Neuropsychological rehabilitation: microcomputer-assisted treatment of brain-injured adults.

This study was designed to investigate the contribution of cognitive rehabilitation therapy delivered by computer within an educationally based treatment program for brain-injured adults. The effectiveness of two forms of computer-assisted neuropsychological treatment was examined, 36 head-injured adults received the treatment targeting either attention and memory skills or reasoning and logical thinking skills. Both groups were assessed on three measures of attention and memory and three measures of reasoning before and after the 8-wk. treatment. Analysis indicated significant improvement on five of six measures by both groups. No differential effect was observed by treatment condition. These findings did not support the hypothesis that computer-assisted neuropsychological rehabilitation programs which differ in both content and focus can produce specific effects on cognitive functioning of brain-injured adults.     

Self-Reported Cognitive Inconsistency in Older Adults

ABSTRACT

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70–91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.     

Characteristics of the Florida cognitive activities scale in older African Americans

Substantial research effort has recently focused on the potential protective effect of cognitively demanding activities on cognitive decline in late life. A significant methodological issue in this effort has been the lack of consistency in approaches to the operational measurement of cognitive activity. In this study, data in support of the reliability and construct validity of the recently developed Florida Cognitive Activities Scale (FCAS) in a sample of 223 African American older adults are provided. Consistent with the findings of the Schinka et al. study using a sample of Whites, the FCAS full scale showed a reasonably high level of internal consistency, small negative correlations with age and a measure of depressive symptomatology, and moderate positive correlations with years of education and neuropsychological measures of overall cognitive functioning, memory, and executive functioning. Even after controlling for the effects of age, education, and gender, the full scale score contributed significantly to the prediction of global cognitive functioning. The results of this study suggest that the FCAS is a reliable and valid measure of cognitive activities in older African Americans and provides additional, although not causative, evidence in support of the hypothesis of a protective effect of cognitive activity against cognitive decline regardless of ethnicity or race.     

Aging and self-reported internal and external memory strategy uses: The role of executive functioning

The aim of this study was to investigate the effect of advanced age on self-reported internal and external memory strategy uses, and whether this effect can be predicted by executive functioning. A sample of 194 participants aged 21 to 80 divided into three age groups (21-40, 41-60, 61-80) completed the two strategy scales of the Metamemory in Adulthood (MIA) questionnaire, differentiating between internal and external everyday memory strategy uses, and three tests of executive functioning. The results showed that: (1) the use of external memory strategies increased with age, whereas use of internal memory strategy decreased; (2) executive functioning appeared to be related only to internal strategies, the participants who reported the greatest use of internal strategies having the highest executive level; and (3) executive functioning accounted for a sizeable proportion of the age-related variance in internal strategy use. These findings suggest that older adults preferentially use external memory strategies to cope with everyday memory impairment due to aging. They also support the view that the age-related decrease in the implementation of internal memory strategies can be explained by the executive hypothesis of cognitive aging. This result parallels those observed using objective laboratory memory strategy measures and then supports the validity of self-reported memory strategy questionnaire.     

Reflections on intersections between cognitive and social psychology: A personal exploration

I appreciate the opportunity offered by the editor to reflect on the relationship between cognitive and social psychology. This topic has interested me my entire professional life, because I was admitted to graduate school to study social psychology and then eventually migrated to cognitive psychology. The organization of this paper is as follows: I first relate my (somewhat puzzling) personal experiences that led me to wonder about relations between cognitive and social psychology. I suggest that, for many topics, the placement of a topic of study in one field or the other is arbitrary. Next I selectively review some common historical influences on the development of both fields, ones that have made them similar. Both grew from common seeds, which include Gestalt psychology as it became applied to a wider array of topics, experimental psychologists becoming interested in attitude change during and after World War II, and Bartlett's famous book on Remembering: A study in experimental and social psychology. Next I review some research from my lab that picked up themes from Bartlett's work and that, in some aspects, combines cognitive and social approaches. I also discuss the issue of memory conformity or the social contagion of memory, and conclude with thoughts about how social and cognitive psychologists might collaborate on an exciting new arena, creating empirical studies of collective memory. Copyright © 2010 John Wiley & Sons, Ltd.     

