Characteristic patterns of verbal memory function in patients with Huntington's disease

Various aspects of verbal memory in patients with Huntington's disease (HD) were studied using the California Verbal Learning Test (CVLT). We tested if the level and interplay between 5 parameters of different memory mechanisms and processes were sufficiently specific to allow acceptable discrimination between patients with HD, patients with Parkinson's disease (PD), and patients without known CNS disease or injury. The HD-patients were characterized by a deficit in acquisition, elevated rates of recall errors and increased use of a passive learning strategy. Preserved aspects were shown in retention over time, interference effects and recognition relative to recall. Employing multivariate classification and validation techniques, the 5 CVLT-features demonstrated good separability between the HD-patients and the control patients. Qualitative similarities between subgroups were suggested, but more disease-specific data seemed necessary in further studies. A number of findings suggested a defect in the active organization of items to be encoded and recalled in HD. Similar findings in the PD-group might indicate that this trait is common in several types of 'subcortical dementia'.     

Neuropsychological aspects of Parkinson's disease

The neuropsychological effects of Parkinson's disease have gained wide recognition in recent literature. Effects have been documented in almost all areas of cognitive functioning, including general intellectual functioning, visual-spatial functioning, executive functions, attention and memory functions, language functions, and affective processes. Visual-spatial functions, memory functions, and executive functions have received particular interest. This review of the literature is an attempt to tie together the large number of studies in these cognitive areas and to present a suggestion for a comprehensive neuropsychological battery tailored to the patient with Parkinson's disease. Throughout the review, factors relevant to Parkinson's disease, e.g., dementia, motor symptoms, and hemiparkinsonism, are considered.     

Overgeneral autobiographical memory predicts higher prospective levels of depressive symptoms and intrusions in borderline patients

Overgeneral memory (OGM), the tendency to retrieve categories of events from autobiographical memory instead of single events, is found to be a reliable predictor for future mood disturbances and post-traumatic symptom severity. Patients with borderline personality disorder (BPD) often report co-morbid episodes of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). Therefore, we investigated whether OGM would predict depression severity and (post-traumatic) stress symptoms in BPD patients. At admission (N?=?54) and at six-month follow-up (N?≥?31), BPD patients completed the Structured Clinical Interview for DSM-IV Disorders, the Assessment of DSM-IV Personality Disorders, the Autobiographical Memory Test, the Beck Depression Inventory—2nd edition (BDI-II), and the Impact of Event Scale. OGM at baseline predicted (a) higher levels of depressive symptoms at follow-up and (b) more intrusions related to a stressful event over and above baseline levels of borderline symptoms, depressive symptoms, and intrusions, respectively. No association was found between memory specificity and event-related avoidance at follow-up. Despite previous findings suggesting that OGM in BPD is less robust than in MDD and PTSD, our results suggest that memory specificity in BPD patients may have some relevance for the course of depressive and stress symptomatology in BPD.     

Dopamine and cognitive functioning: brain imaging findings in Huntington's disease and normal aging

Recent brain imaging studies in Huntington's disease (HD) and normal aging suggest a relationship between central dopaminergic neurotransmission and cognitive performance. Results demonstrate substantial losses in dopamine (DA) function in both HD and aging. Moreover, HD patients and older adults show deficits across multiple cognitive domains, including episodic memory, speed of processing, and executive functioning. Although few studies are available at present, there is converging evidence that multiple measures of pre- and postsynaptic DA biochemistry are (a) highly interrelated, and (b) strongly associated with the cognitive deficits that accompany HD and aging. There is also emerging evidence that DA neurotransmission influences cognitive performance independent of HD or age. In general, the research reviewed in this article indicates that the nigrostriatal DA system is an important component of a frontostriatal circuitry that is critically involved in cognitive functioning.     

