Monitoring and assessing symptoms of chronic fatigue syndrome: use of time series regression

Chronic Fatigue Syndrome's principal symptoms are severe and include prolonged fatigue and a number of other minor symptoms. Behavioral data collection methods were used in a case study to show some of the benefits that can be derived from monitoring symptoms hourly and daily. Using time series regression, several statistically significant correlates of fatigue were found both within days and between days. Perceived energy, physical exertion, and mental exertion were significantly related to fatigue in both analyses. Collection of such data may help resolve a number of theoretical and methodological problems in research on the Chronic Fatigue Syndrome.     

The effect of Multi Convergent Therapy on the psychopathology,mood and performance of Chronic Fatigue Syndrome patients: A preliminary study

Objectives: Multi Convergent Therapy combines approaches such as Cognitive Behaviour Therapy and Graded Exercise Therapy in an holistic treatment of Chronic Fatigue Syndrome. Initial follow‐up data showed that patients were benefiting from this individualised form of therapy. The objective of the present study was to evaluate this Multi Convergent approach, developed at a specialised Chronic Fatigue Syndrome Outpatient clinic in Cardiff, and compare it to Relaxation Therapy and control groups using multiple outcome measures. Design: Thirty‐five participants fitting the Centre for Disease Control criteria for Chronic Fatigue Syndrome were recruited from two outpatient clinics and members of our existing patient panel. Patients were assigned to Multi Convergent Therapy (N=12), Relaxation Therapy (N=14) or recruited as controls (N=9). Methods: Each patient completed a battery of mood and performance tasks along with comprehensive set of questionnaires at baseline, post‐treatment and at six‐month follow‐up. These measures had been validated in previous studies on untreated patients and matched healthy controls. Results: Patients attending the Multi Convergent Therapy clinic showed statistically significant improvements in many of our measures. Most importantly we have produced data indicating that Multi Convergent Therapy provides improvements in objective measures of psychomotor performance and cognition. Discussion: The outcomes of this small study are encouraging. Multi Convergent Therapy has not only produced results indicating significant improvements in standardised questionnaire based measures but also in objective cognitive performance tasks. The next step would be to assess Multi Convergent Therapy at the primary medical care level, with a greater number of patients to further evaluate its efficacy as a treatment for Chronic Fatigue Syndrome.     

A Comparison of the 1988 and 1994 Diagnostic Criteria for Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS) is an illness that involves severe, prolonged fatigue as well as neurological, immunological, and endocrinological system pathology. Because the pathogenesis of CFS has yet to be determined, case definitions have relied on clinical observation in classifying signs and symptoms for diagnosis. In an attempt to address various criticisms and inconsistencies in diagnostic criteria, there have been several revisions of the CFS case definition. The current investigation examined the differences between 1988 and 1994 definitions as well as participants who had a psychiatric explanation for their fatigue. Dependent measures included psychiatric comorbidity, symptom frequency, and functional impairment. The 1988 criteria, compared to the 1994 criteria, appeared to select a group of participants with more symptomatology and functional impairment, but these groups did not significantly differ in psychiatric comorbidity. Implications of these findings are discussed.     

Professional support of self-help groups: a support group project for Chronic Fatigue Syndrome patients

Professionals are involved in self-help groups in a variety of roles as advising experts, facilitators and even as group leaders. A few studies focus on attitudes toward professional involvement, but very little is known about the nature of this collaboration. The study follows a collaborative support group project between a team of health professionals at a regional hospital in Norway and a Chronic Fatigue Syndrome patients' group. It is arguably an advantage for professionals to decide upon the aim of a joint intervention in dialogue with the participants, but simply asking the participants what their aims are does not guarantee actual agreement. As this case study demonstrates, participants may have reason to conceal their objectives.     

