Boredom is a common human experience that has received little attention in the literature. To date, researchers have been unable to agree on a unified theory and definition of the construct. The present study investigated the nature of boredom by exploring its relationship to three phenomenologically similar affective states, namely apathy, anhedonia and depression. Structural equation modeling revealed that although related to apathy, anhedonia and depression to varying degrees, boredom is an empirically distinct construct. Establishing boredom as an independent construct provides an important first step in bringing the field closer to a universally accepted definition of boredom, which will undoubtedly facilitate more effective assessment and treatment of the experience of boredom, particularly in individuals with psychopathological and neuropathological illnesses in which boredom is a pervasive symptom.

Boredom is a common human experience that has received little attention in the literature. To date, researchers have been unable to agree on a unified theory and definition of the construct. The present study investigated the nature of boredom by exploring its relationship to three phenomenologically similar affective states, namely apathy, anhedonia and depression. Structural equation modeling revealed that although related to apathy, anhedonia and depression to varying degrees, boredom is an empirically distinct construct. Establishing boredom as an independent construct provides an important first step in bringing the field closer to a universally accepted definition of boredom, which will undoubtedly facilitate more effective assessment and treatment of the experience of boredom, particularly in individuals with psychopathological and neuropathological illnesses in which boredom is a pervasive symptom.

Apathy is a debilitating non-motor symptom in Parkinson’s disease (PD) that is closely associated with cognitive dysfunction, depression, and caregiver burden. The proposed etiology and operational definition of apathy involves a tripartite model that includes cognitive, behavioral, and emotional manifestations. This theoretical model has not been statistically validated. We examined the tripartite structure of apathy in PD, and subsequent associations between apathy factors and demographic, disease, and neuropsychological measures. One hundred forty-one patients with idiopathic PD underwent neurological examination and comprehensive neuropsychological testing including the Apathy Evaluation Scale (AES). Statistical analyses included correlation, means comparison, item analysis, and confirmatory factor analysis using SEM. The AES was found to be a valid and reliable measure of apathy. Although a tripartite model of apathy was not supported, a novel 3-factor structure of apathy (R-Apathy) emerged characterized by Cognitive/Emotional and Behavioral factors. Both education and depression were significantly associated with R-Apathy. When these were controlled, R-Apathy was associated with impairment in select executive function and visuospatial skills. Apathy remains an important dimension in understanding nonmotor changes in PD. As a whole, apathy correlated with specific areas of neuropsychological dysfunction apart from the influence of depression. Manifestations of apathy such as mental disengagement and behavioral withdrawal are key features of the disease presentation. The importance of evaluating apathy as a contributing factor to patients’ neurocognitive status, mood, and psychosocial functioning should not be underestimated. Furthermore, an apathy evaluation should be included as a standard part of a Parkinson’s evaluation.

Emerging evidence supports the use of methylphenidate (MPH) for the treatment of apathy in Alzheimer’s disease (AD). This study aimed to investigate the additional effects of MPH on attention in an AD sample and the relationship between apathy and attention. AD patients enrolled in a randomized, double-blind placebo-controlled study to examine the safety and efficacy of MPH (10mg PO twice daily) for the treatment of apathetic symptoms were tested on attention and apathy every 2 weeks for 6 weeks. A mixed effects linear regression revealed attention change scores (endpoint - baseline) over time favouring MPH (δ=1.01, p=0.03), though there were no significant associations between apathy and attention change scores (r=-0.08, p=0.54). These results suggest that while MPH can improve both apathy and attention, the effects appear independent in this patient population. This study provides insight into the different effects MPH can produce in a heterogeneous disease such as AD.

Emerging evidence supports the use of methylphenidate (MPH) for the treatment of apathy in Alzheimer’s disease (AD). This study aimed to investigate the additional effects of MPH on attention in an AD sample and the relationship between apathy and attention. AD patients enrolled in a randomized, double-blind placebo-controlled study to examine the safety and efficacy of MPH (10mg PO twice daily) for the treatment of apathetic symptoms were tested on attention and apathy every 2 weeks for 6 weeks. A mixed effects linear regression revealed attention change scores (endpoint - baseline) over time favouring MPH (δ=1.01, p=0.03), though there were no significant associations between apathy and attention change scores (r=-0.08, p=0.54). These results suggest that while MPH can improve both apathy and attention, the effects appear independent in this patient population. This study provides insight into the different effects MPH can produce in a heterogeneous disease such as AD.

