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Haase L, Stewart JL, Youssef B, May AC, Isakovic S, Simmons AN, Johnson DC, Potterat EG, Paulus MP. When the brain does not adequately feel the body: Links between low resilience and interoception. Biol Psychol 2015; 113:37-45. [PMID: 26607442 DOI: 10.1016/j.biopsycho.2015.11.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 02/04/2015] [Revised: 08/26/2015] [Accepted: 11/13/2015] [Indexed: 11/25/2022]
Abstract
This study examined neural processes of resilience during aversive interoceptive processing. Forty-six individuals were divided into three groups of resilience Low (LowRes), high (HighRes), and normal (NormRes), based on the Connor-Davidson Resilience Scale (2003). Participants then completed a task involving anticipation and experience of loaded breathing during functional magnetic resonance imaging (fMRI) recording. Compared to HighRes and NormRes groups, LowRes self-reported lower levels of interoceptive awareness and demonstrated higher insular and thalamic activation across anticipation and breathing load conditions. Thus, individuals with lower resilience show reduced attention to bodily signals but greater neural processing to aversive bodily perturbations. In low resilient individuals, this mismatch between attention to and processing of interoceptive afferents may result in poor adaptation in stressful situations.
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Affiliation(s)
- Lori Haase
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA.
| | - Jennifer L Stewart
- Psychology Department, Queens College, City University of New York, Flushing, NY 11367, USA.
| | - Brittany Youssef
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA.
| | - April C May
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA.
| | - Sara Isakovic
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA.
| | - Alan N Simmons
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA; Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| | - Douglas C Johnson
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA; Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521, USA.
| | - Eric G Potterat
- Naval Special Warfare Command, 2000 Trident Way, San Diego, CA 92155-5599, USA.
| | - Martin P Paulus
- Psychiatry Department, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA; Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
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Harris E, Taylor MK, Drummond SPA, Larson GE, Potterat EG. Assessment of Sleep Disruption and Sleep Quality in Naval Special Warfare Operators. Mil Med 2015; 180:803-8. [PMID: 26126252 DOI: 10.7205/milmed-d-14-00436] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Little is known about sleep in elite military populations who are exposed to higher operational demands, unpredictable training, deployment, and mission cycles. Twenty-nine Naval Special Warfare (NSW) Operators wore an actiwatch for an 8-day/7-night period for objective sleep assessment and completed a nightly sleep log. A total of 170 nights of actigraphically recorded sleep were collected. When comparing objectively versus subjectively recorded sleep parameter data, statistically significant differences were found. Compared with sleep log data, actigraphy data indicate NSW Operators took longer to fall asleep (an average of 25.82 minutes), spent more time awake after sleep onset (an average of 39.55 minutes), and demonstrated poorer sleep efficiency (83.88%) (ps < 0.05). Self-reported sleep quality during the study period was 6.47 (maximum score = 10). No relationships existed between the objectively derived sleep indices and the self-reported measure of sleep quality (rs = -0.29 to 0.09, all ps > 0.05). Strong inter-relationships existed among the subjectively derived sleep indices (e.g., between self-reported sleep quality and sleep efficiency; r = 0.61, p < 0.001). To our knowledge, this is the first study to objectively and subjectively quantify sleep among NSW Operators. These findings suggest sleep maintenance and sleep efficiency are impaired when compared to normative population data.
