Syntactic Errors in Older Adults with Depression

Background and Objectives: This study investigated the differences in syntactic errors in older individuals with and without major depressive disorder and cognitive function disparities between groups. We also explored the correlation between syntax scores and depression severity. Materials and Methods: Forty-four participants, assessed for dementia with the Mini-Cog, completed the 15-item Geriatric Depression Scale (TGDS-15) and specific language tests. Following a single-anonymized procedure, clinical psychologists rated the tests and syntax scores. Results: The results showed that the depressive disorders group had lower syntax scores than the non-depressed group, primarily on specific subtests. Additionally, cognitive test scores were generally lower among the depressed group. A significant relationship between depression severity and syntax scores was observed (r = -0.426, 95% CI = -0.639, -0.143). Conclusions: In conclusion, major depressive disorder is associated with reduced syntactic abilities, particularly in specific tests. However, the relatively modest sample size limited the sensitivity of this association. This study also considered the potential influence of cultural factors. Unique linguistic characteristics in the study's context were also addressed and considered as potential contributors to the observed findings.

The development and validation of a new resilience inventory based on inner strength

There are a number of resilience scales with good psychometric properties. However, the various scales differ in their item content in accordance with the model of resilience the developer had in mind. Culture is one of the reasons for the difference. Thailand, one of the Buddhist cultures, has a different view on resilience compared with Western culture. This study aimed to develop and validate a resilience inventory created based on the inner strength concept using a confirmatory factor analysis (CFA) and Rasch measurement model. The resilience inventory (RI) was developed by creating new items representing inner strengths attributed to resilience. The inner strength was adopted to form the resilience construct, including perseverance, wisdom, patience, mindfulness, loving-kindness and equanimity. In addition, face and content validity were examined by experts in both mental health and Buddhism. The final RI comprised nine items with a 5-point Likert-type scale. The RI-9 was completed by 243 medical students who participated in the study, along with other measurements, i.e., Inner Strength-Based Inventory (iSBI), measuring the ten characteristics of perfection or inner strength, and the Core Symptom Index, measuring anxiety, depression and somatization symptoms. CFA, internal consistency and the Polytomous Rasch rating model were used to investigate the RI-9 construct validity. The mean age of the participants was 22.7 years (SD, 0.8); one-half were male (50%). The RI-9 construct demonstrated item hierarchy as follows: perseverance, patience (tolerance), mindfulness and equanimity, wisdom and loving-kindness. CFA showed that the unidimensional model fitted the data well. Rasch analysis showed no misfitting items and local dependence. The reliability of the person and item was good, and no disordered threshold was observed. Two items were found to exhibit differential item functioning due to sex. RI-9 scores were significantly related to all ten strengths from the iSBI, whereas they were negatively related to depression, anxiety, somatization and interpersonal difficulties. The RI-9 demonstrated validity and reliability. It constitutes a promising tool for outcome assessment in nonclinical populations. Further investigation on external validity as well as psychometric validation in other different cultures, should be encouraged.

Development of the Story Telling Examination for Early Mild Cognitive Impairment (Pre-Mild Cognitive Impairment) Screening

INTRODUCTION

Cognitive function prior to mild cognitive impairment (MCI) has become a burgeoning interest. Tools used to detect this early period before MCI are being pilot-tested. This study aimed to develop a new test to detect pre-MCI and to examine its content validity and feasibility.

METHODS

The Story Telling Examination for Early MCI Screening (STEEMS), an audio cognitive test, was developed. It covers ten cognitive domains, e.g., executive function, language fluency, abstract reasoning. Face and content validity were examined by experts in geriatric psychiatry and psychology. The content validity index was 1.00. STEEMS comprised 12 items with 2-4 types of scoring. The tool was further examined in 16 pilot samples for feasibility among healthy participants having no cognitive impairment (Montreal Cognitive Assessment [MoCA] test score ≥25, Mini-Cog ≥3) and no depressive symptoms (Geriatric Depression Scale <6).

