Thesis (M.A. (Clinical Psychology)) --University of Limpopo (Turfloop Campus), 2005 / The aim of this study was to establish whether children with Attention-Deficit/Hyperactivity show deficits in cognitive impulsiveness and motor functions, caused by a hypofunctioning dopamine system. A group of 84 primary school children, 42 classified as ADHD and 42 controls, matched for age, gender and SES, with children without ADHD symptomatology, were compared on their performance on neuropsychological tests which test the functions of the cortical areas supplied by two dopamine branches, the meso-cortical and nigrostriatal branches. The battery consisted of the Wisconsin Card Sorting Test, the Grooved Pegboard, and the Maze Coordination Task. The results of the tests were analysed as a function of gender and ADHD-subtypes. In the majority of tests the clinical groups performed worse than the control groups. This was the case for both genders. The Hyperactive/Impulsive and Combined subtypes consistently performed poorer than the other groups. The results indicate that children with ADHD are more impulsive (deficient executive functions) and have poorer motor control than their control counterparts, which may be an indication of dopamine dysfunction.

O Teste Hooper de Organização Visual (Visual Organization Test - VOT) foi publicado em 1958 e revisado em 1983. É um instrumento para avaliar a capacidade de organização visual dos estímulos, sendo sensível aos danos neurológicos. O teste é composto por 30 figuras de objetos comuns fragmentadas em duas a quatro partes, mostradas na forma de quebra-cabeças em cartões com fundo branco. Os itens são apresentados um a um para que o examinando diga o nome da figura que seria formada e se as partes do desenho fossem juntadas corretamente. O objetivo desta pesquisa foi realizar estudos psicométricos de padronização, validade e precisão do Teste Hooper para a cidade de São Paulo. Para isso, inicialmente foi investigada a existência de diferenças em relação às variáveis idade, sexo e escolaridade. A precisão foi avaliada por meio do reteste e pelo método das metades e a validade foi obtida pela correlação com os testes Figuras Complexas de Rey (Figura A), e os subtestes Cubos e Armar Objetos da Escala WAIS-III. Também foi feita a análise de itens para determinar a sua dificuldade. A amostra foi composta por 969 adultos de ambos os sexos, sendo 53,5% mulheres e 46,5% homens, com idades entre 18 e 82 anos, que foram subdivididos em seis subgrupos, e a escolaridade variou de ensino fundamental a superior. Os resultados da Análise de Variância indicaram a existência de diferenças significantes (p < 0,05) entre os sexos, as faixas etárias e os níveis de escolaridade, bem como em todas as interações entre essas três variáveis. Os testes Post Hoc de Tukey indicaram diferenças entre as médias dos três níveis de escolaridade, em agrupamento das faixas etárias em quatro conjuntos. Os testes t apontaram diferença entre os sexos apenas na faixa de 61 anos ou mais e para o nível de escolaridade superior, com pontuação maior para os homens. Foram estabelecidas normas em percentis em função da escolaridade e faixa etária para a amostra total e separadas para cada sexo, para o ensino superior e para as idades de 61 anos ou mais. A precisão pelo reteste evidenciou alta correlação (0,897) entre os resultados das duas aplicações. A precisão das metades entre itens pares e ímpares, corrigida pela fórmula de Spearman-Brown foi de 0,884. Para a validade com outros testes que avaliam a organização perceptiva visual as correlações foram significantes (entre 0,302 e 0,543). A análise da dificuldade dos itens mostrou a necessidade de sua reordenação em função da sua dificuldade e também a necessidade de rever os critérios de avaliação de alguns elementos, pois em determinados casos será necessário rever as respostas que são consideradas como de 1 ou 0,5 pontos. Propõe-se também uma nova ordem para a apresentação dos itens na aplicação. Assim, as normas estabelecidas nesta pesquisa, bem como os dados de precisão e de validade, podem permitir a utilização do Teste Hooper para a nossa população, fornecendo critérios seguros para auxiliar no diagnóstico de pacientes com queixas relativas a problemas neurológicos / The Hooper Visual Organization Test (VOT) was published in 1958 and reviewed in 1983. It is a device to evaluate the ability of visual stimuli organization, being sensitive to neural damages. The test is composed by 30 pictures of common objects separated into two to four pieces, presented in a puzzled way on white background cards. The items are presented one by one so that the examinee says the name of the picture that would be formed, if the parts of the drawing were gathered correctly. The aim of this research was to carry out psychometric studies of standardization, validity and reliability of Hooper Test for the city of São Paulo. Therefore it was initially investigated the existence of differences in relation to such variables as age, sex and school grading. The reliability was evaluated through a retest and the split-half method, and the validity was reached by the correlation to the tests: Complex Rey Pictures (Picture A) and subtests Cubes and Object Assembly of WAIS-III. Item analysis was also done to determine their difficulty. The sample was composed by 969 adults of both sexes, being (53.5%) women and (46.5%) men, with ages varying from 18 to 82 years old, who were divided in six subgroups, and school level ranging from elementary to college education. Results of the Variance Analysis indicated the existence of significant differences (p < 0.05) between sexes, ages and school level, as well as in all interactions among these three variables. The Tukey Pos Hoc tests indicated differences among the averages of the three levels of education, an assemblage of ages in four groups. The t tests pointed differences between the sexes only at 61 year old or more groups and for the high school level, men being superior. Norms were established in percentile according to the education level and age for the total sample and, separated for each sex, for high school and for the ages of 61 or more. The retest reliability indicated high correlation (0.897) among the results of the two test administrations. The split-half reliability between even and odd items, corrected by the Spearman-Brown formula was of 0.884. The validity coefficients with other tests that assess the visual perception organization were significant (between 0.302 and 0.543). The analysis of the items difficulty showed the need of reordering the items according to their difficulty, as well as the need of reviewing the scoring criteria of some items, because in some cases, it will be necessary to review the answers which are scored as 1 or 0.5 points. It is also proposed a new order to present the items in the test administration. Therefore the standards established in this research, as well as the reliability and the validity data may allow the use of Hooper Test for our population, providing safe criteria for assist in the diagnosis of patients with complaints related to neural diseases

