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Leibinger KW, Murray E, Aschenbrenner S, Randerath J. Short-term intervention complemented by wearable technology improves Trichotillomania - A naturalistic single-case report. Front Psychol 2023; 14:1071532. [PMID: 37731870 PMCID: PMC10507401 DOI: 10.3389/fpsyg.2023.1071532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
There is a growing interest in using wearable technology for the treatment of body-focused repetitive behaviors (BFRBs), such as Trichotillomania. Yet, to our knowledge, few studies address the applicability and use of wearable technology as a therapeutic element in more naturalistic situations. Here we would like to introduce its potential use combined with a Habit-Reversal Training in a single-case experimental design. In practice, individuals with BFRBs frequently show complex constellations of psychiatric disorders. Accordingly, the here presented participant was diagnosed with Trichotillomania as well as comorbid ADHD and examination phobia. The participant was offered to wear an unobtrusive and user-friendly vibration device that sent an alarm when her critical hairpulling behaviors occurred. The complementing Habit-Reversal Training included an Awareness Training supported by the vibration alarm of the wearable device. It further included a Competing Response Training by learning benign behaviors that could replace the hairpulling behavior. The frequency of hairpulling episodes was assessed using daily self-reports and by using the monitoring function of the wearable device. The intervention procedure was implemented into the participant's everyday life and evaluated over the course of 214 days. The results indicated a significant reduction in the daily episodes of hair pulling. Our preliminary findings suggest that the here applied intervention has the potential to effectively treat Trichotillomania in individuals with comorbid disorders in psychotherapeutic outpatient care. Certainly, group-studies will need to further validate the approach's effectiveness.
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Affiliation(s)
| | - Eileen Murray
- Psychotherapy Training Center Bodensee (apb), Konstanz, Germany
| | - Steffen Aschenbrenner
- Section for Clinical Psychology and Neuropsychology, Department for Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Jennifer Randerath
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Psychotherapy Training Center Bodensee (apb), Konstanz, Germany
- Lurija Institute for Rehabilitation Science and Health Research, Kliniken Schmieder, Allensbach, Germany
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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Becke M, Tucha L, Butzbach M, Aschenbrenner S, Weisbrod M, Tucha O, Fuermaier ABM. Feigning Adult ADHD on a Comprehensive Neuropsychological Test Battery: An Analogue Study. Int J Environ Res Public Health 2023; 20:4070. [PMID: 36901080 PMCID: PMC10001580 DOI: 10.3390/ijerph20054070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
The evaluation of performance validity is an essential part of any neuropsychological evaluation. Validity indicators embedded in routine neuropsychological tests offer a time-efficient option for sampling performance validity throughout the assessment while reducing vulnerability to coaching. By administering a comprehensive neuropsychological test battery to 57 adults with ADHD, 60 neurotypical controls, and 151 instructed simulators, we examined each test's utility in detecting noncredible performance. Cut-off scores were derived for all available outcome variables. Although all ensured at least 90% specificity in the ADHD Group, sensitivity differed significantly between tests, ranging from 0% to 64.9%. Tests of selective attention, vigilance, and inhibition were most useful in detecting the instructed simulation of adult ADHD, whereas figural fluency and task switching lacked sensitivity. Five or more test variables demonstrating results in the second to fourth percentile were rare among cases of genuine adult ADHD but identified approximately 58% of instructed simulators.
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Affiliation(s)
- Miriam Becke
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
- Department of Psychology, National University of Ireland, W23 F2K8 Maynooth, Ireland
| | - Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
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Grossmann JA, Aschenbrenner S, Teichmann B, Meyer P. Foreign language learning can improve response inhibition in individuals with lower baseline cognition: Results from a randomized controlled superiority trial. Front Aging Neurosci 2023; 15:1123185. [PMID: 37032827 PMCID: PMC10076596 DOI: 10.3389/fnagi.2023.1123185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/08/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The world's population is aging, increasing the prevalence of dementia. Recently, foreign language learning in later life has been suggested to improve cognition and thus support healthy cognitive aging. To date, however, there are only a few studies with conflicting findings. Therefore, the purpose of this study was to examine whether learning a foreign language can improve executive attention and executive functions in healthy older adults. Additionally, we sought to identify factors affecting cognitive change in foreign language learners, such as cognitive reserve, previous foreign knowledge and usage, and global cognition at baseline. Methods In a randomized-controlled trial, we assigned 34 monolinguals between the ages of 65 and 80 to a language learning or a waiting list control group. The participants enrolled in a Spanish course for beginners that met five days a week for 1.5 h for a total of 3 weeks. The waiting list control group received no intervention but had the opportunity to join the language training at the end of the study. All participants underwent an assessment of executive attention (primary outcome), executive functions, verbal fluency, and attention (secondary outcomes) before, immediately after the course, or after a waiting period of 3 weeks for the control group and 3 months after the course or the waiting period. Results Foreign language learning did not significantly improve primary or secondary outcomes, neither immediately nor 3 months after the course. However, moderation analyses revealed that participants with lower global baseline cognition tended to improve more on response inhibition than individuals with higher baseline cognition. This relationship was not evident in the waiting list control group. Discussion Our results suggest that studying a foreign language does not generally improve executive attention or executive functioning. Nevertheless, individuals with poorer baseline cognition may benefit cognitively from foreign language learning in response inhibition, a domain particularly affected by cognitive aging. Our findings highlight the need of focusing dementia prevention efforts on groups that are more vulnerable to cognitive decline. Additionally, more individualized approaches, including utilizing technology-assisted learning, might enable participants to practice at their performance level, increasing the likelihood of discernible cognitive gains. Clinical trial registration https://drks.de/search/en, identifier DRKS00016552.
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Affiliation(s)
- Judith Alina Grossmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- *Correspondence: Judith Alina Grossmann,
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Patric Meyer
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- School of Applied Psychology, SRH University Heidelberg, Heidelberg, Germany
- Department for General and Applied Linguistics, Heidelberg University, Heidelberg, Germany
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Guo N, Koerts J, Tucha L, Fetter I, Biela C, König M, Bossert M, Diener C, Aschenbrenner S, Weisbrod M, Tucha O, Fuermaier ABM. Stability of Attention Performance of Adults with ADHD over Time: Evidence from Repeated Neuropsychological Assessments in One-Month Intervals. Int J Environ Res Public Health 2022; 19:15234. [PMID: 36429952 PMCID: PMC9690645 DOI: 10.3390/ijerph192215234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Neuropsychological assessments of attention are valuable sources of information in the clinical evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). However, it is unclear whether the attention performance of adults with ADHD is stable or fluctuates over time, which is of great importance in the interpretation of clinical assessments. This study aimed to explore the stability of attention performance of adults with ADHD in repeated assessments at one-month intervals. Twenty-one adults diagnosed with ADHD took part in this study by completing selective attention and vigilance tests three times, each one month apart. Test scores of participants were compared with and interpreted based on test norms. A considerable proportion of 'below average' performance scores were observed in most of the variables of selective attention and vigilance in all three assessments. Further, selective attention and vigilance performance scores did not differ significantly between the three repeated assessments. Finally, the majority of participants received consistent test score interpretations across the three repeated assessments. This study confirms previous research and highlights abnormal selective attention and vigilance performance in adults with ADHD. Further, this study preliminarily demonstrates relatively stable attention performance across repeated assessments, which has the potential to support clinical assessment, treatment planning, and evaluation.
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Affiliation(s)
- Nana Guo
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, 18147 Rostock, Germany
| | - Isabel Fetter
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
| | - Christina Biela
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
| | - Miriam König
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
| | - Magdalena Bossert
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
| | - Carsten Diener
- Department of Applied Psychology, SRH University Heidelberg, 69123 Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad-Langensteinbach, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, 18147 Rostock, Germany
- Department of Psychology, National University of Ireland, Maynooth, W23 F2H6 Maynooth, County Kildare, Ireland
| | - Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, 9712 TS Groningen, The Netherlands
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Schilling TM, Andelfinger V, Bossert M, König M, Wolfenson D, Lang S, Wirtz G, Weisbrod M, Aschenbrenner S. No clinically relevant effects of 12 sessions of 2 mA of anodal transcranial Direct Current Stimulation over the left DLPFC in combination with concurrent cognitive training compared to cognitive training only on executive functions in patients with schizophrenia - A randomized controlled trial. Schizophr Res 2022; 248:287-289. [PMID: 36122444 DOI: 10.1016/j.schres.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/25/2022] [Accepted: 09/04/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Thomas M Schilling
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany.
| | - Vanessa Andelfinger
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
| | - Magdalena Bossert
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
| | - Miriam König
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
| | - Daliah Wolfenson
- Department of Psychiatry und Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
| | - Sebastian Lang
- Department of Psychiatry und Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
| | - Gustav Wirtz
- SRH Psychiatric Rehabilitation Center, Guttmannstraße 4, 76307 Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry und Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Steffen Aschenbrenner
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Guttmannstraße 1, 76307 Karlsbad, Germany
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Schmidt J, Weisbrod M, Fritz M, Aschenbrenner S. Kognition und Kraftfahreignung bei chronischem Schmerzsyndrom. Nervenarzt 2022; 94:335-343. [PMID: 36169672 PMCID: PMC10104908 DOI: 10.1007/s00115-022-01387-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 10/14/2022]
Abstract
ZusammenfassungKognitive Auffälligkeiten bei Patienten mit chronischen Schmerzen finden in wissenschaftlichen Untersuchungen zunehmend Beachtung. Die Folgen dieser kognitiven Störungen in Bezug auf die Schmerzbewältigung, die Alltagsgestaltung und die Kraftfahreignung werden in der klinischen Praxis jedoch kaum berücksichtigt, obwohl die Hälfte aller Patienten davon betroffen ist. Die vorliegende Arbeit fasst die aktuelle Studienlage zusammen und diskutiert Möglichkeiten der Integration in die klinische und therapeutische Versorgung.
