Is judgment of random time intervals biased and capacity-limited?

 Recently, random generation of time intervals has been proposed as a procedure to impair executive processing in a dual-task paradigm without substantial interference with phonological and visuo-spatial working memory resources. A fundamental assumption of this procedure is that humans are able to distinguish time sequences on their degree of randomness. The present study tests this assumption. To this end, non-biased, repetition-biased, alternation-biased sequences and repetitive rhythms were judged under conditions of higher or lower executive load. In Exp. 1, load depended on the presentation speed, while in Exp. 2, a dual-task condition was used with either a concurrent number-copying task or an arithmetic task. It was found that the participants could distinguish repetitive rhythms from more or less random sequences, and that both accuracy of this judgment and latency were affected by the concurrent load. The findings are taken as a first indication that random time judgment is capacity-limited. Received: 9 September 1999 / Accepted: 1 October 1999     

A neuropsychological assessment of dual-task costs in closed-head injury patients using Cohen’s effect size estimation method

A test of whether patients suffering from a severe closed-head injury (CHI) were affected by disproportionate dual-task costs compared to those of healthy control participants was carried out through a direct comparison of CHI effects on dual-task (psychological refractory period, or PRP) performance and on single-task performance. In the dual-task condition of the present experiment, independent choice-responses were required to two sequential stimuli presented at a variable stimulus onset asynchrony (SOA). A significant delay of the reaction time (RT) to the second stimulus was reported by both CHI patients and controls at short (SOA) compared to long SOA, i.e., a PRP effect. The PRP effect was more pronounced for CHI patients than controls. In the single-task condition, a single choice-response was required to a stimulus presented in isolation. The RT produced by CHI patients in the single-task paradigm was longer than the RT produced by controls. CHI effects on dual-task performance and on single-task performance were compared following (1) their transformation into Cohen’s ds, and (2) the application of a correction algorithm taking into account the different reliability of single-task and dual-task measures. The analysis of Cohen’s ds revealed that CHI effects on performance were, if anything, smaller in the dual-task condition than in the single-task condition. The results imply that CHI patient’s slower responding in single- and dual-task performance reflects a single common cause—slowing of the central processing.     

Executive functions and the frontal lobes: a conceptual view

Several problems in understanding executive functions and their relationships to the frontal lobes are discussed. Data are then presented from several of our studies to support the following statements: (1) the examination of patients with focal frontal lobe lesions is a necessary first step in defining the relation of executive functions to the frontal lobes; (2) there is no unitary executive function. Rather, distinct processes related to the frontal lobes can be differentiated which converge on a general concept of control functions; (3) a simple control-automatic distinction is inadequate to explain the complexity of control-automatic processes; (4) the distinction between complex and simple tasks cannot explain the differences in functions between the frontal lobes and other brain regions; and (5) the most important role of the frontal lobes may be for affective responsiveness, social and personality development, and self-awareness and unconsciousness. Received: 31 March 1999 / Accepted: 23 July 1999     

Automaticity versus timesharing in timing and tracking dual-task performance

Two experiments investigated the interfering effects of a manual tracking task on timing performance. Subjects generated a series of 5-s temporal productions under control (timing only) and experimental (timing + pursuit rotor tracking) conditions. Timing was more variable under experimental conditions, a finding consistent with attentional models which argue that timing tasks compete with concurrent distractor tasks for limited processing resources. A pretest-posttest paradigm was employed to evaluate the hypothesis that practice on the tracking task would lessen its attentional demands and thereby attenuate the interference effect. Experiment 1 involved single-task practice (tracking alone). Single-task practice leads to automaticity, the ability to perform a skilled task using fewer processing resources. Pretest-posttest comparisons showed that such practice reduced interference in timing. Experiment 2 involved dual-task practice (timing + tracking). Dual-task practice promotes the development of timesharing, the ability to efficiently switch attention between multiple tasks. In this case, practice failed to reduce the interference effect in timing. The results suggest that effective strategies for timing in dual-task situations must allow one to closely monitor the ongoing flow of temporal events. Received: 11 November 1996 / Accepted: 6 May 1997     