Executive functioning and memory as potential mediators of the episodic feeling-of-knowing accuracy

The study focused on the cognitive determinants of the accuracy of feeling-of-knowing (FOK) judgments made on episodic memory information. An individual differences approach was used on a sample of healthy older adults assessed on an episodic FOK task and on several neuropsychological measures. At a global level of analysis of FOK accuracy, the contributions of four general cognitive processes--episodic memory, executive functioning, fluid intelligence and processing speed--were examined concurrently. Stepwise regression analyses showed that executive functioning accounted for the major part of variance on FOK accuracy, followed by a significant contribution of episodic memory. After controlling for executive and memory involvement, fluid intelligence and processing speed no longer accounted for significant variance. At a more detailed level of analysis of FOK accuracy, the contributions of three specific executive processes--shifting, updating and inhibition--were assessed. The results revealed shifting function as the primary executive process engaged in the production of accurate FOK judgments in episodic memory. Some hypotheses are put forward to better understand the central role of executive functioning in the production of accurate FOK judgments.     

Peer support telephone dyads for elderly women: Was this the wrong intervention?

Tested a preventive intervention in which peer telephone dyads were developed for low-income, community-living, elderly women with low perceived social support. After an initial assessment, respondents were randomly assigned to either an assessment-only control or received 10 weeks of friendly staff telephone contact. After a second assessment, participants receiving the staff contact were randomly assigned to continue that contact or were paired in dyads to continue phone contact with one another. Dependent variables were measures of perceived social support, morale, depression, and loneliness. All groups, particularly the staff contact group, showed some improvement in mental health scores over time, but there were no significant differences between intervention groups, or between intervention and assessment-only control groups. The results suggest that participation in the study and in personal assessment interviews at home were probably morale enhancing, and that additional telephone contact did not significantly add to that effect. Evidence also indicates that, in this sample, low perceived family support was significantly related to poor mental health, so it is possible that a program designed to increase friend support may have been the wrong intervention.     

Complex span tasks, simple span tasks, and cognitive abilities: A reanalysis of key studies

There is great interest in the relationships between memory span tasks and cognitive abilities. However, the causes underlying their correlation remain unknown. In the present article, five key data sets were reanalyzed according to two criteria: They must consider complex span tasks (so-called working memory [WM] tasks) and simple span tasks (so-called short-term memory [STM] tasks), and they must comprise cognitive ability measures. The obtained results offer several points of interest. First, memory span tasks should be conceived from a hierarchical perspective: They comprise both general and specific components. Second, the general component explains about four times the variance explained by the specific components. Third, STM and WM measures are closely related. Fourth, STM and WM measures share the same common variance with cognitive abilities. Finally, the strong relationship usually found between memory span tasks and cognitive abilities could be tentatively interpreted by the component shared by STM and WM--namely, the capacity for temporarily preserving a reliable memory representation of any given information.     

Cognitive Functioning in Treatment-Seeking Gulf War Veterans: Pyridostigmine Bromide Use and PTSD

Gulf War (GW) deployed veterans have reported health symptoms since returning from the war that suggest dysfunction of the central nervous system (CNS). These symptoms include memory and concentration difficulties, fatigue, and headaches. Leading hypotheses for the etiology of these cognitive complaints include psychological factors and/or exposures to chemicals with neurotoxic properties. In this study, cognitive functioning was compared in treatment-seeking GW-deployed veterans and a treatment-seeking non–GW-deployed veteran control group. Results indicated that GW-deployed veterans performed significantly worse than the comparison group on tests of attention, visuospatial skills, visual memory, and mood. GW-deployed veterans who reported taking pyridostigmine bromide (PB) performed worse than GW-deployed veterans without PB use on executive system tasks. Treatment-seeking GW-deployed veterans with diagnoses of posttraumatic stress disorder (PTSD) did not differ on cognitive test measures compared with GW-deployed veterans without PTSD. No interaction effect of PTSD and PB use was found.     