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Affiliation(s)
- J Schmidt
- Abteilung für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad, Guttmannstr. 1, 76307, Karlsbad-Langensteinbach, Deutschland.
- Medizinische Fakultät Heidelberg der Universität Heidelberg, Heidelberg, Deutschland.
| | - M Weisbrod
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
- Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - M Fritz
- Abteilung für Neurologie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
| | - S Aschenbrenner
- Abteilung für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad, Guttmannstr. 1, 76307, Karlsbad-Langensteinbach, Deutschland
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad, Karlsbad-Langensteinbach, Deutschland
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Becke M, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O, Fuermaier ABM. Correction to: Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners' adult ADHD rating scales. J Neural Transm (Vienna) 2022; 129:1315-1319. [PMID: 35974247 PMCID: PMC9468094 DOI: 10.1007/s00702-022-02533-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Miriam Becke
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, 69115, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Becke M, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O, Fuermaier ABM. Joint Consideration of Validity Indicators Embedded in Conners’ Adult ADHD Rating Scales (CAARS). Psychol Inj and Law 2022. [DOI: 10.1007/s12207-022-09445-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractA decade of research has both illustrated the need for accurate clinical assessment of adult ADHD and brought forward a series of validity indicators assisting this diagnostic process. Several of these indicators have been embedded into Conners’ Adult ADHD Rating Scales (CAARS). As their different theoretical underpinnings offer the opportunity of possible synergy effects, the present study sought to examine whether the item- or index-wise combination of multiple validity indicators benefits classification accuracy. A sample of controls (n = 856) and adults with ADHD (n = 72) answered the CAARS, including the ADHD Credibility Index (ACI) honestly, while a group of instructed simulators (n = 135) completed the instrument as though they had ADHD. First, original CAARS items, which are part of the CAARS Infrequency Index (CII), and items drawn from the ACI were combined into a new CII-ACI-Compound Index. Secondly, existing validity indicators, including suspect T-score elevations and the CII, were considered in combination. Both approaches were evaluated in terms of sensitivity and specificity. The combination of four CII and five ACI items into the CII-ACI-Compound Index yielded a sensitivity between 41 and 51% and an estimated specificity above 87%. Suspect T-score elevations on all three DSM scales emerged as another potentially useful validity indicator with a sensitivity of 45 to 46% and a specificity > 90%. Deeming examinees non-credible whenever two or more validity indicators showed suspect results ensured low false-positive rates (< 10%), but reduced sensitivity significantly. Classifying respondents as non-credible as soon as any given indicator fell into the suspect range resulted in frequent false positives (> 11% of misclassified adults with ADHD). Depending on whether high specificity or high sensitivity is prioritized, such combined considerations offer valuable additions to individual validity indicators. High sensitivity provided by “either/or” combinations could prove useful in screening settings, whereas high stakes settings could benefit from “and” combinations.
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Şahin D, Hever F, Bossert M, Herwig K, Aschenbrenner S, Weisbrod M, Sharma A. Early and middle latency auditory event-related potentials do not explain differences in neuropsychological performance between schizophrenia spectrum patients and matched healthy controls. Psychiatry Res 2021; 304:114162. [PMID: 34380086 DOI: 10.1016/j.psychres.2021.114162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/19/2021] [Accepted: 08/02/2021] [Indexed: 01/05/2023]
Abstract
Abnormalities of early and middle latency auditory event-related potentials (ERPs) are widespread in schizophrenia and have been suggested to be associated with cognitive deficits in schizophrenia patients. In this cross-sectional study with schizophrenia patients (n=30) and psychiatrically healthy counterparts (n=31) (matched for age, sex, education), we investigated whether auditory information processing (measured via amplitudes and gating of the auditory ERPs P50, N100 and P200) correlates with neuropsychological performance across cognitive domains. The groups differed significantly in amplitudes and gating of N100 and P200 potentials as well as in neuropsychological performance, but not in P50 amplitude and gating. Neither amplitudes nor gating of auditory ERPs correlated with neuropsychological performance. Neuropsychological intergroup differences could not be explained by abnormalities in auditory information processing. Although pronounced impairments exist on the levels of both auditory information processing and cognitive performance in schizophrenia, these abnormalities are not directly associated with each other.
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Affiliation(s)
- Derya Şahin
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.
| | - Felix Hever
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Magdalena Bossert
- Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Kerstin Herwig
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Anuradha Sharma
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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Mohamed SMH, Butzbach M, Fuermaier ABM, Weisbrod M, Aschenbrenner S, Tucha L, Tucha O. Basic and complex cognitive functions in Adult ADHD. PLoS One 2021; 16:e0256228. [PMID: 34473722 PMCID: PMC8412315 DOI: 10.1371/journal.pone.0256228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.
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Affiliation(s)
- Saleh M. H. Mohamed
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- * E-mail:
| | - Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - Anselm B. M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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Schilling TM, Bossert M, König M, Wirtz G, Weisbrod M, Aschenbrenner S. Acute effects of a single dose of 2 mA of anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex on executive functions in patients with schizophrenia-A randomized controlled trial. PLoS One 2021; 16:e0254695. [PMID: 34270620 PMCID: PMC8284793 DOI: 10.1371/journal.pone.0254695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 06/27/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Cognitive impairments are a frequent and difficult to treat symptom in patients with schizophrenia and the strongest predictor for a successful reintegration in occupational and everyday life. Recent research suggests transcranial direct current stimulation (tDCS) to enhance cognition in this patient group. However, the question regarding its acute effectiveness on executive functions remains largely unanswered. Here, we examined in a randomized, double blind, sham-controlled repeated-measures design the impact of tDCS on performance in several executive functions in patients with schizophrenia, schizoaffective disorder or acute transient psychotic disorder. Methods Patients (N = 48) were tested twice using standardized, well-constructed and clinically validated neuropsychological tests assessing verbal working memory, response inhibition, mental flexibility and problem solving. In session 1 they solely underwent the neuropsychological assessment, whereas in session 2 they additionally received 2 mA of anodal tDCS stimulation over the left dorsolateral prefrontal cortex (DLPFC), cathode right supraorbital ridge, or sham stimulation for 20 minutes. Results Patients of both groups were not able to correctly discriminate the type of stimulation received confirming the success of the blinding procedure. However, analyzing the whole sample the change in performance from session 1 to session 2 was the same in the verum as in the sham condition (all p >.5). Moreover, a subsequent exploratory analysis showed that performance in the response inhibition task was worse for patients that engaged in the task within 20 minutes after the end of the verum stimulation. Conclusion Hence, 2 mA of anodal tDCS applied over the left DLPFC did not acutely enhance executive functions in patients with schizophrenia or related disorders but impaired performance in the response inhibition task shortly after. Future studies should continue to seek for effective stimulation configurations for this patient group. Clinical trial registration The study is registered in the “Deutsches Register Klinischer Studien DRKS”, German Clinical Trial Register and has been allocated the following number: DRKS00022126.
