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Gozt AK, Hellewell SC, Thorne J, Thomas E, Buhagiar F, Markovic S, Van Houselt A, Ring A, Arendts G, Smedley B, Van Schalkwyk S, Brooks P, Iliff J, Celenza A, Mukherjee A, Xu D, Robinson S, Honeybul S, Cowen G, Licari M, Bynevelt M, Pestell CF, Fatovich D, Fitzgerald M. Predicting outcome following mild traumatic brain injury: protocol for the longitudinal, prospective, observational Concussion Recovery ( CREST) cohort study. BMJ Open 2021; 11:e046460. [PMID: 33986061 PMCID: PMC8126315 DOI: 10.1136/bmjopen-2020-046460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Mild traumatic brain injury (mTBI) is a complex injury with heterogeneous physical, cognitive, emotional and functional outcomes. Many who sustain mTBI recover within 2 weeks of injury; however, approximately 10%-20% of individuals experience mTBI symptoms beyond this 'typical' recovery timeframe, known as persistent post-concussion symptoms (PPCS). Despite increasing interest in PPCS, uncertainty remains regarding its prevalence in community-based populations and the extent to which poor recovery may be identified using early predictive markers. OBJECTIVE (1) Establish a research dataset of people who have experienced mTBI and document their recovery trajectories; (2) Evaluate a broad range of novel and established prognostic factors for inclusion in a predictive model for PPCS. METHODS AND ANALYSIS The Concussion Recovery Study (CREST) is a prospective, longitudinal observational cohort study conducted in Perth, Western Australia. CREST is recruiting adults aged 18-65 from medical and community-based settings with acute diagnosis of mTBI. CREST will create a state-wide research dataset of mTBI cases, with data being collected in two phases. Phase I collates data on demographics, medical background, lifestyle habits, nature of injury and acute mTBI symptomatology. In Phase II, participants undergo neuropsychological evaluation, exercise tolerance and vestibular/ocular motor screening, MRI, quantitative electroencephalography and blood-based biomarker assessment. Follow-up is conducted via telephone interview at 1, 3, 6 and 12 months after injury. Primary outcome measures are presence of PPCS and quality of life, as measured by the Post-Concussion Symptom Scale and the Quality of Life after Brain Injury questionnaires, respectively. Multivariate modelling will examine the prognostic value of promising factors. ETHICS AND DISSEMINATION Human Research Ethics Committees of Royal Perth Hospital (#RGS0000003024), Curtin University (HRE2019-0209), Ramsay Health Care (#2009) and St John of God Health Care (#1628) have approved this study protocol. Findings will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION NUMBER ACTRN12619001226190.
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Affiliation(s)
- Aleksandra Karolina Gozt
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- Perron Institute of Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Sarah Claire Hellewell
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Jacinta Thorne
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Elizabeth Thomas
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
- Division of Surgery, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Francesca Buhagiar
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shaun Markovic
- Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia
- The Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Anoek Van Houselt
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Alexander Ring
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Glenn Arendts
- Emergency Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
| | - Ben Smedley
- Emergency Department, Rockingham General Hospital, Cooloongup, Western Australia, Australia
| | - Sjinene Van Schalkwyk
- Emergency Department, Joondalup Health Campus, Joondalup, Western Australia, Australia
| | - Philip Brooks
- Emergency Department, Saint John of God Midland Public Hospital, Midland, Western Australia, Australia
- School of Medicine, The University of Notre Dame and Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - John Iliff
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
- Emergency Department, Saint John of God Hospital Murdoch, Murdoch, Western Australia, Australia
- Emergency Department, Royal Perth Hospital, Perth, Western Australia, Australia
- Royal Flying Doctor Service- Western Operations, Jandakot, Western Australia, Australia
| | - Antonio Celenza
- Emergency Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Division of Emergency Medicine, School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ashes Mukherjee
- Emergency Department, Armadale Health Service, Mount Nasura, Western Australia, Australia
| | - Dan Xu
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Suzanne Robinson
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Stephen Honeybul
- Statewide Director of Neurosurgery, Department of Health Government of Western Australia, Perth, Western Australia, Australia
- Head of Department, Sir Charles Gairdner Hospital, Royal Perth Hospital and Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Gill Cowen
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Melissa Licari
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
- Telethon Kids Institute, West Perth, Western Australia, Australia
| | - Michael Bynevelt
- Division of Surgery, School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- The Neurological Intervention & Imaging Service of Western Australia at Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Carmela F Pestell
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Daniel Fatovich
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
- Emergency Medicine, Royal Perth Hospital, The University of Western Australia, Perth, Western Australia, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- Perron Institute of Neurological and Translational Science, Nedlands, Western Australia, Australia
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Gass CS, Patten B. Depressive symptoms, memory complaints, and memory test performance. J Clin Exp Neuropsychol 2020; 42:602-610. [PMID: 32752927 DOI: 10.1080/13803395.2020.1782848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The impact of emotional factors on subjective cognitive complaints and memory test performance has been a topic of extensive research, produced conflicting results. Investigators typically used self-report inventories that lack measures of response bias. Studies have also neglected to use performance validity tests (PVTs) to screen participants for incomplete effort. In the present study, 27% of the original sample of non-litigating outpatient referrals (N = 416) failed to meet self-report and performance validity criteria. Remaining participants (N = 226) were classified into high and low depression groups using their median score (66 T) on Scale D (Depression) of the MMPI-2. "High depression" subjects scored over 65 T on the D scale (MN = 77 T). "Low depression" subjects scored below 66 T (MN = 56 T). Test performances were compared across WAIS-IV Digit Span, Wechsler Memory Scale IV Logical Memory and Visual Reproduction subtests, and the Miami Selective Learning Test. High and low depressive groups exhibited no significant mean score differences on any memory measures. Cognitive Complaints on the Cognitive Difficulties Scale (CDS) were associated with level of depressive symptoms (r(226) =.42, p <.001). Complaints were predictive of delayed (30 min) list recall (r(224) =.19, p =.006, but were not related to eight other memory measures. Results suggest that, in general, depression severity is predictive of cognitive complaints yet has little, if any, relation to memory test performance.
