M.A. (Counselling Pyschology) / "Given the environmental and biological studies of criminality and delinquency, it seems clear that offense behaviour is a multifactorial disorder, with contributors possibly including such variables as low IQ, attention deficit disorder with hyperactivity, and early aggressiveness. Protective factors possibly include high IQ and shyness. Each of these factors has been shown to be highly heritable" (Oilalla & Gottesman, 1991, p.128). It is imperative that researchers in the areas of violence, aggression and criminality take into consideration both the social and biological factors and that these areas once integrated, will enhance our understanding and provide a more cohesive picture.

The aim of the study was to produce preliminary normative indications for the Trail Making Test and the Stroop Test, administered in English, on a non-clinical sample of black, Xhosa-speaking, unskilled individuals (N = 33), with an educational level of 11 – 12 years, in two age categories (18 –29 and 30 – 40 years). The sample was equally distributed for gender and level of education. Participants, who were required to have a basic proficiency in English, were from traditionally black township schools with relatively disadvantaged quality of education. Within-sample age and gender effects were investigated. There were no significant age effects on the Trail Making Test, whereas there was one significant difference between age groups on the Stroop Test with respect to the Color-Word task, and a result that strongly approached significance on the Word task, with the younger group performing better than the older group. There were no significant gender effects on the Trail Making Test, whereas there was one significant difference between genders on the Stroop Test with respect to the Word task, and a result that approached significance on the Color task, with females performing better than males. Normative indications for both measures were compared to available normative data on western populations with higher levels and more advantaged quality of education. This comparison revealed consistently poorer performances for both the Trail Making Test and the Stroop Test, confirming the need for localised normative datasets to facilitate accurate neuropsychological diagnoses on culturally disadvantaged individuals.