RESULTS

The 16 healthy older individuals aged 59-73 years, mean age was 65.06 ± 4.07 years, were predominantly males (68.8%). STEEMS scores ranged from 10 to 25, with a mean of 18.38 (SD = 4.2). Thirteen percent obtained 100% correct on the STEEMS, 63% scored 68-92% correct, and 25% scored 40-60% correct. The pre-MCI scores are illustrated by a bell curve's graphical depiction, suggesting a normal distribution probability distribution. Correlation between STEEMS and MoCA test scores was observed. STEEMS showed to be feasible for early elderly or late adults as being brief and easy to understand. The time spent to administer was predictably less than 7 min.

DISCUSSION/CONCLUSION

STEEMS could potentially serve as a tool for pre-MCI screening. Further study and investigation in a larger population are required.

Effects of Combined Physical Movement Activity and Multifaceted Cognitive Training in Older People with Mild Neurocognitive Disorder in a Rural Community: A Randomized Control Trial

INTRODUCTION

Cognitive deterioration in older people with mild neurocognitive disorders (mNCD) increases the risk of progress to major NCD. Health professionals worldwide are trying to find strategies for prevention. There is a limited number of studies that deal with cultural conditions in northern Thailand.

OBJECTIVES

This study aimed to investigate the effects of a combination of physical movement activity and multifaceted cognitive training on cognitive function in older people with mNCD.

METHODS

A randomized control trial involving 70 mNCD people, according to DSM-5 criteria, was conducted on an intervention group and a control group (n = 35 each). The program for the intervention group included 24 sessions (twice a week). The outcome measures on cognitive function were assessed before and after the intervention by means of composite cognitive measures for older people, i.e., the Trail-Making Test (TMT), Digit Span (DS), Verbal Fluency (VF), Word-List Learning (WLL), and Block Design (BD).

RESULTS

The combined intervention enhanced cognitive function. TMT-A was significantly improved in the intervention group. There were significant improvements in DS sequence scores, letter verbal fluency (LVF), and category verbal fluency (CVF). Comparing the groups, there were significant differences in LVF including immediate and delayed recall. BD improved significantly in the intervention group.

CONCLUSIONS

The combined intervention appeared to be effective in delaying/preventing cognitive deterioration and cognitive functional decline in people with mNCD. Further studies on a variation of treatments suited to cultural conditions and their effects are needed. Trials in other communities are also recommended.

Fornix Integrity Is Differently Associated With Cognition in Healthy Aging and Non-amnestic Mild Cognitive Impairment: A Pilot Diffusion Tensor Imaging Study in Thai Older Adults

Damage to the fornix leads to significant memory impairment and executive dysfunction and is associated with dementia risk. We sought to identify if fornix integrity and fiber length are disrupted in mild cognitive impairment (MCI) and how they associate with cognition. Data from 14 healthy older adult controls (HCs) and 17 subjects with non-amnestic MCI (n-aMCI) were analyzed. Diffusion tensor imaging (DTI) at 1.5 Tesla MRI was performed to enable manual tracing of the fornix and calculation of DTI parameters. Higher fractional anisotropy of body and column of the fornix was associated with better executive functioning and memory, more strongly in the HC than in the n-aMCI group. Fornix fiber tract length (FTL) was associated with better executive function, more strongly in the n-aMCI than in the HC group, and with better memory, more strongly in the HC than in the n-aMCI group. These results highlight a decline in the contributions of the fornix to cognition in n-aMCI and suggest that maintenance of fornix FTL is essential for sustaining executive functioning in people with n-aMCI.

Clinical characteristics and immunological status of patients with 22q11.2 deletion syndrome in Northern Thailand

BACKGROUND

22q11.2 deletion syndrome is one of the most prevalent microdeletion syndromes in humans. The syndrome is characterized by extensive phenotypic variability.

OBJECTIVE

to investigate the clinical characteristics, immunological features, and intellectual status of 22q11.2 deletion syndrome patients at Chiang Mai University Hospital, Thailand.

METHODS

Patients who had a confirmed diagnosis of 22q11.2 deletion syndrome by fluorescent in situ hybridization (FISH) were enrolled. Data collated and evaluated included that pertaining to history, physical examination, laboratory testing including T-cell, immunoglobulin, calcium, thyroid and parathyroid levels in the blood, cardiac and urological imaging, and intellectual status.