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Affiliation(s)
- Carlton S Gass
- Memory Disorders Clinic, Tallahassee Memorial Healthcare , Tallahassee, FL, USA
| | - Brooke Patten
- Memory Disorders Clinic, Tallahassee Memorial Healthcare , Tallahassee, FL, USA
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Abstract
AbstractThe concept of minimal emotional dysfunctions (MED) refers to traditional psychopathology in order to describe, classify, and understand personality disorders. Emotional dysfunctions encompass disorders of affect predominance, production, expression, experience, modulation, and regulation. MED can explain the dimensional nature of personality disorders, their multidimensionality and problems with categorical classifications. It can stimulate research on the etiology of personality disorders in reference to modern developmental brain research and trauma psychology. It can guide new developments in pharmacotherapy and psychotherapy. It is suggested to focus on MED in future developments of the description and classification of personality disorders.
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Affiliation(s)
- M Linden
- Research Group Psychosomatic Rehabilitation at the Charité, University Medicine Berlin and the Department of Behavioral Medicine at the Rehabilitation Center Seehof, Lichterfelder Allee 55, Teltow 14513, Berlin, Germany.
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Gass CS, Patten B. Depressive symptoms as a factor in neuropsychological test performance: MMPI-2 and selected tests of the Halstead-Reitan/Halstead-Russell Battery. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:133-138. [PMID: 32083959 DOI: 10.1080/23279095.2020.1720687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The potential impact of depressive symptoms on neuropsychological test performance has been studied extensively yielding mixed results. Self-report depression inventories have been most often used, without a means to screen participants for response bias. Studies have also neglected to screen participants for incomplete effort in testing. In the present study, 48% of an initial sample of outpatient referrals (N = 247) failed to meet traditional validity criteria. The remaining participants were screened for cerebral pathology and then classified into high and low depressive symptom groups (ns = 46) using the median score on Scale D (Depression) of the MMPI-2. The "high depression" subjects scored over 70 T on the D scale (MN = 80 T). The "low depression" subjects scored below 65 T (MN = 58 T). Age, education, and estimated intelligence were equivalent across groups. Neuropsychological test performances were compared across eight tests: Revised Category Test, Trail Making Test, Part B, Tactual Performance Test (TPT), TPT Memory and Location, Reitan-Indiana Aphasia Screening Test, Seashore Rhythm Test, and the Speech Perception Test. A MANOVA revealed no main effect for group., F(8,69) = 1.05, n.s., and univariate analyses for each test also showed no intergroup differences. The results provide evidence that these neuropsychological tests are appropriately interpreted within a framework of brain-behavior relationships irrespective of an examinee's emotional status.
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Affiliation(s)
- Carlton S Gass
- Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
| | - Brooke Patten
- Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
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Gozt A, Licari M, Halstrom A, Milbourn H, Lydiard S, Black A, Arendts G, Macdonald S, Song S, MacDonald E, Vlaskovsky P, Burrows S, Bynevelt M, Pestell C, Fatovich D, Fitzgerald M. Towards the Development of an Integrative, Evidence-Based Suite of Indicators for the Prediction of Outcome Following Mild Traumatic Brain Injury: Results from a Pilot Study. Brain Sci 2020; 10:brainsci10010023. [PMID: 31906443 PMCID: PMC7017246 DOI: 10.3390/brainsci10010023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/16/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Persisting post-concussion symptoms (PPCS) is a complex, multifaceted condition in which individuals continue to experience the symptoms of mild traumatic brain injury (mTBI; concussion) beyond the timeframe that it typically takes to recover. Currently, there is no way of knowing which individuals may develop this condition. Method: Patients presenting to a hospital emergency department (ED) within 48 h of sustaining a mTBI underwent neuropsychological assessment and demographic, injury-related information and blood samples were collected. Concentrations of blood-based biomarkers neuron specific enolase, neurofilament protein-light, and glial fibrillary acidic protein were assessed, and a subset of patients also underwent diffusion tensor–magnetic resonance imaging; both relative to healthy controls. Individuals were classified as having PPCS if they reported a score of 25 or higher on the Rivermead Postconcussion Symptoms Questionnaire at ~28 days post-injury. Univariate exact logistic regression was performed to identify measures that may be predictive of PPCS. Neuroimaging data were examined for differences in fractional anisotropy (FA) and mean diffusivity in regions of interest. Results: Of n = 36 individuals, three (8.33%) were classified as having PPCS. Increased performance on the Repeatable Battery for the Assessment of Neuropsychological Status Update Total Score (OR = 0.81, 95% CI: 0.61–0.95, p = 0.004), Immediate Memory (OR = 0.79, 95% CI: 0.56–0.94, p = 0.001), and Attention (OR = 0.86, 95% CI: 0.71–0.97, p = 0.007) indices, as well as faster completion of the Trails Making Test B (OR = 1.06, 95% CI: 1.00–1.12, p = 0.032) at ED presentation were associated with a statistically significant decreased odds of an individual being classified as having PPCS. There was no significant association between blood-based biomarkers and PPCS in this small sample, although glial fibrillary acidic protein (GFAP) was significantly increased in individuals with mTBI relative to healthy controls. Furthermore, relative to healthy age and sex-matched controls (n = 8), individuals with mTBI (n = 14) had higher levels of FA within the left inferior frontal occipital fasciculus (t (18.06) = −3.01, p = 0.008). Conclusion: Performance on neuropsychological measures may be useful for predicting PPCS, but further investigation is required to elucidate the utility of this and other potential predictors.
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Affiliation(s)
- Aleksandra Gozt
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (A.G.); (A.B.); (C.P.)
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
| | - Melissa Licari
- Telethon Kids Institute, West Perth, WA 6005, Australia;
| | - Alison Halstrom
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.H.); (H.M.); (S.L.)
| | - Hannah Milbourn
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.H.); (H.M.); (S.L.)
| | - Stephen Lydiard
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.H.); (H.M.); (S.L.)
| | - Anna Black
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (A.G.); (A.B.); (C.P.)