Dans sa conception contemporaine, l’hallucination est simplement définie comme une ‘perception sans objet à percevoir’. Elle reste cependant complexe à mettre en évidence et à appréhender en pratique clinique, notamment en population pédiatrique. L’anamnèse, au cours de laquelle le praticien devra éviter des écueils, tels que l’immaturité psychique et la potentielle existence d’un compagnon imaginaire, peut être complétée par des méthodes d’évaluation lui permettant une caractérisation plus spécificique du phénomène. Ce symptôme a fait l’objet d’un regain d’intérêt ces 30 dernières années dans le domaine scientifique. Il est maintenant admis que les hallucinations ne se retrouvent pas exclusivement dans un contexte étiologique schizophrénique, mais qu’elles peuvent également apparaître au cours du développement normal et être de résolution spontanée. Malgré cela, encore peu d’études à l’heure actuelle se sont spécifiquement intéressées à son caractère précoce, transdiagnostique et à sa thérapeutique chez l’enfant et l’adolescent. Néanmoins différentes pistes d’intervention sont à notre disposition pour nous aider à mieux appréhender ce symptôme, qu’il s’agisse de son évaluation ou de sa thérapeutique. Au cours de ce doctorat, nous nous sommes intéressés dans un premier temps aux aspects cognitifs de l’hallucination. Sur la base du modèle de défaut d’attribution de la source, postulant que les hallucinations seraient le résultat d’une tendance à attribuer plus souvent les évènements auto-générés à un sujet externe, nous avons normalisé une tâche évaluant cette capacité cognitive. Nous avons pu mettre en évidence d’une part, chez nos sujets sains recrutés pour l’étude de normalisation, un effet du vieillissement pathologique préférentiellement pour le reality monitoring (distinguant une source interne au sujet d’une source externe à lui) ; d’autre part, ces données confrontées à la pathologie, ont révélé des performances réellement déficitaires chez des patients souffrant de schizophrénie et présentant des hallucinations pharmaco-résistantes pluri-modales. Notre objectif est par la suite d’obtenir des données normatives pour une population pédiatrique. Dans un second temps, nous nous sommes intéressés à l’évaluation psychométrique des hallucinations précoces. Au vu du manque d’outils, nous avons associé l’aspect ludique des nouvelles technologies à une évaluation complète et rigoureuse du symptôme. Ainsi, nous avons développé une application pour tablette tactile combinant l’évaluation de la cognition, notamment de la théorie de l’esprit, et de la sévérité du symptôme. En effet, les capacités de théorie de l’esprit ont récemment été identifiées comme marqueurs pronostiques dans la résolution des hallucinations chez l’enfant. L’objectif premier de ce travail est donc de fournir un outil fiable d’évaluation de l’hallucination précoce, l’objectif sous-jacent de cet outil étant de permettre un suivi longitudinal de l’enfant et d’adapter au mieux sa thérapeutique. Enfin, nous nous sommes attelés à la mise en place d’une thérapeutique innovante chez l’enfant et l’adolescent, qui n’est autre que la stimulation magnétique transcrânienne répétée (rTMS). Cette technique de neuromodulation a pour avantage de cibler un symptôme et non une pathologie et peut donc s’appliquer à un certain nombre de sujets hallucinés. L’objectif de ce travail était d’étudier plus en avant l’hallucination précoce au moyen d’approches diverses et variées facilitant la mise en confiance de l’enfant et la caractérisation tant phénoménologique que cognitive du symptôme par le praticien. Les résultats réunis dans ce travail de doctorat mettent en évidence qu’il est possible d’appréhender le symptôme hallucinatoire précoce grâce à la cognition et aux nouvelles technologiques. Ces approches nous permettent d’améliorer notre prise en charge en nous donnant une meilleure compréhension du symptôme et des mécanismes associés. / In its contemporary conception, the hallucination is simply defined as a ‘perception without object to perceive’. It remains however complex to highlight it in clinical practice, in particular in pediatric population. The clinical interview, during which the clinician have to avoid stumbling blocks, such as psychic immaturity and potential existence of an imaginary companion, can be completed by methods allowing a more specific caracterisation of the phenomenon. This symptom has been a renewed interest in the last 30 years in scientific domain. It is now accepted that the hallucinations are not found exclusively in schizophrenic etiological context, but they can also occur during normal development and be spontaneous resolution. Despite this, few studies currently have a specific interest in its early and transdiagnostic character, and his treatment in children and adolescents.Nevertheless, differents strategies for actions are available to help us better understand this symptom, whether its evaluation or therapeutic. In this PhD work, we initially focused on cognitive aspects of hallucination. Based on the source monitoring framework, assuming that hallucinations are the result of a tendency to attribute more often self-generated events to an external subject, we standardized a task assessing this cognitive ability.We first highlight an age effect in our healthy subjects enrolled in the study of standardization, preferentially for the reality monitoring task (distinction between an external source and an internal source). We then compare these data with those obtained from patients suffering from schizophrenia, revealing loss performance for both tasks. Our goal is then to obtain normative data for a pediatric population.In a second step, we are interested in the psychometric assessment of early-onset hallucinations. Given the lack of tools, we have combined the playfulness of new technologies in a comprehensive and rigorous assessment of the symptom. We thus developed an application for touchpad associating the assessment of cognition, including the theory of mind, and symptom severity. Theory of mind developpement have recently been identified as prognostic marker in the resolution of hallucinations in children. The first objective of this work is to provide a reliable assessment or early-onset hallucinations, the underlying objective is to allow longitudinal assessment of this symptom in children and adolescents and to better adapt its therapeutic. Finally, we are interested in the development of an innovative therapy in children and adolescents, which is the repetitive trancranial magnetic stimulation (rTMS). This neuromodulation technique has the advantage to target a symptom, not a disease, and can therefore be applied to a number of hallucinated subjects.The objective of this work was to study early-onset hallucination through diverse approaches facilitating the trust of the child and both phenomenological and cognitive caracterisation of the symptom by the clinician.The results gathered in this PhD work demonstrate that it is possible to understand the early-onset hallucinatory symptoms through cognition and new technologies. These approaches allow us to adapt our daily practice, gives us a better understanding of the symptoms and associated cognitive mechanisms, thereby improving our therapeutic management .