RESULTS

34 patients diagnosed with 22q11.2 deletion syndrome; 18 (53%) were female. The median age of patients was 18.5 months (IQR; 1.5-35.8). Ninety-one percent of patients had characteristic facial features; 94% had a congenital heart defect with tetralogy of Fallot being the most frequent (72%); 88% had hypocalcemia, and 35% had genitourinary tract abnormalities. Recurrence of 22q11.2 deletion syndrome in the family was detected in 18% of cases. Twenty-eight patients (82%) were found to have a low number or percentage of T-cells. Five patients (15%) had low immunoglobulin levels. Intellectual disability (IQ/DQ scores < 70) were found in 20 out of 25 patients who were evaluated (80%), whereas the other five (20%) performed at a level of borderline intellectual function.

CONCLUSIONS

Tetralogy of Fallot, hypocalcemia, immunologic defect, and cognitive impairment were common in our 22q11.2 deletion syndrome study group. We recommend that all affected patients have a multi-system evaluation by a comprehensive care team.

Development and validation of a 6-item Revised UCLA Loneliness Scale (RULS-6) using Rasch analysis

OBJECTIVE

The UCLA Loneliness Scale, containing 20 items, is one of the commonly used loneliness scales. Some shorter versions have been developed using factor analysis. The study aimed to shorten the UCLA Loneliness Scale using Rasch and factor analysis methods and test the psychometric properties of the new scale.

METHODS

The full sample of the study included 719 respondents, divided into three subsamples (205, 324, and 190 for samples 1-3, respectively). The original, 20-item Revised UCLA Loneliness Scale (R-ULS) was shortened using 205 students (sample 1); the shortened scale was then validated for construct and concurrent validity with 324 students (sample 2) and 190 clinical participants (sample 3). Confirmatory factor analysis and Rasch analysis were used for construct validity. Convergent, discriminant, and concurrent validity were assessed by exploring the correlation with other psychological measurements.

RESULTS

In sample 1, the R-ULS was shortened to a 6-item scale (RULS-6) that fits the Rasch model. The RULS-6 met the criteria of unidimensionality and local independence without differential item functioning due to age and sex, and good targeting the clinical sample. Person Separation Index (PSI) reflected that reliability from the Rasch perspective was acceptable. However, collapsing categories 2 (sometime) and 3 (rarely) may be required in a clinical sample. When tested in samples 2 and 3, the RULS-6 fits the Rasch measurement model. Convergent and discriminant validity were demonstrated with interpersonal problems and attachment scales. As expected, a positive correlation was found between RULS-6 and anxiety, depression subscale, interpersonal difficulties, and somatization subscales denoting concurrent validity. Cronbach's alpha of the RULS-6 was good (.83).

CONCLUSION

Using Rasch analysis, the proposed RULS-6 constituted a 70% reduction of the number of original items, yet preserved the psychometric properties in independent samples of students and psychiatric outpatients. Statement of contribution What is already known on this subject? The UCLA Loneliness Scale is a common instrument used to gauge loneliness levels. The 20-item revised scale (R-ULS) has acceptable psychometric properties but its construct varies. Due to the length of the questionnaire, administration of R-ULS is not always practical. Short versions vary in items and were developed with classic test theory (e.g., factor analysis). Rasch analysis - providing more accuracy based on measurement theory - could be used instead. What does this study add? Using a Rasch analysis approach, a 6-item scale of loneliness (RULS-6) was created. The RULS-6 was tested in student and clinical samples, meeting Rasch measurement model criteria. The RULS-6 showed promising psychometrics to be used in both non-clinical and clinical samples.

Does MMPI assessed at medical school admission predict psychological problems in later years?

