Inferior Parietal Perfusion, Lateralization, and Neuropsychological Dysfunction in Alzheimer's Disease

The severity of inferior parietal perfusion deficits in Alzheimer's disease (AD) is strongly associated with global intellectual decline. The relationship to specific losses of neuropsychological functioning, however, is less clear, as is the relative importance of the side (left vs. right) of hemispheric deficit. In this study, 53 patients with probable AD and 35 elderly controls received both a resting¹³³Xe rCBF measurement and neuropsychological examination. AD patients demonstrated the expected bilateral deficits in inferior parietal perfusion, as well as impairment on measures of mental status, intelligence, verbal and visual memory, attention, language, and construction abilities. The severity of this bilateral parietal deficit, in turn, was associated with virtually all of these AD-related neuropsychological impairments, most strongly with declining Performance IQ. Left-sided deficits correlated better with overall declines in IQ, as well as with declining attention and language fluency. Right-sided deficits, on the other hand, correlated best with declines in mental status and—paradoxically—verbal memory and contributed independently to declines in Full Scale and Performance IQ. In terms of the number and strength of their association to neuropsychological measures, left-sided deficits appear much more predictive of cognitive decline in AD. Right-sided deficits, however, may be most important for predicting aspects of performance skill that are only indirectly assessed in standard paper-and-pencil format. Overall, it appears that both sides make significant, but independent contributions to general functional decline in AD, but that left-sided deficits are more closely associated with cognitive decline as measured by most standard neuropsychological measures.     

Aging, inhibition, and social inappropriateness

This study explores the hypothesis that age-related declines in inhibitory ability are associated with increases in socially inappropriate behavior. Consistent with this hypothesis, older participants were less likely than younger participants to differentiate between public and private settings when inquiring about potentially embarrassing issues, according to their peers. Additionally, this indiscriminate public inquiry was associated with decreased closeness with participants' peers, particularly for older adults. Finally, this age-related increase in social inappropriateness was mediated by inhibitory deficits associated with aging. These results suggest that age-related deficits in inhibitory ability may cause people to become socially inappropriate against their will.     

Sometimes a noun is just a noun: comments on Bird, Howard, and Franklin (2000)

Bird, Howard, and Franklin (2000) have proposed a semantic-conceptual explanation of grammatical category-specific deficits that attributes impairments in noun and verb processing to two distinct mechanisms. According to their account, apparent deficits in verb production are not category specific, but rather result from the lower imageability of verbs compared to concrete nouns. Noun deficits are said to result from differences in the distribution of semantic feature types such that damage to sensory features results in disproportionate impairments in naming nouns, especially animate nouns, compared to verbs. However, this hypothesis, which we call the "extended sensory/functional theory" (ESFT), fails on several counts. First, the assumption that representations of living things are more heavily freighted with sensory features than are those of nonliving objects does not have any reliable empirical basis. Second, the ESFT incorrectly predicts associations between deficits in processing sensory features and living things or functional features and nonliving things. Finally, there are numerous cases of patients with grammatical category-specific deficits that do not seem to be consistent with damage at the semantic level. All of this suggests that the ESFT is not a useful model for considering grammatical (or semantic) category-specific deficits.     

The utility of math difficulties, internalized psychopathology, and visual-spatial deficits to identify children with the nonverbal learning disability syndrome: evidence for a visualspatial disability.

This study examined the criteria currently employed to identify children with the nonverbal learning disability syndrome (NVLD). The most widely accepted definition of NVLD relies on deficits in visual-spatial-organizational, tactile-perceptual, psychomotor, and nonverbal problem-solving skills. These deficits are believed to coexist with strengths in rote verbal learning, phoneme-grapheme matching, verbal output, and verbal classification. The combination of these assets and deficits has been hypothesized to lead to psychosocial and academic problems, including difficulties with mathematics and increased rates of psychopathology. This study compared performance of three groups of children: those with NVLD, those with verbal learning disabilities (VLD), and controls. The results show that the criteria currently employed to identify children with NVLD may not adequately differentiate them. In contrast to previous findings, the study reveals that children with NVLD can demonstrate good math abilities when performing certain types of math tasks, especially those that draw on their robust verbal skills. Also in contrast to most previous findings, in this study children with NVLD (and normal controls) demonstrated lower rates of psychopathology than children with VLD. Finally, for children with NVLD it appears that their visual-perceptual deficits may include a primary deficit in locating objects in space. Based in part on the findings of this study, it may be helpful for diagnostic and treatment purposes to reserve the term Nonverbal Learning Disability for children whose visual-spatial deficits are primary and severe enough to affect academic performance in subjects such as written mathematics. Given the integral nature of social relations in children's lives, a separate category (e.g., social processing disorder) could be created for children whose social skills deficits are primary and impair their social interactions. A broader nonverbal learning model or syndrome, as conceptualized by Rourke (1995), could be retained for describing a broader constellation of assets and deficits across disease types.     