Examining Cognitive Functioning Following TASER Exposure: A Randomized Controlled Trial

Individuals who experience electrical injury suffer significant, sometimes long‐term deficits in neuropsychological functioning. The TASER, an electrical device used by thousands of police departments, generates a high‐voltage (up to 50 000 V), low‐amperage (2.1 mA) current of electricity that is designed to disable a resistive criminal suspect. Questions have emerged regarding the potential for TASER exposure to cause impairment in cognitive functioning. In the current study, healthy human volunteers were randomly assigned to four groups, two of which received a TASER exposure. Participants completed a battery of cognitive tests before and after receiving their assigned treatment. Participants who received a TASER exposure experienced statistically meaningful declines in measures of verbal learning and memory, although deficits lasted less than 1 hour. After TASER exposure, participants also self‐reported significant difficulties with concentration, anxiety, and feeling overwhelmed. Other dimensions of cognitive functioning were not affected. Our findings show that the effects of TASER exposure on brain functioning are not well understood. Copyright © 2015 John Wiley & Sons, Ltd.     

Self-perception of competence in Korean children: Age, sex and home influences

The self-perceived competence of 750 Korean children in kindergarten through the seventh grade was investigated using adaptations of Harter's scales for younger and older children. Measures of family characteristics and the home environment were collected to explore the determinants of variation in self-perceived competence. Adaptations of the competence scales yielded maximum similarity of content across the full age span, and also reflected the Korean emphasis on collectivist, intergenerational social skills and on early, direct training in academic cognitive skills. The results replicate two findings reported for North American and European samples; namely, increasing differentiation of domains of self-perceived competence with age, and decreasing levels of self-perceived competence in the opening years of primary school. In addition, the present study also finds two phenomena not evident in previous reports. First, a significant statistical interaction of grade and sex in the cognitive and physical domain was found, such that girls' self-perceived competence decreased more with age than did that of boys. Second, two social domains were differentiated, one reflecting peer acceptance (like the Harter scales) and the other tapping intergenerational and collectivist social skills that are valued in Korean society. Structural equation modeling revealed different patterns of influence for the four outcome measures. Both the analysis of internal variation and comparison with previous reports highlight the importance of a social and cultural perspective in understanding the development of children's self-perceived competence.     

Cognitive outcomes of pediatric stroke

A limited number of longitudinal studies have investigated long-term neuropsychological development in the pediatric stroke population. This study retrospectively examines cognitive outcomes in 41 children with a history of stroke, with reference to age at stroke, laterality, region and mechanism of stroke. In the course of recovery, neuropsychological measures of intellectual functioning and memory were administered at two time points, whilst executive functioning, attention and academic skills were administered at one time point. As predicted, children with stroke performed significantly worse compared to normative expectations on all neuropsychological measures. Up to two thirds of children scored in the borderline impaired and impaired ranges on at least one domain of cognition. Performance on intellectual and memory assessment remained relatively stable over time. Younger age at stroke was found to be associated with poorer intellectual functioning. No effects of laterality of stroke on neuropsychological performance over time were found. Children with subcortical stroke demonstrated a greater improvement in immediate memory over time than children with cortical stroke. These findings reveal that children with stroke display long-term cognitive difficulties that typically remain stable over time. Attention and academic skills are particularly vulnerable to impairment. Further evidence that age at stroke is a significant factor in terms of cognitive outcome is provided, in support of the “early vulnerability” position.     

