Cognitive Deficits and Positively Biased Self-Perceptions in Children with ADHD

This study examined the relation between cognitive deficits and positive bias in a sample of 272 children with and without Attention Deficit Hyperactivity Disorder (ADHD; 7–12 years old). Results indicated that children with ADHD with and without biased self-perceptions exhibit differences in specific cognitive deficits (executive processes, working memory, broad attention, and cognitive fluency) compared to each other and to control children. Further, specific cognitive deficits emerged as partial mediators of the relation between ADHD diagnostic status and positive bias. Interestingly, some differences in results emerged based on the domain considered (academic, social, behavioral competence). Results lend initial support to the role of cognitive deficits in the positive bias of some children with ADHD. Implications for future research and intervention are discussed.     

Visuo-Spatial Working Memory Span: A Sensitive Measure of Cognitive Deficits in Children With ADHD

Working memory (WM) has been hypothesised to be impaired in attention-deficit/hyperactivity disorder (ADHD). However, there are few studies reported on tests measuring visuo-spatial WM (VSWM) in ADHD. Some of these studies used paradigms including episodic memory, others only used low memory loads. In the present study we used a VSWM test that has not been used previously in ADHD research. The sensitivity of the VSWM test and a choice reaction time (CRT) test was evaluated in a pilot study by comparing them to two commonly used tests in ADHD-research; the Continuous Performance Test (CPT) and a Go/no-go test, in children with and without ADHD. The groups differed significantly in performance on the VSWM test (P<.01) and CRT (P<.05) but not on the CPT (P>.1) or on the Go/no-go test (P>.1). The results from the VSWM and CRT tests were replicated in a larger sample of participants (80 boys; 27 boys with ADHD and 53 controls, mean age 11.4 years). The difference between the groups was significant for both the VSWM test (P<.01) and the CRT test (P<.01). The effect size (ES) of the VSWM test was 1.34. There was a significant age-by-group interaction on the VSWM test, with larger group differences for the older children (P<.01). Our results show that the VSWM test is a sensitive measure of cognitive deficits in ADHD and it supports the hypothesis that deficits in VSWM is a major component of ADHD.     

A Meta-Analysis of Cognitive Deficits in Adults with a Diagnosis of Schizophrenia

This review identified 1275 studies examining cognitive deficits in people with schizophrenia, published between 1990 and 2003. Data from 113 studies (4365 patients and 3429 controls) were combined in a meta-analysis carried out on the five cognitive domains of IQ, memory, language, executive function, and attention. Studies were excluded where they lacked a suitable control group or failed to present complete information. In all five cognitive domains, analysis indicated a consistent trend for patients to perform more poorly than healthy controls, with significant heterogeneity across studies. Sources of heterogeneity were analyzed and a need to ensure more appropriate composition of patient and control groups and to adopt a more refined and methodologically correct, hypothesis-driven approach was identified.     

汉语名词特异性损伤的个案研究

报道了一例汉语命名性失语症个案,他在口语命名图形与口语产生句子时均表现为对名词的作业能力差于动词,而且这种动-名词分离现象仅局限在语音输出通道上。初步推测,他在语音输出通道存在名词特异性损伤;动、名词信息的表征具有相对独立性;词汇与句子水平的损伤彼此对应。     

ADHD Symptoms and Attachment Representations: Considering the Role of Conduct Problems,Cognitive Deficits and Narrative Responses in Non-Attachment-Related Story Stems

