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Allostatic load and cognitive recall among young adults: Racial, ethnic, and sex-specific variations 年轻成年人的静态负荷和认知记忆:种族、民族和性别差异
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-19 DOI: 10.1017/s1355617724000298
Elizabeth Evans, Molly Jacobs, Charles Ellis
Introduction: While factors such as age and education have been associated with persistent differences in functional cognitive decline, they do not fully explain observed variations particularly those between different racial/ethnic and sex groups. The aim of this study was to explore the association between allostatic load (AL) and cognition in a racially diverse cohort of young adults. Methods: Utilizing Wave V of the National Longitudinal Study of Adolescent to Adult Health – a nationally representative, longitudinal survey of adults aged 34–44, this study utilized primary data from 10 immune, cardiovascular, and metabolic biomarkers to derive an AL Index. Cognition was previously recorded through word and number recall scores. Regression analysis evaluated the association between cognitive recall, AL, age, sex, and race/ethnicity. Results: Regression results indicated statistically higher AL scores among Blacks (IRR = 1.09, CI = 1.01, 1.19) compared to Whites and lower AL score among females compared to males (IRR = 0.76, CI = 0.72, 0.81). At zero AL, Blacks (IRR = 1.2399, CI = 1.2398, 1.24) and Other races (IRR = 1.4523, CI = 1.452, 1.4525) had higher recall while Hispanics (IRR = 0.808, CI = 0.8079, 0.8081) had lower recall compared to Whites. Relative to males, females had higher number recall (IRR = 1.1976, CI = 1.1976, 1.1977). However, at higher, positive levels of AL, Blacks (IRR = 0.9554, CI = 0.9553, 0.9554), Other races (IRR = 0.9479, CI = 0.9479, 0.9479) and females (IRR = 0.9655, CI = 0.9655, 0.9655) had significantly lower number recall than Whites and males respectively. Conclusions: Race and sex differences were observed in recall at different levels of AL. Findings demonstrate the need for further exploration of cognition in young adults across diverse populations that includes examination of AL.
简介虽然年龄和教育等因素与认知功能衰退的持续差异有关,但它们并不能完全解释观察到的差异,尤其是不同种族/民族和性别群体之间的差异。本研究的目的是探讨不同种族的年轻成年人群体中的代谢负荷(AL)与认知能力之间的关系。研究方法全国青少年到成人健康纵向研究》是一项针对 34-44 岁成人进行的具有全国代表性的纵向调查,本研究利用该调查第五波的 10 个免疫、心血管和代谢生物标志物的原始数据得出 AL 指数。认知之前通过单词和数字回忆得分进行记录。回归分析评估了认知回忆、AL、年龄、性别和种族/民族之间的关联。结果显示回归结果表明,与白人相比,黑人的认知能力指数得分更高(IRR = 1.09,CI = 1.01,1.19),女性的认知能力指数得分低于男性(IRR = 0.76,CI = 0.72,0.81)。在 AL 为零时,黑人(IRR = 1.2399,CI = 1.2398,1.24)和其他种族(IRR = 1.4523,CI = 1.452,1.4525)的回忆率较高,而与白人相比,西班牙裔(IRR = 0.808,CI = 0.8079,0.8081)的回忆率较低。与男性相比,女性的数字回忆率较高(IRR = 1.1976,CI = 1.1976,1.1977)。然而,在较高的、积极的 AL 水平下,黑人(IRR = 0.9554,CI = 0.9553,0.9554)、其他种族(IRR = 0.9479,CI = 0.9479,0.9479)和女性(IRR = 0.9655,CI = 0.9655,0.9655)的数字回忆能力分别显著低于白人和男性。结论在不同的 AL 水平下,不同种族和性别的回忆能力存在差异。研究结果表明,有必要进一步研究不同人群中年轻人的认知能力,其中包括对AL的研究。
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引用次数: 0
Social cognition and healthy aging: Cross-sectional associations of emotion perception, theory of mind, and emotional empathy 社会认知与健康老龄化:情绪感知、心智理论和情感共鸣的横断面关联
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-19 DOI: 10.1017/s135561772400033x
Amy Jarvis, Stephanie Wong, Michael Weightman, Hannah Keage