Interoceptive Deficits,Nonsuicidal Self‐Injury,and Suicide Attempts Among Women with Eating Disorders

People with eating disorders (ED s) have an elevated risk for both nonsuicidal self‐injury (NSSI ) and suicide compared to the general population. This study tests two theoretically derived models examining interoceptive deficits as a risk factor for NSSI , and examining interoceptive deficits, NSSI , fearlessness about death, and pain tolerance as risk factors for suicide. Ninety‐six adult, treatment‐seeking women with ED s completed self‐report questionnaires at a single time point. Interoceptive deficits were significantly associated with NSSI , and NSSI was in turn associated with both pain tolerance and fearlessness about death. Further, pain tolerance was in turn associated with past suicide attempts, although fearlessness about death was not associated with suicide attempts. Interoceptive deficits had a direct association with fearlessness about death but not pain tolerance. Results regarding the relation between interoceptive deficits and suicide attempts were mixed, yet overall suggest that interoceptive deficits are related to suicide attempts largely indirectly, through the effects of mediating variables such as NSSI , fearlessness about death, and pain tolerance. Results suggest that interoceptive deficits and pain tolerance merit further investigation as potential risk factors for fatal and nonfatal self‐harm among individuals with ED s.     

The problem-solving diathesis in depression,hopelessness, and suicide ideation: A longitudinal analysis

The problem-solving deficit (PSD) diathesis-stress model of suicide behavior proposed by Clum, Patsiokas, and Luscomb (1979) and expanded by Schotte and Clum (1982, 1987) was examined in a short-term longitudinal test. The present study assessed the relationship between problem-solving deficits at Time 1—prior to the stressor (a D or F on a midterm examination)—and adjustment at Time 2—after the Stressor. Evidence was found for an additive predictive relationship for stress and problem-solving deficits to Time 2 measures of depressive symptoms, hopelessness, and suicide ideation. Evidence was also found that PSD × Stress interactions uniquely predicted the three criteria. The results of this study were taken as evidence of problem-solving deficits functioning as a diathesis for depression, hopelessness, and suicide ideation.     

Alcohol,head injury,and neuropsychological function

Evidence is reviewed indicating that the extent of alcohol abuse alone cannot account for the neuropsychological deficits observed in alcoholics, and that alcohol abuse and head injury may interact in some patients to influence neuropsychological status. Alcohol abuse both increases the risk for head trauma and potentiates the resulting brain injury, which can lead to negative neuropsychological consequences. Clinicians involved in the treatment of addiction should assess patients for history of head injury, and neuropsychological deficits consequent to both head injury and ethanol. These deficits may limit patient ability to comply with addiction rehabilitation programs. Conversely, clinicians in acute care and rehabilitation of the sequelae of head trauma should routinely assess their patients for substance abuse, because such abuse can have a significant impact on recovery from brain injury.     

Stress, Coping and Cognitive Deficits in Women After Surgery for Breast Cancer

Research on neuropsychological difficulties among cancer patients has focused on chemotherapy as a primary cause, yet several studies have now shown that some patients evidence cognitive weaknesses prior to chemotherapy. As an alternative to the ‘chemo–brain’ theory, this study examined the hypothesis that stress and coping style may be associated with observed neuropsychological difficulties among female cancer patients. Thirty-six women completed neuropsychological testing and psychological questionnaires following surgery for breast cancer and prior to any subsequent treatments. Twenty-seven percent of participants evidenced deficits on at least one measure of verbal fluency, and 14% of participants were impaired on at least one memory measure. Self-reported stress was correlated with deficits in memory, verbal fluency, and attention. Subsequent mediational analyses indicated that use of passive coping styles may underlie this relationship between stress and neuropsychological deficits. These findings highlight the potential relevance of psychological mechanisms, such as coping style, in cancer patients’ experience of neuropsychological deficits.     

Empathic deficits in sexual offenders: An integration of affective,social, and cognitive constructs

A number of researchers have suggested that lack of empathy is a critical feature in the assessment and treatment of sex offenders. However, difficulties with definitions of empathy and corresponding measures of that construct have led to limited and disparate empirical findings supporting this claim. Such findings may be due to a definition of empathy that fails to incorporate other key factors related to sexual offending. Factors such as inaccurate social perceptions, cognitive distortions, deficits in interpersonal intimacy, maladaptive emotional regulation abilities, and other socio-cognitive deficiencies thought to contribute to sexually assaultive behavior also share a number of core developmental features with affect and emotional responding. As socio-cognitive abilities tend to develop simultaneously at times as humans mature, it is suspected that social, cognitive, and affective skills impact one another's development and ultimately dictate the expression of empathy in adulthood. Accordingly, deficits in social skills, interpersonal intimacy, and cognitive processes necessary to emotional stability and appropriate social interaction may be critical to the development and expression of empathic deficits and subsequent efforts to treat or reduce such deficits in sexual offenders. This paper will review and integrate literature examining the relationship of various socio-cognitive factors to empathic deficits in sexual offenders.     