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
| | - Glenn Arendts
- Emergency Medicine, The University of Western Australia, Crawley, WA 6009, Australia; (G.A.); (S.M.); (D.F.)
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, WA 6000, Australia;
| | - Stephen Macdonald
- Emergency Medicine, The University of Western Australia, Crawley, WA 6009, Australia; (G.A.); (S.M.); (D.F.)
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, WA 6000, Australia;
- Emergency Department, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Swithin Song
- Radiology Department, Royal Perth Hospital, Perth, WA 6000, Australia;
| | - Ellen MacDonald
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, WA 6000, Australia;
- Emergency Department, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Philip Vlaskovsky
- School of Medicine, The University of Western Australia, Crawley, WA 6009, Australia; (P.V.); (S.B.)
| | - Sally Burrows
- School of Medicine, The University of Western Australia, Crawley, WA 6009, Australia; (P.V.); (S.B.)
| | - Michael Bynevelt
- School of Surgery, The University of Western Australia, Crawley, WA 6009, Australia;
- Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gardener Hospital, Nedlands, WA 6009, Australia
| | - Carmela Pestell
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (A.G.); (A.B.); (C.P.)
- School of Psychological Science, The University of Western Australia, Crawley, WA 6009, Australia
| | - Daniel Fatovich
- Emergency Medicine, The University of Western Australia, Crawley, WA 6009, Australia; (G.A.); (S.M.); (D.F.)
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, WA 6000, Australia;
- Emergency Department, Royal Perth Hospital, Perth, WA 6000, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia; (A.G.); (A.B.); (C.P.)
- Perron Institute for Neurological and Translational Science, Nedlands, WA 6009, Australia
- School of Biological Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (A.H.); (H.M.); (S.L.)
- Correspondence: ; Tel.: +61-467-729-300
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Gass CS, Gutierrez L. Psychological variables and Wechsler Adult Intelligence Scale-IV performance. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:357-363. [DOI: 10.1080/23279095.2016.1185427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Carlton S. Gass
- Psychology Services, Bruce Carter VA Healthcare System, Miami, FL, USA
| | - Laura Gutierrez
- Psychology Services, Bruce Carter VA Healthcare System, Miami, FL, USA
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Rohling ML, Meyers JE, Williams GR, Kalat SS, Williams SK, Keene J. Application of the Daubert Standards to the Meyers Neuropsychological Battery Using the Rohling Interpretive Method. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9227-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE There is no report about psychopathological effect causing by disc herniation. The disease could impose psychopathological influence on the social life, the treatment period, and response to the treatment. This study was to evaluate retrospectively the psychopathological influence of lumbar disc herniation (LDH) among Korean 19-year-old males. MATERIALS AND METHODS We compared the Korean military multiphasic personality inventory (KMPI) profiles of 74 LDH cases with the KMPI profiles of 150 controls. The LDH groups were categorized to 2 groups according to the presence of thecal sac compression by disc materials, and evaluated the relation between the KMPI and LDH. RESULTS The decrease of the faking-good response scale and increase of the faking-bad response scale were observed more in the LDH group than in the normal volunteer group (p<0.05). The neurosis set such as anxiety, depression and somatization was markedly increased in the LDH group compared to the normal volunteers group (p<0.05). The scale of personality disorder was also increased more in the LDH group (p=0.002). The differences of KMPI scales were not correlated with the severe pathology of LDH. CONCLUSION Young male with LDH may tend to have more abnormal results of multiphasic personality inventory test compared to the normal volunteers, suggesting that LDH may be related to the psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate and treat the psychopathological aspects in patients with LDH.
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Affiliation(s)
- Tae Woo Kim
- Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea
| | - Chang Hyun Oh
- Department of Neurosurgery, Spine and Joint Research Institute, Guro Teun Teun Hospital, Seoul, Korea
| | - Yu Sik Shim
- Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea
| | - Hyeong-chun Park
- Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea
| | - Chong Oon Park
- Department of Neurosurgery, Inha University College of Medicine, Incheon, Korea
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Oh CH, Shim YS, Yoon SH, Park HC, Park CO, Lee MS. The psychopathological influence of adolescent idiopathic scoliosis in korean male : an analysis of multiphasic personal inventory test results. J Korean Neurosurg Soc 2013; 53:13-8. [PMID: 23440382 PMCID: PMC3579076 DOI: 10.3340/jkns.2013.53.1.13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/15/2012] [Accepted: 01/15/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE There are few published studies which have documented psychopathological abnormalities in patients with of adolescent idiopathic scoliosis (AIS) The aim of this study was to evaluate the psychopathological influence of AIS in Korean 19-year-old males. METHODS The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 105 AIS cases (more than 10 degrees of Cobb's angle without surgical treatment) with the KMPI profiles of 108 normal controls. The AIS group was split depending on Cobb's angle to further evaluate this relation by the severity of AIS. RESULTS A significantly decreased result on the faking-good response scale and an significantly increased result on the faking-bad response were observed in the AIS group compared to the control (p<0.012). The neurosis scale results, including anxiety, depression and somatization symptoms, were significantly increased in the AIS group compared to the control (p<0.010). The severity level of personality disorder and schizophrenia were also significantly increased in the AIS group (p<0.010). Differences in KMPI scale scores were not related to the severity of AIS. CONCLUSION Young males with AIS tend to have abnormal results on the multiphasic personal inventory test compared to normal volunteers, suggesting that AIS may be related to psychopathology in the young male group in Korea. Although these psychopathology in AIS were differently observed compared to normal controls, but not interfered with military life. Clinicians are recommended to pay attention the psychopathological traits of patients with AIS.
