Applied Neuropsychology-Adult最新文献

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with various cognitive, behavioral, and mood symptoms that complicate diagnosis and treatment. The heterogeneity of these symptoms may also vary depending on certain sociodemographic factors. It is therefore important to establish more homogenous symptom profiles in patients with ADHD and determine their association with the patient's sociodemographic makeup. The current study used unsupervised machine learning to identify symptom profiles across various cognitive, behavioral, and mood symptoms in adults with ADHD. It was then examined whether symptom profiles differed based on relevant sociodemographic factors.

Methods: Participants were 382 adult outpatients (62% female; 51% non-Hispanic White) referred for neuropsychological evaluation for ADHD.

Results: Employing Gaussian Mixture Modeling, we identified two distinct symptom profiles in adults with ADHD: "ADHD-Plus Symptom Profile" and "ADHD-Predominate Symptom Profile." These profiles were primarily differentiated by internalizing psychopathology (Cohen's d = 1.94-2.05), rather than by subjective behavioral and cognitive symptoms of ADHD or neurocognitive test performance. In a subset of 126 adults without ADHD who were referred for the same evaluation, the unsupervised machine learning algorithm only identified one symptom profile. Group comparison analyses indicated that female patients were most likely to present with an ADHD-Plus Symptom Profile (χ2 = 5.43, p < .001).

Conclusion: The machine learning technique used in this study appears to be an effective way to elucidate symptom profiles emerging from comprehensive ADHD evaluations. These findings further underscore the importance of considering internalizing symptoms and patients' sex when contextualizing adult ADHD diagnosis and treatment.

The Digit Span test has been part of the Wechsler tests from the first version. In the WAIS-IV the Digit Span Sequencing subtest (DSS) was introduced and in the forthcoming WAIS-5 working memory span will also be measured in the visual modality. The present study analyzes WAIS-IV Digit Span, Letter- Number Span (LNS) and WMS-III Spatial Span (SS) performance in a mixed clinical sample, expecting to find that Digit Span Forwards (DSF) lacks sensitivity to the Working Memory impairment evident in D-KEFS Trail Making Test-4 (TMT-4) scores ≤1 SD below normative means in the sample. The results showed DSF score above normative means, Digit Span Backwards (DSB) around mean, while SS and LNS was slightly impaired and DSS impaired at the same level as TMT- 4. A double dissociation was observed in DSF and SS performance between subjects with Language- and Non-verbal learning disorders. Most subjects scored in the average range on the LNS-span and high kurtosis reduced sensitivity. Taking LNS and TMT-4 as criterion measures of WM, regression analyses showed no unique contribution of DSF to the variance in these tests. The study supports prior critiques regarding the composite Digit Span measure and demonstrates that the DSS are more effective than the current version of LNS in identifying reduced Working Memory capacity.

Purpose: Naming difficulty is associated with temporal lobe epilepsy and a decline in naming ability is reported following dominant temporal lobe resections. The Boston Naming Test (BNT) is the most frequently used test for assessing naming ability. Evaluating naming ability in bilingual/multilingual populations is a challenge when participants are restricted to responding in one language. The study aimed to adapt and standardize the BNT as a valid clinical tool for evaluating bilingual/multilingual people undergoing epilepsy surgery in urban India.

Results: Culture-appropriate adaptations were done, and participants were allowed to respond in any language. Data from 197 participants showed a strong education effect. The adaptation showed strong internal consistency, reliability, construct validity, and high sensitivity to left temporal lobe epilepsy performance.

Conclusions: The adapted version that allowed for flexible use of more than one language is a useful clinical tool for evaluating bilingual people undergoing epilepsy surgery.

Objective: Attempts have been made (with research efforts encouraged) to deconstruct the "race" concept into language, cultural, and life experience variables that can help explain performance differences found between ethnic groups (Romero et al., 2009). The extant empirical literature reveals that early environmental factors and life experiences (e.g., socioeconomic status) are related to cognitive test performance in adulthood (Byrd et al., 2006). This study examined the explanatory value of early life childhood resources in the relationship between ethnicity and neuropsychological test performance in adulthood.

Participants/ methods: Neurologically and psychologically healthy African American (n = 40), Caucasian (n = 14), and Hispanic (n = 107) college students ranging from 19-38 years of age. On average, participants had completed around 13 years of education, indicating that the majority were in the early stages of their undergraduate studies and mostly consisted of females (72%). Each participant completed a comprehensive neuropsychological battery that included tests of executive function and an extensive background questionnaire.

Results: A one-way analysis of variance (ANOVA) revealed that the CA group was significantly older (F (2, 160) = 18.38, p = .045) compared to the AA and H groups, but the groups did not differ in terms of number of years of educations or gender. Also, an ANOVA revealed significant group test performance differences on the Stroop-C [F (2, 160) = 1.53, p = .047], but not on the TMT-B and COWAT. Furthermore, a Tukey post hoc revealed that there were no significant differences in test performance on Stroop-C between the groups. Hierarchical multiple regression analyses revealed that group performance differences on executive function tests were medium or non-existent and only partially explained by years of education and early life financial resources.