An analysis of the hyperactive syndrome: A comparison of hyperactive,behavior problem,asthmatic, and normal children

In an attempt to determine whether the commonly described deficits associated with hyperactivity — inappropriate activity, short attention span, low frustration tolerance, and impulsivity — are unique to this population, hyperactive, behavior problem, asthmatic, and normal control children were studied. The tests most often used in research with hyperactives were administered. Hyperactives, when compared to normals, did show deficits in the aforementioned areas. However, when compared to the behavior problem and asthmatic children only the attentional deficits clearly differentiated hyperactives from the other children.This research was supported, in part, by grants from the Ontario Ministry of Health (DM-304) and the Ontario Mental Health Foundation (#652-76A).     

Schizophrenia, ketamine and cannabis: evidence of overlapping memory deficits

Drug models of mental illness are considered useful if they provoke its characteristic symptoms. In this respect, ketamine and tetrahydrocannabinol (cannabis) are coming under increasing scrutiny as models for schizophrenia. However, although both undoubtedly produce psychotic symptoms characteristic of the disorder, we argue here that, because schizophrenia is also accompanied by cognitive deficits, a full understanding of the impact of these drugs on cognition will be crucial in taking these models further. Memory deficits are pronounced in schizophrenia and we focus upon patterns of working and episodic memory impairment produced by ketamine and cannabis, identifying overlaps between drug and illness. We suggest that close attention to these deficits can offer insights into core pathophysiology of schizophrenia.     

Affect, Social Behavior, and the Brain in Williams Syndrome

ABSTRACT— Williams syndrome (WS) is a rare genetic disorder characterized by intellectual impairment and a distinctive physical and neuropsychological profile. Relative to their level of intellectual functioning, individuals with WS exhibit strengths in language and face recognition, with deficits in visual-spatial cognition. A heightened appetitive drive toward social interaction is a strong behavioral feature. Relative to other neurodevelopmental disorders, WS has a clearly defined genetic basis, together with a consistent neurocognitive profile of strengths and deficits. Thus, this disorder offers unique opportunities for elucidating gene–brain–behavior relationships. We focus on manifestations of the unusual social profile in WS, by examining data within and across levels of cognition, brain, and molecular genetics.     

Early naming deficits, developmental dyslexia, and a specific deficit hypothesis.

The present research represents the final 2 years of a 5-year longitudinal investigation of (a) confrontation-based, word-retrieval deficits in dyslexic children; (b) the role of vocabulary development in these deficits; (c) the relationship between confrontation naming performance and three carefully defined aspects of reading performance in the general population and in eight dyslexic case studies; and (d) the possible specificity of word-retrieval deficits in dyslexia. Results indicate enduring problems in word-retrieval processes for dyslexic children across the primary grades and into middle childhood. Second, these deficits cannot be explained by simple vocabulary deficits. Third, these results in conjunction with our earlier data consolidate a pattern of differential relationships between specific reading and confrontation naming skills that are based on development and on the level of processes involved. Trends within case studies suggest the more pronounced the retrieval deficit, the more global the reading impairment. And fourth, there appear to be some specific differences in the basis of word-retrieval problems between dyslexic and garden-variety or lower achieving readers. Results are discussed within a speculative framework that implicates problems in timing as a possible predetermining condition in the dyslexias.     

Family-of-origin maltreatment, posttraumatic stress disorder symptoms, social information processing deficits, and relationship abuse perpetration

In this study, the authors examined the interrelations among family-of-origin maltreatment variables, posttraumatic stress disorder (PTSD) symptoms, social information processing deficits, and male-to-female psychological and physical intimate relationship abuse perpetration in adulthood among a community sample of 164 men and their partners. In bivariate analyses, higher family-of-origin childhood parental rejection was associated with the perpetration of psychological and physical abuse in adulthood, and childhood exposure to interparental violence was also associated with adult psychological abuse perpetration. Structural equation modeling analyses indicated that when childhood variables and other study variables were considered together, only childhood parental rejection was associated with the abuse perpetration outcomes, and these effects were indirect through PTSD symptoms and social information processing deficits. Results indicate a need for further investigation into the mechanisms accounting for the impact of early maltreatment on the development of abusive intimate relationship behavior.     