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Affiliation(s)
- Chang Hyun Oh
- Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea
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Oh CH, Lim HK, Chung J, Yoon SH, Park HC, Park CO. The psychopathological influence of congenital heart disease in Korean male adolescents: an analysis of multiphasic personal inventory test results. Yonsei Med J 2012; 53:1107-12. [PMID: 23074109 PMCID: PMC3481384 DOI: 10.3349/ymj.2012.53.6.1107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the psychopathological influence of congenital heart disease (CHD) in Korean 19-year-old males. MATERIALS AND METHODS The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 211 CHD cases (atrial septal defect, ventricular septal defect, patent ductus arteriosus, or combined CHD) with the KMPI profiles of 300 normal controls. The CHD group was also divided according to whether or not the subjects had undergone open cardiac surgery in order to evaluate the psychopathological effects of an operation among the subjects. RESULTS A decreased result on the faking-good response scale and an increased result on the faking-bad response were observed in the CHD group compared to the control (p<0.01). The neurosis scale results, including anxiety, depression and somatization symptoms, were markedly increased in the CHD group compared to the control (p<0.01). The severity level of personality disorder was also increased in the CHD group (p<0.001). Differences in KMPI scale scores were not related to open cardiac surgery history. CONCLUSION In this study, young males with CHD tended to report more abnormal results on the multiphasic personal inventory test in comparison to normal subjects, suggesting that CHD may be related to psychopathology in young males in Korea. Therefore, clinicians are recommended to evaluate the psychopathological traits of patients with CHD.
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Affiliation(s)
- Chang Hyun Oh
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
- Seoul Regional Military Manpower Administration, Seoul, Korea
| | - Hyun Kyoung Lim
- Department of Anesthesiology & Pain Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Joonho Chung
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Hyeong-Chun Park
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
| | - Chong Oon Park
- Department of Neurosurgery, College of Medicine, Inha University, Incheon, Korea
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Lim HK, Yoon SH, Oh CH, Choo SH, Kim TH. The impact of primary spontaneous pneumothorax on multiphasic personal inventory test results in young South Korean males. Yonsei Med J 2012; 53:901-5. [PMID: 22869471 PMCID: PMC3423837 DOI: 10.3349/ymj.2012.53.5.901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Few reports have documented psychopathological abnormalities in patients with primary spontaneous pneumothorax (PSP). We analyzed the results of a multiphasic personal inventory test to investigate the psychopathologic impact of PSP in young Korean males. MATERIALS AND METHODS The authors reviewed the results of a Korean military multiphasic personal inventory (KMPI) administered to military conscripts in South Korea. A total of 234 young males participated in this study. The normal volunteer group (n=175) comprised individuals who did not have any lung disease. The PSP group (n=59) included individuals with PSP. None of the examinees had any psychological problems. The KMPI results of both groups were compared. RESULTS There were more abnormal responses in the PSP group (17.0%) than the normal volunteer group (9.1%, p=0.002). The anxiety scale and depression scale scores of the neurosis category were greater for the PSP group than the normal group (p=0.039 and 0.014, respectively). The personality disorder and paranoia scale scores of the psychopathy category were greater for the PSP group than the normal group (p=0.007 and 0.018, respectively). CONCLUSION Young males with PSP may have greater tendencies to suffer from anxiety, depression, personality disorders, and paranoia compared to normal individuals. Clinicians should be advised to evaluate the psychopathological aspects of patients with PSP.
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Affiliation(s)
- Hyun Kyoung Lim
- Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, Incheon, Korea
| | - Seung Hwan Yoon
- Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea
| | - Chang Hyun Oh
- Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea
- Seoul Regional Military Manpower Administration, Seoul, Korea
| | - Seol Ho Choo
- Seoul Regional Military Manpower Administration, Seoul, Korea
| | - Tae Hyun Kim
- Seoul Regional Military Manpower Administration, Seoul, Korea
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Goebel S, Kaup L, Wiesner CD, Mehdorn HM. Affective state and cognitive functioning in patients with intracranial tumors: validity of the neuropsychological baseline assessment. Psychooncology 2012; 22:1319-27. [PMID: 22848042 DOI: 10.1002/pon.3142] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 06/25/2012] [Accepted: 07/02/2012] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The aim of this paper is to investigate the relationship between the affective and cognitive states of neurooncological patients prior to the neurosurgical treatment to assess associations between distress levels and neuropsychological test performance in this sample and setting. METHODS The prospective study population consists of 172 patients. Patients were studied preoperatively with a comprehensive test battery consisting of a variety of affective and cognitive measures. Psychological instruments included the Hospital Anxiety and Depression Scale, the Amsterdam Preoperative Anxiety and Information Scale, and the Acute Stress Disorder Scale. RESULTS Factor analysis revealed two factors representing subjective affective functioning: whereas one reflects the patients' more general emotional state (Hospital Anxiety and Depression Scale, Acute Stress Disorder Scale), the second reflects anxiety specifically related to the neurosurgical procedure (Amsterdam Preoperative Anxiety and Information Scale). After age and education have been accounted for via linear regression analyses, affect did not contribute to cognitive performance in any of the cognitive domains in the whole patient sample. However, in patients with extreme levels of psychiatric morbidity, there was evidence for distinct cognitive morbidity consistent with previous research. CONCLUSIONS Our results suggest that, for a large variety of widely used neuropsychological measures and for most neurooncological patients, the preoperative neuropsychological baseline assessment can be considered valid and dependable. In patients with extreme levels of distress, however, distinct cognitive domains might be differentially affected.
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Affiliation(s)
- Simone Goebel
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany.
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van Wijk CH. Self-Reported Generalised Anxiety and Psychomotor Test Performance in Healthy South Africans. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2012. [DOI: 10.1177/008124631204200102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Tests like the Grooved Pegboard may have specific value in South Africa in the context of screening for HIV-associated neurocognitive disorders. However, there are inconsistent findings on the relationship between self-reported anxiety and neuropsychological performance in healthy adults, and in particular on tests of psychomotor functions such as the Form Board and Grooved Pegboard. Given the potential value, it is important to clarify the relationship between self-reported anxiety and performance on psychomotor tests among South African samples. Two studies are presented here. One sample of 170 young adults (19–30 years) completed the Form Board and Grooved Pegboard, after completing an anxiety scale. A second sample of 1,056 healthy adults (19–49 years) completed the Grooved Pegboard only after completing an anxiety scale. Age, gender, and education have previously been found to confound performance on these tests, and they were thus entered into a Multiple Regression Analysis, together with anxiety. In the first study, anxiety did not contribute significantly to performance variance. In the second study, both gender and anxiety did contribute significantly, and separate gender group regressions were thus done. Anxiety did not have a negative influence on performance in the female group, but it did contribute significantly to reducing performance in the male group. In review of these findings, this study cautions that anxiety may confound psychomotor test performance, and that clinicians need to be aware of its potential influence.