The aim of this study was to determine executive function outcomes after an equi-therapy intervention in a group of Tourette syndrome children. Equi-therapy is a new form of therapeutic horse riding, which is related to the stimulation of the vestibular system through sensory integration in the brain. For this study a non-equivalent control group design was implemented. The study consisted of 8 Tourette syndrome children aged between 9 and 15, who were referred after a definite Tourette syndrome diagnosis from various neurologists and paediatricians. Both groups were evaluated on a battery of 6 neuropsychological tests measuring various aspects of executive function before and after receiving the therapeutic horse riding intervention. The tests used were the Wisconsin Card Sorting Test, the Stroop Colour Word Test, the Rey-Osterrieth Complex Figure Test, the Trail Making Test A and B, the Raven’s Standard Progressive Matrices and the Symbol Digit Modalities Test. Qualitative inputs were also included in the study. These consisted of behavioural checklists completed by the participants’ parents, the evaluation of the participants’ copy drawings as ’frontal’ or ’normal’ obtained from the Rey-Osterrieth Complex Figure test, and results of tests that were administered by an occupational therapist as part of the required evaluation for the therapeutic horse riding (equi-therapy) itself. Results of the neuropsychological tests indicated significant differences for the Wisconsin Card Sorting Test, Stroop Colour Word Test and the Symbol Digit Modalities Test, indicating improvements in selective attention, cognitive flexibility, visualspatial constructional ability, visuomotor integration, visual memory and organisational strategies. The qualitative results indicted improvements in emotional and behavioural aspects. Executive abilities are a very complex system and evaluation should always include robust and sensitive neuropsychological tests. It seems as if Tourette syndrome could be directly related to executive dysfunction, but not in a simple manner as aspects may vary due to other more complex factors that may contribute to these dysfunctions. However, for equi-therapy as an alternative form of therapy, the opportunity should not be lost to establish its efficacy because of the possible beneficial outcome. / Thesis (MA (Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

The study sought to determine whether there is evidence for the presence of residual (chronic) deleterious effects on cognition due to repetitive mild traumatic brain injury in top team university level rugby players, using ImPACT 3.0, Trail Making Test (TMT) and Digit Span. The initial sample of 48 participants was divided into groups; Rugby (n = 30) and Controls (n = 18), Rugby Forwards (n = 14) and Rugby Backs (n = 16). A reduced sample (N = 31) comprised of Rugby (n = 20) and Controls (n = 11), Rugby Forwards (n = 9) and Rugby Backs (n = 11). Comparative subgroups were equivalent for estimated IQ but not for age and educational level in the full sample; in the reduced sample there was equivalence for all three variables of age, education and estimated IQ. All cognitive test measures were subjected to independent t-test analyses between groups at the pre- and post-season, and dependent t-test analyses for Rugby and Controls at pre- versus post-season. Overall, the results implicated the presence of deleterious effects of concussive events on Rugby players in the areas of speed of information processing, working memory and impulse control. Significant practice effects were found on the TMT and Digit Span for controls, but not on ImPACT 3.0, supporting the use of this computer-based programme in the sports management context.

The present study comprises the second phase of a larger and ongoing research study investigating the brain damage effects of cumulative mild head injury in rugby. The purpose of this study was to determine whether cumulative mild head injury sustained in the game of rugby would cause brain injury as evidenced by impaired performance on sensitive neuropsychological tests. Participants were Springbok professional rugby players (n = 26), Under 21 rugby players (n = 19), and a non-contact sport control of national hockey players (n = 21). Comparisons of performance were carried out across a spectrum of neuropsychological tests for the three rugby groups (Total Rugby, Springbok Rugby, and Under 21 Rugby) versus the performance of the non-contact sport control group (Hockey Control), as well as comparisons of performance f9r the subgroups of Rugby Forwards versus Rugby Backs. Comparisons revealed a consistent pattern of poorer performance across all rugby groups relative to the performance of the controls on tests highly sensitive to the effects of diffuse brain damage. Within rugby group comparisons (Forwards versus Backs) showed significantly poorer performance for Total Rugby Forwards and Springbok Rugby Forwards relative to the performance of the respective Total Rugby Backs and Springbok Rugby Backs on sensitive, as well as on somewhat less sensitive, neuropsychological tests. The performance of Under 21 Rugby Forwards relative to Under 21 Rugby Backs demonstrated similar trends. Brain reserve capacity theory was used as a conceptual basis for discussing the implications of these findings.

A number of computerised tests have been especially developed to facilitate the medical management of the sports-related concussion. Probably the most widely used of these programmes is the ImPACT test that was developed in the USA and that is registered with the HPCSA for use in the South African context. A recent Afrikaans version of the test served as the basis of the present study with the following objectives: (i) to collect Afrikaans ImPACT normative data on a cohort of Afrikaans first language adolescent rugby players with Model C education for comparison with existing South African English first language adolescent rugby players with Private/Model C schooling, and (ii) to investigate the pre-versus postseason ImPACT neurocognitive test profiles of this cohort of Afrikaans first language adolescent rugby players versus equivalent noncontact sports controls. The results for Part 1 of the study generally demonstrate poorer performance in respect of the Afrikaans cohort, which is understood to be the result of poorer quality of education. The results for Part 2 demonstrated failure of the rugby group to benefit from practice on the ImPACT Visual Motor Speed composite score to the same extent as the control group. It is argued that this apparent cognitive vulnerability in the rugby group is due to lowered cognitive reserve capacity in association with long term exposure to concussive and sub-concussive injury.