Executive Functioning Characteristics Associated with ADHD Comorbidity in Adolescents with Disruptive Behavior Disorders

The nature of executive dysfunction in youth with disruptive behavior disorders (DBD) remains unclear, despite extensive research in samples of children with attention-deficit hyperactivity disorder (ADHD). To determine the relationship between DBD, ADHD, and executive function deficits in aggressive teens, adolescents with DBD and comorbid ADHD (DBD + ADHD; n = 25), DBD without ADHD (DBD-ADHD; n = 23), and healthy controls (HC; n = 25) were compared on neurocognitive tests and questionnaires measuring executive functioning. Teens with DBD + ADHD performed worse on both neurocognitive and questionnaire measures of executive function than the DBD-ADHD and HC groups. Results suggest that subgroups of DBD may exist depending on the presence or absence of comorbid ADHD, which may have implications for the selection and efficacy of treatment strategies.     

Impact of executive dysfunctions on episodic memory abilities in patients with ruptured aneurysm of the anterior communicating artery

Executive and memory dysfunctions are among the most frequently reported deficits following a ruptured aneurysm of the anterior communicating artery (ACoA). In order to study the impact of the dysexecutive syndrome on episodic and semantic memory, the data obtained from 59 ACoA patients were examined retrospectively. All patients were assessed on a variety of episodic memory tests (Rey Auditory-Verbal Learning Test, Rey Complex Figure Test, Weschler Memory Scale), semantic memory (verbal fluency), and standardized tests of executive functions (Trail Making Test, Maze tests, Wisconsin Card Sorting Test). There was a strong positive correlation between executive dysfunction and retrieval difficulties in episodic and semantic memory tasks. Comparisons of subgroups of patients with high and low frontal lobe functioning on delayed recall and recognition revealed a significant group X condition interaction in addition to significant group and condition main effects. ACoAs patients with low frontal lobe functioning were particularly deficient in free recall (immediate and delayed) while recognition was equally well preserved in the two subgroups. Neither subgroup presented with an abnormal forgetting over time suggesting a retrieval deficit rather than a true retention impairment.     

Constraints on using the dual-task methodology to specify the degree of central executive involvement in cognitive tasks

The dual-task paradigm has been used to examine the role of the central executive in various cognitive tasks. In these studies, performance decrements in primary cognitive tasks performed concurrently with secondary executive tasks have been interpreted as evidence for the involvement of the central executive in those primary tasks. In the present study, we examined the effects of different secondary tasks on performance of three psychometric visuospatial tasks. The decrement in performance of these tasks when they were paired with secondary executive tasks was smallest for the psychometric task considered to most heavily involve the central executive and largest for the task considered least demanding of executive mechanisms. We propose that, when applied to the assessment of central executive involvement, the prevalent simple dual-task logic does not always apply. Special conditions that limit the application of the dual-task methodology include two inherently related factors--a response selection bottleneck and a strategic tradeoff between primary and secondary tasks.     

Visual search does not remain efficient when executive working memory is working

Working memory (WM) has been thought to include not only short-term memory stores but also executive processes that operate on the contents of memory. The present study examined the involvement of WM in search using a dual-task paradigm in which participants performed visual search while manipulating or simply maintaining information held in WM. Experiments 1a and 2a involved executive WM tasks that required counting backward from a target digit and sorting a string of letters alphabetically, respectively. In both experiments, the search slopes in the dual-task condition were significantly steeper than those in a search-alone condition, indicating that performing the WM manipulation tasks influenced the efficiency of visual search. In contrast, when information was simply maintained in WM (Experiments 1b and 2b), search slopes did not differ between the single- and dual-task conditions. These results suggest that WM resources related to executive functions may be required in visual search.     

