0.005; 95%CI 3.22:16.39). For the subsample of patients with age 60 years old we found an inverse association between the verbal fluency test (FAS) with the domain of depressive symptoms retardation (t = -3.13; p = 0.003; 95%CI -4 .72: -1.27). CONCLUSION: Our results support the hypothesis that executive depressive dysfunction described for the elderly also occur for stroke survivors with age < 60 years old and that there is a specific association of executive function with the depressive domain of retardation
2

An examination of the Wechsler Adult Intelligence Scale (WAIS) subtests from a neuopsychological perspective

Wheeler, Thomas E. January 1987 (has links)
The primary purpose of this study was to determine the kind of neuropsychological information that can be obtained from an investigation of the Wechsler Adult Intelligence Scale (WAIS) subtests. Additionally, there was an examination of the shared variance between the WAIS and the Halstead-Reitan Neuropsychological Battery (HRNB). The archival data collected from the files of '220 females and 188 males from a large midwestern medical center were used. They had been originally diagnosed with objective research criteria.All eleven subtests of the WAIS and the HalsteadReitan Neuropsychological Battery were administered to the subjects in the years between 1981 and 1983. Thirteen scores were obtained from the HRNB measures. Statistical analyses of the results made use of the techniques of multiple regression and canonical correlation.The individual WAIS subtests were examined for the neuropsychological information they provided. Globally, three HRNB measures, APHASIA, RHY, AND CAT-TOT contributed significantly to a majority of the regression equations for the WAIS subtests. Their presence suggested that language skills, an auditory attention factor, and a general intellective factor were being tapped (Dean, 1985a).A canonical correlation was computed. The results yielded one significant correlation between the linear components of the WAIS and the HRNB tests. Only canonical variates with weights of +/- .2 were considered large enough for interpretation. The WAIS subtests meeting the .2 criteria included Block Design, Digit Symbol, and Similarities, while the HRNB measures meeting criteria were APHASIA and CAT-TOT. Therefore, it would appear that the significant variables measured the general (g) factor as in Spearman's research (1927). According to the Stewart and Love formula (cited in Pedhazur, 1982), the variability of the WAIS did overlap with the HRNB, and their relationship was symmetrical.This research demonstrated that the measured tasks from the WAIS were a complex of underlying constructs. The verbal portion of the WAIS was shown to be less highly related to the HRNB variables than the performance portion of the scale. The WAIS and HRNB do offer nonredundant information concerning the impaired and unimpaired adult's cognitive functioning.
3

[en] EVIDENCE OF VALIDITY OF A COMPUTERIZED EXECUTIVE TEST IN SCHOOL CHILDREN / [pt] EVIDÊNCIAS DE VALIDADE DE UM INSTRUMENTO EXECUTIVO INFORMATIZADO EM CRIANÇAS ESCOLARES