The use of safety behaviours to manage intrusive memories in depression

Cognitive models of clinical disorders conceptualise cognitive and behavioural safety-seeking behaviours as central to symptom persistence because they prevent disconfirmation of key maintaining beliefs. Despite growing evidence of the role of negative beliefs about intrusive memories in depression, it remains unclear why such beliefs persist. Accordingly, we examined whether safety behaviours in response to unhelpful beliefs about intrusive memories might play a role in their maintenance. Eighteen high dysphoric (i.e., BDI-II12) individuals who reported an intrusive negative autobiographical memory in the past week completed a battery of measures about their memory, associated negative beliefs and safety behaviours adopted in response to their beliefs. The most commonly endorsed beliefs reflected themes of wanting to control memories (e.g., ‘I should be able to rid my mind of this memory’) and self-deprecation about experiencing them (e.g., ‘Because I can’t control this memory, I am a weak person’). The beliefs prompted a range of safety behaviours, with cognitive distraction being the most common. The findings demonstrate that safety behaviours are common in response to maladaptive beliefs about intrusive memories. Treatment developments in this area are needed, and should incorporate strategies to challenge beliefs about memories, reduce the use of safety behaviours, and promote processing of intrusive memories.     

Social and non‐social measures of cognition for predicting self‐reported and informant‐reported functional outcomes in early psychosis

The main aim of this study was to investigate the individual contributions of neurocognitive and social‐cognitive domains to self‐reported and informant‐reported functional outcome in early psychosis. We also sought to further characterize the nature of cognitive impairments in this sample and explore the interrelationships between the social‐cognitive measures and how they correlate with measures of neurocognition and clinical symptoms. In this study, 70 patients (mean age: 24.1; 87.1% males) with primary psychotic disorder diagnosed in the previous 5 years were assessed on multiple neurocognitive (processing speed, attention, working memory, immediate verbal memory, delayed recall, visual reasoning, inhibition, planning, cognitive flexibility), and social‐cognitive domains (theory of mind (ToM), emotion recognition, attributional style, metacognitive overconfidence) as well as measures of clinical symptoms. Functional outcome was assessed with three self‐reports and two informant‐reports. On average, patients performed one or more SD below healthy controls on measures of delayed recall, ToM and metacognitive overconfidence. Emotion recognition and ToM were intercorrelated and correlated with multiple neurocognitive domains and negative symptoms. Attributional style correlated with positive symptoms. In the context of multiple variables, self‐reported functional outcomes were predicted by attributional style, whereas emotion recognition and immediate verbal memory predicted variance in informant‐reported community functioning. These results support the suggestion of a likely distinction between the predictive factors for self‐reported and informant‐reported functional outcome in early psychosis and suggest that consideration of self‐assessment of functional outcome is critical when attempting to evaluate the effects attributional style has on functional disability.     

"LIKE CHEWING GRAVEL"

The researcher's role in creating knowledge and interpretations is of critical concern as new research methods are developed. Recent attention has been given to the "implications of difference" on the research process; however, the processes of analysis/interpretation and presentation of research remain to be illuminated. Seeking to address this, I present my experiences as a White researcher of middle socioeconomic status (SES) conducting qualitative research about childbearing with several pregnant Black American adolescents of lower SES. Although the research process was consistent with qualitative research methods, initial analyses of the data led to findings that seemed far afield from the participants' worlds. I subsequently reanalyzed the data with the principles of a feminist epistemology (Harding, 1991) in mind. The impact of using this epistemology on the processes of analysis and interpretation and my presentation of the data are presented. The results support the importance of developing feminist methodology and epistemology and provide new direction for further work.     

The roles of different executive functioning skills in young children’s mental computation and applied mathematical problem-solving

This study investigated the relationships of four executive functioning skills (including verbal working memory, spatial working memory, inhibitory control, and cognitive flexibility) with young children’s mental computation and applied mathematical problem-solving. Two hundred and twenty-five Chinese kindergarteners were tested with a battery of general cognitive, executive functioning and mathematics skills. Results showed that when children’s age, gender, non-verbal intelligence, and listening comprehension skills were controlled, verbal working memory and cognitive flexibility were significant correlates of mental computation, whereas verbal working memory, spatial working memory, and cognitive flexibility were significant correlates of applied mathematical problem-solving. Inhibitory control was not significantly associated with the two domains of mathematics under investigation. The findings highlight the differential roles of different executive functioning skills in early mathematical skills and offer practical implication for helping young children in learning complex mathematical skills.     