Poorer divided attention in children born very preterm can be explained by difficulty with each component task,not the executive requirement to dual-task

Children born very preterm (VP, ≤ 32 weeks) exhibit poor performance on tasks of executive functioning. However, it is largely unknown whether this reflects the cumulative impact of non-executive deficits or a separable impairment in executive-level abilities. A dual-task paradigm was used in the current study to differentiate the executive processes involved in performing two simple attention tasks simultaneously. The executive-level contribution to performance was indexed by the within-subject cost incurred to single-task performance under dual-task conditions, termed dual-task cost. The participants included 77 VP children (mean age: 7.17 years) and 74 peer controls (mean age: 7.16 years) who completed Sky Search (selective attention), Score (sustained attention) and Sky Search DT (divided attention) from the Test of Everyday Attention for Children. The divided-attention task requires the simultaneous performance of the selective- and sustained-attention tasks. The VP group exhibited poorer performance on the selective- and divided-attention tasks, and showed a strong trend toward poorer performance on the sustained-attention task. However, there were no significant group differences in dual-task cost. These results suggest a cumulative impact of vulnerable lower-level cognitive processes on dual-tasking or divided attention in VP children, and fail to support the hypothesis that VP children show a separable impairment in executive-level abilities.     

Timing and executive function: Bidirectional interference between concurrent temporal production and randomization tasks

A review of interference effects in concurrent temporal/nontemporal dual-task studies suggests that prospective timing may be related to executive cognitive functions. Executive processes play a supervisory role in behavior by controlling attention, coordinating information, and scheduling actions. In the present research, a timing task was paired with an established executive task in a dual-task paradigm. The timing task required subjects t o generate a series o f 5-sec temporal productions,and the executive task was random number generation. These tasks were performed both separately and concurrently. Comparisons of single-task and dual-task conditions showed that (1) the randomization task interfered with timing by making temporal productions more variable and longer and (2) concurrent timing disrupted randomization performance by making responses less random. This pattern of bidirectional interference supports the idea that timing relies on the same attentional resources used by other executive-level tasks.     

Validation of Iranian Version of FI-QOL Scale in Patients with Fecal Incontinence

Pelvic floor dysfunction is a general public health problem with great impact on quality of life. Inability to control the passage of stool can produce embarrassment and may limit daily activities. One of the most important indicators of effectiveness of therapy in patients with fecal incontinence (FI) can be patient’s quality of life. Therefore, a well-constructed questionnaires studying quality of life is necessary. The objective of this study was to assess the Iranian version of Fecal Incontinence Quality of Life Scale in a hospital-based study on patients with FI. Two hundred women were recruited in the study. One group included patients with FI (n = 100) and the control group (n = 100) included patients with any gastrointestinal (GI) problems except FI. The Persian version of fecal incontinence quality of life scale completed by two groups. The FI patients completed the SF-36 questionnaire too. Reliability and validity of questionnaire were evaluated by Cronbach’s alpha, test/retest using correlation analysis, Intraclass correlation coefficient, paired t-test, and analysis of variance. There was not any significant differences between two groups for age, marital status, education, and occupation. The mean age of FI patients and controls were 42.6 (±13.3) and 44.5 (±15.0) respectively. Cronbach’s-α for all domains ranged between 0.72 and 0.92. All scales showed significant correlation between the test and retest administration of questionnaire. The FI patients had lower scores than the controls for all domains adjusted for gender. All correlations between six selected domains of Sf-36 scales and FIQL scales were significant at P ≤ 0.05 levels. The Persian version of FIQL had a good validity and reliability and can be used for accurate measure of quality of life in FI patients.     

Patterns of cognitive ageing

Neuroanatomical evidence suggests that normal ageing affects some brain areas, and the “local” functions they support, earlier and more severely than others. Changes appear to be especially marked in the hippocampus, temporal association and prefrontal cortex. Evidence from classical neuropsychological studies suggests that these brain areas are associated with memory and “executive” functions, respectively. We may, therefore, expect that tests purported to measure these functions may be disproportionately affected in old age and that there may be evidence for some separation of these functions even within neurologically normal populations. What we also know, however, is that measures reflecting general fluid ability also decline with increasing age, so any hypothesis relating to specific “local” deficits must acknowledge and account for any “globar” changes in performance. Volunteers (n=162) aged between 60–80 years who had completed the Cattell and Cattell Culture Fair Intelligence Test (CCF) completed the Cambridge Automated Neuropsychological Test Battery (CANTAB). The CANTAB has been administered to several patient populations and tests from the battery have been shown to be sensitive to damage in both temporal and prefrontal areas (Owen et al., 1996). Results from the test battery showed that both the Paired Associate Learning and Spatial Recognition tests were the most sensitive to normal ageing even when CCF is accounted for. In contrast, this performance on the “executive” tests, shown to be sensitive to frontal lobe damage, was not related to age, and CCF scores predicted performance on these tests. These results are discussed in relation to theories of cognitive ageing and patterns of change and in relation to several important methodological and theoretical considerations for the study of executive function. Received: 31 March 1999 / Accepted: 23 July 1999     