RENATA MASSALAI 23 May 2018 (has links)
[pt] O uso da tecnologia na avaliação neuropsicológica infantil oferece uma série de facilidades como: otimização do tempo, redução de custo e melhor refinamento da cognição por meio do tempo de reação. No Brasil, esta modalidade avaliativa é escassa, principalmente para medidas executivas na infância. Para suprimir tal demanda, investigaram-se as evidências de validade do instrumento executivo informatizado Jogo das Cartas Mágicas (JCM), composto por três fases: classificação por cor (12 itens), por forma (12 itens) e por cor e forma (24 itens) em 113 crianças de seis a nove anos de idade (M igual a 7,58) e (DP igual a 1,07) sem desenvolvimento atípico, matriculadas em escolas particulares e instituições sociais da zona Norte da cidade do Rio de Janeiro. Além do instrumento JCM, outros foram aplicados: WASI, Stroop, Dígitos da Escala (WISC-IV), Trilhas A B, Fluência verbal e o Inventário (SSRS) para crianças, pais e professores em três encontros de 30 minutos com dias alternados. Realizou-se ANOVA mista para verificar os efeitos idade e sexo nos escores brutos do JCM. Em seguida, Analise Fatorial com método de extração os Componentes Principais e rotação varimax com critério de Kaiser. Os dados revelaram que não houve interação entre as variáveis, porém a analise fatorial resultou em quatro componentes nomeados respectivamente: aspectos executivos, aspectos regulatórios, aspectos atencionais e fluídos. Sugerem-se novas pesquisas com o JCM ampliando a amostragem com faixa etária posteriores e novos protocolos de instrumentos executivos, inclusive computadorizados já validados ao contexto brasileiro para eventuais validades convergentes e de critérios a serem investigadas. / [en] The use of technology in children s neuropsychological assessment offers a series of facilities such as: time optimization, cost reduction and better refinement of cognition through reaction time. In Brazil, this type of evaluation is scarce, especially for executive measures in childhood. In order to suppress this demand, we investigated the evidence of validity of the computerized executive tool Game of Magical Letters (JCM), composed of three phases: classification by color (12 items), by form (12 items) and by color and form items) in 113 children aged six to nine years old (M equals 7.58) and (SD equals 1.07) without atypical development, enrolled in private schools and social institutions in the northern part of the city of Rio de Janeiro. In addition to the JCM instrument, others were applied: WASI, Stroop, Scale Digits (WISC-IV), Tracks A B, Verbal Fluency and Inventory (SSRS) for children, parents and teachers in three 30-minute alternating-day meetings. Mixed ANOVA was performed to verify age and sex effects on the gross scores of JCM. Then, Factorial Analysis with extraction method the Principal Components and varimax rotation with Kaiser criterion. The data revealed that there was no interaction between the variables, but the factorial analysis resulted in four components named respectively: executive aspects, regulatory aspects, attentional and fluid aspects. We suggest new researches with the JCM expanding the sample with later age and new protocols of executive instruments, including computerized ones already validated in the Brazilian context for eventual convergent validities and criteria to be investigated.
4

Associação entre função executiva e sintomas depressivos em pacientes com acidente  vascular cerebral isquêmico / Association between depressive symptoms and executive functions in ischemic stroke patients: a cross-sectional study