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Sjøgren P, Christrup LL, Petersen MA, Højsted J. Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre. Eur J Pain 2012; 9:453-62. [PMID: 15979026 DOI: 10.1016/j.ejpain.2004.10.005] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Accepted: 10/06/2004] [Indexed: 11/30/2022]
Abstract
The aim of the study was to investigate the influence of pain, sedation, pain medications and socio-demographics on cognitive functioning in chronic non-malignant pain patients. Chronic non-malignant pain patients (N=91) treated in a multidisciplinary pain centre were compared with age and sex matched healthy volunteers (N=64). Furthermore four subgroups of patients were examined: Group 1 (N=21) received no pain medications, group 2 (N=19) were in long-term oral opioid treatment, group 3 (N=18) were treated with antidepressants and/or anticonvulsants and group 4 (N=33) were treated with a combination of long-term oral opioids and antidepressants and/or anticonvulsants. Assessments comprised pain (PVAS) and sedation (SVAS), Continuous Reaction Time (CRT) testing for sustained attention, Finger Tapping Test (FTT) testing for psychomotor speed, Paced Auditory Serial Addition Task (PASAT) testing for information processing and working memory and Mini Mental State Examination (MMSE). CRT and FTT were impaired in the total patient sample. Treatment with opioids was associated with poorer performance of PASAT. High scores of PVAS and SVAS were associated with poor performance of PASAT and CRT, respectively. MMSE seems to be too insensitive for detecting the milder forms of cognitive impairment found in chronic non-malignant patients.
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Affiliation(s)
- Per Sjøgren
- H: S Multidisciplinary Pain Centre, Dept. 7612, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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15
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Walvoort SJW, Wester AJ, Egger JIM. Neurocognitive parameters should be incorporated in the Minnesota Multiphasic Personality Inventory-2 assessment of patients with alcohol use disorders. Drug Alcohol Rev 2011; 31:550-7. [PMID: 22176199 DOI: 10.1111/j.1465-3362.2011.00407.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Treatment planning for alcohol use disorder (AUD) patients is often preceded by the assessment of psychopathology and personality with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). However, during periods of abstinence, cognitive impairments (e.g. attention, memory and executive dysfunctions) related to neurological and somatic pathology may affect level and pattern of MMPI-2 scale scores, resulting in clinical misinterpretation. DESIGN AND METHODS A re-analysis of the data of the Egger et al. study is conducted in order to examine the clinical significance of the MMPI-2 profiles of 222 AUD patients (mean age 42.2 ± 9.6 years; 76.6% men) by using neurologically relevant item correction procedures. Hierarchical cluster analyses of neurologically relevant item-corrected solutions were compared to the original MMPI-2 profile. RESULTS Impulsiveness and psychopathic deviation were identified as a common denominator. DISCUSSION AND CONCLUSIONS Uncorrected MMPI-2 assessment in AUD tends to overstress psychopathology and to overlook disinhibitory traits in early abstinence, caused by chronic alcoholism.
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Paik HK, Oh CH, Choi K, Kim CE, Yoon SH, Chung J. Influence of history of brain disease or brain trauma on psychopathological abnormality in young male in Korea : analysis of multiphasic personal inventory test. J Korean Neurosurg Soc 2011; 50:114-8. [PMID: 22053230 DOI: 10.3340/jkns.2011.50.2.114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 05/02/2011] [Accepted: 08/16/2011] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of this study is to confirm whether brain disease or brain trauma actually affect psychopathology in young male group in Korea. METHODS The authors manually reviewed the result of Korean military multiphasic personal inventory (KMPI) in the examination of conscription in Korea from January 2008 to May 2010. There were total 237 young males in this review. Normal volunteers group (n=150) was composed of those who do not have history of brain disease or brain trauma. Brain disease group (n=33) was consisted of those with history of brain disease. Brain trauma group (n=54) was consisted of those with history of brain trauma. The results of KMPI in each group were compared. RESULTS Abnormal results of KMPI were found in both brain disease and trauma groups. In the brain disease group, higher tendencies of faking bad response, anxiety, depression, somatization, personality disorder, schizophrenic and paranoid psychopathy was observed and compared to the normal volunteers group. In the brain trauma group, higher tendencies of faking-good, depression, somatization and personality disorder was observed and compared to the normal volunteers group. CONCLUSION Young male with history of brain disease or brain trauma may have higher tendencies to have abnormal results of multiphasic personal inventory test compared to young male without history of brain disease or brain trauma, suggesting that damaged brain may cause psychopathology in young male group in Korea.
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Affiliation(s)
- Ho Kyu Paik
- Department of Neurosurgery, Inha University School of Medicine, Incheon, Korea
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17
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McQueeny T, Padula CB, Price J, Medina KL, Logan P, Tapert SF. Gender effects on amygdala morphometry in adolescent marijuana users. Behav Brain Res 2011; 224:128-34. [PMID: 21664935 DOI: 10.1016/j.bbr.2011.05.031] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/24/2011] [Accepted: 05/26/2011] [Indexed: 11/24/2022]
Abstract
Adolescent developments in limbic structures and the endogenous cannabinoid system suggest that teenagers may be more vulnerable to the negative consequences of marijuana use. This study examined the relationships between amygdala volume and internalizing symptoms in teenaged chronic marijuana users. Participants were 35 marijuana users and 47 controls ages 16-19 years. Exclusions included psychiatric (e.g., mood and anxiety) or neurologic disorders. Substance use, internalizing (anxiety/depression) symptoms and brain scans were collected after 28 days of monitored abstinence. Reliable raters manually traced amygdala and intracranial volumes on high-resolution magnetic resonance images. Female marijuana users had larger right amygdala volumes and more internalizing symptoms than female controls, after covarying head size, alcohol, nicotine and other substance use (p<0.05), while male users had similar volumes as male controls. For female controls and males, worse mood/anxiety was linked to smaller right amygdala volume (p<0.05), whereas more internalizing problems was associated with bigger right amygdala in female marijuana users. Gender interactions may reflect marijuana-related interruptions to sex-specific neuromaturational processes and staging. Subtle amygdala development abnormalities may underlie particular vulnerabilities to sub-diagnostic depression and anxiety in teenage female marijuana users.