Health Related Quality of Life After Gastric Bypass Surgery

The majority of studies which have evaluated health related quality of life are limited in the duration of follow up. The objective of this study was to prospectively conduct an evaluation using a repeated cross sectional analysis of separate patient cohorts who were up to four years after gastric bypass surgery. Adult Roux-en-Y gastric bypass patients were recruited to the study. All patients were requested to complete a general health status questionnaire, the Short Form-36 (SF-36), before surgery or at their post operative out patient follow up visits. Patient weight was documented at each follow up visit. A cross sectional analysis was performed to evaluate SF-36 scores in each annual cohort. Data are reported as mean +/− S.D. Three-hundred-eight patients completed at least one SF-36 assessment [Initial assessment at the time of surgery, time 1, n = 245, 1y n = 149, 2y n = 70, 3y n = 59, 4y n = 61]. The SF-36 scores were greater (p < 0.05) in each of the separate post surgery cohorts for physical functioning, role limitations due to physical health, social functioning, pain, vitality, general health and the physical component summary (PCS) scores. While not comparing changes in scores within individuals over time, these data suggest early improvement especially in the physical dimension of health related quality of life. In this analysis, this finding was also observed in each of the separate cohorts up to 4 years after gastric bypass surgery.     

Practice-related reduction of dual-task costs under conditions of a manual-pedal response combination

Severe dual-task costs emerge when two tasks are performed at the same time. Schumacher, Seymour, Glass, Kieras, and Meyer (2001) showed a complete reduction of dual-task costs after extensive dual-task practice with a visual-manual (VM) task and an auditory-verbal (AV) task. First, we replicated these findings and found task conditions sufficient to achieve a high level of dual-task cost reduction (Experiment 1). Using these conditions, we tested whether the Schumacher et al. findings generalise to a different dual-task situation, in which participants practised a VM task and an auditory-pedal (AP) task (VM-AP) conjointly (Experiment 2). In the VM-AP task situation we found reduced dual-task costs after practice. Dual-task costs, however, remained on a high level after eight sessions of practice and also when extending practice to 12 sessions. No single participant showed evidence for time sharing in the VM-AP dual task. These results suggest that the finding of complete dual-task cost reduction does not generalise to the VM-AP task combination used in the present study. We discuss different factors potentially relevant for the observation of persisting dual-task costs over practice in the VM-AP task.     

Further Evidence of the Reliability and Validity of the Multidimensional Anxiety

The psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) were examined in adolescent psychiatric inpatient samples. In Study 1 (n = 287), confirmatory factor analyses provided satisfactory fit for the four-factor (comparative fit index; CFI = 0.856) and higher-order (CFI = 0.854) solutions. Using parcels as items, the fit of the four-factor model was improved substantially (CFI = 0.935). Next, in the bifactor analyses, support was attained for a model that included a general factor and four domain specific subfactors. In Study 2 (n = 195 inpatient youths), the MASC showed good scale reliability and concurrent validity. Results of the receiver operating characteristic curve and binary logistic regression analyses provided adequate evidence for discriminative validity. In Study 3 (n = 40), test–retest reliability of scores on the MASC-10 scale over a 3-week period was adequate (r _tt = 0.83, p < 0.001) for children ages 8 to 11 years.     