The overall aim of the present study was to investigate ADHD symptoms in relation to attachment representations. We used both attachment- and non-attachment-related story stems, which allowed us to investigate whether problems with narrative production can explain the relation between ADHD symptoms and attachment representations. We also investigated the role of cognitive deficits and conduct problems in these relations. The sample consisted of 89 children (27 % girls) between 6 and 10 years old, with an oversampling of children with high levels of ADHD symptoms. ADHD symptoms and conduct problems were rated by parents and teachers. Cognitive functioning was investigated using laboratory tests of inhibition, working memory and sustained attention. Attachment representations were coded as secure, organized insecure and disorganized categories. Narrative responses to non-attachment-related story stems were coded for incoherence and negative content. Results showed that children in the disorganized attachment category had significantly higher levels of ADHD symptoms compared to those in the secure category. Both ADHD symptoms and disorganized attachment were related to incoherence and negative content. Attachment representations were not associated with ADHD symptoms when controlling for negative content in response to non-attachment-related story stems. These results suggest that the associations between attachment security and ADHD are yet to be fully understood. Importantly, a propensity to envisage negative events seems to characterize children with high levels of ADHD symptoms.     

Perfectionism and Deficits in Cognitive Emotion Regulation

The current study investigated the general hypothesis that perfectionists have deficits in cognitive emotion regulation. A sample of 100 students completed the Perfectionism Cognitions Inventory, the Multidimensional Perfectionism Scale, the Cognitive Emotion Regulation Questionnaire (CERQ), and a measure of depression. Correlational analyses revealed that frequent thoughts involving perfectionism were associated with maladaptive cognitive emotion regulation tendencies, including catastrophization, self-blame, rumination, and lack of positive reappraisal. Socially prescribed perfectionism was associated with the maladaptive cognitive emotion regulation strategies of self-blame, catastrophization, and rumination, and it was correlated negatively with the adaptive cognitive emotion regulation strategies of putting into perspective and positive reappraisal. Trait self-oriented perfectionism was linked with self-blame. As expected, higher levels of depression were associated with perfectionism cognitions, socially prescribed perfectionism and deficits in cognitive emotion regulation. Our findings suggest the need for interventions designed to bolster the cognitive coping skills of at-risk perfectionists. This research was supported by a major research grant from the Social Sciences and Humanities Research Council (SSHRC) of Canada. Gordon Flett was also supported by a Canada Research Chair in Personality and Health.     

Approaches to Cognitive Remediation of Neuropsychological Deficits in Schizophrenia: A Review and Meta-Analysis

A review and critique of the literature pertaining to the use of cognitive remediation techniques in patients with schizophrenia is presented. The review is organized into three sections, according to the neuropsychological deficit targeted for remediation: 1) executive-function, 2) attention, and 3) memory. With regards to executive-function, despite an initial report suggesting that Wisconsin Card Sorting Test performance cannot be remediated, subsequent studies suggest that performance can be improved on a variety of dependent measures including perseverative errors, categories achieved, and conceptual level responses. These observations were confirmed by a meta-analytic investigation that revealed large mean effects sizes (d ₊ = 0.96) for these studies. Effect sizes were homogenous across discrepant remediation strategies and dependent measures. With regards to attention, serial scanning can be improved with instruction and reinforcement, whereas there is mixed evidence suggesting that practice-based attention drills can improve performance on measures of sustained attention in schizophrenia. With regards to memory, relatively simple semantic and affective elaborate encoding strategies elevates verbal list-learning memory in patients with schizophrenia to levels consistent with controls. A similar encoding procedure, combined with vigilance training, produces substantial improvement in social cue recognition. Avenues for future research are discussed.     

Working Memory Deficits and Social Problems in Children with ADHD

Social problems are a prevalent feature of ADHD and reflect a major source of functional impairment for these children. The current study examined the impact of working memory deficits on parent- and teacher-reported social problems in a sample of children with ADHD and typically developing boys (N = 39). Bootstrapped, bias-corrected mediation analyses revealed that the impact of working memory deficits on social problems is primarily indirect. That is, impaired social interactions in children with ADHD reflect, to a significant extent, the behavioral outcome of being unable to maintain a focus of attention on information within working memory while simultaneously dividing attention among multiple, on-going events and social cues occurring within the environment. Central executive deficits impacted social problems through both inattentive and impulsive-hyperactive symptoms, whereas the subsidiary phonological and visuospatial storage/rehearsal systems demonstrated a more limited yet distinct relationship with children’s social problems.     

