A Longitudinal Assessment of Executive Function Skills and Their Association with Math Performance

The present study was designed to examine both concurrent and predictive associations between scores on a measure of executive function (EF) skills, the Contingency Naming Test (CNT), during the early school-age years. A secondary aim of the study was to examine the association between EF skills and mathematics performance. We administered tests of mathematics ability, and the CNT, to 178 children at ages 6 to 7, 8 to 9, and 10 to 11 years. From the CNT we obtained measures of response fluency/efficiency, working memory, and inhibition. The results demonstrate main effects of age on all CNT measures of EF, as anticipated, and inconsistent main effects of gender or mathematics learning disability status. Rates of improvement in EF varied as a function of the working memory demands present during a given task. There were differences in concurrent and predictive correlations for different CNT performance measures. EF scores obtained during the first assessment were as strongly associated with each other as they were with EF scores obtained four years later, suggesting a moderately stable source of individual differences on cognitive performance. EF scores at age 6 to 7 years were associated with concurrent and later mathematics scores, and most of these correlations were stronger than the significant associations found between response fluency on a baseline task (with no working memory demand) and mathematics performance. These findings have implications for the stability of EF skills during the school-age years, and the role of EF in early and later elementary school mathematics performance.     

A longitudinal assessment of executive function skills and their association with math performance.

The present study was designed to examine both concurrent and predictive associations between scores on a measure of executive function (EF) skills, the Contingency Naming Test (CNT), during the early school-age years. A secondary aim of the study was to examine the association between EF skills and mathematics performance. We administered tests of mathematics ability, and the CNT, to 178 children at ages 6 to 7, 8 to 9, and 10 to 11 years. From the CNT we obtained measures of response fluency/efficiency, working memory, and inhibition. The results demonstrate main effects of age on all CNT measures of EF, as anticipated, and inconsistent main effects of gender or mathematics learning disability status. Rates of improvement in EF varied as a function of the working memory demands present during a given task. There were differences in concurrent and predictive correlations for different CNT performance measures. EF scores obtained during the first assessment were as strongly associated with each other as they were with EF scores obtained four years later, suggesting a moderately stable source of individual differences on cognitive performance. EF scores at age 6 to 7 years were associated with concurrent and later mathematics scores, and most of these correlations were stronger than the significant associations found between response fluency on a baseline task (with no working memory demand) and mathematics performance. These findings have implications for the stability of EF skills during the school-age years, and the role of EF in early and later elementary school mathematics performance.     

The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting

There are few long-term follow-up studies on psychological treatment of anxiety disorders carried out in clinical mental health settings, so called effectiveness studies. The present paper presents a four year follow-up of patients with obsessive-compulsive disorder treated by the Bergen 4-day treatment (B4DT), a concentrated form of exposure and response prevention (ERP). A total of 77 obsessive–compulsive disorder (OCD) patients received treatment during four consecutive days and were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) pre, post, and at follow-ups after 3 and 6 months, and 4 years post-treatment. The Y-BOCS mean score changed from 25.9 at pre- to 10.0 post-treatment and 9.9 at long-term follow-up. The proportion fulfilling the strict international consensus criteria for remission was 73% at post-treatment and 69% at follow-up. When taking declining rate, attrition rate, remission, relapse, and further improvement during the follow-up period into account, 72% were recovered on a long-term basis. A comparison with previously published effectiveness studies of ERP indicated that the 4-day treatment yielded significantly higher proportions of remission at post-treatment and recovery at follow-up, as well as within-group effect size on the Y-BOCS. The implications of these results are discussed.     

Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.

A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.     

How Substance Abuse Recovery Skills, Readiness to Change and Symptom Reduction Impact Change Processes in Wilderness Therapy Participants

Previous research has demonstrated that wilderness therapy is effective, yet very few studies have attempted to discern quantitative factors responsible for change that occur during wilderness therapy. This study aimed to tease apart specific factors that impact client progress and outcome. A sample of 189 adolescent clients in a wilderness therapy program completed the Youth Outcome Questionnaire Self-Report, the University of Rhode Island Change Assessment (URICA), and the Adolescent Relapse Coping Questionnaire (ARCQ) at pre-treatment, post-treatment, and follow-up intervals. Analysis of the complete data sets of 41 adolescents indicated that client Y-OQ scores improved significantly at post and follow-up assessments. URICA scores were not significantly related to such changes, while the ARCQ subscale of abstinence-focused coping strategies accounted for a significant proportion of the variance in Y-OQ change. These results indicate that clients in wilderness therapy do not necessarily need to want to change in order to do so. Furthermore, helping adolescents in wilderness therapy settings gain abstinence-focused coping strategies may be the most effective tool to improve treatment outcomes.     