Matildes de Freitas Menezes Sobreiro 29 May 2012 (has links)
INTRODUÇÃO: Associação entre sintomas depressivos e prejuízos cognitivos após o acidente vascular cerebral isquêmico tem sido descrito em vários estudos. Estudos recentes tem focado a associação de sintomas depressivos com a função executiva. A hipótese Depression Executive dysfunction tem sido investigada em pacientes com AVC e não se sabe se essa associação ocorre com algum grupo de sintomas depressivos específico. Portanto, o principal objetivo desse estudo, foi o de investigar a associação entre função executiva e grupos de sintomas depressivos no primeiro mês após o acidente vascular cerebral isquêmico e como objetivo secundário investigar a associação entre função executiva e grupos de sintomas depressivos em adultos jovens. MÉTODOS: Foram triados consecutivamente 343 pacientes admitidos na enfermaria da neuroclínica do Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. Fizeram parte o estudo 87 pacientes que preencheram os critérios de inclusão e exclusão e foram incluídos no estudo. Eles foram submetidos aos testes neuropsicológicos que consistiu em: teste Fluência verbal fonêmica para as letras (F.A.S.), Dígitos Ordem Direta e Ordem Inversa, subteste da Escala Weschler de Inteligência para Adultos (WAIS-III-R) e as 03 partes do Stroop Teste. A avaliação psiquiátrica consistiu na entrevista estruturada para o diagnóstico pelo DSM-IV, no manual estruturado para entrevista da Escala Hamilton para Depressão, na versão 31 itens. Nós usamos o Índice de Barthel, para avaliar o comprometimento nas atividades de vida diária e o grau de gravidade do acidente vascular cerebral foi mensurado pela escala para acidente vascular cerebral do Natitonal Institutes of Health.A média do intervalo de tempo entre o AVC e as avaliações foi de 12,4; (dp±3,8) dias. Equações de regressão linear múltipla foram montadas usando os sete domínios dos sintomas depressivos da HAM-D-31 como variável independente e os testes neuropsicológicos como variável dependente. Os resultados foram ajustados para idade sexo e grau de instrução. RESULTADOS: Nós encontramos associação inversa entre o grupo de sintomas depressivos de retardo e o teste de fluência verbal (t=-3,46; p=0,001; IC 95% -4,46:-0,81), e associação positiva com as três partes do Stroop, SR (t=3,32; p=0,002; IC 95% 1,63:6,72), SP(t=3,05; p=0,004; IC 95% 1,68:8,21) e SC (t=3,01; p=0,005; IC 95% 3,22:16,39). Para a subamostra de pacientes com idade 60 anos foi encontrada associação inversa entre o teste de fluência verbal fonêmica (FAS) com o grupo de sintomas retardo ( t= -3,13; p= 0,003; IC 95% -4,72: -1,27). CONCLUSÃO: Nossos resultados suportam a hipótese que a disfunção executiva depressiva descrita para idosos pode ocorrer em pacientes com idade 60 anos e é uma associação específica da função executiva e o grupo de sintomas depressivos de retardo / BACKGROUD: The association between depressive symptoms and cognitive impairment after ischemic stroke has been described in several studies. Recently, studies have focused on the association of depressive symptoms and executive function. Actually, the hypothesis of a Depression Executive dysfunction in stroke patients has been investigated. However, it is not known whether such association occurs with any specific depressive group of symptoms and also if it occurs among the non elderly. Thus, the main objective this study is to investigate the association between executive function and domains of depressive symptoms in the first month after an ischemic stroke. As a secondary objective we investigated whether this association existed for those with below 60 years old. METHODS: We screened 343 patients consecutively admitted to the neurological unit of the Clinics Hospital of the University of São Paulo School of Medicine. Eight seven patients satisfied the inclusion and exclusion criteria and were included in the study. They were submitted to neuropsychological tests including the Phonemic Verbal Fluency for letters (F.A.S.); digits forwards and backwards, the subtest of the Weschler Adult Intelligence Scale (WAIS-III-R) and 3 parts of the Stroop Test. The psychiatric evaluation included the structured Clinical Interview for DSM-IV and the 31-item version of the Hamilton Rating Scale for Depression. We used the Barthel Indices to assess the impairment in activities of daily living and the severity of the stroke was assessed with the stroke Scale of the National Institutes of Health. The mean time interval between the stroke and the assessments were 12.4 (SD±38) days. Equations of multiple linear regression were performed using the seven domains of depressive symptoms of the HAM-D-31 as independent variable and the neuropsychological tests as the dependent variable. Results were adjusted for age, gender and educational level. RESULTS: We found an inverse association between the retardation domain of depressive symptoms and the verbal fluency test FAS (t = -3.46; p = 0.001; 95%CI -4.46, - 0.81) and a positive association with the three parts of the stroop test SR (t = 3.32; p= 0.002; 95%CI 1.63:6.72) SP (t = 3.05; p=0.004; 95% CI 1.68:8.21) and SC (t = 3.01; p = 0.005; 95%CI 3.22:16.39). For the subsample of patients with age 60 years old we found an inverse association between the verbal fluency test (FAS) with the domain of depressive symptoms retardation (t = -3.13; p = 0.003; 95%CI -4 .72: -1.27). CONCLUSION: Our results support the hypothesis that executive depressive dysfunction described for the elderly also occur for stroke survivors with age < 60 years old and that there is a specific association of executive function with the depressive domain of retardation
5

NEPSY profiles in children diagnosed with different ADHD subtypes.

