Made available in DSpace on 2014-12-17T15:39:02Z (GMT). No. of bitstreams: 1 RosaliaCLF_DISSERT.pdf: 7248091 bytes, checksum: 78f0c88f129b94ac237649d5f3159584 (MD5) Previous issue date: 2013-07-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / This research aimed to contribute to the characterization of a neuropsychological phenotype of adolescents with Down Syndrome (DS). A multicases study of six adolescents (three males and three females, aged 13 to 14 years) diagnosed with DS and treated at two institutions in the city of Natal (Brazil), was conducted. Participants were assessed using the methodological approach developed by Luria, which is composed by four complementary stages. The first one aimed to investigate the qualitative impact of DS in school life and social development of the adolescents; dimensions of behavior and social-affective aspects of the members of the study were investigated. In the second stage participants performed a battery of neuropsychological tests in order to identify strengths and weaknesses in their cognitive functioning. The third stage was incorporated into the second in order to analyze the quality of the activity of the participants along the quantitative evaluation, highlighting strategies used, errors produced among other indicators. Lastly, the fourth stage refers to the intervention with the participants. Although this is not a specific objective of the study, it is argued that the outcome of this research will subsidize the practice of different professionals working with this clinical group. The results of the first stage emphasized the presence of difficulties in social relationships and in school life of observed adolescents. In turn, the second and third stages pointed out to the presence of difficulties in tasks involving logical and abstract thinking, as well as difficulties in expressive language. In relation to visual memory, we observed a better performance in activities of lower complexity, ie, with less interference of executive functioning, particularly in terms of the functions of planning and initiative. Finally, it was found motor and mental retardation, affecting significantly the performance related to different cognitive areas. The results highlighted here can be considered as subsidies for future interventions, suggesting the need for developping projects that take into account different aspects constituents of the human subject, involving not only the individual with developmental changes, as well as their families, teachers, schools and society in general / A presente pesquisa teve como objetivo contribuir para a caracteriza??o de um fen?tipo neuropsicol?gico de adolescentes com S?ndrome de Down (SD). Foi realizado um estudo multicasos de seis adolescentes diagnosticados com SD, sendo tr?s do sexo masculino e tr?s do sexo feminino, na faixa et?ria de 13 e 14 anos, atendidos em duas institui??es da cidade de Natal. Os participantes foram avaliados a partir da metodologia desenvolvida por Luria, sendo esta constitu?da de quatro etapas complementares. A primeira teve como objetivo a investiga??o qualitativa do impacto da SD no cotidiano escolar e social dos adolescentes. Foram investigadas as dimens?es do comportamento e dos aspectos s?cio-afetivos dos integrantes do estudo. Na segunda etapa, os participantes realizaram uma bateria de testes neuropsicol?gicos com o intuito de identifica??o de pontos fortes e fragilidades em seu funcionamento cognitivo. A terceira etapa foi incorporada ? segunda e teve como objetivo central analisar a qualidade da atividade dos participantes ao longo da avalia??o quantitativa, destacando estrat?gias utilizadas, erros produzidos dentre outros indicadores. Por fim, a quarta etapa refere-se ? interven??o junto aos participantes. Apesar desta n?o ser um objetivo espec?fico do estudo, defende-se que o resultado final desta pesquisa subsidiar? a pr?tica significativa de diferentes profissionais que atuam junto a este grupo cl?nico. Os resultados da primeira etapa ressaltam a presen?a de dificuldades nos relacionamentos sociais e no cotidiano escolar deste subgrupo. Por sua vez, as etapas dois e tr?s apontam para a presen?a de dificuldades em tarefas que envolvem o pensamento l?gico e abstrato, bem como preju?zos significativos na linguagem expressiva. Em rela??o ? mem?ria visual, observou-se um desempenho melhor em atividades de menor complexidade, ou seja, com menos interfer?ncia do funcionamento executivo, notadamente em termos das fun??es de planejamento e iniciativa. Por fim, destaca-se a presen?a de lentifica??o motora e mental, repercutindo significativamente no desempenho de diferentes ?reas cognitivas. Nesse sentido, os resultados aqui destacados podem ser considerados enquanto subs?dios para interven??es futuras, sugerindo a necessidade do desenvolvimento de projetos que levem em considera??o os diferentes aspectos constituintes do sujeito humano, envolvendo n?o apenas o indiv?duo com altera??es desenvolvimentais, como tamb?m suas fam?lias, professores, escolas e a sociedade em geral

