1
|
Pichlmeier S, Streb J, Rösel FA, Dobler H, Dudeck M, Fritz M. Subjective and objective assessments of executive functions are independently predictive of aggressive tendencies in patients with substance use disorder. Compr Psychiatry 2024; 132:152475. [PMID: 38531178 DOI: 10.1016/j.comppsych.2024.152475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/14/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND AND AIMS Impairments in executive functions have been found to influence violent behavior. Executive functions are crucial in the treatment of patients with substance use disorders because substance use generally impairs cognitive processes and is therefore detrimental for executive functions thereby reducing control of behavior and thus of consumption impulses. We studied correlations between subjective, i.e. self-report, and objective, i.e. behavior-based, assessment of executive functions and the predictive validity of these measures for aggression in patients with substance use disorder. METHODS The study included 64 patients with a diagnosed substance use disorder who were convicted according to the German Criminal Code for crimes they committed in the context of their disorder and were therefore in treatment in forensic psychiatric departments in Germany. Multiple self-report and behavior-based instruments were used to assess executive functions, appetitive and facilitative aggression as well as clinical and sociodemographic variables. RESULTS Participants showed impaired executive functions, and measures of executive functions predicted aggressive tendencies and violent offenses. Despite ecological validity of the findings, the subjective and objective assessments of executive functions did not correlate with each other, which corroborates studies in other clinical settings. CONCLUSIONS We discuss that this finding may be due to the conceptual differences between subjective and objective measures. Therefore, self-report and behavior-based measures should not be used as proxies of each other but as complementary measures that are useful for comprehensive diagnostics of cognitive impairments and assessment of risks for violent behavior.
Collapse
Affiliation(s)
- Sebastian Pichlmeier
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.
| | - Judith Streb
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Franziska Anna Rösel
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Hannah Dobler
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Michael Fritz
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany; School of Health and Social Sciences, AKAD University of Applied Sciences, Stuttgart, Germany
| |
Collapse
|
2
|
Mürner-Lavanchy IM, Parzer P, Brüstle J, Koenig J, Kaess M, Resch F. Normierung der Testbatterie COGBAT bei Jugendlichen im Alter von 12 bis 15 Jahren. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2022. [DOI: 10.1024/1016-264x/a000356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Zusammenfassung: Das Jugendalter stellt eine wichtige Phase in der Entwicklung der Verarbeitungsgeschwindigkeit, der Aufmerksamkeit, des Gedächtnisses und der exekutiven Funktionen dar. Im Rahmen einer Normierungsstudie der kognitiven Basistestung (COGBAT) für das Jugendalter wurden Testwerte bei n = 269 Jugendlichen im Alter von 12 bis 15 Jahren erhoben und mit den Normen der Altersgruppe der 16- bis 30-Jährigen verglichen. Zusätzlich wurde überprüft, inwiefern sich diese Testergebnisse in der subjektiven Einschätzung zur Leistungsfähigkeit (FLei) und Psychopathologie (SDQ) abbilden lassen. Im Jugendalter zeigte sich ein starker Zuwachs in der kognitiven Flexibilität, der Verarbeitungs- und Reaktionsgeschwindigkeit sowie der Inhibitions- und Planungsfähigkeit. Ein bedeutsamer Geschlechtsunterschied fand sich in der Inhibition, mit stärkeren Leistungen bei Mädchen als bei Jungen. Zwischen den Testergebnissen und den subjektiven Einschätzungen zeigten sich keine Zusammenhänge.