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Affiliation(s)
- Thomas M. Schilling
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- * E-mail:
| | - Magdalena Bossert
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Miriam König
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Gustav Wirtz
- SRH Psychiatric Rehabilitation Center, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Section of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
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12
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Butzbach M, Fuermaier ABM, Aschenbrenner S, Weisbrod M, Tucha L, Tucha O. Metacognition, psychopathology and daily functioning in adult ADHD. J Clin Exp Neuropsychol 2021; 43:384-398. [PMID: 34157944 DOI: 10.1080/13803395.2021.1940104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Previous research indicated that adults with ADHD may have deficits in metacognition, yet the evidence base is scarce. This study aims to explore the existence and nature of metacognitive deficits in adults with ADHD, how psychopathology (such as inattention and depression) may affect metacognition and whether metacognition may impact daily functioning in adults with ADHD. METHOD Forty-six adult patients with ADHD and 46 controls completed questionnaires for metacognition, psychopathology and daily functioning (subjective assessment; self- and informant report). Participants performed two attention tests in a neuropsychological assessment. After test completion, participants were asked to evaluate their performance with the help of a visual aid and this self-evaluation of test performance was compared with their actual test performance (objective assessment). RESULTS Patients with ADHD reported large deficits in knowledge of cognition and medium deficits in regulation of cognition compared to controls. Self-evaluation of cognitive test performance revealed no significant deficits. Regression analyses revealed that psychopathology may explain a part of the variation in metacognition. Further regressions indicated that metacognition may account for a significant and meaningful proportion of variance in daily functioning, both self-rated and informant-rated. CONCLUSIONS Current findings of compromised metacognitive functioning of adults with ADHD suggest that clinicians may not want to rely on patients' self-reports in the clinical assessment. Inattention predicted impairments in metacognition, pointing toward the importance of attention for awareness and metacognition. Finally, we recommend that metacognition is addressed in the treatment trajectory of patients with ADHD, given that aspects of metacognition were directly linked to impairments in daily functioning as rated by participants and their relatives.
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Affiliation(s)
- Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany.,Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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13
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Bernhardt M, Schwert C, Aschenbrenner S, Weisbrod M, Schröder A. Subjective cognitive and neurocognitive functions over the course of CBT. Psychiatry Res 2021; 300:113895. [PMID: 33799194 DOI: 10.1016/j.psychres.2021.113895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
The aim of the study was to investigate changes in both subjectively and objectively measured cognitive functions as well as their discrepancy in outpatients with major depression disorder in the course of cognitive-behavioural therapy (CBT). A neuropsychological test battery with cognitive tests measuring the domains of attention, memory, and executive functions as well as a questionnaire for the self-assessment of cognitive functions (FLei) in these domains were administered to depressed outpatients (n = 46) at the beginning of CBT, post-treatment after on average 40 sessions, as well as six months after the end of treatment. We found that subjectively as well as objectively measured cognitive functions did not change. The discrepancy between subjective and objective cognitive functions found at the beginning of therapy was no longer significant at post-treatment and six months later. The results indicate, that self-perceived and neuropsychologically measured cognitive impairments show stability despite improved depression. Specific interventions such as cognitive remediation therapy should be additionally applied to depressed patients who suffer from cognitive deficits.
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Affiliation(s)
- Maren Bernhardt
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany.
| | - Christine Schwert
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany
| | - 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
| | - Annette Schröder
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Germany
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14
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Bernhardt M, Schwert C, Aschenbrenner S, Weisbrod M, Schröder A. Longitudinal Changes of Cognitive Deficits and Treatment Outcome of Cognitive Behavioral Therapy for Major Depression. J Nerv Ment Dis 2021; 209:336-342. [PMID: 33555821 DOI: 10.1097/nmd.0000000000001301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT The current study examined neuropsychological changes over the course of cognitive behavioral therapy (CBT) in outpatients with major depressive disorder and the influence of cognitive deficits as predictors of clinical outcome in depression. A neuropsychological test battery was carried out on depressed outpatients (N = 54) at the beginning and at the end of CBT. Small improvements were found in divided attention, figural memory, and processing speed from pre- to posttreatment. Cognitive deficits in executive functions before treatment predicted the clinical outcome at the end of CBT. The present study reveals that attention and memory deficits are most likely to improve over the course of treatment, whereas executive functions remain stable in the long term. Depressed patients with worse executive functions at the beginning of treatment seem to benefit more from long-term CBT therapy.
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Affiliation(s)
- Maren Bernhardt
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
| | - Christine Schwert
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad
| | | | - Annette Schröder
- Department of Clinical Psychology and Psychotherapy, University of Koblenz-Landau, Landau
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15
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Aschenbrenner S, Schilling TM, Grossmann J, Heck T, Bossert M. [Mental disorders after acquired CNS damage]. Fortschr Neurol Psychiatr 2021; 89:114-129. [PMID: 33684946 DOI: 10.1055/a-1309-0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mental disorders are a frequent consequence of acquired central nervous damage. If not recognized and treated early, they have a negative impact on the course of neurological rehabilitation. This article deals with the diagnosis and treatment of mental disorders after acquired damage to the central nervous system.
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16
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Becke M, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O, Fuermaier ABM. Non-credible symptom report in the clinical evaluation of adult ADHD: development and initial validation of a new validity index embedded in the Conners' adult ADHD rating scales. J Neural Transm (Vienna) 2021; 128:1045-1063. [PMID: 33651237 PMCID: PMC8295107 DOI: 10.1007/s00702-021-02318-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/15/2021] [Indexed: 11/10/2022]
Abstract
As attention-deficit/hyperactivity disorder (ADHD) is a feasible target for individuals aiming to procure stimulant medication or accommodations, there is a high clinical need for accurate assessment of adult ADHD. Proven falsifiability of commonly used diagnostic instruments is therefore of concern. The present study aimed to develop a new, ADHD-specific infrequency index to aid the detection of non-credible self-report. Disorder-specific adaptations of four detection strategies were embedded into the Conners’ Adult ADHD Rating Scales (CAARS) and tested for infrequency among credible neurotypical controls (n = 1001) and credible adults with ADHD (n = 100). The new index’ ability to detect instructed simulators (n = 242) and non-credible adults with ADHD (n = 22) was subsequently examined using ROC analyses. Applying a conservative cut-off score, the new index identified 30% of participants instructed to simulate ADHD while retaining a specificity of 98%. Items assessing supposed symptoms of ADHD proved most useful in distinguishing genuine patients with ADHD from simulators, whereas inquiries into unusual symptom combinations produced a small effect. The CAARS Infrequency Index (CII) outperformed the new infrequency index in terms of sensitivity (46%), but not overall classification accuracy as determined in ROC analyses. Neither the new infrequency index nor the CII detected non-credible adults diagnosed with ADHD with adequate accuracy. In contrast, both infrequency indices showed high classification accuracy when used to detect symptom over-report. Findings support the new indices’ utility as an adjunct measure in uncovering feigned ADHD, while underscoring the need to differentiate general over-reporting from specific forms of feigning.
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Affiliation(s)
- Miriam Becke
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, 69115, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Abstract
Cognitive impairments are frequent in patients suffering from major depressive disorders. They are among the first symptoms, often persist independently of improvement even after remission of the affective symptoms and are an important predictor of psychosocial functioning. In the clinical practice it is mandatory to ask about subjective complaints of the patient as well as to assess the cognitive abilities with the help of a standardized neuropsychological test battery. Cognitive remediation, selective serotonin reuptake inhibitors (SSRI) and vortioxetine as well as repetitive transcranial magnetic stimulation have proven their effectiveness as treatment options.
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Affiliation(s)
- Thomas M Schilling
- Sektion für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad-Langensteinbach GmbH, Guttmanstraße 1, 76307, Karlsbad, Deutschland.
| | - Magdalena Bossert
- Sektion für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad-Langensteinbach GmbH, Guttmanstraße 1, 76307, Karlsbad, Deutschland
| | - Matthias Weisbrod
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad-Langensteinbach, Guttmanstraße 1, 76307, Karlsbad, Deutschland.,Klinik für Allgemeine Psychiatrie, Zentrum für Psychosoziale Medizin, Universitätsklinikum Heidelberg, Voßstraße 4, 69115, Heidelberg, Deutschland
| | - Steffen Aschenbrenner
- Sektion für Klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad-Langensteinbach GmbH, Guttmanstraße 1, 76307, Karlsbad, Deutschland
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18
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Hever F, Sahin D, Aschenbrenner S, Bossert M, Herwig K, Wirtz G, Oelkers-Ax R, Weisbrod M, Sharma A. Visual N80 latency as a marker of neuropsychological performance in schizophrenia: Evidence for bottom-up cognitive models. Clin Neurophysiol 2021; 132:872-885. [PMID: 33636604 DOI: 10.1016/j.clinph.2021.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Cognitive deficits and visual impairment in the magnocellular (M) pathway, have been independently reported in schizophrenia. The current study examined the association between neuropsychological (NPS) performance and visual evoked potentials (VEPs: N80/P1 to M- and P(parvocellular)-biased visual stimuli) in schizophrenia and healthy controls. METHODS NPS performance and VEPs were measured in n = 44 patients and n = 34 matched controls. Standardized NPS-scores were combined into Domains and a PCA (Principal Component Analysis) generated Composite. Group differences were assessed via (M)ANOVAs, association between NPS and VEP parameters via PCA, Pearson's coefficient and bootstrapping. Logistic regression was employed to assess classification power. RESULTS Patients showed general cognitive impairment, whereas group differences for VEP-parameters were non-significant. In patients, N80 latency across conditions loaded onto one factor with cognitive composite, showed significant negative correlations of medium effect sizes with NPS performance for M/P mixed stimuli and classified low and high performance with 70% accuracy. CONCLUSION The study provides no evidence for early visual pathway impairment but suggests a heightened association between early visual processing and cognitive performance in schizophrenia. SIGNIFICANCE Our results lend support to bottom-up models of cognitive function in schizophrenia and implicate visual N80 latency as a potential biomarker of cognitive deficits in schizophrenia.