Executive Function in Very Preterm Children at Early School Age

We examined whether very preterm (≤30 weeks gestation) children at early school age have impairments in executive function (EF) independent of IQ and processing speed, and whether demographic and neonatal risk factors were associated with EF impairments. A consecutive sample of 50 children (27 boys and 23 girls) born very preterm (mean age = 5.9 years, SD = 0.4, mean gestational age = 28.0 weeks, SD = 1.4) was compared to a sample of 50 age-matched full-term controls (23 girls and 27 boys, mean age = 6.0 years, SD = 0.6) with respect to performance on a comprehensive EF battery, assessing the domains of inhibition, working memory, switching, verbal fluency, and concept generation. The very preterm group demonstrated poor performance compared to the controls on all EF domains, even after partialing out the effects of IQ. Processing speed was marginally related to EF. Analyses with demographic and neonatal risk factors showed maternal education and gestational age to be related to EF. This study adds to the emerging body of literature showing that very preterm birth is associated with EF impairments.     

Are Patient Rights to Information and Self-Determination in Diagnostic Genetic Testing Upheld? A Comparison Of Patients’ and Providers’ Perceptions

This study assessed how the patient’s right to receive information and the right to self-determination were followed during diagnostic testing, according to the perceptions of patients and parents of tested children (group 1, n = 106) and healthcare personnel (group 2, n = 162). Data were collected in three Finnish university hospitals using a questionnaire. Results revealed one between group difference: patients/parents agreed more strongly than did personnel that self-determination was followed before testing. Within groups included: patients/parents had stronger agreement that self-determination was followed before testing than after testing; personnel had stronger agreement about information received after testing than before testing, and they had weaker agreement about how well self-determination was followed before testing than after testing. Received information was experienced as similar both before and after testing and by patients/parents and by personnel. Providing adequate time to consider whether or not to be tested and giving more support to patients after testing would promote the rights of patients. Furthermore, assessment of personnel characteristics is needed to determine, for example, the kinds of value conflicts that exist between personnel’s own values and patients’ values.     

Few Preschool Boys and Girls with ADHD are Well-Adjusted During Adolescence

To estimate the prevalence of being well-adjusted in adolescence, boys and girls with (n = 96) and without (n = 126) attention-deficit/hyperactivity disorder (ADHD) were assessed seven times in eight years starting when they were 4–6 years of age. Symptoms of ADHD, ODD/CD, and depression/anxiety in addition to social skills and social preference were gathered using multiple methods and informants. Being well-adjusted was defined by surpassing thresholds in at least four of the five domains. At the 7- and 8-year follow-up, when youth were 11–14 years old, probands were significantly less likely to be well-adjusted relative to age- and ethnicity-matched control children. Only a minority of children with ADHD was well-adjusted in adolescence when emotional, behavioral, and social domains were considered simultaneously. Even when their ADHD symptoms improved over time, most probands exhibited significant impairment 7–8 years after their initial assessment.     

Age differences in dual-task performance after practice

This study investigated whether older adults could acquire the ability to perform 2 cognitive operations in parallel in a paradigm in which young adults had been shown to be able to do so (K. Oberauer & R. Kliegl, 2004). Twelve young and 12 older adults practiced a numerical and a visuospatial continuous memory updating task in single-task and dual-task conditions for 16 to 24 sessions. After practice, 9 young adults were able to process the 2 tasks without dual-task costs, but none of the older adults had reached the criterion of parallel processing. The results suggest a qualitative difference between young and older adults in how they approach dual-task situations.     

Working memory and mental arithmetic: A case for dual central executive resources

The current study was designed to examine the possible existence of two limited-capacity pools of central executive resources: one each for verbal and visuospatial processing. Ninety-one college students (M age = 19.0, SD = 2.2) were administered a verbal working memory task that involved updating numbers in 2-, 3-, and 4-load conditions. The task was administered in both single task (no-interference condition) and dual-task (verbal interference and visuospatial interference conditions) formats. Findings indicated main effects for both memory load and type of interference, as well as, a load × interference interaction. Verbal interference led to a steeper increase in errors on the primary verbal working memory task; whereas, there was a smaller increase in errors across load in both the non-verbal and no-interference conditions. The effect of verbal interference and the lack of a spatial interference effect on a primary task that utilized verbal working memory resources, suggests that the processing of verbal and spatial stimuli in a dual-task paradigm requires separate central executive resources.