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Affiliation(s)
- Erica Harris
- Health and Behavioral Sciences Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106
| | - Marcus K Taylor
- Warfighter Performance, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106
| | - Sean P A Drummond
- Veterans Affairs Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161
| | - Gerald E Larson
- Warfighter Performance, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106
| | - Eric G Potterat
- Naval Special Warfare Command, 2000 Trident Way, Building 603M, San Diego, CA 92155
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Johnson DC, Thom NJ, Stanley EA, Haase L, Simmons AN, Shih PAB, Thompson WK, Potterat EG, Minor TR, Paulus MP. Modifying resilience mechanisms in at-risk individuals: a controlled study of mindfulness training in Marines preparing for deployment. Am J Psychiatry 2014; 171:844-53. [PMID: 24832476 PMCID: PMC4458258 DOI: 10.1176/appi.ajp.2014.13040502] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Military deployment can have profound effects on physical and mental health. Few studies have examined whether interventions prior to deployment can improve mechanisms underlying resilience. Mindfulness-based techniques have been shown to aid recovery from stress and may affect brain-behavior relationships prior to deployment. The authors examined the effect of mindfulness training on resilience mechanisms in active-duty Marines preparing for deployment. METHOD Eight Marine infantry platoons (N=281) were randomly selected. Four platoons were assigned to receive mindfulness training (N=147) and four were assigned to a training-as-usual control condition (N=134). Platoons were assessed at baseline, 8 weeks after baseline, and during and after a stressful combat training session approximately 9 weeks after baseline. The mindfulness training condition was delivered in the form of 8 weeks of Mindfulness-Based Mind Fitness Training (MMFT), a program comprising 20 hours of classroom instruction plus daily homework exercises. MMFT emphasizes interoceptive awareness, attentional control, and tolerance of present-moment experiences. The main outcome measures were heart rate, breathing rate, plasma neuropeptide Y concentration, score on the Response to Stressful Experiences Scale, and brain activation as measured by functional MRI. RESULTS Marines who received MMFT showed greater reactivity (heart rate [d=0.43]) and enhanced recovery (heart rate [d=0.67], breathing rate [d=0.93]) after stressful training; lower plasma neuropeptide Y concentration after stressful training (d=0.38); and attenuated blood-oxygen-level-dependent signal in the right insula and anterior cingulate. CONCLUSIONS The results show that mechanisms related to stress recovery can be modified in healthy individuals prior to stress exposure, with important implications for evidence-based mental health research and treatment.
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Thom NJ, Johnson DC, Flagan T, Simmons AN, Kotturi SA, Van Orden KF, Potterat EG, Swain JL, Paulus MP. Detecting emotion in others: increased insula and decreased medial prefrontal cortex activation during emotion processing in elite adventure racers. Soc Cogn Affect Neurosci 2012; 9:225-31. [PMID: 23171614 DOI: 10.1093/scan/nss127] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [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: 11/14/2022] Open
Abstract
Understanding the neural processes that characterize elite performers is a first step to develop a neuroscience model that can be used to improve performance in stressful circumstances. Adventure racers are elite athletes that operate in small teams in the context of environmental and physical extremes. In particular, awareness of team member's emotional status is critical to the team's ability to navigate high-magnitude stressors. Thus, this functional magnetic resonance imaging (fMRI) study examined the hypothesis that adventure racers would show altered emotion processing in brain areas that are important for resilience and social awareness. Elite adventure racers (n = 10) were compared with healthy volunteers (n = 12) while performing a simple emotion face-processing (modified Hariri) task during fMRI. Across three types of emotional faces, adventure racers showed greater activation in right insula, left amygdala and dorsal anterior cingulate. Additionally, compared with healthy controls adventure racers showed attenuated right medial prefrontal cortex activation. These results are consistent with previous studies showing elite performers differentially activate neural substrates underlying interoception. Thus, adventure racers differentially deploy brain resources in an effort to recognize and process the internal sensations associated with emotions in others, which could be advantageous for team-based performance under stress.
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Affiliation(s)
- Nathaniel J Thom
- University of California San Diego, 8939 Villa La Jolla Dr. Suite 200, La Jolla, CA 92037-0855, USA.