Traumatic brain injury (TBI) is a multi-faceted disease that affects individuals on physical, cognitive and emotional levels. The specific aims of this research are to explore the prevalence of depression and the relationship between depression, neuropsychological performance and clinical variables in a cohort with TBI. This is accomplished through the retrospective review of 75 neuropsychological reports containing information on clinical variables, performance on neuropsychological measures and Beck Depression Inventory- Second Edition (BDI-II) scores of individuals who had sustained a TBI. The neuropsychological domains assessed via the standardized neuropsychological measures were the domains of attention, concentration, memory, learning, non-verbal and abstract reasoning, manual dexterity, verbal recall, working memory, perception, psychomotor performance, incidental learning, concept formation and verbal fluency. These results were statistically analysed to determine relationships with depression and clinical variables. The investigations undertaken in this study signified particularly pertinent relationships in the interactions among the variables of interest. Higher education level was found to be extremely critical in assisting retention of cognitive abilities following a TBI. Primary language was also a significant differentiator of performance among tests. Age had contrasting effects, with increasing age being favourable on the Similarities Test and related to poorer performance on the Letter Cancellation Test. Increasing GCS scores were related to slower performance on the Letter Cancellation Test and decreased performance on the RAVLT Free Recall Test. Longer PTA duration was related to worse performance on the Matrix Reasoning Test. These results indicate that these indicators of injury severity did not correlate with cognitive performance in this sample after TBI. The high incidence of depression in this study confirms that major depression is a very common occurrence after TBI. This has widespread implications for patient and family counselling, and psychotropic interventions in treatment planning after TBI. Further research on the emotional and cognitive aspects of TBIs within the South African population is needed to supplement the lack of information currently available. It is recommended that further studies build on the current study by exploring larger samples, and using more stratification specificity in terms of the type of injury sustained as well as functional outcomes. Copyright / Dissertation (MA)--University of Pretoria, 2010. / Psychology / unrestricted

When a client has cognitive impairment resulting from cerebral dysfunction (CD) that goes undiagnosed and, therefore, untreated, psychotherapy and rehabilitation outcome is likely to be impacted negatively. Due primarily to managed care, screening for CD has reduced substantially. Master's level counselors need a cost-efficient way to detect possible CD and, thus, justify referral for neuropsychological evaluation. This study examined the Wechsler Abbreviated Scale of Intelligence™ (WASI™) instrument's ability to screen for possible CD by examining the relationship between a) WASI Performance IQ (PIQ) and Verbal IQ (VIQ) scores and neuropsychological test scores, and b) the VIQ-PIQ discrepancy and the severity of disability. In this retrospective study, test scores were extrapolated from neuropsychological assessments conducted between 2001 and 2004 on 73 CD-diagnosed adults at a CARF accredited rehabilitation facility. Disability severity ratings of mild, moderate, and severe were assigned based on clinical judgment and interrater agreement. The assessment battery included the WASI and several neuropsychological tests: Halstead-Reitan TPT, TMT-A and B, and FOT; WMS-III VR-I and 2, LM-1 and 2, and MC; McCarron-Dial HVDT; SDMT; and SCT. Based upon a multitrait-multimethod matrix, mild to moderate convergent and discriminant validity was found with the WASI VIQ and PIQ traits among neuropsychological verbal and performance measures. Statistically, the SCT, TMT-A, and HVDT-right shape were most predictive of the PIQ, and the WMS-III LM-2 and MC were most predictive of the VIQ. VIQ-PIQ discrepancy did not predict severity of disability, but IQ means and subtest scores between the mild and severe groups were significantly different. Results indicated that WASI VIQ-PIQ discrepancy did not detect CD. However, WASI subtest scores of 40 or lower may justify further evaluation of potential CD. Contrary to the WASI manual, Similarities and Block Design rather than Vocabulary and Matrix Reasoning subtest scores may be more predictive of CD. This author suggested that counselors administer the WASI, SCT, and TMT-A as a time efficient screening method for CD.