Couvadelli, Barbara 12 1900 (has links)
The purpose of this study was to determine if attention-deficit/hyperactivity disorder (ADHD) subtypes (predominantly hyperactive/impulsive, ADHD-HI; predominantly inattentive, ADHD-IA; combined, ADHD-C) exhibit distinct neuropsychological profiles, using the Attention and Executive Function subtests of the Developmental Neuropsychological Assessment, (NEPSY) and the omission and commission scores obtained on the Conners' Continuous Performance Test-II (CPT-II), a test that assesses attention processes. The sample was selected using archival data collected in a neurodevelopmental clinic over the past decade and consisted of 138 children between the ages of 6 and 12 years old. Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) criteria, the children were placed in either the ADHD-HI (n = 40), ADHD-IA (n = 35), or ADHD-C (n = 36) group, or a symptom free comparison group (n = 27). It was hypothesized that children with elevations on the impulsivity/ hyperactivity (ADHD-HI and ADHD-C) scale would be impaired on measures of inhibition and those with elevations on the inattention scale (ADHD-IA and ADHD-C) would be impaired on tests of attention, vigilance, and other executive functions. A one-way multivariate analyses of variance (MANOVA) was conducted (Group X Task), with significant results for overall main effect for group on the 7 dependent variables post hoc tests using the Tukey's honestly significant difference (HSD) revealed the following: the ADHD-HI group scored significantly lower on tests that require behavioral inhibition processes (Knock and Tap, Statue and CPT-Commission errors). The ADHD-IA group scored significantly lower on tests of problem-solving and planning (Tower) but not on tests of attention as was expected. The ADHD-C group scored significantly lower on tests of inhibition, attention, and other executive functions (Auditory Attention Response Set, Visual Attention, Tower, Knock and Tap, Statue, and CPT-Omission and CPT-Commission errors). Overall results suggest that the NEPSY Attention and Executive Function subtests are able to differentiate ADHD subtypes. Recommendations for future research are discussed.
6

Investigation into cognitive function in first episode psychosis and chronic schizophrenia patients. An investigation into cognitive deficits associated with first episode psychosis and chronic schizophrenia patients in South Asian and Caucasian populations as assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB).

Saleem, Majid M. January 2012 (has links)
Rationale Cognitive deficits are now recognised as a major symptom of schizophrenia with a number of studies reporting profound deficits in cognitive function in both chronic and first episode patients. Recent advances in cognitive remediation therapy have provided the opportunity for patients to improve their cognitive function and therefore improve their functional outcome. Aim The aim of the present study was to investigate cognitive deficits using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in first episode psychosis and chronic schizophrenia patients. In the first episode population the effect of ethnicity on cognition was also examined. In the chronic schizophrenia study comparisons between severity of deficits with first episode psychosis patients were also made. The effects of cognitive remediation therapy were also examined in a sample of first episode patients. Methods A total of 35 patients and 30 healthy controls were recruited into the first episode study, 17 patients and 17 controls into the chronic schizophrenia study and 11 patients into the cognitive remediation study. The first episode psychosis patients were recruited from the Bradford and Airedale Early Intervention Service and the chronic patients from the Leeds Partnership NHS Foundation Trust. The control subjects were matched as closely as possible in terms of intelligence and demographics to the patient groups. The Wechsler Test of Adult Reading (WTAR) was used to estimate subjects pre-morbid IQ. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). All subjects who took part in the study completed a comprehensive battery of neuropsychological tests from the CANTAB®. Patients in the cognitive remediation study participated in group therapy sessions using X-cog®. Results There were no significant differences found between There were no significant differences found between patients and controls in relation to intelligence or demographics in all studies. The effect of ethnicity was shown to be not significant in the first episode study. Results show that patients performed significantly worse than controls across all iv cognitive domains tested in all studies. A correlation between negative symptoms and executive function was found in both first episode and chronic schizophrenia patients. Comparisons between first episode psychosis and chronic schizophrenia patients in cognition showed no significant differences, however significant differences were found in levels of negative symptoms and age between the two groups with chronic patients scoring higher on negative symptoms and being older. In the cognitive remediation study a significant improvement was observed in patients in the domain of executive function and a reduction in negative symptoms following completion of the intervention. Conclusion First episode and chronic schizophrenia patients display significant cognitive deficits across all domains when tested using the CANTAB®. Some of these deficits appear to be independent of the length of the illness but dependent on negative symptoms. This study demonstrates that cognitive deficits exist across all patient groups regardless of age, gender, pre-morbid IQ, years in education and ethnicity. Cognitive remediation therapy has also been shown to be effective in improving cognitive functioning in patients.
7