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Paulus MP, Simmons AN, Fitzpatrick SN, Potterat EG, Van Orden KF, Bauman J, Swain JL. Differential brain activation to angry faces by elite warfighters: neural processing evidence for enhanced threat detection. PLoS One 2010; 5:e10096. [PMID: 20418943 PMCID: PMC2854680 DOI: 10.1371/journal.pone.0010096] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [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: 10/01/2009] [Accepted: 02/12/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the neural basis of elite performers and their optimal performance in extreme environments. The purpose of this study was to examine brain processing differences between elite warfighters and comparison subjects in brain structures that are important for emotion processing and interoception. METHODOLOGY/PRINCIPAL FINDINGS Navy Sea, Air, and Land Forces (SEALs) while off duty (n = 11) were compared with n = 23 healthy male volunteers while performing a simple emotion face-processing task during functional magnetic resonance imaging. Irrespective of the target emotion, elite warfighters relative to comparison subjects showed relatively greater right-sided insula, but attenuated left-sided insula, activation. Navy SEALs showed selectively greater activation to angry target faces relative to fearful or happy target faces bilaterally in the insula. This was not accounted for by contrasting positive versus negative emotions. Finally, these individuals also showed slower response latencies to fearful and happy target faces than did comparison subjects. CONCLUSIONS/SIGNIFICANCE These findings support the hypothesis that elite warfighters deploy greater processing resources toward potential threat-related facial expressions and reduced processing resources to non-threat-related facial expressions. Moreover, rather than expending more effort in general, elite warfighters show more focused neural and performance tuning. In other words, greater neural processing resources are directed toward threat stimuli and processing resources are conserved when facing a nonthreat stimulus situation.
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Affiliation(s)
- Martin P Paulus
- University of California San Diego, San Diego, California, United States of America.
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Taylor MK, Mujica-Parodi LR, Potterat EG, Momen N, Dial Ward MD, Padilla GA, Markham AE, Evans KE. Anger Expression and Stress Responses in Military Men. ACTA ACUST UNITED AC 2009; 80:962-7. [DOI: 10.3357/asem.2536.2009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Taylor MK, Mujica-Parodi LR, Padilla GA, Markham AE, Potterat EG, Momen N, Sander TC, Larson GE. Behavioral predictors of acute stress symptoms during intense military training. J Trauma Stress 2009; 22:212-7. [PMID: 19479980 DOI: 10.1002/jts.20413] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A better understanding of factors influencing human responses to acute stress is needed to enhance prevention and treatment of stress-related disorders. In the current study, the authors examined predictors of acute stress symptoms during intense military training in 35 men. In univariate and multivariate models, perceived stress, passive coping, and emotion-focused coping during daily living predicted acute stress symptoms in response to realistic survival training, whereas active coping and problem-focused coping did not. Baseline stress levels and coping styles, both of which may be modifiable, appear to play a fundamental role in the human response to acute uncontrollable stress. Additional research is needed to better elucidate the relative and interactive contributions of behavioral predictors of acute stress.
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Affiliation(s)
- Marcus K Taylor
- Naval Aerospace Medical Research Laboratory, 280 Fred Bauer Street, Pensacola, FL 32508, USA.
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Paulus MP, Potterat EG, Taylor MK, Van Orden KF, Bauman J, Momen N, Padilla GA, Swain JL. A neuroscience approach to optimizing brain resources for human performance in extreme environments. Neurosci Biobehav Rev 2009; 33:1080-8. [PMID: 19447132 DOI: 10.1016/j.neubiorev.2009.05.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 05/05/2009] [Accepted: 05/05/2009] [Indexed: 11/18/2022]
Abstract
Extreme environments requiring optimal cognitive and behavioral performance occur in a wide variety of situations ranging from complex combat operations to elite athletic competitions. Although a large literature characterizes psychological and other aspects of individual differences in performances in extreme environments, virtually nothing is known about the underlying neural basis for these differences. This review summarizes the cognitive, emotional, and behavioral consequences of exposure to extreme environments, discusses predictors of performance, and builds a case for the use of neuroscience approaches to quantify and understand optimal cognitive and behavioral performance. Extreme environments are defined as an external context that exposes individuals to demanding psychological and/or physical conditions, and which may have profound effects on cognitive and behavioral performance. Examples of these types of environments include combat situations, Olympic-level competition, and expeditions in extreme cold, at high altitudes, or in space. Optimal performance is defined as the degree to which individuals achieve a desired outcome when completing goal-oriented tasks. It is hypothesized that individual variability with respect to optimal performance in extreme environments depends on a well "contextualized" internal body state that is associated with an appropriate potential to act. This hypothesis can be translated into an experimental approach that may be useful for quantifying the degree to which individuals are particularly suited to performing optimally in demanding environments.