Context-processing deficits in schizophrenia: diagnostic specificity, 4-week course,and relationships to clinical symptoms

Previous research on schizophrenia suggests that context-processing disturbances are one of the core cognitive deficits present in schizophia. However, it is not clear whether such deficits are specific to schizophrenia as compared with other psychotic disorders. To address this question, the authors administered a version of the AX Continuous Performance Test designed to assess context processing in a sample of healthy controls, patients with schizophrenia, and patients with other psychotic disorders. Participants were tested at index (when medication naive and experiencing their first contact with psychiatric services) and 4 weeks later, following medication treatment. At index, patients with schizophrenia and the psychotic comparison group demonstrated similar impairments in context processing. However, context-processing deficits improved in the psychotic comparison group at 4 weeks but did not improve in patients with schizophrenia.     

Information processing,neuropsychological function,and the inherited predisposition to alcoholism

Sons of male alcoholics are at particularly heightened risk for the development of alcoholism. This heightened risk frequently appears in association with increased incidence of conduct disorder or hyperactivity, with deficits in abstract thinking and poor school performance, with abnormalities in cued psychophysiological response, and with increased sensitivity to the putatively stress-response-dampening effects of alcohol intoxication. This risk and its associated features are discussed within the context of a neuropsychological theory, predicated on the notions (1) that deficits in cognitive functions theoretically dependent upon the intact functioning of the prefrontal cortex could underlie manifestation of the idiosyncracies commonly attributed to sons of male alcoholics, and (2) that acute alcohol intoxication could relieve the subjective discomfort associated with the consequences of such deficits.     

Pessimistic self-preoccupation, performance deficits, and depression

Three studies are presented testing a model of the cognitive performance deficits shown in depression. The model proposes that such deficits occur as an interaction of expectancy and focus of attention variables, that is, in the presence of both low expectancy of success and high self-focus. Study 1 was a pilot study which documented that depressed undergraduates evidence poorer anagram performance, greater self-focus, and lower pretask expectancies than do nondepressed subjects. Study 2 showed that nondepressed undergraduates evidence performance deficits only when both expectancy is lowered and self-focus is increased. Study 3 suggested that depressed undergraduates' performance deficits are overcome either by lowering self-focus or by raising expectancy. Discussed are discrepancies between self-report and performance data, the relevance of these studies to the test anxiety literature, the need to integrate literature concerning the effects of depression, anxiety, and self-esteem on performance, and how the interactive roles of positive expectancy and focus of attention may be related to effective coping in a variety of situations.     

Meaning,metaphor, and metabolization: the case of eating disorders

The American Journal of Psychoanalysis - Eating disorders mark deficits in the ability to be nourished and to symbolize embodied experience. Such deficits can be traced to difficulties in early...     

Hyperactivity and pediatrician diagnoses,parental ratings,specific cognitive abilities,and laboratory measures

Children diagnosed as hyperactive and treated for hyperactivity by private pediatricians were compared to a large unselected sample of children on parental ratings of behavioral problems (Conners Symptoms Rating Questionnaire), laboratory measures (a week-long assessment of locomotion as measured by pedometers, sustained attention, selective attention, fidgeting, and aggressiveness), and 10 tests of specific cognitive abilities (verbal reasoning, spatial reasoning, memory, and perceptual speed). Test-retest reliability was obtained for all measures. The results indicated that pediatrician diagnoses of hyperactivity are related to parental ratings but not to laboratory assessments. Diagnoses by private pediatricians may include more heterogeneous and nonspecific behavioral problems than diagnoses made in most research contexts. Pediatrician diagnoses were related to deficits in specific cognitive abilities, most notably perceptual speed and verbal ability. Hyperactivity as diagnosed by private pediatricians may reflect deficits in skills necessary to pace oneself appropriately in school-related tasks. In general, these results suggest that the criteria and methods used to diagnose hyperactivity deserve greater attention.We are grateful to the Spencer Foundation for their support of this research. Preparation of this report was supported in part by a Research Scientist Development Award (AA-00041) from the ADAMHA NIAAA.     

Social problem-solving in depressed,conduct-disordered,and normal adolescents

Although past theory and research implicate social problem-solving deficits in both depression and aggressive disorders, research examining carefully diagnosed groups of adolescent depressed and conduct-disordered groups had not previously been conducted. In the current study three groups of adolescents (major depression, conduct-disordered, and normal) were studied using two social problem-solving measures. Both the Means-Ends Problem-Solving task (MEPS) and the Social Situations Analysis measure (SSA) failed to show social problem-solving problem deficits in the depressed group relative to their normal age peers, but did provide corroborative evidence for social problem-solving deficits in the conduct-disordered sample. Relative to the other two groups, the conduct-disordered adolescents were found to generate fewer means to a social end, to anticipate fewer obstacles in the pursuit of solutions to interpersonal situations, and to generate fewer assertive behavioral solutions to difficult social situations. The results are discussed in relation to other work with depressed and aggressive youth, and directions for future research are given.