The effects of second-language acquisition on verbal fluency among elderly israelis

The present study investigated the effect of age of second-language acquisition (Hebrew) on verbal fluency in a random sample of 196 elderly Israelis from four distinct ethnic groups. Using conventional statistics, it was shown that phonemic fluency, particularly switching, is associated with education and the age of Hebrew acquisition, while semantic fluency, particularly clustering, is associated with age. Ethnic differences were not significant after controlling for the age of Hebrew acquisition and education. Additional analyses show that the tendency of subjects to use borrowed, non-Hebrew words on the phonemic fluency task was associated with lower total scores on this task and later age of Hebrew acquisition. In contrast, the tendency to use non-Hebrew words on the semantic fluency task was associated with age and higher total scores. These findings are discussed with regard to recent functional imaging studies of bilingual subjects. Such findings indicate that native and second languages form distinct areas of activation in the dominant anterior language area, an area often associated with phonemic processing and switching, whereas an overlap of activation of various languages has been demonstrated within the posterior language areas, those that are often associated with semantic processing.     

Cognitive restructuring treatment: A controlled trial with anxious patients

Cognitive restructuring, modified systematic desensitization and a combined treatment (cognitive behaviour modification) were compared with a no-treatment control group, using a simple randomized design. Twenty seven general anxiety out-patients selected from the hospital waiting list were used as subjects. Assessments were made at the beginning and end of treatment, and at follow-up 1 month later. The assessments included two subjective anxiety measures, the Zung self-rating anxiety scale and fear thermometer scores, a behavioural anxiety measure, a measure of cognitive anxiety as estimated by a diary recording of thinking time, fear survey schedule scores and I/E scores.Cognitive behaviour modification was found to be a superior form of treatment, relative to the no-treatment control and the other active treatment groups as assessed by FSS intensity score. The cognitive behaviour modification group showed greater improvement than the cognitive restructuring group on the diary anxiety scores. The results also demonstrated a relationship between outcome and initial severity of condition. The higher the subjects' initial scores on neurotic symptoms and subjective anxiety level, the greater the degree of positive change after treatment. Moreover, subjects with high levels of internal control prior to treatment responded most to therapy.     

小学低年级儿童阅读流畅性的发展轨迹及其对阅读理解的预测作用

对149名小学一年级儿童的阅读流畅性进行历时三年五次的追踪测试,采用潜变量增长模型探索了儿童阅读流畅性的发展轨迹,并在控制相关变量后,考察了阅读流畅性的起始水平和发展速度对阅读理解的预测作用。结果发现：（1）小学低年级儿童字词阅读流畅性呈非线性发展,其中一年级快速发展,二、三年级时进一步发展,但发展速度变缓,起始水平低的儿童其后发展速度快,表现出补偿模式;句子阅读流畅性呈线性发展,儿童个体之间的差异随时间逐渐增大,表现出马太效应;（2）控制一般认知能力、家庭社会经济地位及相关语言认知技能后,字词阅读流畅性的起始水平和发展速度均可预测儿童三年级时阅读理解水平,而句子阅读流畅性的起始水平不能预测,但发展速度有显著预测作用。结果说明字词阅读流畅性和句子阅读流畅性有不同的发展轨迹和发展模式,在小学低年级阶段,相比句子阅读流畅性,儿童字词阅读流畅性的起始水平对阅读理解有预测作用,且两者的发展速度均对阅读理解有预测作用。     

中美成人基本认知能力的年龄差异

为了研究中关成人基本认知能力的年龄差异,采用西亚图纵向研究模型的方法对中关被试5种基本认知能力进行测量。结果发现,不同文化下5种能力的成绩存在显著的年龄差异。并且这种差异不能完全用教育上的差异来解释。年龄较大被试在所有基本能力测验上成绩较低。男性被试在归纳推理、空间和数字能力上成绩较好,女性被试在语义和词语流畅性测验上成绩较好。研究表明文化环境和历史等因素对成人认知发展具有一定的影响。     