Objective: Older adults are identified to have reduced social cognitive performance compared to younger adults. However, few studies have examined age-associations throughout later life to determine whether these reductions continue with advancing age. Method: This study assesses cross-sectional associations of emotion perception, cognitive and affective theory of mind (ToM), and emotional empathy in a healthy sample of 157 adults aged 50–89 years (M = 65.31, SD = 9.00, 68% female sex). Emotion perception, cognitive ToM, and affective ToM were measured using The Awareness of Social Inference Test Short Form (TASIT-S), while affective ToM was also measured using Reading the Mind in the Eyes Revised (RME-R). Emotional empathy was measured using the Empathy Quotient. Results: Multiple regression analyses, adjusting for multiple comparisons, revealed a moderate negative association between age and emotion perception for all emotions combined, as well as for sad and revolted expressions, but not happy, neutral, anxious, or angry expressions. Age had a negative, moderate association with first-order cognitive, second-order cognitive, and affective ToM measured using TASIT-S, but not RME-R. Age was not significantly associated with emotional empathy. Conclusions: This study contributes to the limited understanding of age-related associations of social cognitive performance throughout later life. This knowledge can inform future research examining the clinical utility of including social cognitive measures in neuropsychological screening and diagnostic tools for later-life neurological disorders.
目的与年轻人相比,老年人的社会认知能力有所下降。然而,很少有研究对整个晚年生活中的年龄关联进行研究,以确定这些降低是否会随着年龄的增长而持续。研究方法本研究评估了 157 名年龄在 50-89 岁之间的健康成年人(男 = 65.31,女 = 9.00,女性占 68%)在情绪感知、认知和情感心智理论(ToM)以及情感共鸣方面的横断面关联。情绪感知、认知心智图式和情感心智图式采用社会推理意识测验简表(TASIT-S)进行测量,情感心智图式则采用 "读心术修订版"(RME-R)进行测量。情感移情使用移情商数进行测量。研究结果经多重比较调整后进行的多元回归分析表明,年龄与情绪感知之间存在中度负相关,包括所有情绪,以及悲伤和反感的表情,但不包括快乐、中性、焦虑或愤怒的表情。年龄与使用 TASIT-S 测量的一阶认知、二阶认知和情感 ToM 呈中度负相关,但与 RME-R 无关。年龄与情感移情没有明显关联。结论这项研究有助于加深人们对晚年社会认知表现与年龄相关性的有限了解。这些知识可为今后的研究提供参考,以探讨将社会认知测量纳入神经心理学筛查和晚年神经系统疾病诊断工具的临床实用性。
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引用次数: 0
Cognitive reserve as residual variance in cognitive performance: Latent dimensionality, correlates, and dementia prediction 认知储备作为认知表现的残差:潜在维度、相关性和痴呆症预测
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000353
Stephen R. Aichele
Objectives: Cognitive reserve (CR) is typically operationalized as episodic memory residualized on brain health indices. The dimensionality of more generalized models of CR has rarely been examined. Methods: In a sample of N = 113 dementia-free older adults (ages 62–86 years at MRI scan; 58.4% women), the domain-specific representation of general cognition (COG) before vs. after residualization on brain indices (brain volume loss, cerebral blood flow, white matter hyperintensities) was compared (i.e., COG vs. CR). COG and CR were assessed by 15 tasks spanning five domains: processing speed, verbal memory, visuospatial memory, fluid reasoning, and vocabulary. Measurement invariance and item-construct representation were tested in a series of structural factor analyses. COG and CR were then examined in relation to 22 risk and protective factors and dementia status at time of death. Results: Item-factor loadings differed such that CR more strongly emphasized fluid reasoning. More years of education, higher occupational class, more hobbies/interests, and fewer difficulties with personal mobility similarly predicted better COG and CR. Only the sub-domain of visuospatial memory (both before and after residualization) was associated with conversion to dementia by end-of-life (r = −.30; p = .01). Conclusions: Results provide tentative support for the role of fluid reasoning (intelligence) as a potential compensatory factor for age- and/or neuropathology-related reductions in processing speed and memory. Intellectually stimulating work, efforts to preserve personal mobility, and a diversity of hobbies and interests may attenuate age- and/or pathology-related reductions in cognitive functioning prior to dementia onset.