In attending to consumption as a defining feature of life in Western societies, existing consumer research has tended to envisage, construct and reproduce ‘the consumer’ as either enthusiastically embracing the delights of the market, or as actively resisting or rebelling against its evils. The extant research has therefore tended to assume a high degree of reflexive conscious engagement in consumption as the norm. In this research, I argue that this might have inadvertently obscured the possibility of non-participation in various aspects of consumption through disinterest. This appears within the field as a theoretical space where people relate to consumption opportunities with rather less reflection or emotion and allows for the choice not to buy to be part of an accepted and unreflected-upon aspect of existence; a diverse shadow-realm of consumer inactivity in which feelings of indifference may be significant. Though a general lack of interest in various aspects of consumption may constitute an ontologically common experience, indifference has remained a largely unnoticed and under-theorised element of social reality in a consumer culture. In this study, I explore the possibilities of indifference in a consumer culture, not as a psychological construct or symptom of pathology but as a lived experience, understood in different ways and constituted through different discursive contexts. In this research, I draw on 29 phenomenological interviews to offer an empiricallygrounded interpretation of what it means to be indifferent to consumption. From the stories the informants shared with me, I articulate how the experience of indifference can appear as a genuine blindness towards a spectacular world of consumption, underpinned by other sociocultural narratives that construct the marketplace as a remote, unfamiliar or unappealing domain. In other stories, experiences of indifference appeared to be maintained by a constant and taken-for-granted adherence to a classification system that denotes consumerism as a powerful source of physical and spiritual pollution. Whilst in other narratives, a general lack of interest in various aspects of consumption revealed a paradoxical desire for a personal identity forged from a dismissal of consumption; a culturally-shaped performance of pseudoindifference that involved refusing ‘consumer activity’ in order to construct a defiantly nonconsumer self. In addressing the cultural narratives and contexts that seem to account for nonconsumption through indifference, this study contributes to wider debates on processes of disengagement and less material living, and invites consumer researchers to develop a greater sensitivity to indifference within sociological accounts of consumption.

Thesis (M.F.A.)--Montana State University--Bozeman, 2005. / Typescript. Chairperson, Graduate Committee: Michael Peed.

Normal pressure hydrocephalus (NPH) is characterised by a build-up of cerebrospinal fluid (CSF) in the brain despite apparently normal CSF pressure at lumbar puncture. In addition to movement and urinary symptoms, patients commonly display cognitive decline and apathy. NPH is recognised as an important cause of cognitive decline as it is thought be reversible with surgical CSF diversion (e.g. shunt surgery). However, this remains controversial and the neuropsychology of NPH is relatively poorly understood. Further, despite being the most commonly reported neuropsychiatric symptom in NPH, the significance of the symptom of apathy has not yet been elucidated. This thesis aims to expand on the neuropsychological and neuropsychiatric research in NPH, with the main objectives being to investigate neuropsychological outcome, and the significance of the symptom of apathy in NPH. In order to investigate neuropsychological outcome following shunt surgery in NPH, a systematic review and meta-analysis was conducted (Chapter 2). The findings from studies which used a battery of neuropsychological tests to assess cognitive outcome in NPH were combined. Meta-analyses were conducted on pre-operative and difference scores for the most commonly used neuropsychological tests. These were seven tests which spanned global cognitive function, learning and memory, executive function and psychomotor speed. Results for all tests were significant in the direction of improvement. However, the significance of the results for two measures of executive function were deemed not to be robust. This is discussed in line with previous research which suggests that executive function may be less likely to improve following shunt surgery than other neuropsychological domains. Next, the thesis focuses on the symptom of apathy. Chapter 3 investigated whether apathy in NPH relates to cognitive outcome and to a measure of ventricular enlargement. A reduction in apathetic symptoms following treatment was associated with better performance in a measure of global cognitive function. Further, larger ventricles (which may indicate greater disease severity/ brain damage) was associated with more severe apathy. A structural MRI study was then conducted to expand on these findings and to define brain structural correlates of apathy in NPH (Chapter 4). Results from this study suggested a potential role of the caudate nuclei in apathetic symptoms in NPH. Finally, consideration is given to the assessment of apathy in NPH. Since apathy is rarely investigated in patients with NPH it is unclear which assessment method is most appropriate for this patient group. Chapter 5 presents findings from a feasibility study of a novel reward learning task to determine whether it might be useful as an objective measure of motivation and apathy in NPH.

Alzheimer's disease (AD) is the most common cause of dementia initially characterised by short-term memory deficits followed by a progressive cross domain cognitive and functional decline over time and loss of independence in carrying out activities of daily living (ADL). Apathy and depression are also the two most frequent neuropsychiatric sequalae associated with AD and have an impact on patients' ability to execute ADLs. Little is still known if apathy subdomains differently predict ADL performance in these patients. In this study, we aimed to quantitatively investigate if global apathy and depression predict ADL performance. We also wanted to establish if the apathy evaluation scale (AES) items resolve into three factors as proposed by Marin and if those factors differently predict performance of ADLs. We recruited a sample of 115 patients diagnosed with probable or possible AD. Basing on current literature, we hypothesised that apathy and depression predict ADL performance. We also hypothesised that AES items will load into three factors relating to cognitive, behavioural and affective apathy subdomains and that these subdomains will differentially predict ADL performance in our patient sample. Our results indicated that high apathy and depression symptoms were associated with problems to carryout ADLs. They also indicated that AES items resolved into a three factor solution in analogy with Marin's conceptualisation but they did not cluster in the manner that he proposed. Finally, when these factors are regressed simultaneously, (derived from factor analysis) only behavioural apathy significantly predicted ADLs.

No description available.