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Affiliation(s)
- Felix Hever
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany.
| | - Derya Sahin
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Magdalena Bossert
- Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Kerstin Herwig
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Gustav Wirtz
- SRH RPK Karlsbad, Psychiatric Rehabilitation, Karlsbad-Langensteinbach, Germany
| | - Rieke Oelkers-Ax
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Matthias Weisbrod
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Department of Psychiatry and Psychotherapy, SRH Hospital Karlsbad-Langensteinbach, Germany
| | - Anuradha Sharma
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
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19
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Grossmann JA, Koelsch VM, Degirmenci MG, Aschenbrenner S, Teichmann B, Meyer P. Effects of foreign language learning on executive functions in healthy older adults: study protocol for a randomised controlled trial. BMC Geriatr 2021; 21:122. [PMID: 33588784 PMCID: PMC7885378 DOI: 10.1186/s12877-021-02051-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 01/26/2021] [Indexed: 11/20/2022] Open
Abstract
Background With age, most cognitive functions decline. As the number of people aged 60 years and older is expected to rise rapidly within the next decades, identifying interventions that promote healthy cognitive ageing is of utmost importance. Promising research on bilingualism has led to the notion that learning a foreign language could protect against cognitive decline. Foreign language learning likely promotes executive functions, which are higher-order cognitive abilities particularly affected by age-related cognitive decline. However, evidence is still sparse and has produced contradictory results. This study aims to investigate the effects of short and intensive foreign language learning on executive functions in healthy older adults. Methods In a randomised controlled trial, we will assign 60 native German-speaking monolingual healthy older adults, aged 65–80 years, to either a foreign language learning or a waiting list control group. Language learners will attend a face-to-face, group-based Spanish course for beginners for 1.5 h a day, 5 days a week, for a total of 3 weeks. Cognitive performance in executive functions will be assessed before and after the intervention or after a waiting period of 3 weeks (waiting list control group). Participants will be tested again after 3 months to evaluate longitudinal effects of foreign language learning. The waiting list control group will receive Spanish lessons only after the final assessment and will be invited to an additional voluntary evaluation after completion of the course. Discussion To the best of our knowledge, we are conducting the first randomised controlled trial on the effects of short and intensive foreign language learning in older adulthood on executive functions. Enhanced cognitive performance after foreign language learning would indicate that learning a foreign language could enlarge cognitive reserve and thus promote healthy cognitive ageing in older adults. Trial registration German Clinical Trials Register DRKS00016552. Registered on 11 February 2019.
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Affiliation(s)
- Judith Alina Grossmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany. .,Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.
| | | | | | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Birgit Teichmann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Patric Meyer
- Network Aging Research, Heidelberg University, Heidelberg, Germany.,SRH University Heidelberg, Heidelberg, Germany
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20
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Butzbach M, Fuermaier ABM, Aschenbrenner S, Weisbrod M, Tucha L, Tucha O. Metacognition in adult ADHD: subjective and objective perspectives on self-awareness of cognitive functioning. J Neural Transm (Vienna) 2021; 128:939-955. [PMID: 33464422 PMCID: PMC8295131 DOI: 10.1007/s00702-020-02293-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
Although attention deficit hyperactivity disorder (ADHD) in adulthood is associated with marked cognitive impairment, research on metacognition in adult ADHD is scarce. Deficits in metacognition may have a negative impact on treatment adherence, functional outcomes, and everyday life. This study explores metacognition, specifically self-awareness of cognitive performance, in adults with ADHD by combining objective and subjective assessments. Forty-seven patients with ADHD and 47 control individuals completed a neuropsychological assessment battery including tests for attention, executive functions and memory (objective assessment), as well as questionnaires for cognitive functioning and symptom severity (subjective assessment; self- and informant-report). Participants evaluated their test performance of the objective assessment after test completion by selecting a percentile rank which was subtracted from their normed test result, yielding a discrepancy score. Compared to controls, adults with ADHD showed impairments in attention (medium effects) and memory (small and medium effects), but not in executive functions. The discrepancy scores between self-evaluation and cognitive performance revealed deficits in self-awareness of attentional functions (small effects), but not in executive functions and memory in patients with ADHD compared to controls. Discrepancy scores between self- and informant-reports of cognitive functioning revealed no significant differences. Adults with ADHD show impairments in metacognition in attentional functions, but may have intact metacognitive abilities in other domains. Patients with ADHD tend to overestimate their abilities, especially in attentional functions. Subjective and objective measures of metacognition may not correspond, highlighting the need for clinicians to not solely rely on patients' self-report in their assessment.
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Affiliation(s)
- Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands.
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
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21
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Groen Y, Priegnitz U, Fuermaier ABM, Tucha L, Tucha O, Aschenbrenner S, Weisbrod M, Garcia Pimenta M. Testing the relation between ADHD and hyperfocus experiences. Res Dev Disabil 2020; 107:103789. [PMID: 33126147 DOI: 10.1016/j.ridd.2020.103789] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/08/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) has been associated with hyperfocus, a transient experience of enhanced attentional focus and diminished awareness of time and the environment. AIMS This study aims to investigate the association between the frequency, duration and pervasiveness of hyperfocus across different situations in adults with and without ADHD. METHOD AND PROCEDURES Within a healthy sample (n = 1124), we analysed correlations between scores on the ADHD Rating Scale and self-reports of frequency, duration and pervasiveness of hyperfocus. An ADHD patient group (n = 78) was compared to matched healthy participants on all hyperfocus variables. OUTCOMES AND RESULTS In healthy adults, the frequency of hyperfocus was positively correlated with ADHD traits; older age and higher education were correlated with fewer hyperfocus occurrences in a smaller number of situations. ADHD patients and matched controls did not differ in the occurrence, frequency, duration and pervasiveness of hyperfocus, but hyperfocus was less likely to occur in educational and social situations in ADHD patients. CONCLUSIONS AND IMPLICATIONS Hyperfocus experiences are not specific of ADHD patients. The divergent findings might reflect multiple hyperfocus dimensions (situational and motivational) assessed in different studies which need to be addressed in future research.
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Affiliation(s)
- Yvonne Groen
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands
| | - Ulrike Priegnitz
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands
| | - Anselm B M Fuermaier
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Oliver Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany; Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307, Karlsbad, Germany; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
| | - Miguel Garcia Pimenta
- University of Groningen, Clinical and Developmental Neuropsychology, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
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22
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Godfrey E, Fuermaier ABM, Tucha L, Butzbach M, Weisbrod M, Aschenbrenner S, Tucha O. Public perceptions of adult ADHD: Indications of stigma? J Neural Transm (Vienna) 2020; 128:993-1008. [PMID: 33241459 PMCID: PMC8295125 DOI: 10.1007/s00702-020-02279-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
Abstract
Stigmatization represents a major barrier to treatment seeking across mental disorders. Despite this, stigma research on individual mental disorders remains in its infancy. Attention-deficit hyperactivity disorder (ADHD) in adults also represents an under-researched area-being far less studied than its child counterpart. This study examined the current state of public perceptions towards adult ADHD. A simulation group consisting of 105 participants performed the Weiss Functional Impairment Rating Scale (WFIRS) and Conners' Adult ADHD Rating Scales (CAARS) as though they had ADHD. These scores were compared to a group consisting of 98 individuals with adult ADHD and a group of 117 healthy individuals both groups being instructed to complete the WFIRS and CAARS to the best of their abilities. Simulators were found to overestimate impairments in adult ADHD (to a large effect) in the domains of hyperactivity, DSM-IV hyperactivity-impulsivity, DSM-IV total, work, school, (to a medium effect) in family and social, and (to a negligible-small effect) in inattention, impulsivity, DSM-IV inattention, and life skills when compared to the ADHD group, and in all domains (to a large effect) when compared to the control group. Current and retrospective ADHD symptoms were found to be associated with more accurate perceptions in a number of domains. Evidence for the presence of perceptions considered to be stigmatizing was found, with largest effects present in the domains of hyperactivity, impulsivity, impairments at work, school, and engagement in risky behaviour.