目的:认知储备(CR)通常被操作化为大脑健康指数上的外显记忆残余。目前还很少有人对更广泛的认知储备模型的维度进行研究。研究方法在 N = 113 位无痴呆症的老年人(磁共振成像扫描时年龄为 62-86 岁;58.4% 为女性)样本中,比较了脑指数(脑容量损失、脑血流量、白质高密度)残余化前后一般认知(COG)的特定领域代表性(即 COG 与 CR)。COG和CR通过15项任务进行评估,这些任务横跨五个领域:处理速度、言语记忆、视觉空间记忆、流体推理和词汇。通过一系列结构因素分析,对测量不变性和项目-结构表征进行了测试。然后研究了COG和CR与22个风险和保护因素以及死亡时痴呆状态的关系。结果显示项目因子载荷不同,CR更强调流体推理。受教育年限越长、职业等级越高、爱好/兴趣越多、个人行动困难越少,也同样预示着COG和CR越好。只有视觉空间记忆子域(残差化之前和之后)与临终前转为痴呆症有关(r = -.30; p = .01)。结论研究结果初步支持了流体推理(智力)作为潜在补偿因素对与年龄和/或神经病理相关的处理速度和记忆力下降的作用。激励智力的工作、保持个人活动能力的努力以及兴趣爱好的多样性可能会减轻痴呆症发病前与年龄和/或病理有关的认知功能下降。
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引用次数: 0
Coping patterns associations with cognitive function in older adults 应对模式与老年人认知功能的关系
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000377
Rebecca K. MacAulay, Morgan Tallman, Taylor R. Maynard, Holly Timblin
Objective: Cognitive function may contribute to variability in older adults’ ability to cope with chronic stress; however, limited research has evaluated this relationship. This study investigated the relationship between theoretically derived coping domains and cognitive function in 165 middle-to-older adults during the Omicron stage of COVID-19. Method: Participants completed a clinical interview and self-report measures of health. The National Alzheimer’s Coordinating Center Uniform Data Set neuropsychological battery was used to evaluate memory, language, executive function/speed, and working memory. Structural equation modeling evaluated the underlying factor structure of the Brief COPE adapted for COVID-19. Results: The data supported the proposed second-order Approach factor comprised of Problem-Solving and Emotion Regulation (ER) strategies and a first-order Avoidance factor. Higher Avoidance was associated with greater depression symptoms, lower income and worse memory, executive function, working memory, and verbal fluency performance. Higher Problem-Solving was associated with better verbal fluency performance. ER strategies were not significantly associated with cognitive function. The use of Problem-Solving was not associated with less Avoidance. Greater use of Problem-Solving, ER, and Avoidance were all associated with higher levels of stress. Post-hoc analyses found that higher Acceptance was the only coping strategy associated with less stress. Conclusions: These findings demonstrate that older adults with worse cognitive function were more likely to use Avoidance during the pandemic, which could result in prolonged stress and adverse health consequences. Future research is warranted to investigate whether acceptance-based interventions reduce the avoidance and impact of stress on health in vulnerable older adults.