A Review of Diagnostic Techniques in the Differential Diagnosis of Epileptic and Nonepileptic Seizures

The diagnosis of psychogenic nonepileptic seizures (PNES) is complex. Long-term electroencephalogram monitoring with video recording (video EEG) is the most common method of differential diagnosis of epilepsy and PNES. However, video EEG is complex, costly, and unavailable in some areas. Thus, alternative diagnostic techniques have been studied in the search for a diagnostic method that is as accurate as video EEG, but more cost effective, convenient, and readily available. This paper reviews the literature regarding possible diagnostic alternatives and organizes findings into 7 areas of study: demographic and medical history variables, seizure semiology, provocative testing, prolactin levels, single photon emission computed tomography, psychological testing, and neuropsychological testing. For each area, the literature is summarized, and conclusions about the accuracy of the technique as a diagnostic tool are drawn. Overall, it appears unlikely that any of the reviewed alternative techniques will replace video EEG monitoring; rather they may be more successful as complementary diagnostic tools. An important focus for further investigations involves combinations of diagnostic techniques for the differential diagnosis of epilepsy and PNES.     

Affective Processing and Emotion Regulation in Dysphoria and Depression: Cognitive Biases and Deficits in Cognitive Control

In this article, we take a closer look at the cognitive processing of emotional material in dysphoria and depression and link cognitive biases and deficits to individual differences in emotion regulation, an important risk factor for depression. Specifically, we propose that cognitive biases are associated with individual differences in the initial appraisal and reappraisal of emotion‐eliciting events. In addition, deficits in cognitive control result in prolonged processing of negative, goal‐irrelevant aspects of information as well as in decreased accessibility of mood‐incongruent material. These deficits further affect people’s ability to regulate negative affect by setting the stage for ruminative responses and by interfering with the use of reappraisal after the onset of an emotional response. This article provides a brief summary of findings that support these propositions and outlines implications for future research on the relation among affective processing, cognitive control, and emotion regulation in dysphoria and depression.     

Cognitive Deficits in the Early Stages of Alzheimer's Disease

ABSTRACT— Evidence from longitudinal, experimental, and neuroimaging studies converge to indicate that psychological functions other than episodic memory are affected very early in the course of Alzheimer's disease and, indeed, may predate or influence the apparent memory deficits. Changes in personality and difficulty in executive function, especially in terms of attentional and inhibitory control, are especially prominent. Deficits in other types of memory (i.e., semantic memory, conditioning) can also be detected in the early stages of the disease. It is time to update existing diagnostic criteria for this form of dementia in terms of current knowledge of multiple and interacting brain systems.     

Inhibitory Control Deficits in Individuals with Amnestic Mild Cognitive Impairment: a Meta-Analysis

Neuropsychology Review - Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer’s disease that is characterized by impairments in episodic memory. Recent evidence has...     

Differential Automatic Processing Deficits in Early Stage Alzheimer's Disease

This experiment sought further support for the view that early stage Alzheimer's disease (AD) disrupts cognitive structures that cast experience into a temporal framework. Forty participants, evenly divided between normal elderly (NE) and persons diagnosed with mild AD, viewed 19 lists of 14 pictures each. Following the presentation of each list participants were asked to identify the most recently experienced picture (target) from 3 pictures. A second stimulus was a picture never previously seen; the third picture was a distracting item that had appeared in the list on either one or three occasions. The results show that whereas choice accuracy of the NE group remained largely unimpaired regardless of the delay between the target and the judgment task or the frequency of the distractor, the AD participants exhibited large and profound deficits in temporal judgments, especially when distractor frequency was greater than the more recent event. In effect, the AD group relied on how often an event occurred rather than the time of its occurrence. This finding is consistent with previous research that found AD patients deficient in forming a temporal representation of their experience.     