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Affiliation(s)
- Emmet Godfrey
- Faculty of Behavioral and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
| | - Anselm B M Fuermaier
- Faculty of Behavioral and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Faculty of Behavioral and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Marah Butzbach
- Faculty of Behavioral and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.,Center of Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Faculty of Behavioral and Social Sciences, Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany
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23
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Listunova L, Kienzle J, Bartolovic M, Jaehn A, Grützner TM, Wolf RC, Aschenbrenner S, Weisbrod M, Roesch-Ely D. Cognitive remediation therapy for partially remitted unipolar depression: A single-blind randomized controlled trial. J Affect Disord 2020; 276:316-326. [PMID: 32871662 DOI: 10.1016/j.jad.2020.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is an urgent need for the development and evaluation of targeted interventions for cognitive impairment (CI) in patients with (partially) remitted major depressive disorder (MDD). The aim of our study was therefore to evaluate the effect of cognitive remediation therapy (CRT) on cognitive and psychosocial functioning in a sample of patients with MDD, taking into account comorbidity, psychopathology, remission status and CI profile. Furthermore, we compared a generalized training (GT) with an individualized training (IT) approach regarding their effects on cognition. METHODS Sixty-two MDD patients in partial remission with CI were randomly assigned to a control group (CG), IT or GT. Participants of GT trained six cognitive subdomains (divided attention, selective attention, alertness, working memory, planning and response inhibition), whereas participants of IT trained their three most deficient cognitive subdomains as identified at baseline. Participants of both intervention groups trained three times per week over a five-week period. Both training groups received additional 30-minute compensatory-transfer sessions once per week. RESULTS Attention appeared to be the most frequently impaired cognitive domain as well as the domain which was significantly improved by CRT, with medium to large effect sizes. No difference in improvement was found between IT and GT. The analyses also revealed greater improvement in self-assessed psychosocial functioning in training participants (GT and IT combined) compared to the CG. LIMITATIONS Due to the small sample size, the present results are preliminary in nature. CONCLUSION CRT was well accepted, and patients transferred the attentional improvement to real life, as measured by self-assessed psychosocial functioning. IT yielded no additional advantages over GT. We propose CRT as an integral part of the treatment plan for patients with depression suffering from CI.
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Affiliation(s)
- Lena Listunova
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany.
| | - Johanna Kienzle
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Marina Bartolovic
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Anna Jaehn
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Thea Marianne Grützner
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | - Robert Christian Wolf
- Centre for Psychosocial Medicine, Department of General Psychiatry, Cognitive Neuropsychiatry Section, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
| | | | - Matthias Weisbrod
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany; Department of Adult Psychiatry, SRH-Klinik, Karlsbad-Langensteinbach, Germany
| | - Daniela Roesch-Ely
- Centre for Psychosocial Medicine, Department of General Psychiatry, Division Neurocognition, Heidelberg University Hospital, Voßstraße 4, 69115 Heidelberg, Germany
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24
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Fuermaier ABM, Tucha O, Russ D, Ehrenstein JK, Stanke M, Heindorf R, Buggenthin R, Aschenbrenner S, Koerts J, Tucha L. Utility of an attention-based performance validity test for the detection of feigned cognitive dysfunction after acquired brain injury. J Clin Exp Neuropsychol 2020; 42:285-297. [PMID: 32041477 DOI: 10.1080/13803395.2019.1710468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: The Groningen Effort Test (GET) is a recently developed performance validity test (PVT) for the identification of noncredible performance in a neuropsychological assessment of attention abilities. Because the majority of already established PVTs are based on memory functions, the GET has the potential to make a valuable contribution to validity testing.Method: The current study examined the utility of the GET in the detection of feigned cognitive dysfunction after acquired brain injury (ABI) and its incremental validity over already established PVTs, namely the Test of Memory Malingering (TOMM), the Dot Counting Test (DCT), and the b Test. Three hundred and forty-eight participants took part in this study, including 58 patients with ABI (stroke or traumatic brain injury), 43 healthy individuals instructed to show normal behavior, and 247 healthy individuals instructed to feign cognitive dysfunction after ABI.Results: With excellent overall classification accuracy, the GET performed close to the level of the TOMM, and superior to the b Test and DCT. Data analyses further revealed that the GET provides additional diagnostic accuracy compared to the b Test and the DCT in the detection of feigned cognitive dysfunction, but has no incremental validity over the TOMM. For each of the four PVTs in this study, diagnostic sensitivity was independent of the simulation strategy used.Conclusions: It is concluded that the GET is an attention-based PVT with promising test characteristics and high diagnostic accuracy in the detection of noncredible cognitive performance using a simulation design. Given the results can be replicated in studies using known-groups methodology, it may be a useful tool for clinical practice to complement neuropsychological assessments of patients with ABI.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
| | - Dorothea Russ
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
| | - Johanna K Ehrenstein
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
| | - Martin Stanke
- Neurological Rehabilitation Friedehorst, Bremen, Germany
| | - Ralf Heindorf
- Neurological Rehabilitation Friedehorst, Bremen, Germany
| | - Rieka Buggenthin
- Department of Neurology, Marcus Hospital Bad Driburg, Bad Driburg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, The Netherlands
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25
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Bossert M, Westermann C, Schilling TM, Weisbrod M, Roesch-Ely D, Aschenbrenner S. Computer-Assisted Cognitive Remediation in Schizophrenia: Efficacy of an Individualized vs. Generic Exercise Plan. Front Psychiatry 2020; 11:555052. [PMID: 33192669 PMCID: PMC7524883 DOI: 10.3389/fpsyt.2020.555052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/20/2020] [Indexed: 11/17/2022] Open
Abstract
Computer-assisted cognitive remediation (CACR) is an economical, adjustable, and effective treatment for individuals with schizophrenia. The current randomized controlled study examined whether an individualized or generic exercise plan in CACR is superior in patients with multiple cognitive deficits compared to treatment-as-usual (TAU). Fifty-nine inpatients diagnosed with schizophrenia were randomly assigned to 1) TAU, 2) TAU plus an individualized exercise plan in CACR, or 3) TAU plus a generic exercise plan in CACR. Neuropsychological performance, psychopathology, and functional outcome were assessed at baseline and post-treatment. The results show a medium to large training effect for all neuropsychological performance measures. Contrary to our expectations the neuropsychological improvement over time did not differ between groups. Self-reported depression, global level of functioning, and activity and participation functioning showed a significant improvement from baseline to post-treatment. However no further group, time, or interaction effects for other psychopathology and functional outcome could be demonstrated. Possible implications for clinical use of CACR and future studies are discussed.
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Affiliation(s)
- Magdalena Bossert
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Celina Westermann
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Thomas M Schilling
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry und Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Daniela Roesch-Ely
- Centre for Psychosocial Medicine, Department of General Adult Psychiatry, Division Neurocognition, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany
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26
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Schwert C, Stohrer M, Aschenbrenner S, Weisbrod M, Schröder A. Neurocognitive profile of outpatients with unipolar depressive disorders. J Clin Exp Neuropsychol 2019; 41:913-924. [PMID: 31437083 DOI: 10.1080/13803395.2019.1634180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | | | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Baden-Baden, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Baden-Baden, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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27
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Becke M, Fuermaier ABM, Buehren J, Weisbrod M, Aschenbrenner S, Tucha O, Tucha L. Utility of the Structured Interview of Reported Symptoms (SIRS-2) in detecting feigned adult attention-deficit/hyperactivity disorder. J Clin Exp Neuropsychol 2019; 41:786-802. [DOI: 10.1080/13803395.2019.1621268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Miriam Becke
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Jannes Buehren
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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28
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Fuermaier ABM, Groen Y, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O. Everyday Life Attention Scale (ELAS): Normative data of n = 1,874 Dutch participants. Appl Neuropsychol Adult 2019; 28:140-147. [PMID: 31075993 DOI: 10.1080/23279095.2019.1605994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The Everyday Life Attention Scale (ELAS) is a sensitive and reliable self-report questionnaire assessing attentional capacities of respondents in nine different situations of daily life. The ELAS has the potential to add relevant information to the clinical evaluation of attention deficits, to guide treatment planning, as well as to evaluate treatment outcome. The present study provides normative data of 1,874 Dutch speaking participants, ranging from 18 to 76 years of age, with mixed levels of education and a roughly equal distribution in gender. Normative data are calculated based on multiple linear regression models for each of the nine ELAS situations. In this article, the ELAS questionnaire as well as norm data are offered free of use. Use of normative ELAS data as presented in this study enables its use in clinical practice and research. Potential applications of the ELAS and future directions are discussed.