目的:认知功能可能会导致老年人应对慢性压力的能力发生变化;然而,对这种关系进行评估的研究却很有限。本研究调查了 165 名中老年人在 COVID-19 的 Omicron 阶段从理论上得出的应对领域与认知功能之间的关系。研究方法参与者完成了临床访谈和自我健康报告测量。国家阿尔茨海默氏症协调中心统一数据集神经心理测试用于评估记忆、语言、执行功能/速度和工作记忆。结构方程模型评估了为 COVID-19 改编的简要 COPE 的基本因子结构。结果:数据支持所提出的由解决问题和情绪调节(ER)策略组成的二阶接近因子和一阶回避因子。回避程度越高,抑郁症状越严重,收入越低,记忆力、执行功能、工作记忆和语言流畅性越差。问题解决能力越强,语言流畅性越好。应急策略与认知功能的关系不大。使用 "问题解决 "策略与减少回避并无关联。更多地使用 "解决问题"、"应急 "和 "回避 "都与更高的压力水平有关。事后分析发现,较高的接受度是唯一与较小压力相关的应对策略。结论这些研究结果表明,认知功能较差的老年人在大流行期间更有可能使用回避策略,这可能会导致长期的压力和不良的健康后果。今后有必要开展研究,探讨以接纳为基础的干预措施是否能减少易受伤害的老年人对压力的回避和压力对健康的影响。
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引用次数: 0
Anxiety in late-life depression is associated with poorer performance across multiple cognitive domains 晚年抑郁症患者的焦虑与多个认知领域的较差表现有关
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000262
Maria Kryza-Lacombe, Michelle T. Kassel, Philip S. Insel, Emma Rhodes, David Bickford, Emily Burns, Meryl A. Butters, Duygu Tosun, Paul Aisen, Rema Raman, Andrew J. Saykin, Arthur W. Toga, Clifford R. Jack, Michael W. Weiner, Craig Nelson, R. Scott Mackin
Objective: Anxiety is a common comorbid feature of late-life depression (LLD) and is associated with poorer global cognitive functioning independent of depression severity. However, little is known about whether comorbid anxiety is associated with a domain-specific pattern of cognitive dysfunction. We therefore examined group differences (LLD with and without comorbid anxiety) in cognitive functioning performance across multiple domains. Method: Older adults with major depressive disorder (N = 228, ages 65–91) were evaluated for anxiety and depression severity, and cognitive functioning (learning, memory, language, processing speed, executive functioning, working memory, and visuospatial functioning). Ordinary least squares regression adjusting for age, sex, education, and concurrent depression severity examined anxiety group differences in performance on tests of cognitive functioning. Results: Significant group differences emerged for confrontation naming and visuospatial functioning, as well as for verbal fluency, working memory, and inhibition with lower performance for LLD with comorbid anxiety compared to LLD only, controlling for depression severity. Conclusions: Performance patterns identified among older adults with LLD and comorbid anxiety resemble neuropsychological profiles typically seen in neurodegenerative diseases of aging. These findings have potential implications for etiological considerations in the interpretation of neuropsychological profiles.
目的:焦虑是晚年抑郁症(LLD)的常见并发症,与抑郁症的严重程度无关,与较差的整体认知功能有关。然而,人们对合并焦虑症是否与认知功能障碍的特定领域模式有关却知之甚少。因此,我们研究了多个领域认知功能表现的组间差异(伴有和不伴有焦虑的晚期抑郁症患者)。研究方法对患有重度抑郁症的老年人(228 人,年龄 65-91 岁)的焦虑和抑郁严重程度以及认知功能(学习、记忆、语言、处理速度、执行功能、工作记忆和视觉空间功能)进行评估。在对年龄、性别、教育程度和并发抑郁严重程度进行调整后,普通最小二乘法回归检验了焦虑组在认知功能测试中的表现差异。结果显示在对抗命名和视觉空间功能以及言语流畅性、工作记忆和抑制能力方面出现了显著的组间差异,在控制抑郁严重程度的情况下,合并焦虑症的 LLD 与仅合并焦虑症的 LLD 相比表现较差。结论在患有 LLD 并合并焦虑症的老年人中发现的表现模式类似于老年神经退行性疾病中常见的神经心理学特征。这些发现对解释神经心理学特征时的病因学考虑具有潜在的意义。
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引用次数: 0
Identification of amnestic mild cognitive impairment among Black and White community-dwelling older adults using NIH Toolbox Cognition tablet battery 使用美国国立卫生研究院工具箱认知平板电脑电池识别黑人和白人社区老年人的失忆性轻度认知障碍
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000213
Taylor Rigby, Allyson M. Gregoire, Johnathan Reader, Yonatan Kahsay, Jordan Fisher, Anson Kairys, Arijit K. Bhaumik, Annalise Rahman-Filipiak, Amanda Cook Maher, Benjamin M. Hampstead, Judith L. Heidebrink, Voyko Kavcic, Bruno Giordani