Conclusion: The results are discussed in light of the existing literature, study strengths and limitations, as well as directions for future research. This research can aid in pinpointing variables crucial for interpreting differences in neuropsychological assessments among diverse populations, holding potential implications for intervention research and policy settings. It is particularly relevant in the context of the continuously evolving social, political, and economic landscapes of societies.

Subjective cognitive decline (SCD) may serve as an early indicator of Alzheimer's disease (AD). However, accurately quantifying cognitive impairment in SCD is challenging, mainly because existing assessment tools lack sensitivity. This study examined how tasks specifically designed to assess knowledge of famous people, could potentially aid in identifying cognitive impairment in SCD. A total of 60 adults with SCD and 60 healthy controls (HCs) aged 50 to 82 years performed a famous people verbal fluency task and a famous people naming task. In the famous people fluency task, the results showed that the individuals with SCD produced significantly fewer famous names in the total time allowed than the HCs, and this difference was also found in the first and the second time interval. In the famous people naming task, the performance of the SCD group was significantly lower than that of the HC group only in the more recent period of fame. Overall, these results suggest that retrieving the names of famous people was more difficult for people with SCD than for people without cognitive complaints. They also suggest that famous people verbal fluency and naming tasks could be useful in detecting cognitive decline at the preclinical stage of AD.

This study is part of a longitudinal research program, in which patients diagnosed with low-grade gliomas (LGG: n = 13), as well as healthy controls (n = 13), were consecutively recruited and neuropsychologically followed for 7 years. The patients are followed up regardless of variations in treatment. A composite score is used (Global Deficit Score: GDS) included cognitive measures where at least five patients had a negative change: information processing speed, speed of naming, construction ability, verbal fluency, non-verbal thinking, and immediate non-verbal memory. The most important finding in this 7-year follow-up study is that two-thirds of the patients developed cognitive impairment. The remaining third of the patients showed stability in their cognitive ability and were still alive 17 years after diagnosis. Younger patients with tumors in the right frontal or posterior regions showed a more favorable development. Patients with frontal tumors and a declined GDS show also significant changes in executive functions. Given the limited number, no firm conclusions can be drawn regarding the impact of tumor localization. The impact of LGG on cognition and the survival time after diagnosis varies considerably between patients. However, most of the patients (69%) showed cognitive impairment during the seven years we followed them.

Quantifying learning deficits provides valuable information in identifying and diagnosing mild cognitive impairment and dementia. Previous research has found that a learning ratio (LR) metric, derived from the list learning test from the Neuropsychological Assessment Battery (NAB), was able to distinguish between those with normal cognition versus memory impairment. The current study furthers the NAB LR research by validating a NAB story LR, as well as an aggregate LR. The aggregate LR was created by combining the individual list and story LRs. Participants were classified as those with normal cognition (n = 51), those with MCI (n = 39) and those with dementia (n = 35). Results revealed the story LR was able to accurately distinguish normal controls from those with mild cognitive impairment and those with dementia and offers enhanced discriminability beyond the story immediate recall score (sum of trial 1 and trial 2). Further, the aggregate LR provided superior discriminability beyond the individual list and story LRs and accounted for additional variance in diagnostic group classification. The NAB aggregate LR provides improved sensitivity in detecting declines in impaired learning, which may assist clinicians in making diagnoses earlier in a disease process, benefiting the individual through earlier interventions.

The current study examined whether the Memory Similarities Extended Test (M-SET), a memory test based on the Similarities subtest of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II), has value in neuropsychological testing. The relationship of M-SET measures of cued recall (CR) and recognition memory (REC) to brain injury severity and memory scores from the Wechsler Memory Scale, Fourth Edition (WMS-IV) was analyzed in examinees with traumatic brain injuries ranging from mild to severe. Examinees who passed standard validity tests were divided into groups with intracranial injury (CT + ve, n = 18) and without intracranial injury (CT-ve, n = 50). In CT + ve only, CR was significantly correlated with Logical Memory I (LMI: r_s = .62) and Logical Memory II (LMII: r_s = .65). In both groups, there were smaller correlations with delayed visual memory (VRII: r_s = .38; r_s = .44) and psychomotor speed (Coding: r_s = .29; r_s = .29). The REC score was neither an indicator of memory ability nor an internal indicator of performance validity. There were no differences in M-SET or WMS-IV scores for CT-ve and CT + ve, and reasons for this are discussed. It is concluded that M-SET has utility as an incidental cued recall measure.

An existing theoretical framework proposes that aberrant temporal processing and a fast internal clock, denoted by overestimation and under-reproduction of time, increases the likelihood of engagement in risky behaviors (ERB). The primary aim of this project was to improve our understanding of the relationship between temporal processing and ERB in college students. The present study used the Wittmann and Paulus (2008) theoretical framework to examine the associations between temporal processing and ERB in college students. College student participants (N = 215) completed self-report measures of ERB, delay aversion, inhibitory control, ADHD symptoms and objective cognitive time estimation and time reproduction tasks. Time estimation accuracy was significantly associated with lower engagement in sexual risk behaviors (OR = .988; 95% CI: .979, .996; p = .006) and aggressive behaviors (OR = .989; 95% CI: .980, .998; p = .018). Time reproduction was not significantly associated with ERB. The present study established preliminary support for the associations between aberrant temporal processing, namely aberrant time estimation, and ERB among college students.