No description available.

Neuropsychologists are becoming increasingly aware that there is a complex interplay of cognitive, personality, and sociocultural factors that affect an individual's performance on neuropsychological tests. The current study investigated the effect of one aspect of the sociocultural environment, that is, quality of education, on performance on neuropsychological tests of executive function. The sample included 40 high school learners: Group A comprised learners with a high quality of education and Group B comprised learners with a low quality of education. Four tests of executive function were administered: the Verbal Fluency Test, the Design Fluency Test, the Stroop Test and the Wisconsin Card Sorting Test. Results indicated that quality of education significantly affected the participants' performance with Group A performing significantly better than Group B on all the tests of executive function. These findings have implications for the interpretation of neuropsychological test performance in cross-cultural research and practice. / Psychology / M.A. (Clinical Psychology)

Background: Assessment of dementia in adults with intellectual disabilities poses specific challenges. Firstly, there is a paucity of validated, standardised and appropriate neuropsychological assessments of memory for adults with intellectual disabilities. Secondly, there are difficulties determining whether performance on neuropsychological assessments are attributable to preexisting intellectual disabilities, ‘normal’ ageing or part of a dementing process. A systematic review was therefore carried out to examine if there are memory changes associated with ‘normal’ ageing in the Down syndrome population. Following this an exploratory empirical research project was undertaken to examine one aspect of construct validity (i.e. convergent validity) of an associative memory test in a sample of adults with intellectual disabilities. This research project is presented as a journal article titled ‘Convergent validity of the Visual Association Test (VAT) in adults with intellectual disabilities’. Methods: 40 participants aged between 18-45 years were recruited from Community Learning Disability Teams. Participants completed the VAT and subtests of the modified Cambridge Cognitive Examination (CAMCOG-DS). IQ was assessed using the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV). Correlational analysis of the test variables were carried out. Participants with a diagnosis of dementia were excluded from the study. Results: All participants performed well on the VAT irrespective of age, gender or IQ. It was well received by participants. No significant correlations were found between the VAT and the subtests of the CAMCOG-DS or with the subtests of the WAIS-IV. Therefore, there was no evidence of convergent validity with this test in this sample of participants. Conclusions: While the VAT was found to be an easy, quick test to use with people with intellectual disabilities and all participants scored above ‘floor’ level, it was not found to have convergent validity with the CAMCOG-DS. Further research is needed to determine if the VAT represents a useful tool for assessment with this population.

No description available.

Selective eating (SE) refers to an individual narrowing their range of preferred foods, resulting in a restricted food intake, high levels of rigidity and food refusal (Bryant-Waugh, 2000). SE is encompassed in the new Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) (American Psychiatric Association, 2013) category avoidant restrictive food intake disorder (ARFID). Such difficulties are common in children with an autism spectrum disorder (ASD) (Raiten & Massaro, 1986) and neuropsychological differences have been found in children with ASD (Hill, 2004). This research aimed to be the first to investigate whether a distinct neuropsychological profile exists in children and adolescents with SE and furthermore, whether aspects of the profile vary depending on whether the child or adolescent displays elevated autistic traits. A case series of 10 children between the ages of 8 to 13 years old were recruited. A well-established neuropsychological test battery, the Ravello Profile (Rose, Frampton & Lask, 2012), was modified and administered to assess visuospatial processing, central coherence, executive functions (including cognitive flexibility, inhibition and planning) and theory of mind abilities. The results demonstrated a high degree of variability across the group in terms of visuospatial processing and theory of mind, weak central coherence across all participants and otherwise relatively intact abilities in executive function domains. There were no substantive findings in relation to those children with elevated autistic traits although a trend toward visuospatial processing differences did emerge. This exploratory case series was the first attempt to describe a neuropsychological profile in SE, however the small sample size and high variability in the data meant that a distinct neuropsychological profile did not emerge. The results did however provide an initial indication of possible trends in strengths and weaknesses across neuropsychological domains in SE. These findings have implications for the assessment and treatment of SE difficulties.