Objectives: Identify which NIH Toolbox Cognition Battery (NIHTB-CB) subtest(s) best differentiate healthy controls (HC) from those with amnestic mild cognitive impairment (aMCI) and compare the discriminant accuracy between a model using a priori “Norm Adjusted” scores versus “Unadjusted” standard scores with age, sex, race/ethnicity, and education controlled for within the model. Racial differences were also examined. Methods: Participants were Black/African American (B/AA) and White consensus-confirmed (HC = 96; aMCI = 62) adults 60–85 years old that completed the NIHTB-CB for tablet. Discriminant function analysis (DFA) was used in the Total Sample and separately for B/AA (n = 80) and White participants (n = 78). Results: Picture Sequence Memory (an episodic memory task) was the highest loading coefficient across all DFA models. When stratified by race, differences were noted in the pattern of the highest loading coefficients within the DFAs. However, the overall discriminant accuracy of the DFA models in identifying HCs and those with aMCI did not differ significantly by race (B/AA, White) or model/score type (Norm Adjusted versus Unadjusted). Conclusions: Racial differences were noted despite the use of normalized scores or demographic covariates—highlighting the importance of including underrepresented groups in research. While the models were fairly accurate at identifying consensus-confirmed HCs, the models proved less accurate at identifying White participants with an aMCI diagnosis. In clinical settings, further work is needed to optimize computerized batteries and the use of NIHTB-CB norm adjusted scores is recommended. In research settings, demographically corrected scores or within model correction is suggested.
目标:确定美国国立卫生研究院工具箱认知测验(NIHTB-CB)的哪些子测验最能区分健康对照组(HC)和失忆性轻度认知障碍(AMCI)患者:确定哪些 NIH 工具箱认知测试(NIHTB-CB)子测试最能区分健康对照组(HC)和伴有失忆性轻度认知障碍(aMCI)的患者,并比较使用先验 "规范调整 "分数与 "未调整 "标准分数的模型之间的判别准确性,同时在模型中控制年龄、性别、种族/民族和教育程度。此外,还研究了种族差异。研究方法受试者为黑人/非洲裔美国人(B/AA)和白人共识确认(HC = 96;aMCI = 62)的 60-85 岁成年人,他们完成了 NIHTB-CB 药片。在总样本中使用了判别函数分析 (DFA),并分别对黑人/非洲裔美国人(n = 80)和白人参与者(n = 78)进行了分析。结果在所有 DFA 模型中,图片序列记忆(一种外显记忆任务)的负荷系数最高。如果按种族进行分层,则会发现 DFA 中最高负载系数的模式存在差异。然而,DFA 模型在识别 HC 和 aMCI 患者方面的总体判别准确性并没有因种族(B/AA、白人)或模型/评分类型(规范调整与未调整)的不同而产生显著差异。结论:尽管使用了规范化评分或人口统计学协变量,但仍发现了种族差异--这凸显了将代表性不足的群体纳入研究的重要性。虽然模型在识别共识确认的高危人群方面相当准确,但在识别被诊断为 aMCI 的白人参与者方面,模型的准确性较低。在临床环境中,需要进一步优化计算机化电池,建议使用 NIHTB-CB 标准调整分数。在研究环境中,建议使用人口统计学校正分数或模型内校正。
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引用次数: 0
Neuropsychological application of the International Test Commission Guidelines for Translation and Adapting of Tests 国际测验委员会《测验翻译和改编准则》在神经心理学方面的应用
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000286
Christopher Minh Nguyen, Shathani Rampa, Mathew Staios, T. Rune Nielsen, Busisiwe Zapparoli, Xinyi Emily Zhou, Lingani Mbakile-Mahlanza, Juliet Colon, Alexandra Hammond, Marc Hendriks, Tumelo Kgolo, Yesenia Serrano, María J. Marquine, Aparna Dutt, Jonathan Evans, Tedd Judd
Objective: The number of test translations and adaptations has risen exponentially over the last two decades, and these processes are now becoming a common practice. The International Test Commission (ITC) Guidelines for Translating and Adapting Tests (Second Edition, 2017) offer principles and practices to ensure the quality of translated and adapted tests. However, they are not specific to the cognitive processes examined with clinical neuropsychological measures. The aim of this publication is to provide a specialized set of recommendations for guiding neuropsychological test translation and adaptation procedures. Methods: The International Neuropsychological Society’s Cultural Neuropsychology Special Interest Group established a working group tasked with extending the ITC guidelines to offer specialized recommendations for translating/adapting neuropsychological tests. The neuropsychological application of the ITC guidelines was formulated by authors representing over ten nations, drawing upon literature concerning