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Affiliation(s)
- Tim McQueeny
- Department of Psychology, University of Cincinnati, Cincinnati, OH 45221, USA
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18
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Gass CS, Curiel RE. Test anxiety in relation to measures of cognitive and intellectual functioning. Arch Clin Neuropsychol 2011; 26:396-404. [PMID: 21636602 DOI: 10.1093/arclin/acr034] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The potential impact of test anxiety on cognitive testing was examined in a sample of 300 predominantly male veteran referrals who were administered a comprehensive neuropsychological test battery. Exclusionary criteria included failure on effort testing (n= 14). Level of test anxiety was significantly related to performance on the WAIS-III Working Memory Index (r = -.343, p < .001) but not to scores on the Processing Speed, Perceptual Organization, or Verbal Comprehension indexes. Test anxiety was not related to a global index of neuropsychological performance on the HRNES-R (Average Impairment Scale). Level of education had a collinear relationship with test anxiety in predicting cognitive test performance. Regression analyses revealed a more prominent role for education, indicating the possibility that test anxiety may be a reaction to, more than a cause of, deficient working memory performance. These results suggest that clinicians who use these particular tests should be reluctant to attribute poor test performance to anxiety that occurs during the testing process.
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Affiliation(s)
- Carlton S Gass
- Psychology Service (116B), Veterans Affairs Medical Center, Miami, FL 33125-1693, USA.
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19
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Taylor J, Baker GA. Newly diagnosed epilepsy: cognitive outcome at 5 years. Epilepsy Behav 2010; 18:397-403. [PMID: 20558112 DOI: 10.1016/j.yebeh.2010.05.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 05/10/2010] [Accepted: 05/13/2010] [Indexed: 10/19/2022]
Abstract
Many people with epilepsy experience cognitive problems as a consequence of their epilepsy and its treatment. However, relatively few longitudinal studies have been conducted to investigate how these problems progress during the course of the disorder, particularly in those who are newly diagnosed. Fifty patients with newly diagnosed epilepsy were assessed using a comprehensive neuropsychological test battery before they started antiepileptic treatment and after a mean of 5 years. At the 5-year follow-up, the majority of cognitive measures remained stable, although significant (but subtle) declines were noted for memory and psychomotor speed domains in 38% of people with epilepsy.
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Affiliation(s)
- Joanne Taylor
- Neuroscience Research Unit, University of Liverpool, Liverpool, UK.
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20
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Bush SS. Determining Whether Or When To Adopt New Versions Of Psychological And Neuropsychological Tests: Ethical And Professional Considerations. Clin Neuropsychol 2010; 24:7-16. [DOI: 10.1080/13854040903313589] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Ruocco AC, Swirsky-Sacchetti T, Choca JP. Assessing personality and psychopathology after traumatic brain injury with the Millon Clinical Multiaxial Inventory–III. Brain Inj 2009; 21:1233-44. [DOI: 10.1080/02699050701716919] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Rutherford A, Stephens R, Fernie G, Potter D. Do UK university football club players suffer neuropsychological impairment as a consequence of their football (soccer) play? J Clin Exp Neuropsychol 2008; 31:664-81. [PMID: 19048428 DOI: 10.1080/13803390802484755] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Male players from football and rugby clubs and sportsmen from a variety of noncontact sports clubs at a UK university were compared on biographical and neuropsychological test measures. A data analysis paradigm was developed and employed to control the inflation of Type 1 error rate due to multiple hypotheses testing. Rugby players sustained most head injuries in their chosen sport, but neuropsychological tests of attention, memory, and executive function provided no evidence of performance impairment attributable to the number of head injuries sustained or the football, rugby, or noncontact sport groups. Footballers' heading frequency was related to the number of football head injuries sustained, but no relationship was detected between footballers' heading frequency and their neuropsychological test performance. Following discussion of pertinent methodological limitations it is concluded that there was no evidence in this dataset of neuropsychological impairment consistent with either mild head injury incidence or football heading frequency. However, a need for further research examining the long-term neuropsychological consequences of such head injuries was identified.
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Affiliation(s)
- Andrew Rutherford
- School of Psychology, Keele University, Keele, Staffordshire, ST5 5BG, UK.
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23
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Preece MHW, Geffen GM. The contribution of pre-existing depression to the acute cognitive sequelae of mild traumatic brain injury. Brain Inj 2008; 21:951-61. [PMID: 17729048 DOI: 10.1080/02699050701481647] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PRIMARY OBJECTIVE To determine the effect of pre-existing depression on the cognitive sequelae of mild traumatic brain injury (mTBI) within 24 hours of injury. RESEARCH DESIGN A 2 x 2 between-subjects design was used to examine the effect of depression and injury type on neuropsychological test performance. The independent variables were the injury type (mTBI or control) and the presence of depression (depressed or not depressed). METHODS AND PROCEDURES Participants who had sustained mTBI (30 with depression, 30 without depression) within the previous 24 hours and control participants (19 with depression, 30 without depression) were assessed on the Digit Symbol Substitution Test (DSS), Hopkins Verbal Learning Test (HVLT) and the Speed of Comprehension Test. RESULTS Participants with mTBI performed worse than controls on the tests, particularly HVLT delayed recall and DSS total correct. Participants with depression did not perform worse than participants without depression. However, there was a significant univariate interaction for HVLT recognition, participants who had sustained mTBI and were classified in the depressed group exhibited worse recognition compared to mTBI participants without depression. CONCLUSIONS The results indicate that depression may interact with mTBI to impair word recognition during the acute phase after a head injury.