Is objective and accurate cognitive assessment across the menstrual cycle possible? A feasibility study

Farrar, D., Neill, Joanna C., Scally, Andy J., Tuffnell, D.J., Marshall, Kay M. 02 December 2014 (has links)
Yes / OBJECTIVES: Variation in plasma hormone levels influences the neurobiology of brain regions involved in cognition and emotion processing. Fluctuations in hormone levels across the menstrual cycle could therefore alter cognitive performance and wellbeing; reports have provided conflicting results, however. The aim of this study was to assess whether objective assessment of cognitive performance and self-reported wellbeing during the follicular and luteal phases of the menstrual cycle is feasible and investigate the possible reasons for variation in effects previously reported. METHODS: The Cambridge Neuropsychological Test Automated Battery and Edinburgh Postnatal Depression Scale were used to assess the cognitive performance and wellbeing of 12 women. Data were analysed by self-reported and hormone-estimated phases of the menstrual cycle. RESULTS: Recruitment to the study and assessment of cognition and wellbeing was without issue. Plasma hormone and peptide estimation showed substantial individual variation and suggests inaccuracy in self-reported menstrual phase estimation. CONCLUSION: Objective assessment of cognitive performance and self-assessed wellbeing across the menstrual cycle is feasible. Grouping data by hormonal profile rather by self-reported phase estimation may influence phase-mediated results. Future studies should use plasma hormone and peptide profiles to estimate cycle phase and group data for analyses.
8

Kognitiv funktion vid insomni, depression samt komorbid insomni och depression : skiljer grupperna sig åt och spelar det någon roll för behandlingsutfall? / Cognitive functioning in insomnia, depression and comorbid insomnia and depression : do the groups differ and does it matter for treatment outcome?

Häggqvist, Jenni, von Salomé, Hanna January 2014 (has links)
Insomni och depression är psykiatriska åkommor som idag drabbar många människor. Forskning har visat att det råder en stor samsjuklighet mellan diagnoserna där många drabbade lider av samtidig insomni och depression vilket utgör en stor belastning för den enskilde individen. Patienter rapporterar ofta en negativ påverkan på kognitiva funktioner, bland annat minnessvårigheter och problem med koncentration och uppmärksamhet. Inom forskningen råder det i dagsläget en osäkerhet kring vilka kognitiva nedsättningar som karakteriserar personer med dessa diagnoser och på vilka sätt de skiljer sig åt. Det finns också ett behov av att undersöka vilken roll kognitiv förmåga spelar för människors möjlighet att tillgodogöra sig psykologisk behandling. I föreliggande studie var syftet att undersöka dessa båda områden. Resultaten visade inte på några signifikanta skillnader mellan personer med insomni, personer med depression och personer med det komorbida tillståndet avseende kognitiva funktioner, när det mättes genom test av uppmärksamhet, arbetsminne och exekutiva funktioner. Däremot framkom vissa samband mellan arbetsminne och förbättring av upplevda sömnbesvär, liksom mellan förmåga till bibehållen uppmärksamhet och förbättring av depressionssymtom. Vidare forskning med större och jämnare urvalsgrupper behövs för att undersöka stabiliteten i dessa fynd.
9