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Affiliation(s)
- Anselm B M Fuermaier
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Yvonne Groen
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany.,Experimental Psychopathology and Neurophysiology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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29
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Fuermaier ABM, Piersma D, Huntjens RJC, de Waard D, Westermann C, Bossert M, Lange KW, Weisbrod M, Bruggeman R, Aschenbrenner S, Tucha O. Simulated car driving and its association with cognitive abilities in patients with schizophrenia. Schizophr Res 2019; 204:171-177. [PMID: 30219605 DOI: 10.1016/j.schres.2018.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/07/2018] [Accepted: 09/08/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Patients with schizophrenia commonly suffer from impairments in various aspects of cognition. These deficits were shown to have detrimental effects on daily life functioning and might also impair car driving. This study is the first to examine driving behaviour of patients with schizophrenia using an advanced driving simulator, and to explore the role of cognitive abilities of people with schizophrenia for driving. METHODS Non-acute patients with schizophrenia (n = 31) and healthy comparison participants (n = 31) performed a comprehensive neuropsychological assessment and driving simulator rides. Neuropsychological and driving performances were compared between groups. Moreover, associations were explored between cognitive functions and driving behaviour in the entire group. RESULTS Patients with schizophrenia revealed impairments in multiple aspects of cognition. In the driving simulator, patients with schizophrenia showed no indication of deviant driving in terms of number of collisions or reacting to critical situations, and even showed better lane control compared to healthy individuals. However, patients with schizophrenia drove significantly slower than healthy individuals, and caused more hindrance to the car behind while merging on the motorway. Slower driving was associated with lower test scores on attention and processing speed. Hindering the car behind was associated with test performance on planning and inhibition. CONCLUSIONS It is concluded that driving of patients with schizophrenia is characterized by a relatively slow speed, and can also be impaired in certain aspects, i.e. hindering a car behind while merging. Cognitive functions are crucial for driving, and should be target of treatment.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands.
| | - Dafne Piersma
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Rafaele J C Huntjens
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Dick de Waard
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Celina Westermann
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Magdalena Bossert
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Klaus W Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany; Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Richard Bruggeman
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
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30
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Schwert C, Stohrer M, Aschenbrenner S, Weisbrod M, Schröder A. Biased neurocognitive self-perception in depression - What is the reason for the discrepancy? Reply to Dehn & Beblo (2018). J Affect Disord 2019; 243:193. [PMID: 30245250 DOI: 10.1016/j.jad.2018.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/09/2018] [Indexed: 11/28/2022]
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
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31
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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32
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Fuermaier ABM, Tucha O, Koerts J, Send TS, Weisbrod M, Aschenbrenner S, Tucha L. Is motor activity during cognitive assessment an indicator for feigned attention-deficit/hyperactivity disorder (ADHD) in adults? J Clin Exp Neuropsychol 2018; 40:971-986. [DOI: 10.1080/13803395.2018.1457139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Tabea S. Send
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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33
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Groen Y, Fuermaier ABM, Tucha L, Weisbrod M, Aschenbrenner S, Tucha O. A situation-specific approach to measure attention in adults with ADHD: The everyday life attention scale (ELAS). Applied Neuropsychology: Adult 2018. [DOI: 10.1080/23279095.2018.1437730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Yvonne Groen
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Anselm B. M. Fuermaier
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
- General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, German
| | - Steffen Aschenbrenner
- Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad, Germany
| | - Oliver Tucha
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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34
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Fuermaier ABM, Tucha O, Koerts J, Lange KW, Weisbrod M, Aschenbrenner S, Tucha L. Noncredible cognitive performance at clinical evaluation of adult ADHD: An embedded validity indicator in a visuospatial working memory test. Psychol Assess 2017; 29:1466-1479. [DOI: 10.1037/pas0000534] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fuermaier ABM, Tucha O, Koerts J, Butzbach M, Weisbrod M, Aschenbrenner S, Tucha L. Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD. Clin Neuropsychol 2017; 32:671-680. [DOI: 10.1080/13854046.2017.1406143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
- Section for Experimental Psychopathology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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Sharma A, Schray A, Bartolovic M, Roesch-Ely D, Aschenbrenner S, Weisbrod M. Relationship between serum calcium and neuropsychological performance might indicate etiological heterogeneity underlying cognitive deficits in schizophrenia and depression. Psychiatry Res 2017; 252:80-86. [PMID: 28259035 DOI: 10.1016/j.psychres.2017.01.101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/06/2017] [Accepted: 01/11/2017] [Indexed: 10/20/2022]
Abstract
Cognitive dysfunction is a core feature of schizophrenia spectrum and depressive disorders. Influx of extracellular calcium is essential for neuronal processes such as pre-synaptic neurotransmitter release and NMDA receptor mediated neuroplasticity. Since serum and brain interstitial fluids maintain equilibrium for ion concentrations via passive diffusion, the amount of peripheral calcium could affect neuronal and hence cognitive function. Within the physiological norm-levels, we hypothesized higher serum-calcium would be associated with better neuropsychological performance in patients diagnosed with schizophrenia or depression. One-tailed Pearson's correlations were calculated between total serum-calcium levels and performance on an extensive computer-based neuropsychological test battery. Influence of covariates was assessed using linear regression. Serum calcium was significantly and positively correlated with neuropsychological composite, information processing speed, executive function and global assessment of functioning (GAF) in depression patients but not in schizophrenia patients. Amongst covariates, age associated significantly with serum calcium and neuropsychological functioning in depression but only with serum calcium in schizophrenia group. The study provides first evidence for a positive relationship between serum calcium and neuropsychological/daily-life function in depression. Absence of this correlation in schizophrenia could point to etiological heterogeneity concerning calcium-related processes underlying cognitive deficits in these disorders.
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Affiliation(s)
- Anuradha Sharma
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany.
| | - Angela Schray
- Department of Visceral Surgery, University Hospital Heidelberg, Germany
| | - Marina Bartolovic
- Heidelberg Institute for Psychotherapy, University Hospital Heidelberg, Germany
| | - Daniela Roesch-Ely
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Hospital, Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Research Group Neurocognition, Department of General Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany; Department of Psychiatry and Psychotherapy, SRH Hospital, Karlsbad-Langensteinbach, Germany
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Hartmann-Riemer MN, Aschenbrenner S, Bossert M, Westermann C, Seifritz E, Tobler PN, Weisbrod M, Kaiser S. Deficits in reinforcement learning but no link to apathy in patients with schizophrenia. Sci Rep 2017; 7:40352. [PMID: 28071747 PMCID: PMC5223142 DOI: 10.1038/srep40352] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/05/2016] [Indexed: 01/28/2023] Open
Abstract
Negative symptoms in schizophrenia have been linked to selective reinforcement learning deficits in the context of gains combined with intact loss-avoidance learning. Fundamental mechanisms of reinforcement learning and choice are prediction error signaling and the precise representation of reward value for future decisions. It is unclear which of these mechanisms contribute to the impairments in learning from positive outcomes observed in schizophrenia. A recent study suggested that patients with severe apathy symptoms show deficits in the representation of expected value. Considering the fundamental relevance for the understanding of these symptoms, we aimed to assess the stability of these findings across studies. Sixty-four patients with schizophrenia and 19 healthy control participants performed a probabilistic reward learning task. They had to associate stimuli with gain or loss-avoidance. In a transfer phase participants indicated valuation of the previously learned stimuli by choosing among them. Patients demonstrated an overall impairment in learning compared to healthy controls. No effects of apathy symptoms on task indices were observed. However, patients with schizophrenia learned better in the context of loss-avoidance than in the context of gain. Earlier findings were thus partially replicated. Further studies are needed to clarify the mechanistic link between negative symptoms and reinforcement learning.
