Hypothesis testing in patients with chronic progressive multiple sclerosis

Patients with chronic progressive MS (N = 38) were compared with an age and education matched medical control group (N = 19) on a visual discrimination task designed to evaluate hypothesis testing and focusing behavior. Thirty-three MS patients (85%) and all control patients were able to formulate and use hypotheses, but MS patients were less likely to employ strategies leading to a correct solution. Furthermore, MS patients were more likely to perseverate with one strategy despite negative verbal feedback. Five MS patients were unable to formulate hypotheses. These findings suggest that MS patients have impaired cognitive functioning in addition to previously reported problems with memory.     

Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple sclerosis

Deficits in semantic encoding have been described in patients with frontal lobe disease who also show memory impairments. As a group, patients with multiple sclerosis (MS) exhibit memory impairment, fail to make effective use of semantic encoding to aid memory, and perform poorly on verbal fluency and concept formation tests which are sensitive to frontal lobe damage. In the present study the semantic encoding capacity of MS patients was measured using a modification of Wicken's release from proactive interference (PI) paradigm. Individual patients varied considerably in the severity of their impairments on verbal fluency, verbal recognition memory and on Wisconsin Card Sorting Task, but even patients who evidenced both memory impairment and signs of frontal lobe dysfunction showed normal release from PI after a categorical shift. Memory disturbances in MS are unlikely to result from an incapacity for semantic encoding, which seems preserved in MS, but may arise instead from deficits in processing information rapidly.     

Orienting reaction in patients with multiple sclerosis

A polygraphic study of the somatic (EMG), autonomic (finger plethysmogram, galvanic skin reaction, respiration, pulse, and EEG (acoustic-evoked potential and EEG-blocking reaction) components of the orienting reaction elicited by an auditory stimulus was performed in 71 patients with multiple sclerosis and in 74 matched normal subjects (control group). The study showed a significantly less intense orienting reaction in patients with multiple sclerosis than in control normal subjects. The severity of this responsiveness disturbance depended on the patients’ age at symptom onset, major symptom types on admission, and the relapse frequency. The orienting reaction changes found in patients with multiple sclerosis may be ascribed to the diffuse demyelinating lesions in the nervous system of these patients, which generate, apart from the so polymorphous clinical manifestations of this disease, also important responsiveness disturbances.     

Factors affecting the disease course in multiple sclerosis

This study investigate the significance of various data of patient's and family's history according to the disease activity of MS. 350 patients with definitive MS were divided into two groups according to a different clinical course. There was no difference in the frequency of the registered factors between these two groups. Our conclusion is, that the evaluated factors don't have prognostic significance in the course of MS. The results support the model of a phase characteristic course of MS which has been suggested by Fog and Linnemann.     

Personality and family functioning in families of depressed patients

In this cross-sectional study, the authors attempted to identify correlates of family functioning in 86 couples with a depressed member during the acute phase of the patient's depression. Demographic variables, psychiatric status, and personality traits of both the patient and spouse were investigated as potential predictors of family functioning. Regression analyses indicated that lower levels of personality pathology in the patient, higher levels of patient conscientiousness, and less psychological distress in the spouse were associated with healthier family functioning. Future research implications and clinical importance of these findings are discussed.     

Personality functioning in people living with HIV

This investigation adopted a multiple case study approach to determine the personality functioning in people living with HIV/ AIDS (PLWHA). Participants comprised a convenience sample of four PLWHA (male?=?3, female?=?1). The majority of the participants were white (n?=?3) and one was black African. Only one participant was married at the time of participation. Data on aspects such as their suicidal ideation, affect, problem solving styles, ego functioning, self-perception, and interpersonal functioning were collected using the Rorschach inkblot test and clinical interview. The data were actuarially analysed and organised under themes, namely; dominant personality style, capacity for control and stress, situational related stress, affect, interpersonal relations and self-perception. Findings revealed that participants had high levels of potential mood disorders and interpersonal difficulties for which targeted psychological services may be needed.     

Experiences with psychosocial management of patients with multiple sclerosis in a discussion group

Patients with multiple sclerosis must come to terms with their unpredictable chronic disease. Frequently, they want to establish contacts and exchange information with others sharing the same problems. Discussion groups of outpatients offer many opportunities to further the process of coping with the disease as an interlocking web of defensive and coping patterns. The patients can learn from each other to assess their disabilities and capabilities more realistically and to deal more openly with their fears, hopes and disappointments.     

Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

Adjustment modes in the trajectory of progressive multiple sclerosis: a qualitative study and conceptual model

Objective: We examined cognitive and behavioural challenges and adaptations for people with progressive multiple sclerosis (MS) and developed a preliminary conceptual model of changes in adjustment over time.