The aim of the study was to obtain preliminary normative data for two tests of hand motor function (Successive Finger Tapping and Purdue Pegboard tests) and two tests of verbal fluency ("S"-Words-In-One-Minute and Words-In-One-Minute), administered in English, on a non-clinical sample of black, isiXhosa-speaking unskilled workers with a background of relatively disadvantaged former DET education (N = 33). The sample was equally distributed for gender; educational level was restricted to 11 - 12 years; age range was 18 - 40 years divided further into two age categories (18 - 29 and 30 - 40 years). Results of t-test comparative analyses revealed significant age effects on both trials of the Successive Finger Tapping test in the direction of the younger age group outperforming the older age group, and a marginal but consistent tendency towards poorer performance at an earlier age stage than proposed by the available literature, for the Purdue Pegboard, "S"Words- In-One-Minute and Words-In-One-Minute. Gender effects were only in evidence on the Purdue Pegboard in the direction of females outperforming males. A descriptive comparison of the norms acquired for the present study with available normative data for English first language speaking populations with higher levels and/ or relatively advantaged quality of education revealed consistently poorer performance for the present study. The findings highlight the effect of relatively low levels and/ or poor quality of education on both verbal and non-verbal neuropsychological test performance and confirm the need for demographically specific normative data.

The present study comprises part of an ongoing research study investigating the effects 0 f cumulative mild head injuries 0 n Rugby Union p layers. The aim 0 f t he study was to ascertain whether there are neuropsychological effects of cumulative mild head injuries sustained during the rugby-playing careers of senior schoolboy rugby players. Participants were top-level rugby players from high schools in Grahamstown and Cape Town (n = 79) and non-contact sport controls of top-level field hockey players from the same schools (n = 58). Group mean comparisons across a battery of neuropsychological tests were carried out between the Total Rugby versus the Total Field Hockey group, and the Rugby Forwards versus the Rugby Backs group. Comparisons between Total Rugby versus Total Field Hockey revealed impaired performance by the rugby players on two tests of visuoperceptual tracking, namely Digit Symbol Substitution and Trail Making Test (Part A). For Rugby Forwards versus Rugby Backs, there were no consistent differences to support the expectation that forwards would perform worse than backs. Forwards performed more poorly than backs on WMS Associate Learning Subtest - Hard (Delayed Recall), whereas backs performed more poorly than forwards on Digits Backwards. This suggests that some individuals in the cohort were starting to exhibit verbal memory deficit, albeit not clearly in association with forward positional play. Overall, results of the present study provide tentative support for the hypothesis that school level rugby players are more susceptible to the effects of cumulative concussive and sub-concussive head injuries than are non-contact sport controls. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

The objective of the study was to investigate the cumulative neurocognitive effects of repetitive concussive and subconcussive events in club level Rugby Union (hereafter rugby) during the course of one rugby season, in a combined group and individualized case-based approach. Amateur adult club level rugby players (n = 20) were compared with a non-contact control group (n = 22) of equivalent age, years of education and estimated IQ (p = > .05, in all instances), although the two groups were clearly differentiated on the basis of a history of reported concussions (p = < .05). Video analyses documented the tackling maneuvers observed amongst the players during all matches across the rugby season revealing a sobering average of more than a thousand tackles per player, excluding any contact practice sessions. Five rugby players (n = 5) who were observed to have a head jarring event were also isolated for individualized postconcussive follow-up analysis of their neurocognitive profiles. Measures included the ImPACT Verbal and Visual Memory, Visual Motor Speed and Reaction Time composites and the Purdue Pegboard. Independent and dependent statistical analyses were employed to compare the rugby versus control group neurocognitive test profiles at and between the three test intervals. Correlational analyses explored the association between concussion, tackling and neurocognitive test outcomes. Descriptive comparisons of individual neurocognitive test scores with normative data were employed for the case analyses. Taken together, the results implicated vulnerability amongst club rugby players on the motor and speeded tasks, with less robust indications on the memory tasks. While limited in terms of its small sample size, it is considered that the outcome of the study was rendered more robust by virtue of being methodologically multifaceted with heuristic implications for future research studies in the area. The novel inclusion of tackling data as well as fine-tuned case analyses, were of particular relevance in that regard. The results add to a growing body of literature that implicates deleterious neurocognitive effects in participants of a sport such as rugby due to repetitive head jarring incidents that are intrinsic to the game.