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Taylor MK, Markham AE, Reis JP, Padilla GA, Potterat EG, Drummond SPA, Mujica-Parodi LR. Physical fitness influences stress reactions to extreme military training. Mil Med 2008; 173:738-42. [PMID: 18751589 DOI: 10.7205/milmed.173.8.738] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Physical fitness and physical conditioning have long been valued by the military for their roles in enhancing mission-specific performance and reducing risk of injury in the warfighter. It is not known whether physical fitness plays a causal role in attenuating acute military stress reactions or the evolution of post-traumatic stress disorder. OBJECTIVE The objective of this study was to determine whether physical fitness influences the impact of stressful events during military survival training in 31 men. METHODS Participants self-reported their most recent Physical Readiness Test scores and completed a trait anxiety measure before survival training. Participants also completed the Impact of Events Scale (IES) 24 hours after training. RESULTS Aerobic fitness was inversely associated with the total IES score (p < 0.01, adjusted R2 = 0.19). When adjusted for trait anxiety, this relationship was substantially attenuated and no longer significant (p = 0.11). Trait anxiety was inversely associated with aerobic fitness (p < 0.05) and positively related to IES (p < 0.001). CONCLUSIONS Physical fitness may buffer stress symptoms secondary to extreme military stress and its effects may be mediated via fitness-related attenuations in trait anxiety.
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Affiliation(s)
- Marcus K Taylor
- Stress Physiology Research Core, Department 162, Warfighter Performance, Naval Health Research Center, San Diego, CA 92106, USA.
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Taylor MK, Markham AE, Reis JP, Padilla GA, Potterat EG, Drummond S, Mujica-Parodi LR. Physical Fitness Influences Stress Reactions To Extreme Military Training. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000321522.42150.fa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Taylor MK, Sausen KP, Potterat EG, Mujica-Parodi LR, Reis JP, Markham AE, Padilla GA, Taylor DL. Stressful military training: endocrine reactivity, performance, and psychological impact. ACTA ACUST UNITED AC 2008; 78:1143-9. [PMID: 18064919 DOI: 10.3357/asem.2151.2007] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We examined the responsiveness of both cortisol and dehydroepiandrosterone sulfate (DHEAS) to the stress of survival training in military men and evaluated relationships to performance, peritraumatic dissociation, and the subsequent impact of stressful events. METHODS Baseline salivary cortisol samples were self-collected by 19 men at 0900 and 1930 in a free-living (FL) environment. DHEAS samples were also collected in a subset of this sample (N = 12). Samples were subsequently taken at similar time points during a stressful captivity (SC) phase of training. Repeated-measures analyses of variance with follow-up paired t-tests examined differences across time and conditions. RESULTS Significant increases were observed at both time points (0900 and 1930) from FL to SC in both cortisol (0900: 9.2 +/- 3.4 nmol x L(-1) vs. 18.4 +/- 10.5 nmol x L(-1); 1930: 3.5 +/- 3.0 nmol x L(-1) vs. 27.7 +/- 10.9 nmol x L(-1)) and DHEAS (0900: 1.7 +/- 1.3 ng x ml(-1) vs.6.7 +/- 3.5 ngx ml(-1); 1930: 1.5 0.84 ng x ml(-1) vs. 4.5 +/- 3.0 ng x ml(-1)). Also, overall performance during a high-intensity captivity-related challenge was inversely related to the DHEAS-cortisol ratio; conversely, overall performance during a low-intensity captivity-related challenge was positively related to DHEAS at the 0900 time point during SC. Dissociation was unrelated to endocrine indices measured during SC, while total impact of events was inversely related to percent change in DHEAS from FL to SC. CONCLUSIONS Cortisol and DHEAS increase in response to allostatic load, and may relate to human performance during SC as well as PTSD symptoms.