neuropsychological test translation, adaptation, and development, as well as their own expertise and consulting colleagues experienced in this field. Results: A summary of neuropsychological-specific commentary regarding the ITC test translation and adaptation guidelines is presented. Additionally, examples of applying these recommendations across a broad range of criteria are provided to aid test developers in attaining valid and reliable outcomes. Conclusions: Establishing specific neuropsychological test translation and adaptation guidelines is critical to ensure that such processes produce reliable and valid psychometric measures. Given the rapid global growth experienced in neuropsychology over the last two decades, the recommendations may assist researchers and practitioners in carrying out such endeavors.
目的:在过去二十年里,测试翻译和改编的数量呈指数级增长,这些过程现已成为一种普遍做法。国际测验委员会(ITC)《测验翻译和改编指南》(2017 年第二版)提供了确保翻译和改编测验质量的原则和实践。然而,这些准则并不针对临床神经心理学测量所检查的认知过程。本出版物旨在提供一套专门的建议,用于指导神经心理学测验的翻译和改编程序。方法:国际神经心理学会文化神经心理学特别兴趣小组(Cultural Neuropsychology Special Interest Group)成立了一个工作组,其任务是扩展 ITC 指南,为神经心理学测验的翻译/改编提供专门的建议。代表十多个国家的作者们参考了有关神经心理学测验翻译、改编和开发的文献,以及他们自己的专业知识,并咨询了该领域经验丰富的同事,最终制定了神经心理学应用 ITC 指南。结果:本文概述了有关 ITC 测验翻译和改编指南的神经心理学评论。此外,还提供了在各种标准中应用这些建议的实例,以帮助测验开发人员获得有效、可靠的结果。结论:制定具体的神经心理学测验翻译和改编指南对于确保此类过程产生可靠有效的心理测量结果至关重要。鉴于过去二十年来神经心理学在全球范围内的快速发展,这些建议可以帮助研究人员和从业人员开展此类工作。
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引用次数: 0
Internalizing and somatic symptoms influence the discrepancy between subjective and objective cognitive difficulties in adults with ADHD who have valid and invalid test scores 内化症状和躯体症状对测试成绩有效和无效的成人多动症患者主观和客观认知困难之间差异的影响
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000365
John-Christopher A. Finley, Anthony D. Robinson, Hannah B. VanLandingham, Devin M. Ulrich, Matthew S. Phillips, Jason R. Soble
Objectives: This study investigated the relationship between various intrapersonal factors and the discrepancy between subjective and objective cognitive difficulties in adults with attention-deficit hyperactivity disorder (ADHD). The first aim was to examine these associations in patients with valid cognitive symptom reporting. The next aim was to investigate the same associations in patients with invalid scores on tests of cognitive symptom overreporting. Method: The sample comprised 154 adults who underwent a neuropsychological evaluation for ADHD. Patients were divided into groups based on whether they had valid cognitive symptom reporting and valid test performance (n = 117) or invalid cognitive symptom overreporting but valid test performance (n = 37). Scores from multiple symptom and performance validity tests were used to group patients. Using patients’ scores from a cognitive concerns self-report measure and composite index of objective performance tests, we created a subjective-objective discrepancy index to quantify the extent of cognitive concerns that exceeded difficulties on objective testing. Various measures were used to assess intrapersonal factors thought to influence the subjective-objective cognitive discrepancy, including demographics, estimated premorbid intellectual ability, internalizing symptoms, somatic symptoms, and perceived social support. Results: Patients reported greater cognitive difficulties on subjective measures than observed on objective testing. The discrepancy between subjective and objective scores was most strongly associated with internalizing and somatic symptoms. These associations were observed in both validity groups. Conclusions: Subjective cognitive concerns may be more indicative of the extent of internalizing and somatic symptoms than actual cognitive impairment in adults with ADHD, regardless if they have valid scores on cognitive symptom overreporting tests.