Anger management: age differences in emotional modulation of visual processing

Although positive and negative images enhance the visual processing of young adults, recent work suggests that a life-span shift in emotion processing goals may lead older adults to avoid negative images. To examine this tendency for older adults to regulate their intake of negative emotional information, the current study investigated age-related differences in the perceptual boost received by probes appearing over facial expressions of emotion. Visually-evoked event-related potentials were recorded from the scalp over cortical regions associated with visual processing as a probe appeared over facial expressions depicting anger, sadness, happiness, or no emotion. The activity of the visual system in response to each probe was operationalized in terms of the P1 component of the event-related potentials evoked by the probe. For young adults, the visual system was more active (i.e., greater P1 amplitude) when the probes appeared over any of the emotional facial expressions. However, for older adults, the visual system displayed reduced activity when the probe appeared over angry facial expressions.     

比较视觉搜索任务的认知老化研究

本研究通过增加组成图片的图形数量和改变目标图形的特征,考察老年人和大学生在比较视觉搜索任务中的眼动特点和图形特征加工的优先性。结果表明与青年人相比,老年人在比较视觉搜索过程中总注视时间和注视次数增加,平均眼跳幅度减少,对目标刺激的注视时间增加。老年人和青年人在目标刺激的注视过程中都表现出图形维度数量的优先性,即表现为颜色和形状都不同的目标刺激注视时间最短,颜色不同和形状不同的目标刺激在注视时间上差异不显著。说明老年人在比较视觉搜索过程中存在认知老化,在图形特征加工的优先性上结果和青年人一致,以上结果与年龄和研究任务有关。     

Clinical Differences Exist Between Patients Fulfilling the 1988 and 1994 Case Definitions of Chronic Fatigue Syndrome

Despite the existence of 2 different case definitions for chronic fatigue syndrome, little data exist to evaluate how each performs. We evaluated the symptom patterns of patients fulfilling either the more demanding 1988 or the less demanding 1994 case definitions of Chronic Fatigue Syndrome over an 11-year period from 1991 to 2001. Factor analysis identified 3 factors: muscular–skeletal, viral, and sleep:memory symptom factors accounting for significant variation in the data. Further discriminant analysis showed that the first 2 factors and a self-reported measure of decrease in activity alone gave 91% accuracy in the placement of patients into their respective case definitions. This analysis did indicate that both case definitions were capturing the same broad group of patients. However, the patients in the 1994 group do not endorse infectious-type symptoms as often or to the same degree of severity as those in the 1988 group. This may mean that infection as a cause of CFS is more likely in patients fulfilling the earlier, more demanding case definition.     

Seeing either the forest or the trees: dissociation in visuospatial processing

Traditionally, visuospatial processing has resisted fractionation into functional substrates. Recently, however, it has been shown that the brain honors the distinction between global and local processing of hierarchical visual stimuli: unilateral left hemisphere brain-damaged subjects were impaired in their ability to draw the local forms of a hierarchical design, whereas right hemisphere-damaged patients demonstrated the opposite pattern (Delis, Robertson, & Efron, 1986; Delis, Kiefner, & Fridlund, 1988). The present study reports a similar pronounced dissociation in hierarchical visual processing but in quite different populations and in the absence of focal structural brain damage. Mentally retarded subjects with Williams Syndrome are considerably more impaired in global relative to local analysis, whereas subjects with Down Syndrome display the opposite pattern. These results, in concert with other neuropsychological data, are provocative because they suggest that certain cognitive deficits may cluster even in the absence of frank cerebral damage, just as they cluster following insult to one hemisphere. These findings should provide clues to the interrelationship of components of visuospatial processing and other cognitive functions.     

Hemispheric processing of idioms in schizophrenia and autism spectrum disorder

Studies conducted on individuals with schizophrenia (SZ) and autism spectrum disorder (ASD) show that they find it difficult to comprehend figurative language, and have a tendency to interpret it literally. This study examines hemispheric processing of idioms in patients with SZ, in comparison to individuals with ASD. Seventeen adults with SZ and 18 adults with ASD participated in the study. The two clinical groups were matched in age, vocabulary scores and verbal executive function scores. Using the divided visual field paradigm, the participants performed a lexical decision task for a target word related to either a literal or a figurative interpretation of an idiom. Whereas SZ patients showed the typical right lateralisation for non-salient literal interpretations of idioms, adults with ASD showed atypical bilateral processing. These findings indicate different hemispheric lateralisation in idiom processing in the two clinical groups.     