Identifying AD/HD subtypes using the cognitive assessment system and the NEPSY

Pottinger, Lindy Sylvan 08 1900 (has links)
The purpose of this study was to examine the ability of the Cognitive Assessment System (CAS) and the NEPSY, A Developmental Neuropsychological Assessment, to differentiate between the subtypes of Attention Deficit/ Hyperactivity Disorder (AD/HD). The CAS and NEPSY are neuropsychological instruments which provide norms for AD/HD children in general. This study examined the performance of the two subtypes of AD/HD on the CAS and NEPSY. In addition, this study examined the performance of the two AD/HD groups on the Screening Test for Auditory Processing Disorders (SCAN). Since AD/HD children tend to have difficulty with language, the SCAN was used to determine if any of the AD/HD subjects had auditory processing difficulties that might impact their performance on the CAS and/or NEPSY subtests. The sample consisted of 118 children between the ages of 8 and 12 years of age. Using the DSM-IV criteria, the children were diagnosed as having three types of AD/HD: A Predominantly Hyperactive-Impulsive Type (AD/HD-HI), a Predominantly Inattentive Type (AD/HD-I) and a Combined Type The subtypes were also identified by the Attention Deficit Disorders Evaluation Scale-Home Version (ADDES-H). Only two subtypes, AD/HD-I and AD/HD-C, were identified by the ADDES-H. There were not enough AD/HD-HI subjects to include in the study. Therefore, this study focused on the AD/HD-I and AD/HD-C subtypes. A binomial logistic regression analysis was conducted on the AD/HD-I and AD/HD-C subtypes with selected subtests of the NEPSY and the four PASS Scales of the CAS. Results indicated a significant difference between the AD/HD-I and AD/HD-C groups on the Tower subtest of the NEPSY and the Planning Scale of the CAS. The Tower and the Planning Scale are both purported measures of executive functioning; however, results of the Planning Scale were in an unexpected direction. No significant difference was found between the two AD/HD groups on the other subtests examined. The results of the SCAN analysis suggested there were no significant differences in auditory processing between the two AD/HD groups. Recommendations for future research are discussed.
10

Investigation into cognitive function in first episode psychosis and chronic schizophrenia patients : an investigation into cognitive deficits associated with first episode psychosis and chronic schizophrenia patients in South Asian and Caucasian populations as assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB)

Saleem, Majid Mohammed January 2012 (has links)
Rationale Cognitive deficits are now recognised as a major symptom of schizophrenia with a number of studies reporting profound deficits in cognitive function in both chronic and first episode patients. Recent advances in cognitive remediation therapy have provided the opportunity for patients to improve their cognitive function and therefore improve their functional outcome. Aim The aim of the present study was to investigate cognitive deficits using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in first episode psychosis and chronic schizophrenia patients. In the first episode population the effect of ethnicity on cognition was also examined. In the chronic schizophrenia study comparisons between severity of deficits with first episode psychosis patients were also made. The effects of cognitive remediation therapy were also examined in a sample of first episode patients. Methods A total of 35 patients and 30 healthy controls were recruited into the first episode study, 17 patients and 17 controls into the chronic schizophrenia study and 11 patients into the cognitive remediation study. The first episode psychosis patients were recruited from the Bradford and Airedale Early Intervention Service and the chronic patients from the Leeds Partnership NHS Foundation Trust. The control subjects were matched as closely as possible in terms of intelligence and demographics to the patient groups. The Wechsler Test of Adult Reading (WTAR) was used to estimate subjects pre-morbid IQ. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). All subjects who took part in the study completed a comprehensive battery of neuropsychological tests from the CANTAB®. Patients in the cognitive remediation study participated in group therapy sessions using X-cog®. Results There were no significant differences found between There were no significant differences found between patients and controls in relation to intelligence or demographics in all studies. The effect of ethnicity was shown to be not significant in the first episode study. Results show that patients performed significantly worse than controls across all iv cognitive domains tested in all studies. A correlation between negative symptoms and executive function was found in both first episode and chronic schizophrenia patients. Comparisons between first episode psychosis and chronic schizophrenia patients in cognition showed no significant differences, however significant differences were found in levels of negative symptoms and age between the two groups with chronic patients scoring higher on negative symptoms and being older. In the cognitive remediation study a significant improvement was observed in patients in the domain of executive function and a reduction in negative symptoms following completion of the intervention. Conclusion First episode and chronic schizophrenia patients display significant cognitive deficits across all domains when tested using the CANTAB®. Some of these deficits appear to be independent of the length of the illness but dependent on negative symptoms. This study demonstrates that cognitive deficits exist across all patient groups regardless of age, gender, pre-morbid IQ, years in education and ethnicity. Cognitive remediation therapy has also been shown to be effective in improving cognitive functioning in patients.

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