To align the neuropsychological functioning of our adult euthymic patient group with that reported in previous studies on euthymic bipolar disorder (BD), we used a neuropsychological battery that examined sustained attention (Rapid Visual Information Processing Task), verbal memory (California Verbal Learning Task), executive functioning (Intradimensional-Extradimensional Shift Task, Barrett Impulsivity Task, and Framing Task), and emotion responsiveness/regulation (Positive Affect/Negative Affect Scales, Behavioral Inhibition/Behavioral Activation Scale, and Affective Lability/Affective Intensity Scales) in patients versus healthy volunteers (HV). Our results corroborated existing evidence of reduced sustained attention, impaired verbal memory and executive functioning, and abnormal emotional responsiveness and regulation in euthymic BD relative to healthy controls (Chapter 2). To investigate how abnormal development of brain function in BD leads to deficits in decision-making, motor inhibition, and response flexibility, we examined child and adult BD using a novel risky decision-making task, and used cross-sectional (age x diagnosis) functional magnetic resonance (fMRI) designs to examine neural activation associated with motor inhibition and response flexibility in BD relative to HV. During the risky decision-making task, adult euthymic BD patients were no different from healthy controls in their proportion of risky lottery choices over a range of competing lotteries. This matched behavioral performance was associated with similar prefrontal and striatal brain activation between the patient and control groups during response, anticipation, and outcome phases of decision-making (Chapter 3). These results are different from previous studies that have shown increased risk taking during decision-making in euthymic BD. Similarly, young BD patients were no different from age-matched healthy and patient controls in their pattern of decision making during the risky choice task. This was evidenced by a similar number of risky lottery selections over the range of changing expected values between the young BD group and control groups (Chapter 4). Using a cross-sectional, fMRI analytic design during the stop signal task, we found that child and adult BD showed similar behavioral performance to child and adult HV during motor inhibition. However, this matched behavioral performance was associated with abnormal neural activation in patients relative to controls. Specifically, during unsuccessful motor inhibition, there was an age group x diagnosis interaction, with BD youth showing reduced activity in left and right ACC compared to both age-matched HV and adult BD, and adult BD showing increased activation in left ACC compared to healthy adults. During successful motor inhibition there was a main effect of diagnosis, with HV showing greater activity in left VPFC and right NAc compared to BD (Chapter 5). These neuroimaging data support existing laboratory-based evidence of motor inhibition impairments in BD relative to HV, and indicate brain dysregulation during motor control is important to BD pathophysiology. A previous behavioral study showed impaired response flexibility in young BD patients relative to age-matched controls when using the change task. Here, we used the change task during fMRI to examine response flexibility in child and adult BD compared to child and adult HV. We found that patient and control groups showed similar change signal reaction times in response to change cues. However, this matched behavioral performance was associated with abnormal age group x diagnosis activations in brain regions important in signal detection, response conflict, response inhibition, and sustained attention. Specifically, during successful change trials, child BD participants showed frontal, parietal, and temporal hyperactivation relative to healthy children and adult BD, while adult BD showed hypoactivation in these regions relative to healthy adults. These novel fMRI findings during the change task indicate impaired neural activation during response flexibility may be important to the pathophysiology of BD development.

Reitan and Wolfson's General Neuropsychological Deficit Scale and Left and Right Neuropsychological Deficit Scales were applied to Halstead-Reitan test data of individuals with psychotic or substance abuse disorders with and without a head injury.