Collapse
Affiliation(s)
- Ines M. Mürner-Lavanchy
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Peter Parzer
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Deutschland
| | - Julia Brüstle
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Deutschland
| | - Julian Koenig
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Deutschland
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universität zu Köln, Deutschland
| | - Michael Kaess
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Deutschland
| | - Franz Resch
- Klinik für Kinder- und Jugendpsychiatrie, Universitätsklinikum Heidelberg, Deutschland
| |
Collapse
|
3
|
Gorny I, Wenn W, Biermann L, Habermehl L, Mross PM, Krause K, Möller L, Fuest S, Menzler K, Knake S. Perception of memory performance after first seizure in patients with and without an epilepsy diagnosis. Epilepsy Behav 2021; 122:108195. [PMID: 34256337 DOI: 10.1016/j.yebeh.2021.108195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/19/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Memory complaints in patients with epilepsy have been well-studied. Although memory complaints are commonly reported by patients with chronic epilepsy, to date, few studies exist on memory complaints at the onset of epilepsy. The present study investigated the presence of memory complaints and their relation to mood and memory performance in patients after their first seizure. Thereby, we examined differences between individuals who received a diagnosis of epilepsy immediately with the occurrence of their first seizure and those who were diagnosed as having the first epileptic seizure, without fulfilling the ILAE criteria for the diagnosis of epilepsy. METHODS Sixty-one patients participated in the study and completed, among others, a memory task and questionnaires on memory complaints and depression after their first epileptic seizure. We investigated the level of memory complaints and their correlation and accuracy in classification with a memory measure. We compared patients who received an epilepsy diagnosis after the first seizure with those who did not. RESULTS Memory complaints did not correlate with objective memory performance. Classification into impaired/unimpaired showed low concordance between memory complaints and neuropsychological memory measures. After their first epileptic seizure, patients reported few memory complaints overall (10%), and there were no differences in memory complaints between patients with and without an epilepsy diagnosis. CONCLUSION At epilepsy onset, in contrast to established epilepsies, memory complaints are rare. Although influences of anticonvulsant drugs and seizures are not present at the beginning of epilepsy, this substantial absence of memory complaints at epilepsy onset emphasizes the need for comprehensive neurological and psychological treatment early with the given diagnosis. Treatment should focus on anticonvulsant drug regimens, patients' concerns and convey realistic expectations.
Collapse
Affiliation(s)
- Iris Gorny
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg.
| | - Wiebke Wenn
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Louise Biermann
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Lena Habermehl
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Peter Michael Mross
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Kristina Krause
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Leona Möller
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Sven Fuest
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Katja Menzler
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| | - Susanne Knake
- Epilepsy Center Hessen, Department of Neurology, Philipps-University, Marburg
| |
Collapse
|
4
|
Müller K, Fröhlich S, Germano AMC, Kondragunta J, Agoitia Hurtado MFDC, Rudisch J, Schmidt D, Hirtz G, Stollmann P, Voelcker-Rehage C. Sensor-based systems for early detection of dementia (SENDA): a study protocol for a prospective cohort sequential study. BMC Neurol 2020; 20:84. [PMID: 32145744 PMCID: PMC7060588 DOI: 10.1186/s12883-020-01666-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/28/2020] [Indexed: 02/06/2023] Open
Abstract
Background Dementia and cognitive decline are serious social and economic burdens. An increase in the population of older people, as well as longer lifespans mean that numbers of dementia cases are exponentially rising. Neuropathological changes associated with dementia are thought to appear before the clinical manifestation of cognitive symptoms, i.e., memory impairments. Further, some older adults (OA) experience cognitive decline before it can be objectively diagnosed. For optimal care of these patients, it is necessary to detect cognitive decline and dementia at an early stage. In this vein, motor, sensory, and neurophysiological declines could be promising factors if found to be present before the onset of cognitive impairment. Hence, the objective of the SENDA study is to develop a multi-dimensional sensor-based instrument that allows early detection of cognitive decline or dementia in OA with the help of cognitive, sensory, motor, and neurophysiological parameters before its clinical manifestation. Methods/design In the cohort sequential study, participants are assigned to one of three study groups depending on their cognitive status: 1. cognitively healthy individuals (CHI), 2. subjectively cognitively impaired persons (SCI), or 3. (possible) mildly cognitively impaired persons (pMCI, MCI). All groups take part in the same cognitive (e.g., executive function tests), motor (e.g., gait analyses, balance tests), sensory (e.g., vibration perception threshold test, proprioception tests), and neurophysiological (e.g., electroencephalograms) measurements. Depending on the time at which participants are included into the study, all measurements are repeated up to four times in intervals of 8 months within 3 years to identify associations with cognitive changes over time. Discussion This study aims to detect possible motor, sensory, neurophysiological, and cognitive predictors to develop an early screening tool for dementia and its pre-stages in OA. Thus, affected persons could receive optimal health care at an earlier time point to maintain their health resources. Trial status The study is ongoing. The recruitment of participants will be continued until May 2020.