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Affiliation(s)
- Matthias N Hartmann-Riemer
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Psychiatric Hospital; University of Zurich, Switzerland
| | | | | | | | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Psychiatric Hospital; University of Zurich, Switzerland
| | - Philippe N Tobler
- Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Matthias Weisbrod
- Psychiatric Hospital Karlsbad Langensteinbach, Karlsbad, Germany.,University of Heidelberg, Heidelberg, Germany
| | - Stefan Kaiser
- Department of Psychiatry, Psychotherapy, and Psychosomatics; Psychiatric Hospital; University of Zurich, Switzerland
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Schwert C, Aschenbrenner S, Weisbrod M, Schröder A. Cognitive Impairments in Unipolar Depression: The Impact of Rumination. Psychopathology 2017; 50:347-354. [PMID: 28850956 DOI: 10.1159/000478785] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/19/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with impairments in several cognitive domains. People with depression also tend to focus on and think about their problems ("ruminate") more than people without depression. Recent studies indicate that depressive rumination is connected to cognitive impairments in MDD. However, there is little scientific understanding of the role of rumination in these deficits. SAMPLING AND METHODS The current study examined the performance of 62 outpatients suffering from unipolar major depression with a low tendency to ruminate versus outpatients with a high tendency to ruminate using a neuropsychological battery covering the 5 cognitive domains: attention, memory, working memory, executive functions and processing speed. RESULTS The results indicated that high ruminators show a lower performance than low ruminators with regard to processing speed and executive function tasks with low effect sizes. However, these findings were not significant after Bonferroni correction. Hierarchical linear regression revealed that the effect on processing speed could be partially attributed to rumination, but an effect on executive functions was not established. CONCLUSIONS The current study is the first to systematically investigate the impact of rumination on cognitive impairments in MDD, exploring a broad range of cognitive domains. The results partially support the hypothesis that rumination has an impact on single cognitive domains and highlight the necessity for further investigations in order to generalize these findings.
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Terhoeven V, Kallen U, Ingenerf K, Aschenbrenner S, Weisbrod M, Herzog W, Brockmeyer T, Friederich HC, Nikendei C. Meaningful Memory in Acute Anorexia Nervosa Patients-Comparing Recall, Learning, and Recognition of Semantically Related and Semantically Unrelated Word Stimuli. Eur Eat Disord Rev 2016; 25:89-97. [PMID: 28032373 DOI: 10.1002/erv.2496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/17/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE It is unclear whether observed memory impairment in anorexia nervosa (AN) depends on the semantic structure (categorized words) of material to be encoded. We aimed to investigate the processing of semantically related information in AN. METHOD Memory performance was assessed in a recall, learning, and recognition test in 27 adult women with AN (19 restricting, 8 binge-eating/purging subtype; average disease duration: 9.32 years) and 30 healthy controls using an extended version of the Rey Auditory Verbal Learning Test, applying semantically related and unrelated word stimuli. RESULTS Short-term memory (immediate recall, learning), regardless of semantics of the words, was significantly worse in AN patients, whereas long-term memory (delayed recall, recognition) did not differ between AN patients and controls. DISCUSSION Semantics of stimuli do not have a better effect on memory recall in AN compared to CO. Impaired short-term versus long-term memory is discussed in relation to dysfunctional working memory in AN. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Valentin Terhoeven
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Kallen
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy Bethel, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
| | - Katrin Ingenerf
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Weisbrod
- Department of General Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Wolfgang Herzog
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Timo Brockmeyer
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Christoph Nikendei
- Department of General Internal and Psychosomatic Medicine, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Fuermaier ABM, Tucha O, Koerts J, Grabski M, Lange KW, Weisbrod M, Aschenbrenner S, Tucha L. The Development of an Embedded Figures Test for the Detection of Feigned Attention Deficit Hyperactivity Disorder in Adulthood. PLoS One 2016; 11:e0164297. [PMID: 27732620 PMCID: PMC5061314 DOI: 10.1371/journal.pone.0164297] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/22/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES It has been shown that an increasing number of adults deliberately feign attention deficit hyperactivity disorder (ADHD), which demonstrates the need for new tests designed to detect feigned ADHD. METHODS An Embedded Figures Test (EFT) was developed for the detection of feigned ADHD in adulthood. EFT performance of 51 adults with ADHD was compared to the performance of 52 matched healthy individuals, as well as to 268 undergraduate students who were randomly allocated in a simulation design to one of four experimental conditions, i.e. a control group, a naïve simulation group, a symptom-coached simulation group or a test-coached simulation group. Furthermore, an independent sample of 11 adults with ADHD as well as a sample of 17 clinicians experienced in the work with adults with ADHD were assessed for further validation of the EFT. RESULTS The EFT was relatively easy to perform for both patients with ADHD and healthy comparisons as shown by low error rates and non-significant group differences. However, simulation groups differed from patients with ADHD by significant and large effects. An EFT index for the prediction of feigned ADHD was derived based on logistic regression coefficients. Receiver Operating Characteristics (ROC) demonstrated good classification accuracy of feigned ADHD relative to ADHD (AUC = 94.8%), i.e. high sensitivity (88%) and specificity (90%). CONCLUSIONS This study supports the utility of the EFT for the detection of feigned adult ADHD.
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Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- * E-mail:
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Meryem Grabski
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Klaus W. Lange
- Department of Experimental Psychology, University of Regensburg, 93040 Regensburg, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
- Section for Experimental Psychopathology and Neurophysiology, Centre for Psychosocial Medicine, University of Heidelberg, 69115 Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, 76307 Karlsbad, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
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Fuermaier ABM, Tucha L, Koerts J, Weisbrod M, Grabemann M, Zimmermann M, Mette C, Aschenbrenner S, Tucha O. Evaluation of the CAARS Infrequency Index for the Detection of Noncredible ADHD Symptom Report in Adulthood. Journal of Psychoeducational Assessment 2016. [DOI: 10.1177/0734282915626005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The reliance on self-reports in detecting noncredible symptom report of attention-deficit/hyperactivity disorder in adulthood (aADHD) has been questioned due to findings showing that symptoms can easily be feigned on self-report scales. In response, Suhr and colleagues developed an infrequency index for the Conners’ Adult ADHD Rating Scale (CII) and provided initial validation for its utility in detecting noncredible symptom report. The aim of this study was to evaluate the utility of the CII in detecting noncredible aADHD symptom report by using a simulation design. Data did not support the validity of the CII for the detection of noncredible aADHD symptoms, as it failed to differentiate instructed malingerers from genuine patients with sufficient accuracy. It is concluded that there is a need for infrequency scales composed of items that were specifically developed to be endorsed infrequently and embedded within valid self-report scales.
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Affiliation(s)
| | - Lara Tucha
- University of Groningen, The Netherlands
| | | | - Matthias Weisbrod
- SRH Clinic Karlsbad-Langensteinbach, Germany
- University of Heidelberg, Germany
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Gmehlin D, Fuermaier AB, Walther S, Tucha L, Koerts J, Lange KW, Tucha O, Weisbrod M, Aschenbrenner S. Attentional Lapses of Adults with Attention Deficit Hyperactivity Disorder in Tasks of Sustained Attention. Arch Clin Neuropsychol 2016; 31:343-57. [DOI: 10.1093/arclin/acw016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/13/2022] Open
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Fuermaier ABM, Tucha L, Koerts J, Weisbrod M, Lange KW, Aschenbrenner S, Tucha O. Effects of methylphenidate on memory functions of adults with ADHD. Applied Neuropsychology: Adult 2016; 24:199-211. [DOI: 10.1080/23279095.2015.1124108] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
- Section for Experimental Psychopathology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Klaus W. Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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Liesche C, Venkatraman L, Aschenbrenner S, Grosse S, Grimm D, Eils R, Beaudouin J. Death receptor-based enrichment of Cas9-expressing cells. BMC Biotechnol 2016; 16:17. [PMID: 26883910 PMCID: PMC4755021 DOI: 10.1186/s12896-016-0250-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/09/2016] [Indexed: 12/26/2022] Open
Abstract
Background The CRISPR/Cas9 genome editing system has greatly facilitated and expanded our capacity to engineer mammalian genomes, including targeted gene knock-outs. However, the phenotyping of the knock-out effect requires a high DNA editing efficiency. Results Here, we report a user-friendly strategy based on the extrinsic apoptosis pathway that allows enrichment of a polyclonal gene-edited cell population, by selecting Cas9-transfected cells that co-express dominant-negative mutants of death receptors. The extrinsic apoptosis pathway can be triggered in many mammalian cell types, and ligands are easy to produce, do not require purification and kill much faster than the state-of-the-art selection drug puromycin. Stringent assessment of our advanced selection strategy via Sanger sequencing, T7 endonuclease I (T7E1) assay and direct phenotyping confirmed a strong and rapid enrichment of Cas9-expressing cell populations, in some cases reaching up to 100 % within one hour. Notably, the efficiency of target DNA cleavage in these enriched cells reached high levels that exceeded the reliable range of the T7E1 assay, a conclusion that can be generalized for editing efficiencies above 30 %. Moreover, our data emphasize that the insertion and deletion pattern induced by a specific gRNA is reproducible across different cell lines. Conclusions The workflow and the findings reported here should streamline a wide array of future low- or high-throughput gene knock-out screens, and should largely improve data interpretation from CRISPR experiments. Electronic supplementary material The online version of this article (doi:10.1186/s12896-016-0250-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Liesche
- Department for Bioinformatics and Functional Genomics at the Institute of Pharmacy and Molecular Biotechnology and BioQuant BQ0020, University of Heidelberg, and Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - L Venkatraman
- Department for Bioinformatics and Functional Genomics at the Institute of Pharmacy and Molecular Biotechnology and BioQuant BQ0020, University of Heidelberg, and Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - S Aschenbrenner
- Department for Bioinformatics and Functional Genomics at the Institute of Pharmacy and Molecular Biotechnology and BioQuant BQ0020, University of Heidelberg, and Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - S Grosse
- Department of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, Heidelberg University Hospital, BioQuant BQ0030, Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - D Grimm
- Department of Infectious Diseases/Virology, Cluster of Excellence CellNetworks, Heidelberg University Hospital, BioQuant BQ0030, Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - R Eils
- Department for Bioinformatics and Functional Genomics at the Institute of Pharmacy and Molecular Biotechnology and BioQuant BQ0020, University of Heidelberg, and Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
| | - J Beaudouin
- Department for Bioinformatics and Functional Genomics at the Institute of Pharmacy and Molecular Biotechnology and BioQuant BQ0020, University of Heidelberg, and Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 267, 69120, Heidelberg, Germany.