Differences in cognitive performance between informal caregivers and non-caregivers

ABSTRACT

Extensive literature exists documenting the relationship between stress and cognition. Caregiving for an individual with Alzheimer’s disease can be aunique and chronic stress experience due to the increasing dependency of the care-recipient as the disease progresses. The current study examines the relationship between stress and cognitive performance in 47 dementia caregivers compared to 47 noncaregiver control participants matched on age, gender, and education. Participants completed measures assessing stress (measured via the Perceived Stress Scale) and seven domains of cognition including episodic memory, working memory, executive functioning, attention, visuospatial processing, processing speed, and implicit memory. Results showed that caregivers had poorer performance than non-caregivers on certain measures of episodic memory, working memory, and executive functioning; while no significant differences were observed on measures of attention, visuospatial processing, processing speed, or implicit memory. In addition, when controlling for general stress, caregiver performance on measures of processing speed and visuospatial processing was also poorer than non-caregivers. By controlling for levels of general stress that may not be related to caregiving, these results show that differences in cognitive performance are unlikely to be explained by general stress alone.     

Categorization and cognitive deficits in compulsive hoarding

According to the cognitive-behavioural model of compulsive hoarding, information-processing deficits in the areas of attention, memory, decision-making, and categorization contribute to hoarding behaviour. The purpose of the current study was to examine whether individuals with compulsive hoarding exhibited impairment on executive functioning and categorization tasks. Three groups of participants were recruited (N = 60): individuals with compulsive hoarding syndrome, individuals with an Axis I mood or anxiety disorder, and non-clinical control participants. All participants completed self-report measures of cognitive difficulties, neuropsychological tests of executive functioning and decision-making, and four categorization tasks. Results suggested that hoarding participants reported more cognitive failures and more problems with attention and decision-making than non-clinical control participants. In addition, hoarding participants performed worse than both control groups on the Stockings of Cambridge (SOC), a neuropsychological test of planning ability, and were slower and more anxious during a categorization task. These findings suggest that specific deficits in executive functioning may be associated with the difficulties hoarding patients have organizing their possessions.     

Sex differences in a human analogue of the Radial Arm Maze: the "17-Box Maze Test"

This study investigated sex differences in spatial memory using a human analogue of the Radial Arm Maze: a revision on the Nine Box Maze originally developed by called the 17-Box Maze Test herein. The task encourages allocentric spatial processing, dissociates object from spatial memory, and incorporates a within-participants design to provide measures of location and object, working and reference memory. Healthy adult males and females (26 per group) were administered the 17-Box Maze Test, as well as mental rotation and a verbal IQ test. Females made significantly fewer errors on this task than males. However, post hoc analysis revealed that the significant sex difference was specific to object, rather than location, memory measures. These were medium to large effect sizes. The findings raise the issue of task- and component-specific sexual dimorphism in cognitive mapping.     

Memory training and strategy use in older adults: results from the ACTIVE study

Little is known about the long-term effects of memory training in later life on strategy use. Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 1,401) were used to describe strategy use in a community-dwelling sample of older adults. Strategy clustering scores on verbal list learning tasks of episodic memory were used to test the impact of memory training on strategy use and study longitudinal associations between strategy clustering, memory performance, and everyday functioning. Results suggested that younger, female, white, healthier, and more educated participants show higher strategy clustering scores initially but no characteristics were consistently associated with different trajectories in strategy clustering across all strategy clustering measures together. Memory training had significant immediate effects on all measures of strategy use that were maintained through five years of follow-up. With respect to longitudinal mediation, pre-post training changes in most strategy clustering scores mediate changes in objective memory performance and everyday functioning, implying that strategies can be modified and are closely related to both memory ability and the ability to function independently. This study provides evidence that older adults can be trained to use cognitive strategies, the effects are durable, and strategies are associated with memory and everyday functioning.