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Affiliation(s)
- Megan Haf Wyn Preece
- Cognitive Psychophysiology Laboratory, School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
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24
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Rutherford A, Stephens R, Potter D, Fernie G. Neuropsychological Impairment as a Consequence of Football (Soccer) Play and Football Heading: Preliminary Analyses and Report on University Footballers. J Clin Exp Neuropsychol 2007; 27:299-319. [PMID: 15969354 DOI: 10.1080/13803390490515504] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Previous research has claimed neuropsychological impairment occurs as a result of professional and amateur football play, and, specifically, football heading. However, much of this research exhibits substantial methodological problems. By investigating less committed amateur level footballers, the current study sought to gain some insight into the developmental history of any neuropsychological consequences of football play. University football, rugby and noncontact sports players were compared on a range of biographical and neuropsychological test variables. While playing their chosen sports, rugby players sustained many more head injuries than footballers and noncontact sportsmen, but footballers did not sustain significantly more head injuries than noncontact sportsmen. The number of head injuries sustained predicted Trails B and TAP Divided Attention latencies in a positive fashion. After controlling for the number of head injuries sustained, sport group effects were detected with TAP Divided Attention accuracy scores, with footballers exhibiting poorest performance. After controlling for the number of head injuries sustained, the total amount of heading done by footballers predicted the number of Wisconsin Card Sorting category shifts in a negative fashion. Nevertheless, over interpretation of all of these results should be resisted because of the exploratory nature of the analyses and the possibility that the sport groups may differ in ways other than just the nature of their sports activities.
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Affiliation(s)
- A Rutherford
- Department of Psychology, Keele University, Keele, Staffordshire ST55BG, UK.
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25
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Trahan E, Pépin M, Hopps S. Impaired Awareness of Deficits and Treatment Adherence Among People With Traumatic Brain Injury or Spinal Cord Injury. J Head Trauma Rehabil 2006; 21:226-35. [PMID: 16717500 DOI: 10.1097/00001199-200605000-00003] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relation between impaired awareness of deficits (IAD) and treatment adherence and to verify previous findings regarding the types of disabilities that people with traumatic brain injury (TBI) tend to underestimate. DESIGN Cross-sectional study. PARTICIPANTS Twenty-four persons with moderate to severe TBI and 16 persons with traumatic spinal cord injury (SCI) admitted to an inpatient neurorehabilitation program. MAIN OUTCOME MEASURES IAD assessed using the short version of the Problem Checklist of the Head Injury Family Interview and treatment adherence using the Medical Regimen Adherence Scale. RESULTS Presence of IAD is linked with poor adherence. Patients with TBI significantly underestimate their emotional/behavioural and cognitive disabilities, but accurately assess their physical disabilities, whereas patients with SCI accurately assess all spheres. Patients with TBI are significantly less aware of their disabilities compared with the patients with SCI as expected. CONCLUSIONS These results confirm IAD's link to treatment adherence, and support the observation that IAD is a common clinical feature of brain injury that should be carefully considered when making prognoses and developing and applying interventions with this population.
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26
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Green HJ, Pakenham KI, Gardiner RA. Cognitive deficits associated with cancer: A model of subjective and objective outcomes. PSYCHOL HEALTH MED 2005. [DOI: 10.1080/13548500500093308] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lucas M, Turnbull OH, Berk M, Fritz V. Predictive Testing for Huntington's Disease: How Does it Impact on Cognitive Performance? SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2002. [DOI: 10.1177/008124630203200306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The discovery of a polymorphic DNA marker for Huntington's Disease (HD) in 1983, and the specific gene responsible in 1993, led to predictive testing programmes out of which came research into whether or not cognitive impairment was present presymptomatically in those at risk for HD. The results of these studies have been conflicting and inconclusive. Methodoiogical limitations have probably contributed to the differing findings. The present study attempted to expand upon previous studies by analysing the data in a more comprehensive manner, and with additional control conditions. In this study, 26 individuals, at risk but presymptomatic, for HD were recruited from the Johannesburg Predictive Testing Programme and administered a battery of psychological tests prior to molecular analysis. Of this HD group, 11 were subsequently positive for the gene (the HD+ group) and 15 were negative (HD- group). A carefully chosen control group, (matched for age, sex, and education - Control Group 1) and a group of individuals experiencing a life threatening medical illness (without CNS involvement - Control Group 2) were administered the same battery of psychological tests. Four-way Analysis of Variance between the HD+, HD-, and Control groups was conducted to detect specific differences between the groups. The results indicated that the HD+ group showed mild impairment for declarative memory function. However, it would appear that undergoing the psychological evaluation itself impacted upon the test performance of both the HD+ and HD- groups.
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Affiliation(s)
- M.D. Lucas
- Associate Professor & Head of Psychology Department, Monash South Africa, P. Bag X60, Ruimsig, Roodepoort 1725, South Africa
| | | | - M. Berk
- Department of Psychiatry, University of the Witwatersrand, Johannesburg, South Africa (Now Professor of Psychiatry, University of Melbourne, Geelong Hospital and Geelong Clinic)
| | - V.U. Fritz
- Department of Neurology, University of the Witwatersrand, Johannesburg, South Africa
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28
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Benke T, Karner E. The neuropsychological assessment of dementia. CNS Spectr 2002; 7:371-5. [PMID: 15122108 DOI: 10.1017/s109285290001782x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It has become standard practice to base the diagnosis of dementia on the combination of neuropsychological and non-behavioral findings. The present article provides a short, clinically oriented synopsis of the targets, investigational procedures, and difficulties of the modern neuropsychological approach to the diagnosis of dementia. Over the years, neuropsychology has developed assessment tools to evaluate the cognitive and behavioral abnormalities of many dementias. Validated tests of memory, language, executive, and other cognitive functions are used to screen for dementia and identifying certain dementia profiles. Behavioral assessment procedures are available for non-cognitive neurodegenerative alterations. At present, problems arise mainly with the behavioral heterogeneity of certain dementia syndromes. Especially problematic are discrimination of age-associated or mild cognitive impairments from incipient dementia and the impact of psychiatric symptoms on cognitive functions. It is concluded that neuropsychology offers a valuable contribution to the diagnosis and differential diagnosis of dementia.