There is widespread concern within at least Western cultures of the potential damage that sex offenders may cause to society. The government statistics highlight a frightening pattern of sexual abuse in Australia, with the trend implicating that sexual assault is on the rise and that children are the predominant victims (ABS, 2003b). Specifically, 17,850 reports of sexual assault were recorded in 2002, a 6% increase since 2001. Further to this, there is still no universal agreement as to the extent to which treatment effectively reduces sexual recidivism. Therefore, there is an urgent need for research into this problem behaviour. Research examining the causes of sexual offending has examined a biological hypothesis that sex offenders have functional brain impairment. However, the results of neuropsychological assessments of various sex offender populations are inconsistent and inconclusive. The aim of this study was to investigate the brain function of males convicted and incarcerated for sexual offences against children using neuropsychological assessment. Specifically, it was hypothesised that the sex offenders would show functional impairment in their frontal and temporal lobes. A battery of neuropsychological tests was compiled to assess the functions of these regions including four WAIS-Ill subtests (Arithmetic, Vocabulary, Block Design and Picture Arrangement), Rey Auditory Verbal Learning Test (RAVLT), Rey Complex Figure (RCF), Wisconsin Card Sorting Test (WCST) and the FAS Test. These tests were administered to 25 incarcerated male sex offenders, 25 incarcerated male non-sex offenders and 25 men with no criminal history. Although attempts were made to match these groups on age, level of education and level of intelligence, statistical analyses revealed that there were significant differences between the groups on these variables. These differences were statistically controlled using analyses of covariance (ANCOVAs) and factorial analyses of variance (ANOVA). The results indicated that the sex offenders performed significantly worse than the controls on all neuropsychological tests. However, statistically significant differences were only found between the sex offenders and control group on the immediate recall trials of the RAVLT and RCF. These observed differences did not change when age, level of education and level of intelligence were statistically controlled. It was concluded that there is insufficient evidence from this study to support the hypothesis that sex offenders have functional impairment in their frontal and temporal lobes. However, given the relevance of potential brain impairment to both the biological and social-cognitive perspectives of sexual offending, future research in this field is warranted.