The Role of Cognitive Deficits in the Development of Eating Disorders

Eating disorders (ED), including anorexia and bulimia nervosa, are chronic illnesses with periods of symptom exacerbation and remission. Because symptoms are usually present from 6 to 24 months before a diagnosis is made, aetiological agents are believed to be active well before symptoms appear. It is proposed that neuropsychological deficits in various cognitive domains preexist and underlie the aetiology of ED. This paper provides a comprehensive review of the literature relevant to neuropsychological deficits in ED patients and explores the relationship between cognitive deficits, psychosocial development, and the development of ED. Although the role of neuropsychological deficits in the evolution of ED requires further research, the proposed association has significant implications for clinical practice.     

Reading Comprehension in Children with ADHD: Cognitive Underpinnings of the Centrality Deficit

We examined reading comprehension in children with ADHD by assessing their ability to build a coherent mental representation that allows them to recall central and peripheral information. We compared children with ADHD (mean age 9.78) to word reading-matched controls (mean age 9.89) on their ability to retell a passage. We found that even though children with ADHD recalled more central than peripheral information, they showed their greatest deficit, relative to controls, on central information—a centrality deficit (Miller and Keenan, Annals of Dyslexia 59:99–113, 2009). We explored the cognitive underpinnings of this deficit using regressions to compare how well cognitive factors (working memory, inhibition, processing speed, and IQ) predicted the ability to recall central information, after controlling for word reading ability, and whether these cognitive factors interacted with ADHD symptoms. Working memory accounted for the most unique variance. Although previous evidence for reading comprehension difficulties in children with ADHD have been mixed, this study suggests that even when word reading ability is controlled, children with ADHD have difficulty building a coherent mental representation, and this difficulty is likely related to deficits in working memory.     

Women with Childhood ADHD: Comparisons by Diagnostic Group and Gender

This study compared adult women with childhood ADHD to adult women without childhood ADHD and to adult men with childhood ADHD. The participants, all from a larger longitudinal study, included 30 women and 30 men (approximately age 23 to 24) with childhood ADHD, and 27 women without ADHD. Women with childhood ADHD were matched to comparison women on age, ethnicity, and parental education, and to men with childhood ADHD on age, ethnicity, and IQ. Self- and parent-reports of internalizing, interpersonal, academic, and job impairment, as well as substance use and delinquency indicated group differences on measures of self-esteem, interpersonal and vocational functioning, as well as substance use. Follow-up planned comparison tests revealed that almost all of these differences emerged by diagnostic status, and not by gender. This study adds to research on the negative adult outcomes of ADHD and demonstrates that the outcomes of men and women with childhood ADHD are relatively similar.     

Consistency of Cluster Analysis for Cognitive Diagnosis: The Reduced Reparameterized Unified Model and the General Diagnostic Model

The asymptotic classification theory of cognitive diagnosis (ACTCD) provided the theoretical foundation for using clustering methods that do not rely on a parametric statistical model for assigning examinees to proficiency classes. Like general diagnostic classification models, clustering methods can be useful in situations where the true diagnostic classification model (DCM) underlying the data is unknown and possibly misspecified, or the items of a test conform to a mix of multiple DCMs. Clustering methods can also be an option when fitting advanced and complex DCMs encounters computational difficulties. These can range from the use of excessive CPU times to plain computational infeasibility. However, the propositions of the ACTCD have only been proven for the Deterministic Input Noisy Output “AND” gate (DINA) model and the Deterministic Input Noisy Output “OR” gate (DINO) model. For other DCMs, there does not exist a theoretical justification to use clustering for assigning examinees to proficiency classes. But if clustering is to be used legitimately, then the ACTCD must cover a larger number of DCMs than just the DINA model and the DINO model. Thus, the purpose of this article is to prove the theoretical propositions of the ACTCD for two other important DCMs, the Reduced Reparameterized Unified Model and the General Diagnostic Model.