研究目的本研究调查了注意力缺陷多动障碍(ADHD)成人患者的各种人际因素与主观和客观认知困难之间的差异之间的关系。研究的第一个目的是在认知症状报告有效的患者中研究这些关联。其次是研究在认知症状过度报告测试中得分无效的患者的相同关联。研究方法样本包括154名接受过多动症神经心理学评估的成年人。根据患者是否具有有效的认知症状报告和有效的测试表现(n = 117)或无效的认知症状过度报告但具有有效的测试表现(n = 37)将其分为两组。采用多种症状和表现有效性测试的得分对患者进行分组。利用患者在认知问题自我报告测量中的得分和客观表现测试的综合指数,我们创建了一个主客观差异指数,以量化认知问题超出客观测试困难的程度。我们还使用了各种测量方法来评估被认为会影响主观-客观认知差异的个人内部因素,包括人口统计学、估计的病前智力、内化症状、躯体症状和感知到的社会支持。结果显示与客观测试结果相比,患者在主观测量中报告的认知困难更大。主观评分与客观评分之间的差异与内化症状和躯体症状的关系最为密切。这些关联在两个有效性组中都能观察到。结论:与实际认知障碍相比,主观认知问题可能更能反映成人多动症患者的内化症状和躯体症状的程度,无论他们在认知症状过度报告测试中的得分是否有效。
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引用次数: 0
Using augmented reality to assess spatial neglect: The Free Exploration Test (FET) 利用增强现实技术评估空间忽视:自由探索测试 (FET)
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000274
Britta Stammler, Marian Lambert, Thomas Schuster, Kathrin Flammer, Hans-Otto Karnath
Background: To capture the distortion of exploratory activity typical of patients with spatial neglect, traditional diagnostic methods and new virtual reality applications use confined workspaces that limit patients’ exploration behavior to a predefined area. Our aim was to overcome these limitations and enable the recording of patients’ biased activity in real, unconfined space. Methods: We developed the Free Exploration Test (FET) based on augmented reality technology. Using a live stream via the back camera on a tablet, patients search for a (non-existent) virtual target in their environment, while their exploration movements are recorded for 30 s. We tested 20 neglect patients and 20 healthy participants and compared the performance of the FET with traditional neglect tests. Results: In contrast to controls, neglect patients exhibited a significant rightward bias in exploratory movements. The FET had a high discriminative power (area under the curve = 0.89) and correlated positively with traditional tests of spatial neglect (Letter Cancellation, Bells Test, Copying Task, Line Bisection). An optimal cut-off point of the averaged bias of exploratory activity was at 9.0° on the right; it distinguished neglect patients from controls with 85% sensitivity. Discussion: FET offers time-efficient (execution time: ∼3 min), easy-to-apply, and gamified assessment of free exploratory activity. It supplements traditional neglect tests, providing unrestricted recording of exploration in the real, unconfined space surrounding the patient.