Developmental differences in visual processing: strategy versus structure

The present study was an examination of two contrasting explanations for the finding that young children tend to classify objects according to similarity relations whereas adults emphasize dimensional structure. Subjects from three different age groups were given tasks that tapped different aspects of the visual process: Feature search, Conjunction search, and Restricted Classification tasks. In addition, three different stimulus objects (a highly separable, a highly integral, and an intermediate dimensional combination) were studied to explore the contribution of stimulus structure in dictating the nature of the processing mode. The results provided evidence against the view that children perceive objects according to a more primitive holistic structure. Rather, the results can be taken with past research to suggest that less efficient visual processing may lead the younger subjects to adopt a classification strategy that emphasizes similarity relations. In addition, the current research supported Garner's (1974, The processing of information and structure, Potomac, MD: Erlbaum) suggestion that the nature of the processing mode is stimulus-driven.     

The detection of vulnerable road users by younger and older drivers

The detection of vulnerable road users (VRUs), especially under time constraints, may be impaired in elderly drivers, due to their visual and cognitive decline. This represents a major concern for road safety. The objective of the present study was to investigate the effect of aging on the detection of VRUs. A further aim was to investigate the impact of external factors on VRU detection. Twenty-two young adults, 20 younger-old adults, and 32 older-old adults were included in the study. A series of photographs were displayed for 500 ms. Participants were asked to detect the VRU, which could be a motorcyclist, a cyclist, or a pedestrian. The VRU was located at one of two distances (near/far), one of two locations (off-centered/centered), and in two car-DRL (daytime running lights) environments (on/off). The ability to correctly detect a VRU was measured. An eye-tracker was used to record eye movements. The main findings showed that VRU-detection performance decreased with aging, even in the younger-old group (ages 55–68). The ability to correctly detect a VRU by older-old adults was poorer particularly when the VRU was a motorcyclist or a cyclist. As a whole, the older-old adults made more fixations to correctly detect the VRU than the other two age groups did. Moreover, the visual angle between the gaze of the participant’s last fixation and the target in the older-old group was lower than in the other two groups, particularly when the VRU was off-centered. This finding suggests that older-old adults compensated for their visual-field decline by doing more visual exploration than the other two groups did to correctly detect the VRU. The results are discussed with regards to age-related cognitive and visual deficits.Word count: 279.     

Age and culture modulate object processing and object—scene binding in the ventral visual area

Behavioral differences in the visual processing of objects and backgrounds as a function of cultural group are well documented. Recent neuroimaging evidence also points to cultural differences in neural activation patterns. Compared with East Asians, Westerners’ visual processing is more object focused, and they activate neural structures that reflect this bias for objects. In a recent adaptation study, East Asian older adults showed an absence of an object-processing area but normal adaptation for background areas. In the present study, 75 young and old adults (half East Asian and half Western) were tested in an fMR-adaptation study to examine differences in object and background processing as well as object—background binding. We found equivalent background processing in the parahippocampal gyrus in all four groups, diminished binding processes in the hippocampus in elderly East Asians and Westerners, and diminished object processing in elderly versus young adults in the lateral occipital complex. Moreover, elderly East Asians showed significantly less adaptation response in the object areas than did elderly Westerners. These findings demonstrate the malleability of perceptual processes as a result of differences in cohort-specific experiences or in cultural exposure over time.     

Inter-hemispheric recruitment as a function of task complexity,age and cognitive reserve

In a behavioral divided visual field study, we investigated the efficiency of inter-hemispheric cooperation according to (1) task computational complexity (physical-identity versus name-identity letter matching), (2) age (younger versus older adults) and (3) educational attainment, used as a proxy for cognitive reserve. Overall, the results indicated a shift from within- to across-hemisphere processing advantage with increasing task complexity, suggesting that bilateral engagement leads to enhanced performance under high-demand conditions. This pattern was influenced by age, with older adults showing no within-hemisphere advantage in the simpler task and a greater across-hemisphere advantage in the more complex one, consistent with an age-compensatory view of inter-hemispheric recruitment. Moreover, for older adults, more years of education was associated with a weaker across-hemisphere advantage. Thus, we propose that cognitive reserve may account for bilateral engagement efficiency. Finally, the groups differed in terms of laterality effects, with only younger adults demonstrating a left visual field advantage in the name-identity task, lending some support to the right hemi-aging hypothesis.     