Langzeitergebnisse einer Funktionellen-Magnetresonanztomographie-Studie

In a controlled functional magnetic resonance imaging (fMRI) study the effect of psychodynamic short-term psychotherapy on cerebral activation of panic disorder patients was determined. In a linguistic go-no go paradigm behavioral measures and cerebral activation to affective word stimuli with threatening, neutral and positive content were assessed pretreatment and post-treatment in 9 patients with panic disorder. 18 healthy controls were scanned twice at the same intervals. In an additional long-term follow-up after approximately 3 years post-treatment the effect of brain activation changes during treatment on the long-term outcome of core symptoms (panic-related cognition and fear of body sensations) were determined. In accordance with the hypotheses increased limbic (hippocampus and amygdala) activation accompanied by low prefrontal activation to negative words were found. At treatment termination, panic-related symptoms had improved significantly and fronto-limbic activation patterns were normalized. Reduction of activation of the limbic system during treatment was predictive of a favorable long-term outcome. The results indicate that short-term psychodynamic treatment leads to changes in fronto-limbic networks, similar to previous findings on cognitive-behavioural treatment.     

Vagus nerve stimulation therapy in a patient with treatment-resistant depression: a case report of long-term follow-up and battery end-of-service

This is the first case report of a patient who received long-term (69-month) adjunctive vagus nerve stimulation (VNS) therapy for treatment-resistant depression (TRD) and reached VNS battery end-of-service (EOS). The patient is a 41-year-old female with depression who entered a study of adjunctive VNS therapy for TRD. Her Hamilton Rating Scale for Depression (HAM-D) scores dropped from a mean of 33.5 (pre-implantation baseline period) to 16 at the end of the 12-week acute-phase treatment period, and then fluctuated from <7 (normal range) to scores in the moderately depressed range (approximately 20) during long-term follow-up. Three and one-half years after VNS implantation, the patient's HAM-D scores began to increase from a score of 18 to a peak score of 27 approximately 16 months later (5-years post-implantation). The patient subsequently reported that she could no longer feel stimulation from the device and device interrogation 2 weeks later indicated battery EOS. The patient was hospitalized due to worsened depression, the pulse generator was replaced, and medication adjusted. HAM-D scores through the subsequent 9 months of follow-up returned to a pattern of fluctuations within the range noted during the long-term follow-up period prior to VNS battery EOS.     

Long-Term Follow-Up of Children with Mental Retardation/Borderline Intellectual Functioning and ADHD

Fifty-two children (ages 7 to 14 years) with moderate mental retardation to borderline intellectual functioning were recontacted 12 to 65 months following participation in a double-blind, placebo-controlled trial of methylphenidate (MPH). Sixty-nine percent of subjects continued to be prescribed medication for behavior control at follow-up. While 72% of the sample evidenced improvement, over two-thirds continued to be rated at or above the 98th percentile on the Hyperactivity Index of the Parent Conners. In fact, 22% of subjects had received inpatient psychiatric treatment between the time of the initial MPH trial and follow-up. Finally, subjects with high initial ratings on the Parent Conners Conduct Problems scale were more likely to be suspended from school or receive inpatient psychiatric treatment than subjects with low initial ratings. The results suggested that children with ADHD and mental retardation or borderline intellectual functioning continued to exhibit significant symptoms associated with attention deficit hyperactivity disorder (ADHD) at follow-up and that early conduct problems were predictive of continuing behavioral difficulties.     

Predicting the outcome of behaviour therapy for agoraphobia

Multiple linear regression analyses were conducted on questionnaire data obtained from 33 agoraphobic women and their husbands before and after intensive exposure in vivo for the agoraphobia. The dependent variable in the regression equation was treatment outcome as determined by changes in composite ratings of patients' two main phobias. On this criterion, patients improved by 64% immediately after treatment and by 69% 1 year later. The main predictors of treatment outcome were patients' pre-treatment levels of agoraphobic disability and of extrapunitiveness. The main pre-treatment predictors of change during follow-up were patients' levels of social fear, and of fears which suggested dependency problems. When post-treatment questionnaire responses were used to predict patients' phobia change during follow-up, husbands' scores contributed 50% to the variance. This finding, together with clinical observations, suggested that if husbands were unable to fully acknowledge the emotional impact upon themselves of rapid and substantial improvements in their wives, then they were unlikely to facilitate further phobia improvement in their wives during the first 6 months of follow-up. It was concluded that involvement of the husbands in their wives' therapy would increase the likelihood of continuing phobia improvement after treatment.     

