Cognitive Profile Discrepancy as a Possible Predictor of Emotion Dysregulation in a Clinical Sample of Female Adolescents with Suicidal Behavior

Emotional dysregulation (ED) has not yet been defined as a clinical entity, although it plays an important role in child and adolescent psychopathology. It is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions to produce an appropriate emotional response, to cope with excitability, mood instability, and emotional over-reactivity. The aim of this study is to assess, in a sample of female patients with internalizing disorders and suicidal behavior, the correlation between cognitive profile (assessed with Wechsler Scales) and the dimensions of emotion regulation assessed with the Difficulties in Emotion Regulation Scale (DERS). We also investigated whether a discrepancy between the General Ability Index (GAI) and the Cognitive Proficiency Index (CPI) could have predictive value for certain ED domains. Our results confirmed a statistically significant prediction of the ΔGAI-CPI for individual DERS domains and for the total (p = 0.014 for DERS-TOT, p = 0.04 for GOALS, p = 0.002 for STRATEGIES and p = 0.015 for CLARITY); furthermore, IAG and PRI correlate with worse ability to find ER strategies (p = 0.04, p = 0.010). These results suggest the importance of examining the impact of cognitive vulnerabilities on the ability to manage emotions and psychopathology in general, even with normal FSIQ/GAI.

Mismatch negativity as an early biomarker of cognitive impairment in schizophrenia

Background

Due to its disturbance in schizophrenic patients, mismatch negativity (MMN) generation is believed to be a potential biomarker for recognizing primary impairments in auditory sensory processing during the course of the disease. However, great controversy exists regarding the type and onset of MMN-related impairments, with the deficits to frequency deviants is more debatable. This cross-sectional, case–control study was conducted to assess the cognitive functions among 33 eligible Egyptian schizophrenics (15 early and 18 chronic), and 30 matched healthy controls by assessing their psychometric tests and correlating them to the coexisting frequency deviant MMN responses (using both tone and speech stimuli).

Results

Deficits in frequency MMN and neuropsychological tests were evident among early and chronic schizophrenics compared to their matched control counterparts, and also between early versus chronic schizophrenia in favor of the later. MMN deficits to speech stimuli were more elicited than tone stimuli among schizophrenics. Moreover, significant correlations were identified between MMN parameters and the results of psychiatric cognitive scales.

Conclusions

We demonstrated that frequency-deviant MMN deficits are evident feature among the enrolled Egyptian schizophrenics. The cognitive functions as indexed by MMN seem affected early, with the striking decrease of MMN amplitude and delay of latency point towards the progression of the illness. The normal lateralization of MMN was absent in chronic schizophrenia. These findings could be helpful in using the MMN as an additional objective tool for confirming cognitive impairments among schizophrenics and to differentiate between early- and chronic-schizophrenic patients for medico-legal purposes and clinical implication for medications.

Assessing Cognitive Abilities Using the WAIS-IV: An Item Response Theory Approach

Background: The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) has been adapted to 28 different cultures and there has been considerable interest in examining its structure through exploratory and confirmatory factor analysis. This study investigates item and scale properties of the Egyptian WAIS-IV using item response theory (IRT) models. Methods: The sample consisted of 250 adults from Egypt. The item-level and subtest statistical properties of the Egyptian WAIS-IV were established using a combination of four dichotomous IRT models and four polytomous IRT models. In addition, factor analysis was performed to investigate the dimensionality of each subtest. Results: Factor analysis indicated the unidimensionality of each subtest. Among IRT models, the two-parameter logistic model provided a good fit for dichotomous subtests, while the graded response model fitted the polytomous data. Most items of the Egyptian WAIS-IV showed high discrimination, and the scale was adequately informative across the levels of latent traits (i.e., cognitive variables). However, each subtest included at least some items with limited ability to distinguish between individuals with differing levels of the cognitive variable being measured. Furthermore, most subtests have items that do not follow the difficulty rank they are ascribed in the WAIS-IV manual. Conclusions: Overall, the results suggest that the Egyptian WAIS-IV offers a highly valid assessment of intellectual abilities, despite the need for some improvements.

A Demonstration of Mokken Scale Analysis Methods Applied to Cognitive Test Validation Using the Egyptian WAIS-IV

The fourth edition of the Wechsler Adult Intelligence Scale (WAIS-IV) has been used extensively for assessing adult intelligence. This study uses Mokken scale analysis to investigate the psychometric proprieties of WAIS-IV subtests adapted for the Egyptian population in a sample of 250 adults between 18 and 25 years of age. The monotone homogeneity model and the double monotonicity model were consistent with the subtest data. The items of all subtests except Matrix Reasoning, Information, Similarities, and Vocabulary formed a unidimensional scale. The WAIS-IV subtests have discriminatory and invariantly ordered items, although some items violated the invariant item ordering and scalability criteria. Therefore, the WAIS-IV subtests—with the exception of some items—are hierarchical scales that allow items to be ordered according to difficulty and subjects to be ordered using the sum score. In conclusion, the current study provides evidence of the dimensionality and hierarchy of the WAIS-IV subtests in the framework of Mokken scaling, although care should be taken when interpreting or including certain items.