Assessment of 'subcortical dementia' in patients with Huntington's disease, Parkinson's disease, multiple sclerosis and AIDS by a neuropsychological screening battery

Four diagnostic groups categorized as 'subcortical dementia' were studied using a neuropsychological screening battery. The specificity of the battery in disclosing characteristic patterns of impairment in subgroups within the category, and the correspondence between natural subgroups generated by an unsupervised statistical classification technique and the diagnostic labels were investigated. All cognitive affected subgroups demonstrated impairment on tests of sensomotor function, congnitive efficiency and/or memory, and were characterized in terms of severity of impairment as well as a progressive involvement of functional areas. The diagnostic groups were not evenly represented in all natural subgroups. Affected AIDS-patients seemed to resemble patients with Huntington's disease more than the other diagnostic groups. The screening battery could give a general characterization of the pattern of 'subcortical dementia' and different levels of impairment, but more specific process-oriented tasks are needed to contrast diagnostic groups within the concept of 'subcortical dementia'.     

Olfaction in Persons with Alzheimer's Disease

The need for low cost, noninvasive procedures for aiding in the diagnosis and understanding of Alzheimer's Disease (AD) has led to theories and procedures examining the role of olfactory disorders because of the finding that the brains of AD patients invariably exhibit neuropathology hi the hippocampus and entorhinal cortex. This loss correlates with the increase in the number of plaques and tangles and with the severity of dementia. Considered together, these findings suggest that brain structures closely related to the olfactory system demonstrate significant histopathology in AD. A comprehensive review of the literature pertaining to olfaction in persons with AD revealed that the olfactory identification ability of patients with memory disorders is impaired relative to controls. Consistency is lacking, however, when olfactory detection thresholds are investigated. Also, there is inconsistency in regards to severity of illness and olfactory function. In addition to differentiating AD patients from normals, the olfactory paradigm has shown some limited usefulness in differentiating AD patients from some other demented patients.     

Newborns of mothers with depressive symptoms are less expressive

The facial expressions of 40 newborns of mothers with depressive symptoms (n = 20) and of nondepressive mothers (n = 20) were recorded during the Brazelton Neonatal Behavior Assessment Scale and during the modeling of happy, sad, and surprised faces. Infants of mothers with depressive symptoms demonstrated inferior performance on the orientation cluster of the Brazelton scale and showed fewer interest and more precry expressions during the Brazelton. During the facial expression modeling, they showed less orientation and fewer facial expressions in response to the modeled happy and surprise facial expressions.     

Acoustic parameters of infant-directed singing in mothers with depressive symptoms

The purpose of this study was to explore the relationship between mothers’ depressive symptoms and the acoustic parameters of infant-directed (ID) singing. Participants included 80 mothers and their 3- to 9-month-old infants. A digital recording was made of each mother's voice while singing to her infant. Extraction and analyses of vocal data revealed a main effect of tempo, meaning that as mothers reported more depressive symptoms, they tended to sing faster to their infants. Additionally, an interaction effect indicated that mothers with depressive symptoms were more likely to sing with tonal key clarity to their male infants. These findings suggest that as mothers experience depressive symptoms, their ID singing may lack the sensitivity and emotional expression that infants need for affect regulation. An intervention that combines interaction coaching and ID singing may help mothers with depressive symptoms to engage in sensitive and emotionally synchronized interactions with their infants.     

Social support, locus of control, and depressive symptoms in hemodialysis patients

This study aimed to reveal how social support and psychological well-being association might differ with locus of control orientation for chronically ill patients receiving a restrictive and unpleasant medical treatment (i.e., hemodialysis). Data were collected from 104 hemodialysis patients. After controlling for the variance accounted for by gender and duration of dialysis, for patients with internal locus of control, lack of "perceived social support" was found to be associated with depressive symptoms. On the other hand, for patients with external locus of control, the same analysis revealed that lack of "satisfaction from the received social support" was associated with depressive symptoms. Thus, for hemodialysis patients the variables associated with depressive symptoms varied with their locus of control orientations. Furthermore, the present study underlined the importance of considering different aspects of social support while studying with chronically ill patients.     