Objective

Results

Electronic supplementary material

Acute effects of essential oil blend containing phlai oil on mood among healthy male volunteers: Randomized controlled trial

Background Essential oil blend (ESOB) containing Zingiber montanum or Phlai and Zingiber tenuiscapus oils as the major components has high levels of terpenes such as sabinene, terpinene, terpinolene, and terpine-4-ol. Phlai is well known for its analgesic property, but its effects on mood remain unclear. This study aimed to investigate the acute effects of inhaling the ESOB containing phlai essential oils on mood and stress among healthy volunteers. Methods A prospective, randomized, double-blinded, controlled trial pilot study was conducted among 38 healthy male volunteers; 19 in the ESOB containing phlai oil group and 19 in the control group, which used olive oil. One single inhalation was provided continuously for 15 min via hot steam. Mood status was assessed pre- and post-intervention using the Visual Analog Scales for Mood, Anxiety, Stress and Alertness (MASA). Rorschach tests, in a modified analysis, were also employed. One-way ANCOVA was used to determine statistical differences of the mood test results between ESOB containing phlai oil and olive oil. Results Mean age of the participants was 22.11 (SD 2.1) years. Both ESOB containing phlai oil and olive oil increased the post-test scores of positive mood and reduced the scores of negative mood. However, no difference was observed regarding the mood test scores between groups, except concerning the Rorschach stress test (F (1,38)=6.486, p=0.015). The variance of change, explained by the model (R square), was 32.8%, while the adjusted R-squared was 0.290. Conclusions Single inhalation aromatherapy using ESOB containing phlai oil or olive oil showed an immediate improvement of mood states among healthy young male volunteers by easing the negative emotions and enhancing positive emotions, especially feelings of pleasure and contentment. Natural blend of phlai essential oils was more efficacious than olive oil in reducing emotional stress.

Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's r_s's=0.33-0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Development of the mizes anorectic cognitions questionnaire-revised: psychometric properties and factor structure in a large sample of eating disorder patients

OBJECTIVE

This project was designed to develop and test the psychometric properties and factor structure of a revision of the Mizes Anorectic Cognitions questionnaire (MAC). The goals of the revision were to improve the reliability and discriminant validity of the Weight and Approval subscale and to equalize the length of the three subscales. Also, the study compared the original MAC and the MAC-R in terms of their psychometric properties.

METHOD

Twenty-four new items were developed for potential inclusion in the MAC-R, in addition to the original 33 items of the MAC. These items were administered to 205 eating disorder patients from five eating disorder clinics or programs, including inpatient, outpatient, and residential treatment settings that served diverse patient populations. Additionally, other measures of eating disorder constructs were administered to assess construct validity.

RESULTS

Factor analysis of the large pool of items and item reduction resulted in the final 24-item MAC-R, each subscale being eight items in length. Results showed that the MAC-R highly correlated with the MAC and other eating disorder questionnaires. Reliability of the MAC-R was improved over that of the MAC. Two subscales of the MAC-R discriminated among diagnostic groups, whereas the original MAC did not, indicating improved sensitivity of the revised scale.

DISCUSSION

The MAC-R appears to be an improvement over the original MAC. It provides useful information on the cognitions of eating-disordered patients and merits further investigation into its psychometric properties.

Attention, stress and negative emotion in persistent sleep-onset and sleep-maintenance insomnia

This study investigated the relation of negative emotions, attention and stress to sleep parameters in insomniacs. It also assessed whether sleep-onset insomniacs differ from sleep-maintenance/mixed insomniacs in the relations of these variables to sleep parameters. Fourteen sleep-onset insomniacs, 13 sleep-maintenance or mixed insomniacs and 13 normal sleepers were recruited using two sequential questionnaires. The groups differed significantly on diagnostically relevant sleep parameters, assessed over 1 week by sleep diary. After completing standard anxiety, anger and depression inventories, subjects participated in two laboratory procedures during which electrophysiological responses were recorded: orienting response habituation and emotional stress elicitation. The 28 significant correlations of sleep parameters with emotion, habituation and stress measures averaged r = 0.415. In multiple regression analyses, emotion, attention and stress variables accounted for an average of 41% of the variance in sleep parameters (mean R = 0.64). Discriminant function analysis using these variables correctly classified 66% of the subjects into the three groups. It was concluded that negative emotions, stress responsiveness and attentional factors interact to influence insomnia.