One of the major goals of cognitive neuroscience is to better understand the psychological and neural bases of human executive-attention. Executive or supervisory attention refers to a collection of higher-order cognitive functions whose primary contribution to behavior is to support controlled information processing and action. The capacity to control attention is essential for our adaptive interaction with the environment because it allows flexibility in our responses to ever changing situational contexts and demands. Executive-attention processes therefore play a unique role in shaping the human experience. Use of three-dimensional functional neuroimaging has fast become the empirical standard for investigating how executive-attention is implemented in the human brain. Most recently, emphasis has been placed on the use of these techniques to parse discrete components of a putative neural network relating to action-monitoring and cognitive control processes of the medial and lateral prefrontal cortex. This work has relied heavily on the use of popular experimental paradigms such as the Stroop task and their unique capacity to challenge such processes in humans. These tasks have also been especially useful for conceptualizing the nature of higher-cognitive dysfunction in complex brain disorders such as schizophrenia. The focus of this thesis concerns a novel application of the Stroop paradigm and functional imaging approach to examine executive-attention performance in healthy subjects and patients with schizophrenia and obsessive-compulsive disorder. On one hand, this work aimed to address current ideas on the nature of executive-control mechanisms and how they may be compromised in these two common psychiatric disorders. On the other hand, this work aimed to examine important conceptual and methodological issues associated with functional imaging approaches to the study of higher-cognition and cognitive psychopathology in humans. In line with connectionist models of executive-attention phenomena, the first study in this thesis investigated the effects of task practice on a larger-scale neurocognitive network associated with performance of the Stroop task in healthy subjects. This study involved the use of a novel methodological approach to model physiological covariances or ?functional connectivity? in PET data, which generated previously unseen and interesting insights into the neural basis of Stroop phenomena, whilst complimenting existing ideas on the role of the anterior cingulate and lateral prefrontal cortex in mediating executive-control functions. These findings were then extended to a comparative study of patients with schizophrenia and obsessive-compulsive disorder. This study largely corroborated previous reports of prefrontal executive dysfunction in schizophrenia, although patients also showed evidence for a compensatory strengthening of connectivity in a fronto-parietal network that accompanied task practice. This finding has important implications for existing models of higher-cognitive dysfunction and abnormal brain integration in schizophrenia. For patients with OCD compared to healthy subjects, performance of the Stroop task evoked a pattern of abnormal connectivity among predominantly corticostriatal regions, including a previously reported hyperfunction of the dorsal anterior cingulate cortex. While this latter result has been linked to a specific disturbance of action-monitoring in patients with OCD, the current study suggests that this may map onto a more extensive corticostriatal network abnormality in line with current theoretical models of this illness. One caveat raised in the first study of patients with schizophrenia concerned the effects of illnesschronicity and medication on functional imaging studies of higher-cognition and prefrontal function in schizophrenia. To address this, a second clinical study was undertaken in patients with a first-episode of schizophrenia (diagnosis confirmed at follow-up) who were examined before and after commencing antipsychotic treatment. Overall, the findings from this study support the idea of trait-like disturbances of prefrontal executive function in schizophrenia; however, they also suggested that aspects of this disturbance may be specific to the critical, early stage of illness - implicating progressive changes with illness chronicity and/or treatment intervention. These findings are discussed in relation to the developmental context of cognitive psychopathology in schizophrenia.

<p>In this study have I examined how treatment of girls with neuropsychological impairments is functioning? I have looked at the theories and methods of treatment on the base of the care program and how it is put into practice. In addition I have interviewed four girls who have undergone the treatment program.</p><p>To gain perspective on institutional care as a social phenomenon, I have tried to give a brief historical retrospect in which particular care for women are described. I am also affecting certain gender aspects of institutional care. I have also tried to make a brief account of current research on the treatment.</p><p>The study is a qualitative study in which I am apart from literature studies used participant observation in depth interviews as a method.</p><p>My results indicate that a well structured treatment with CBT approach can work well to achieve lasting behavioural changes in students.</p>

<p>Wilson's disease (WD), bepatolenticular degeneration, is an autosomal recessive disorder caused by mutations in the ATP7B gene, and is characterised by abnormal metabolism and deposition of copper in the liver, brain and other organs. The main aim of this thesis was to investigate the occurrence of psychopathology, as well as personality traits and neuropsychological function in Swedish patients with treated WD. The research subjects were 29 patients with confirmed WD, investigated at the Department of Internal Medicine at Uppsala University Hospital between 1996 and 2000. </p><p>The treated WD patients showed prominent psychopathology as determined by the Comprehensive Psychopathological Rating Scale. The spectrum of psychopathological symptoms is not typical of classic psychiatric syndromes, and includes symptoms from Anxiety, Depression and Obsessive-Compulsive disorders as well as Negative Symptoms. In self-assessment, the WD patients tended to underestimate the presence of psychopathological symptoms. The treated WD patients differed in their sleep pattern from the control group, as measured with the Uppsala Sleep Inventory. The spectrum of self-reported symptoms suggests an altered REM sleep function. </p><p>The treated WD patients had significant deviations in personality traits, especially in aggressivity-hostility related scales and Psychic anxiety, compared to healthy controls, as measured with the Karolinska Scales of Personality. The deviations were not related to age, age at onset or duration of WD. The treated WD patients displayed a specific profile of moderate neuropsychological impairment, as determined by the Automated Psychological Test battery. Finally, an attempt was made to search for, possible genotype-phenotype relationships in some ATP7B mutations. </p>