Design: Using theoretical sampling, 34 semi-structured interviews were conducted with people with MS. Participants were between 41 and 77 years of age. Thirteen were diagnosed with primary progressive MS and 21 with secondary progressive MS. Data were analysed using a grounded theory approach.

Results: Participants described initially bracketing the illness off and carrying on their usual activities but this became problematic as the condition progressed and they employed different adjustment modes to cope with increased disabilities. Some scaled back their activities to live a more comfortable life, others identified new activities or adapted old ones, whereas at times, people disengaged from the adjustment process altogether and resigned to their condition. Relationships with partners, emotional reactions, environment and perception of the environment influenced adjustment, while people were often flexible and shifted among modes.

Conclusions: Adjusting to a progressive condition is a fluid process. Future interventions can be tailored to address modifiable factors at different stages of the condition and may involve addressing emotional reactions concealing/revealing the condition and perceptions of the environment.     

Neuropsychology of mildly disabled patients with relapsing-remitting multiple sclerosis

Previous papers have mainly demonstrated the presence of cognitive impairment in patients with multiple sclerosis (MS), these changes have been traditionally associated with the later stages of the disease. In the current study, a comprehensive neuropsychological battery was administered to 216 relapsing-remitting MS patients with mild clinical disability (EDSS相似文献   

Loneliness in cancer and multiple sclerosis patients

Loneliness is a universal social phenomenon often producing debilitating effects on many aspects of human functioning. The present study compared the qualitative aspects of loneliness in two terminally ill samples to that of a more healthy sample. 329 multiple sclerosis and 315 cancer patients, as well as 391 nonrandom healthy participants answered a 30-item questionnaire on loneliness. Analysis indicated the experience of loneliness which characterizes multiple sclerosis and cancer patients differs from that of the more healthy group.     

Electromyographic studies of the blink reflex in patients with multiple sclerosis

The latencies of two components of the blink reflex in 90 patients with multiple sclerosis have been compared with these of 30 healthy subjects. Early response R1 was absent in 33,33% of the patients and was with prolonged latency in 41,11%. The late ipsilateral response was absent in 20,00% of the patients and in 32,22% was with prolonged latency. The late contralateral response was absent in 25,55% of the patients and was with prolonged latency in 40,00%. The latencies of all components of the reflex may be prolonged in patients with no clinical brain-stem signs as well.     

Influence of IQ in interpreting MMSE scores in patients with multiple sclerosis

The Mini-Mental State Examination (MMSE) and Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) were administered to 46 outpatients diagnosed with multiple sclerosis (MS). MMSE total raw score was significantly and positively correlated with all WAIS-IV indexes, even when controlling for the effects of participant educational level, with the strongest relationship being with Full Scale IQ. These results suggest that clinicians consider patient intellectual functioning, in particular Full Scale IQ, when diagnosing neurocognitive impairment based on screening with the MMSE in individuals with MS.     

Personality in the life course

Using elements borrowed from psychology, sociology, and history, this article outlines a conceptual framework for the analysis of personality in the life course. It is proposed that the interactional framework toward which personality psychology aspires may be conceived of as a sequence of interactions of personality with age-graded roles and social transitions in historically changing environments. To the extent that one can (a) identify the age-graded role paths in the social structure, (b) select the age-relevant situations in which these roles are enacted, and (c) identify measures relevant to the culture pattern across these age-relevant situations, it should be possible to uncover the coherence of personality--ways of approaching and responding to the world--across time and in diverse situations. Each of these steps is delineated and then illustrated with a longitudinal study of explosive, undercontrolled children. This is not an effort to articulate a theory of personality development but to outline the parameters of social life--temporal and situational--to which personality research should attend.     

Assessing the quality of life in patients with multiple sclerosis in Kuwait: a cross sectional study

The main objective of this paper was to assess the level and the determinants of quality of life (QOL) amongst patients with multiple sclerosis (MS). A cross-sectional study was conducted among a convenience sample of 200 adult MS patients. Inclusion criteria were: MS diagnosis for at least one year, and aged 21+ years. However, exclusion criteria were: having other neurological diseases, serious cardiovascular, orthopedic or other disability precluding participation. Self-administered questionnaire employed MSQOL-54 with two outcomes: Physical Health Composite (PHC) and mental health composite (MHC). Satisfaction with Daily Occupation scale was adopted through face to face interviews. The median of PHC and MHC scores were 48.9/100, and 53.4/100 respectively. Multivariate analysis revealed that unemployment was a determinant of poor PHC, while low monthly income was a predictor of poor MHC. Additionally, low endurance and sensory problems were associated with poor PHC, and MHC, while motor problems were allied with only poor PHC. Patient’s satisfaction level with performing activities of daily living was positively associated with PHC and MHC. Assessment of QOL is suggested to be comprised in medical settings.