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Affiliation(s)
- Thomas Benke
- University Clinic of Neurology, Innsbruck, Austria.
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29
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Rosselli M, Ardila A, Lubomski M, Murray S, King K. Personality profile and neuropsychological test performance in chronic cocaine-abusers. Int J Neurosci 2001; 110:55-72. [PMID: 11697211 DOI: 10.3109/00207450108994221] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Little is known about the association between personality disorders and neuropsychological test performance in chronic cocaine users. The aims of the present study were to (1) pinpoint the specific neuropsychological characteristics of chronic cocaine abusers, (2) analyze their personality profile, and (3) explore the association between personality traits and neuropsychological test performance. A sample of 42 drug-abusers (mean age = 34.15; SD = 6.73; mean educational level = 11.44; SD = 2.01) was selected from a state rehabilitation facility and was compared to a control group (mean age = 34.53; SD = 9.01; mean educational level = 12.29; SD = 1.31). The following information was collected for each subject: (1) A clinical history adapted from Horton (1996). (2) The Personality Assessment Inventory (PAI) (Morey, 1991). (3) A neuropsychological test battery including: Arithmetic and Digits subtests from the WAIS-R, California Verbal Learning Test, Trial Making Test, Verbal Fluency tests, Rey-Osterrieth Complex Figure, Wisconsin Card Sorting Test, Benton Visual Retention Test, Stroop Neurological Screening Test and Hooper Visual Organization. Thirty-seven of the drug-dependent subjects obtained an abnormal score in at least one PAI scale. The personality profile of the drug-dependent subjects found via the PAI pointed to a Borderline/Antisocial personality, frequently associated with mania features. In six of the drug-abusers, a normal personality profile was observed. Neuropsychological test performance scores were within the low average or borderline range. The most abnormal scores were observed in attention, memory, and executive functioning tests. The results did not show any robust association between personality profile and neuropsychological test performance.
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Affiliation(s)
- M Rosselli
- Florida Atlantic University, College of Liberal Arts, Division of Psychology, 2912 College Avenue, Davie, Florida 33314, USA.
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30
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Meyers JE, Diep A. Assessment of malingering in chronic pain patients using neuropsychological tests. APPLIED NEUROPSYCHOLOGY 2001; 7:133-9. [PMID: 11125706 DOI: 10.1207/s15324826an0703_3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Validity checks into neuropsychological tests have been successful at detecting malingering in litigant patients with mild brain injury in recent years. This study expanded on these findings and examined whether 6 neuropsychological tests could be used to detect malingering in litigant (n = 55) and nonlitigant (n = 53) patients claiming cognitive deficits due to chronic pain. Encouraging findings were found. When patients were matched on age, gender, racial or ethnic background, years of education, and time postinjury, almost one third (29%) of patients in the litigant group failed 2 or more validity checks in these 6 neuropsychological tests versus none (0%) of the patients in the nonlitigant group. This result challenges the validity of some litigant patients who complain of cognitive deficits due to chronic pain. Furthermore, the findings suggest that neuropsychological assessments can be used as part of the assessment of chronic pain complainants. Further investigation of the validity markers in these 6 neuropsychological tests is recommended.
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Affiliation(s)
- J E Meyers
- Mercy Rehabilitation Clinic, Suite 340, 500 Jackson Street, Sioux City, IA 51101, USA
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31
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Margulies S. The postconcussion syndrome after mild head trauma: is brain damage overdiagnosed? Part 1. J Clin Neurosci 2000; 7:400-8. [PMID: 10942660 DOI: 10.1054/jocn.1999.0681] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
UNLABELLED Many investigators attribute the postconcussion syndrome following mild closed head injury to permanent brain damage. The evidence supporting this conclusion is reviewed, including the force necessary to cause permanent brain damage; the basis for determining whether the patient was exposed to sufficient force in the accident to permanently damage the brain; the basis for determining whether the patient actually has permanent brain damage (not just brain dysfunction) traceable to the accident; and whether the location and severity of brain damage is sufficient to account for the postconcussion syndrome. CONCLUSION the evidence for permanent traumatic brain damage as the cause of the postconcussion syndrome following mild closed head injury is weak.
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Meyers JE, Galinsky AM, Volbrecht M. Malingering and mild brain injury: how low is too low. APPLIED NEUROPSYCHOLOGY 2000; 6:208-16. [PMID: 10635435 DOI: 10.1207/s15324826an0604_3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The purpose of this study was to investigate potential validity markers for 4 commonly used neuropsychological tests. Participants were divided into 5 groups: moderate/severe brain injury (n = 27), mild brain injury--nonlitigating (n = 35), normal controls (n = 30), mild brain injury--litigating (n = 49), and malingering "actors" (n = 20). Participants completed a flexible neuropsychological battery that included the 4 tests of interest (Judgment of Line Orientation, Token Test, Dichotic Listening, and 20-item forced choice). Results demonstrated cutoff levels on all 4 tests below which people with mild brain injury would not be expected to fall. The fact that some litigants, but no nonlitigants, fell below these cutoff levels suggests these tests and their cutoff levels may be used appropriately as internal validity markers. There was 100% specificity and 95% sensitivity found when all 4 tests were used together (1-test criteria) to separate litigants, nonlitigants, and actors. It is suggested that further examination of these tests and other neuropsychological tests, be completed so that, eventually, all neuropsychological tests will have internal validity markers.
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Affiliation(s)
- J E Meyers
- Mercy Rehabilitation Center, Sioux City, IA 51101, USA
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Neuropsychological Deficits in Patients with Alcohol and Other Psychoactive Substance Abuse and Dependence. ALCOHOLISM TREATMENT QUARTERLY 1999. [DOI: 10.1300/j020v16n04_09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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