The prevention of depressive symptoms in rural Australian women

Two interventions aimed at preventing depressive symptoms in women living in Western Australian rural communities were evaluated against a no‐intervention control condition. The standard intervention was based upon traditional cognitive‐behaviour treatments for depression; the experimental intervention was based upon prevention strategies derived from the learned helplessness model of depression (e.g. Peterson, Maier, & Seligman, 1993 ). Seventy‐six women were randomly assigned to either the standard or the experimental group, and a further 20 women formed a no‐intervention control group. The standard group showed a reduction in depressive symptoms at post‐test, but no effects at 6‐week or 6‐month follow‐ups. In contrast, a reduction in depressive symptoms did not appear for the experimental group until the 6‐week follow‐up at which time a less depressive attributional style was also evident; these effects were even more pronounced at the 6‐month follow‐up. The no‐intervention control group showed no changes across time. It is argued that these results support the applicability of prevention strategies based on the learned helplessness model to this population. Copyright © 2003 John Wiley & Sons, Ltd.     

Neuropsychological outcome of GPi pallidotomy and GPi or STN deep brain stimulation in Parkinson's disease

This paper highlights the neuropsychological sequelae of posteroventral pallidotomy (PVP) and deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the internal segment of the globus pallidus (GPi) at 3/6 months postoperatively. Results are based on our extensive experience with PVP and our preliminary observations with DBS. Patients with borderline cognitive or psychiatric functioning risk postoperative decompensation. Nonlateralizing attentional and hemisphere-specific impairments of frontostriatal cognitive functions followed unilateral PVP. "Frontal" behavioral dyscontrol was observed in approximately 25% of patients. Three cases of staged bilateral PVP suggest that premorbid factors may predict outcome, although lesion size and location are also critical. Older patients are at risk for significant cognitive and behavioral decline after bilateral STN DBS, while GPi DBS may be safer.     

Rural breast cancer patients,coping and depressive symptoms: A prospective comparison study

Many studies have revealed that individual differences in coping responses to the diagnosis and treatment of breast cancer are associated with psychological adjustment. The vast majority of these studies, however, focus exclusively on urban breast cancer survivors despite that rural breast cancer survivors are likely to have distinct experiences both in general and in relation to breast cancer. The current study quantitatively examined the coping strategies employed by both rural and urban breast cancer patients while they were undergoing radiation therapy. Further, the influence of these coping behaviours on concurrent as well as subsequent depressive symptoms (3 and 6 months later) was examined. The results revealed that the rurality of breast cancer patients was unrelated to the ways in which they coped, but did influence the relationships between some coping responses and depressive symptoms. Specifically, active coping and positive reinterpretation were negatively related to depressive symptoms for more rural breast cancer patients, but not their relatively urban counterparts. Similarly, behavioural disengagement was more strongly related to depressive symptoms for more rural patients. Possible reasons for this pattern of results and implications are discussed.     

Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early‐onset schizophrenia patients

Cognitive deficits in several domains have been demonstrated in early‐onset schizophrenia patients but their profile and relation to depressive symptoms and intelligence need further characterization. The purpose was to characterize the profile of cognitive deficits in chronic, early‐onset schizophrenia patients, assess the potential associations with depressive symptom severity, and examine whether cognitive deficits within several domains reflect intelligence impairments. This study compared attention, visual‐construction, aspects of visual and verbal memory, and executive functions in chronic, early‐onset schizophrenia patients (mean age = 20.7 years) (N = 18) and healthy controls (N = 38). Schizophrenia diagnoses were established at the time of the patients' first clinical presentation during childhood or adolescence and were confirmed five years later. In the chronic phase of early‐onset schizophrenia, significant deficits were observed in all specific cognitive functions. The profile of cognitive deficits was jagged, and visual‐construction, attention, and one aspect of verbal memory (verbal stories recall) were differentially impaired. Deficits of visual recall, visual recognition, and executive functions were accounted for by deficits in intelligence, while this was not the case for deficits of verbal recall of stories or attention. No significant associations were observed between the severity of cognitive deficits and that of depressive symptoms. Chronic, early‐onset schizophrenia is characterized by a broad and jagged profile of cognitive deficits. Deficits of attention and verbal recall of stories appear not to be accounted for by deficits in intelligence, and the severity of cognitive deficits seems independent from that of depressive symptoms     