Wilson's disease (WD), bepatolenticular degeneration, is an autosomal recessive disorder caused by mutations in the ATP7B gene, and is characterised by abnormal metabolism and deposition of copper in the liver, brain and other organs. The main aim of this thesis was to investigate the occurrence of psychopathology, as well as personality traits and neuropsychological function in Swedish patients with treated WD. The research subjects were 29 patients with confirmed WD, investigated at the Department of Internal Medicine at Uppsala University Hospital between 1996 and 2000. The treated WD patients showed prominent psychopathology as determined by the Comprehensive Psychopathological Rating Scale. The spectrum of psychopathological symptoms is not typical of classic psychiatric syndromes, and includes symptoms from Anxiety, Depression and Obsessive-Compulsive disorders as well as Negative Symptoms. In self-assessment, the WD patients tended to underestimate the presence of psychopathological symptoms. The treated WD patients differed in their sleep pattern from the control group, as measured with the Uppsala Sleep Inventory. The spectrum of self-reported symptoms suggests an altered REM sleep function. The treated WD patients had significant deviations in personality traits, especially in aggressivity-hostility related scales and Psychic anxiety, compared to healthy controls, as measured with the Karolinska Scales of Personality. The deviations were not related to age, age at onset or duration of WD. The treated WD patients displayed a specific profile of moderate neuropsychological impairment, as determined by the Automated Psychological Test battery. Finally, an attempt was made to search for, possible genotype-phenotype relationships in some ATP7B mutations.

In this study have I examined how treatment of girls with neuropsychological impairments is functioning? I have looked at the theories and methods of treatment on the base of the care program and how it is put into practice. In addition I have interviewed four girls who have undergone the treatment program. To gain perspective on institutional care as a social phenomenon, I have tried to give a brief historical retrospect in which particular care for women are described. I am also affecting certain gender aspects of institutional care. I have also tried to make a brief account of current research on the treatment. The study is a qualitative study in which I am apart from literature studies used participant observation in depth interviews as a method. My results indicate that a well structured treatment with CBT approach can work well to achieve lasting behavioural changes in students.

The purpose of the study was to investigate whether sleep-disordered breathing (SDB) impairs executive functioning in children. Additionally, the study sought to identify the executive functions at risk in SDB and the contribution of daytime sleepiness. SDB represents a spectrum of upper airway conditions that can be mild, such as snoring, or severe, such as obstructive sleep apnea (OSA). Children with these problems may present with excessive sleepiness, failure to thrive, and a variety of cognitive and behavioral dysfunctions including impaired executive functioning. Beebe and Gozal (2002) developed a theoretical model to explain the impact of sleepiness and hypoxia on executive functioning. This model provided a framework to examine links between the medical disorder and the neuropsychological consequences. Twenty-seven children with suspected SDB were tested with polysomnography (PSG) and a neuropsychological battery. Parents completed subjective measures of cognitive function and sleep symptoms. The children were ages 8 to 18 and had no congenital or acquired brain damage. They were matched for age and gender with 21 healthy controls. The executive function protocol included subtests from the Delis-Kaplan Executive Function System (D-KEFS), the digit span subtest from the Wechsler Intelligence Scale for Children (WISC-IV), the Tower of London-II-Drexel University (TOL-II), the Behavioral Rating Inventory of Executive Functioning (BRIEF), and the Conners’ Continuous Performance Test (CPT-II). Statistical analysis was performed using 2 statistical software packages, SAS and NCSS. Regression analysis was used to evaluate all variables. Due to significant group differences in socio-economic status (SES), SES was included as a covariate, along with IQ. No group differences in IQ were found. Significantly less robust executive function in children with SDB was identified in the domains of cognitive flexibility and impulsivity. Additionally, poorer executive planning and overall inattentiveness was also associated with SDB. Level of significance was set at 0.05 and trends (0.05 < p < 0.10) were acknowledged. Other areas of executive function, including working memory, behavioral and emotional inhibition, and processing speed were not associated with SDB. Moreover, academic functioning was significantly lower in children with SDB, although the differences can be shared equally with SDB, SES and IQ.

Mitochondrial Diseases (MD) are disorders of function in cellular oxidative phosphorylation caused by diverse nuclear DNA and mtDNA mutations and seen in 1/5,000 births. The purpose of this study was to examine relationships across medical indices, biochemical measures, and neurobehavioral functioning in children with MD. Findings from Western Blot, Native Gels, High Resolution Respirometry, and the Nijmegen diagnostic criteria were assessed in relation to children’s processing speed and attention, based on the prediction that impaired functioning of proteins, complexes, and cellular respiration, that are critical in ATP production, will impact neurodevelopment and related neuropsychological processes in children with MD. Twenty-five children (ages 4-13) were administered subtests from the DAS-II and NEPSY-II. Results from multiple regression analyses suggest that processing speed and attention deficits may be markers of abnormal protein expression that interferes with the production of ATP in the oxidative phosphorylation process; implications for future research are presented.