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Fuermaier ABM, Tucha L, Evans BL, Koerts J, de Waard D, Brookhuis K, Aschenbrenner S, Thome J, Lange KW, Tucha O. Driving and attention deficit hyperactivity disorder. J Neural Transm (Vienna) 2015; 124:55-67. [PMID: 26419597 PMCID: PMC5281661 DOI: 10.1007/s00702-015-1465-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/18/2015] [Indexed: 12/01/2022]
Abstract
Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies.
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Affiliation(s)
- Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Ben Lewis Evans
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Dick de Waard
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Karel Brookhuis
- Traffic and Environmental Psychology Group, University of Groningen, Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Klaus W Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Tucha L, Fuermaier ABM, Koerts J, Buggenthin R, Aschenbrenner S, Weisbrod M, Thome J, Lange KW, Tucha O. Sustained attention in adult ADHD: time-on-task effects of various measures of attention. J Neural Transm (Vienna) 2015. [PMID: 26206605 PMCID: PMC5281679 DOI: 10.1007/s00702-015-1426-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Neuropsychological research on adults with ADHD showed deficits in various aspects of attention. However, the majority of studies failed to explore the change of performance over time, so-called time-on-task effects. As a consequence, little is known about sustained attention performance of adults with ADHD. The aim of the present study was therefore to test the hypothesis of sustained attention deficits of adults with ADHD. Twenty-nine adults with ADHD and 30 healthy individuals were assessed on four 20-min tests of sustained attention, measuring alertness, selective attention, divided attention and flexibility. The deterioration of performance over time (time-on-task effects) was compared between patients with ADHD and healthy individuals to conclude on sustained attention performance. Compared to healthy individuals, patients with ADHD showed significant deficits of medium size in selective attention and divided attention. Furthermore, medium sustained attention deficits was observed in measures of alertness, selective attention and divided attention. This study supports the notion of sustained attention deficits of adults with ADHD.
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Affiliation(s)
- Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Rieka Buggenthin
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Section for Experimental Psychopathology, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Johannes Thome
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Klaus W Lange
- Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Fuermaier ABM, Tucha L, Koerts J, Aschenbrenner S, Kaunzinger I, Hauser J, Weisbrod M, Lange KW, Tucha O. Cognitive impairment in adult ADHD—Perspective matters! Neuropsychology 2015; 29:45-58. [DOI: 10.1037/neu0000108] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Bossert M, Weisbrod M, Aschenbrenner S. [Cognitive remediation in clinical routine: a study on psychiatric patients' acceptance]. Fortschr Neurol Psychiatr 2014; 82:691-4. [PMID: 25489756 DOI: 10.1055/s-0034-1385477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Cognitive remediation represents an effective treatment for improving functional outcome of psychiatric diseases like schizophrenia or depression. However, in clinical routine the therapeutic approach has not been established continuously. This can be partly attributed to doubts about the reasonableness of cognitive remediation for psychiatric patients. Therefore the current study investigates psychiatric patients' acceptance of, motivation for, and exhaustion due to cognitive remediation compared to an established treatment programme. METHODS 21 psychiatric patients who simultaneously participated in occupational therapy and cognitive remediation rated the motivation, exhaustion, enjoyment, and effort on a visual analogue scale (VAS) over five weeks with regard to the respective therapy. RESULTS The ratings of occupational therapy and cognitive remediation did not differ relating to motivation, exhaustion, and enjoyment. The subjective effort in cognitive remediation was higher than that in occupational therapy. DISCUSSION Cognitive remediation is evaluated as being equivalent to an already established treatment programme by psychiatric patients concerning motivation, enjoyment, and exhaustion. Doubts about the acceptance and reasonableness of cognitive remediation could not be confirmed. In clinical routine cognitive remediation as an effective and accepted therapeutic approach should be integrated as a standard procedure for various disorders.
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Affiliation(s)
- M Bossert
- Abteilung für klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad-Langensteinbach
| | - M Weisbrod
- Abteilung für Psychiatrie und Psychotherapie, SRH Klinikum Karlsbad-Langensteinbach
| | - S Aschenbrenner
- Abteilung für klinische Psychologie und Neuropsychologie, SRH Klinikum Karlsbad-Langensteinbach
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Gmehlin D, Fuermaier ABM, Walther S, Debelak R, Rentrop M, Westermann C, Sharma A, Tucha L, Koerts J, Tucha O, Weisbrod M, Aschenbrenner S. Intraindividual variability in inhibitory function in adults with ADHD--an ex-Gaussian approach. PLoS One 2014; 9:e112298. [PMID: 25479234 PMCID: PMC4257533 DOI: 10.1371/journal.pone.0112298] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 10/08/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Attention deficit disorder (ADHD) is commonly associated with inhibitory dysfunction contributing to typical behavioral symptoms like impulsivity or hyperactivity. However, some studies analyzing intraindividual variability (IIV) of reaction times in children with ADHD (cADHD) question a predominance of inhibitory deficits. IIV is a measure of the stability of information processing and provides evidence that longer reaction times (RT) in inhibitory tasks in cADHD are due to only a few prolonged responses which may indicate deficits in sustained attention rather than inhibitory dysfunction. We wanted to find out, whether a slowing in inhibitory functioning in adults with ADHD (aADHD) is due to isolated slow responses. METHODS Computing classical RT measures (mean RT, SD), ex-Gaussian parameters of IIV (which allow a better separation of reaction time (mu), variability (sigma) and abnormally slow responses (tau) than classical measures) as well as errors of omission and commission, we examined response inhibition in a well-established GoNogo task in a sample of aADHD subjects without medication and healthy controls matched for age, gender and education. RESULTS We did not find higher numbers of commission errors in aADHD, while the number of omissions was significantly increased compared with controls. In contrast to increased mean RT, the distributional parameter mu did not document a significant slowing in aADHD. However, subjects with aADHD were characterized by increased IIV throughout the entire RT distribution as indicated by the parameters sigma and tau as well as the SD of reaction time. Moreover, we found a significant correlation between tau and the number of omission errors. CONCLUSIONS Our findings question a primacy of inhibitory deficits in aADHD and provide evidence for attentional dysfunction. The present findings may have theoretical implications for etiological models of ADHD as well as more practical implications for neuropsychological testing in aADHD.
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Affiliation(s)
- Dennis Gmehlin
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Stephan Walther
- Section of Experimental Psychopathology and Neurophysiology, Department of child and adolescent Psychiatry, University of Heidelberg, Germany
| | | | - Mirjam Rentrop
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Celina Westermann
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Anuradha Sharma
- Section of Experimental Psychopathology and Neurophysiology, Department of child and adolescent Psychiatry, University of Heidelberg, Germany
| | - Lara Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Matthias Weisbrod
- Psychiatric Department, SRH Klinikum, Karlsbad-Langensteinbach, Germany
- SüdWestAkadamie für Neuropsychologie (SWAN), Heidelberg, Germany
- Section of Experimental Psychopathology and Neurophysiology, Department of child and adolescent Psychiatry, University of Heidelberg, Germany
| | - Steffen Aschenbrenner
- Department of Clinical Psychology and Neuropsychology, SRH Klinikum, Karlsbad-Langensteinbach, Germany
- SüdWestAkadamie für Neuropsychologie (SWAN), Heidelberg, Germany
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Fuermaier AB, Tucha L, Koerts J, Aschenbrenner S, Weisbrod M, Lange KW, Tucha O. Cognitive Complaints of Adults With Attention Deficit Hyperactivity Disorder. Clin Neuropsychol 2014; 28:1104-22. [DOI: 10.1080/13854046.2014.964325] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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