Night waking in 6-month-old infants and maternal depressive symptoms

Relations between night waking in infants and depressive symptoms in their mothers at 6 months postpartum were examined using the data from the National Institute for Child Health and Human Development Study of Early Child Care. Although more depressive symptoms were only weakly correlated with a higher frequency of infant waking, longer wake times, and more total time awake, the rate of clinically significant depression scores was about double in mothers of chronically waking infants in comparison with mothers whose infants did not awaken during the night. The value of comparing subgroups to elucidate relations identified through correlations is discussed.     

Protective factors for depressive symptoms in emerging adulthood

Emerging adulthood is characterized by pervasive changes in identity and relationships. These challenges can entail problems for subjective well-being, leading to depressive symptoms. The development of an autonomous-related self is considered crucial for emerging adults’ personal growth and psychological well-being. Autonomous-related self is linked to self-esteem and secure attachment style, which are also protective factors for depression. The current research sought to investigate the relation between autonomous-related self and depressive symptoms, as well as the role of secure attachment style and self-esteem, in a sample of 356 Italian emerging adults. Gender differences were taken into account in preliminary analyses. Gender differences emerged for autonomous-related self and self-esteem, while secure attachment and depression levels were similar across gender. Our results suggest that autonomous-related self, mediated by self-esteem and secure attachment style, is a protective factor for emotional states of depression, controlling for social desirability. These findings emphasize the importance of taking autonomy and relatedness into account in emerging adulthood and represent a starting point for future studies.     

Early manifestations of childhood depression: influences of infant temperament and parental depressive symptoms

In this longitudinal study, 83 parents of infants between 3 and 12 months completed questionnaires assessing demographic information, infant temperament, and maternal depression. When these children were at least 18 months of age, parents completed follow‐up questionnaires assessing toddler temperament and depression‐like symptoms. We were primarily interested in the contributions of infant temperament and maternal depression to toddler depressive problems, and the analytic strategy involved controlling for toddler temperament in order to isolate the influence of infancy characteristics. The findings indicated that lower levels of infant regulatory capacity and greater severity of maternal depression were predictive of toddler depression‐like symptoms. Moderator effects of infant temperament were also examined, with the negative affectivity * maternal depression interaction emerging as significant. Follow‐up analyses indicated that the risk for early manifestations of depression was attenuated for children with lower negative affectivity in infancy and parents who reported lower levels of their own depressive symptoms; conversely, children exhibiting higher infant negative emotionality had higher levels of depression‐like symptoms as toddlers, regardless of their parents' level of depression. The present findings further suggest that parental depressive symptoms need not be ‘clinically significant’ to predict toddler affective problems. Copyright © 2008 John Wiley & Sons, Ltd.     

Specificity in autobiographical memory narratives correlates with performance on the Autobiographical Memory Test and prospectively predicts depressive symptoms

Reduced autobiographical memory specificity (AMS) is an important cognitive marker in depression that is typically measured with the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986). The AMT is widely used, but the over-reliance on a single methodology for assessing AMS is a limitation in the field. The current study investigated memory narratives as an alternative measure of AMS in an undergraduate student sample selected for being high or low on a measure of depressive symptoms (N=55). We employed a multi-method design to compare narrative- and AMT-based measures of AMS. Participants generated personally significant self-defining memory narratives, and also completed two versions of the AMT (with and without instructions to retrieve specific memories). Greater AMS in self-defining memory narratives correlated with greater AMS in performance on both versions of the AMT in the full sample, and the patterns of relationships between the different AMS measures were generally similar in low and high dysphoric participants. Furthermore, AMS in self-defining memory narratives was prospectively associated with depressive symptom levels. Specifically, greater AMS in self-defining memory narratives predicted fewer depressive symptoms at a 10-week follow-up over and above baseline symptom levels. Implications for future research and clinical applications are discussed.