Collapse
Affiliation(s)
- Katrin Müller
- Department of Sports Psychology (with focus on prevention and rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Germany.
| | - Stephanie Fröhlich
- Department of Sports Psychology (with focus on prevention and rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Germany
| | - Andresa M C Germano
- Department of Human Locomotion, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Jyothsna Kondragunta
- Department of Digital Signal Processing and Circuit Technology, Faculty of Electrical Engineering and Information Technology, Chemnitz University of Technology, Chemnitz, Germany
| | | | - Julian Rudisch
- Department of Sports Psychology (with focus on prevention and rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Germany.,Department of Neuromotor Behavior and Exercise, University of Münster, Münster, Germany
| | - Daniel Schmidt
- Department of Human Locomotion, Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Gangolf Hirtz
- Department of Digital Signal Processing and Circuit Technology, Faculty of Electrical Engineering and Information Technology, Chemnitz University of Technology, Chemnitz, Germany
| | - Peter Stollmann
- Department of Analysis, Faculty of Mathematics, Chemnitz University of Technology, Chemnitz, Germany
| | - Claudia Voelcker-Rehage
- Department of Sports Psychology (with focus on prevention and rehabilitation), Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126, Chemnitz, Germany.,Department of Neuromotor Behavior and Exercise, University of Münster, Münster, Germany
| |
Collapse
|
5
|
Schwert C, Stohrer M, Aschenbrenner S, Weisbrod M, Schröder A. Biased neurocognitive self-perception in depressive and in healthy persons. J Affect Disord 2018; 232:96-102. [PMID: 29481997 DOI: 10.1016/j.jad.2018.02.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/11/2018] [Accepted: 02/16/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cognitive deficits across several domains and subjective complaints about cognition are prevalent in major depression disorder (MDD). Nevertheless, subjective and objective cognitive functions show no associations. However, research concerning the extent and direction of discrepancy is rare. The present study examined the relationship and discrepancy between subjective and objective cognitive deficits both in patients with MDD and healthy individuals. METHOD Outpatients with MDD (n = 102) and a healthy control group (n = 88) were assessed with a neuropsychological test battery and completed a questionnaire for the self-assessment of cognitive performance (FLei) concerning the domains of attention, memory, and executive functions. RESULTS There were no associations between subjective and objective cognitive deficits in any domain in both the MDD group and the healthy control group. The groups did not differ regarding the extent of the discrepancy between subjective and objective cognition. However, depressed outpatients' subjective cognitive complaints significantly exceeded their neuropsychological deficits, whereas healthy individuals reported significantly higher subjective cognitive functioning than objectively measured. LIMITATIONS The cross-sectional study design does not allow for causal conclusions. Due to concerns regarding the suitability of the subjective measure of cognitive deficits used in this study, the findings should be interpreted cautiously. CONCLUSIONS The current study reveals a discrepancy between subjective and objective cognitive function not only in the MDD group, but also in the control group. Whereas depressed outpatients tend to underestimate their objective cognitive abilities, healthy individuals tend to overestimate them.
Collapse
Affiliation(s)
| | | | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Germany; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | | |
Collapse
|