视觉表象扫描加工可塑性水平的研究

本研究通过两个实验分别检测20名飞行员和10名老年被试及其相应控制组的表象扫描加工水平,旨在探讨表象扫描这一典型视觉空间认知加工所表现出的可塑性水平。研究结果表明,表象扫描加工水平既没有因外界系统的训练而发生功能增强的练习效应,也未出现随年老化过程所表现出的功能显著下降的年龄效应。研究提示,由于受大脑神经细胞活动特性改变的影响,表象扫描加工能力更多地表现出了其认知加工的相对稳定性或可塑性较低的认知特性。     

Ethnic Differences in the Relation Between Parental Emotion Socialization and Mental Health in Emerging Adults

The present study examined the relation between retrospectively reported parental emotion socialization practices and emerging adults’ mental health across four ethnic groups. Participants were 112 European American, 89 Latino/a American, 82 African American/Black, and 83 Asian American emerging adults. Participants completed questionnaires assessing current mental health symptoms and retrospective reports of parents’ responses to their expression of negative affect as adolescents. Fathers’ socialization practices were associated with emerging adults’ functioning across ethnic groups, but the relation between mothers’ socialization and emerging adults’ functioning varied across ethnic groups. Supportive practices were significantly associated with fewer symptoms in emerging adults only for Latino/a American families, and unsupportive practices were associated with more symptoms in emerging adults only for European American and African American/Black families. Results point to the importance of parental emotion socialization practices during adolescence for emerging adults’ well-being, but suggest that some practices may be more important than others depending on cultural background.     

Developmental changes in the processing of hierarchical shapes continue into adolescence

The present study was designed to trace the normal development of local and global processing of hierarchical visual forms. We presented pairs of hierarchical shapes to children and adults and asked them to indicate whether the two shapes were the same or different at either the global or the local level. In Experiments 1 (6-year-olds, 10-year-olds, adults) and 2 (10-year-olds, 14-year-olds, adults), we presented stimuli centrally. All age groups responded faster on global trials than local trials (global precedence effect), but the bias was stronger in children and diminished to the adult level between 10 and 14 years of age. In Experiment 3 (10-year-olds, 14-year-olds, adults), we presented stimuli in the left or right visual field so that they were transmitted first to the contralateral hemisphere. All age groups responded faster on local trials when stimuli were presented in the right visual field (left hemisphere); reaction times on global trials were independent of visual field. The results of Experiment 3 suggest that by 10 years of age the hemispheres have adult-like specialization for the processing of hierarchical shapes, at least when attention is directed to the global versus local level. Nevertheless, their greater bias in Experiments 1 and 2 suggests that 10-year-olds are less able than adults to modulate attention to the output from local versus global channels-perhaps because they are less able to ignore distractors and perhaps because the cerebral hemispheres are less able to engage in parallel processing.     

Auditory information is beneficial for adults with Down syndrome in a continuous bimanual task

Much recent research using discrete unimanual tasks has indicated that individuals with Down syndrome (DS) have more difficulty performing verbal-motor tasks as compared to visual-motor tasks (see Perceptual-Motor Behavior in Down Syndrome, Human Kinetics, Champaign, IL, 2000, p. 305 for a review). In continuous tasks, however, individuals with DS perform better when movement is guided by auditory information compared to visual information (Downs Syndr.: Res. Prac. 4 (1996) 25; J. Sport Exercise Psy. 22 (2000) S90). The aim of the present study was to investigate if there are any differences for adults with DS between visual, auditory and verbal guidance in a continuous bimanual task. Ten adults with DS, 10 adults without DS and 10 typically developing children drew lines bimanually towards the body (down) and away from the body (up) following three different guidance conditions: visual (flashing line), auditory (high tone, low tone), and verbal (“up”, “down”). All participants produced mostly in-phase movements and were close to the 1000 ms target time for all guidance conditions. The adults with DS, however, displayed greater variability in their movement time, movement amplitude and bimanual coordination than adults without DS. For all groups, the left hand was slower and more variable in producing the lateral movements than the right hand. The results regarding guidance information suggest that auditory information is beneficial for repetitive bimanual tasks for adults with DS. Possible mechanisms that cause these results will be discussed.     