背景:为了捕捉空间忽略症患者典型的探索活动失真,传统诊断方法和新的虚拟现实应用都使用封闭的工作空间,将患者的探索行为限制在预先设定的区域内。我们的目标是克服这些限制,在真实、无限制的空间中记录患者的偏差活动。方法:我们开发了基于增强现实技术的自由探索测试(FET)。通过平板电脑上的后置摄像头进行实时流媒体传输,患者在他们所处的环境中寻找一个(不存在的)虚拟目标,同时他们的探索动作将被记录 30 秒。我们对 20 名忽视患者和 20 名健康参与者进行了测试,并将自由探索测试的表现与传统的忽视测试进行了比较。测试结果与对照组相比,忽视患者的探索动作明显偏右。FET具有很高的辨别力(曲线下面积=0.89),并与传统的空间忽略测试(字母取消、铃铛测试、复制任务、线段分割)呈正相关。探索活动平均偏差的最佳分界点是右侧 9.0°;它能以 85% 的灵敏度将忽视患者与对照组区分开来。讨论自由探索活动评估(FET)提供了省时(执行时间:∼3 分钟)、易于应用和游戏化的自由探索活动评估。它是对传统忽视测试的补充,可在患者周围真实、无限制的空间内不受限制地记录探索活动。
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引用次数: 0
Altered learning from positive feedback in adolescents with anorexia nervosa 神经性厌食症青少年从正反馈中学习的能力发生改变
IF 2.6 4区 心理学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.1017/s1355617724000237
Blair Uniacke, Wouter van den Bos, Joseph Wonderlich, Jessica Ojeda, Jonathan Posner, Joanna E. Steinglass, Karin Foerde
Objective: Anorexia nervosa (AN) is characterized by severe restriction of calorie intake, which persists despite serious medical and psychological sequelae of starvation. Several prior studies have identified impaired feedback learning among individuals with AN, but whether it reflects a disturbance in learning from positive feedback (i.e., reward), negative feedback (i.e., punishment), or both, and the extent to which this impairment is related to severity and duration of illness, has not been clarified. Method: Participants were female adolescents with AN (n = 76) and healthy teen volunteers (HC; n = 38) between the ages of 12–18 years who completed a probabilistic reinforcement learning task. A Bayesian reinforcement learning model was used to calculate separate learning rates for positive and negative feedback. Exploratory analyses examined associations between feedback learning and duration of illness, eating disorder severity, and self/parent reports of reward and punishment sensitivity. Results: Adolescents with AN had a significantly lower rate of learning from positive feedback relative to HC. Patients and HC did not differ in learning from negative feedback or on overall task performance measures. Feedback learning parameters were not significantly associated with duration of illness, eating disorder severity, or questionnaire-based reports of reward and punishment sensitivity. Conclusion: Adolescents with AN showed a circumscribed deficit in learning from reward that was not associated with duration of illness or reported sensitivity to reward or punishment. Subsequent longitudinal research should explore whether differences in learning from positive feedback relate to course of illness in youth with AN.
目的:神经性厌食症(AN)的特点是严重限制卡路里摄入量,尽管饥饿会带来严重的医学和心理后遗症,但患者仍会持续厌食。之前的一些研究发现,神经性厌食症患者的反馈学习能力受损,但这是否反映了他们从正反馈(即奖励)、负反馈(即惩罚)或两者中学习的障碍,以及这种障碍在多大程度上与病情严重程度和病程长短有关,尚未得到澄清。研究方法参与者为患有自闭症的女性青少年(76人)和健康青少年志愿者(38人),年龄在12-18岁之间,完成一项概率强化学习任务。使用贝叶斯强化学习模型分别计算正反馈的学习率。探索性分析检验了反馈学习与病程、饮食失调严重程度以及自我/父母报告的奖惩敏感性之间的关联。结果显示青少年厌食症患者从积极反馈中学习的比率明显低于正常人。在负反馈学习或整体任务表现测量方面,患者与正常人没有差异。反馈学习参数与病程、进食障碍严重程度或基于问卷的奖惩敏感性报告无明显关联。结论患有自闭症的青少年在反馈学习方面表现出局限性的缺陷,这种缺陷与病程长短或报告的奖惩敏感性无关。后续的纵向研究应探讨从积极反馈中学习的差异是否与患有AN的青少年的病程有关。
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Journal of the International Neuropsychological Society
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