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Affiliation(s)
- Marcus K Taylor
- Naval Health Research Center, Dept. 162, P.O. Box 85122, San Diego, CA 92186-5122, USA.
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Taylor MK, Reis JP, Sausen KP, Padilla GA, Markham AE, Potterat EG, Drummond SP. Trait Anxiety and Salivary Cortisol During Free Living and Military Stress. ACTA ACUST UNITED AC 2008; 79:129-35. [DOI: 10.3357/asem.2131.2008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Taylor MK, Sausen KP, Mujica-Parodi LR, Potterat EG, Yanagi MA, Kim H. Neurophysiologic methods to measure stress during survival, evasion, resistance, and escape training. Aviat Space Environ Med 2007; 78:B224-30. [PMID: 17547323] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Training in Survival, Evasion, Resistance, and Escape (SERE) is required for U.S. military members at high risk of capture. This physically and psychologically demanding course is considered an analog to the stress imposed by war, captivity, and related events, thus offering a unique and unprecedented medium in which to systematically examine human stress and performance during a realistically intense operational context. Operational stress is multifaceted, manifesting cerebral, neuroendocrine, cardiac, and cognitive characteristics, and necessitating an integration of multiple methods of measurement to appropriately characterize its complexity. Herein we describe some of our present research methods and discuss their applicability to real-time monitoring and predicting of key aspects of human performance. A systems approach is taken, whereby some of the "key players" implicated in the stress response (e.g., cerebral, neuroendocrine, cardiac) are briefly discussed, to which we link corresponding investigative techniques (fMRI, acoustic startle eye-blink reflex, heart rate variability, and neuroendocrine sampling). Background and previous research with each investigative technique and its relationship to the SERE context is briefly reviewed. Ultimately, we discuss the operational applicability of each measure, that is, how each may be integrated with technologies that allow computational systems to adapt to the performer during operational stress.
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Affiliation(s)
- Marcus K Taylor
- Naval Health Research Center, PO Box 85122, San Diego, CA 92186-5122, USA.
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Perry W, Potterat EG, Braff DL. Self-monitoring enhances Wisconsin Card Sorting Test performance in patients with schizophrenia: performance is improved by simply asking patients to verbalize their sorting strategy. J Int Neuropsychol Soc 2001; 7:344-52. [PMID: 11311035 DOI: 10.1017/s1355617701733085] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Patients with schizophrenia have Wisconsin Card Sorting Test (WCST) deficits, which are commonly interpreted as reflecting frontal cortex-based executive dysfunction. One means of assessing the refractoriness of frontal-executive impairment is to utilize a training or modification strategy to improve WCST performance. In this study, 73 patients with schizophrenia were assigned to 1 of 2 groups. Group 1 received the standard WCST instructions for 64 cards (Condition 1). For the second 64-card deck, the patients were asked to verbalize the reason that they placed the card where they did after each sort (Condition 2). Group 2 received this modified instruction 1st (Condition 1) and then the standard instructions for the second deck (Condition 2). A group of normal comparison participants was also tested using standard instructions alone. Group 2 committed significantly fewer perseverative responses than did Group 1. Furthermore, there was no significant difference between Group 2 (Condition 1) and the normal participants. Group 1's performance improved when patients were exposed to the modified instructions (Condition 2). Additionally, poor premorbid factors and disorganized symptoms were associated with decreased benefit from the modified instructions across both groups. Cumulatively, these data suggest that a simple instruction may enhance executive function and impact WCST performance in patients with schizophrenia.
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Affiliation(s)
- W Perry
- University of California, San Diego, Department of Psychiatry, USA.
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