Fatigue, cognitive functioning and psychological distress in Marfan syndrome, a pilot study

Marfan patients report fatigue as a major subjective complaint. We found no studies exploring the subject. The aim of this study was in a strictly defined Marfan population to assess self-reported fatigue, cognitive functions and psychological distress, correlations among them and correlations to visual acuity, joint hypermobility and use of beta-blockers. Sixteen subjects aged 18 - 30 years, fulfilling the Gent criteria, were assessed with the Fatigue Severity Scale, Fatigue Questionnaire, a comprehensive battery of neuropsychological tests and the General Health Questionnaire (GHQ). Self-reported fatigue was comparable with fatigue reported in other severe chronic diseases and disabilities, and was primarily in the mental/psychological domain. Psychological distress was higher than expected compared with the population at large. All neuropsychological test results were within the normal range, except for tests of visuo-motor coordination and speed of information processing. There was a significant inverse correlation between Fatigue Questionnaire ratings and some neuropsychological tests. Fatigue seems to be a serious problem for persons with Marfan syndrome and seems related to some areas of cognitive functioning. We found no overall impairment in cognitive functioning, but slightly reduced speed of information processing. Reduced visuo-motor coordination could be explained by impaired visual acuity.     

Multi- and unisensory decoding of words and nonwords result in differential brain responses in dyslexic and nondyslexic adults

The present functional magnetic resonance imaging (fMRI) study was designed, in order to investigate the neural substrates involved in the audiovisual processing of disyllabic German words and pseudowords. Twelve dyslexic and 13 nondyslexic adults performed a lexical decision task while stimuli were presented unimodally (either aurally or visually) or bimodally (audiovisually simultaneously).The behavioral data collected during the experiment evidenced more accurate processing for bimodally than for unimodally presented stimuli irrespective of group. Words were processed faster than pseudowords. Notably, no group differences have been found for either accuracy or for reaction times. With respect to brain responses, nondyslexic compared to dyslexic adults elicited stronger hemodynamic responses in the leftward supramarginal gyrus (SMG), as well as in the right hemispheric superior temporal sulcus (STS). Furthermore, dyslexic compared to nondyslexic adults showed reduced responses to only aurally presented signals and enhanced hemodynamic responses to audiovisual, as well as visual stimulation in the right anterior insula.Our behavioral results evidence that the two groups easily identified the two-syllabic proper nouns that we provided them with. Our fMRI results indicate that dyslexics show less neuronal involvement of heteromodal and extrasylvian regions, namely, the STS, SMG, and insula when decoding phonological information. We posit that dyslexic adults evidence deficient functioning of word processing, which could possibly be attributed to deficits in phoneme to grapheme mapping. This problem may be caused by impaired audiovisual processing in multimodal areas.     

Task demand effects on postural control in older adults

The literature shows conflicting results regarding older adults' (OA) postural control performance. Differing task demands amongst scientific studies may contribute to such ambiguous results. Therefore, the purpose of this study was to examine the performance of postural control in older adults and the relationship between visual information and body sway as a function of task demands. Old and young adults (YA) maintained an upright stance on different bases of support (normal, tandem and reduced), both with and without vision, and both with and without room movement. In the more demanding tasks, the older adults displayed greater body sway than the younger adults and older adults were more influenced by the manipulation of the visual information due to the room movement. However, in the normal support condition, the influence of the moving room was similar for the two groups. These results suggest that task demand is an important aspect to consider when examining postural control in older adults.