Neuropsychological outcome following unilateral stereotactic pallidotomy in intractable Parkinson's disease

Neuropsychological functioning was examined at baseline and 2- to 3-month follow-up in 40 subjects with advanced Parkinson's disease (PD) who underwent unilateral posteroventral pallidotomy. Most subjects demonstrated improved verbal learning, visual memory, confrontation naming, and figural fluency at follow-up. Right pallidotomy was associated with decreased cognitive flexibility and increased verbal fluency, whereas Left pallidotomy uniquely resulted in a decline in verbal fluency. Significant motor improvement was demonstrated in both groups. Pallidotomy appears to be an effective treatment for advanced PD, providing a significant improvement in motor functioning, while resulting in few deleterious neurocognitive changes in most cases.     

Stuttering treatment for a school-age child with Down syndrome: A descriptive case report

BackgroundLittle is known about optimal treatment approaches and stuttering treatment outcomes for children with Down syndrome.Aims and methodThe purpose of this study was to investigate outcomes for a child with Down syndrome who received a combination of fluency shaping therapy and parent delivered contingencies for normally fluent speech, prolonged speech, and stuttered speech.ResultsIn-clinic speech measures obtained at post-treatment and at 4 months follow-up reflected improvements in fluency of 89.0% and 98.6%, respectively. The participant's beyond-clinic follow-up sample reflected an improvement of 95.5%. Following treatment, the participant demonstrated improved self-confidence, self-esteem, and improved participation and functioning at school.ConclusionsFindings suggest that fluency shaping with parental contingencies may be a viable treatment approach to reduce stuttering in children with Down syndrome. Future research using an experimental research design is warranted.Educational objectives: Readers will be able to describe (a) prevalence estimates of stuttering in individuals with Down syndrome, (b) the main components of a fluency shaping program for a child with Down syndrome who stutters and has co-occurring speech and language delays, and (c) speech and parent-, teacher-, and self-report treatment outcomes.     

Cognitive modification versus prolonged exposure in vivo: a comparison with agoraphobics as subjects.

Cognitive restructuring and prolonged exposure in vivo were compared in a cross-over design with 21 agoraphobics.Assessments were made at the beginning of treatment, at cross-over, at the end of treatment and at the follow-up one month later. Assessment were carried out by an independent observer (phobic anxiety and avoidance scales and anxious mood) and by the client (measurement in vivo, phobic anxiety and avoidance scales. FSS, ASES, SDS and 1-E scale). Prolonged exposure in vivo proved to be a definitely superior form of treatment to cognitive restructuring, as measured by the behavioral in vivo measurement and the phobic anxiety and avoidance scales.     

Call for a follow-up study of experiments on long-term deprivation of human infants

Three experiments on long-term isolation and educational deprivation of infants were performed 50 years ago by Myrtle McGraw and by Wayne and Marsena Dennis. Current textbooks regularly present these studies incorrectly as supporting the notion that early motor development is unaffected by environment. This presentation is shown to be incorrect by a reanalysis of the studies which indicates severe and far-reaching negative effects of the depriving conditions upon the experimental infants. A follow-up study of the experimental subjects in later years and a publication of McGraw's unreported study are called for.     

A Two-Year Longitudinal Study of Neuropsychological and Cognitive Performance in Relation to Behavioral Problems and Competencies in Elementary School Children

Despite interest in early neuropsychological status as a possible contributor to children's behavioral development, prospective longitudinal investigations of neuropsychological measures in relation to later behavioral outcomes in childhood are few. A 2-year longitudinal study in a nonselected childhood sample is reported. The study tested the influence of early neuropsychological performance (verbal fluency, mental inhibitory control, and visual spatial ability) on later childhood behavioral problems and social competency. Regular education children (n = 235) were assessed at three time points 1 year apart. To control for autocorrelation of outcome measures, Time 1 behavior was partialed while testing the effects of Time 1 neuropsychological scores on Time 3 outcome. To control for autocorrelation of neuropsychological scores, Time 2 scores were partialed while testing the predictive effect of Time 1 scores on Time 3 outcome. Both sets of regression models suggested modest but statistically significant effects for inhibitory control and verbal fluency, but not IQ, reading, or visual spatial ability, on behavioral outcome. Study results are consistent with a modest causal effect of selected neuropsychological skills on later behavioral adjustment. The findings support theories that implicate subtle neuropsychological dysfunction in the development of behavioral problems in childhood.     

The maintenance of fluency after intensive in-patient therapy: Long-term follow-up

Maintenance of fluency after intensive in-patient treatment was studied in eight male stammerers. Reasons for success and failure are discussed in relation to objective and subjective data collected at the final follow-up interview.     

Interpersonal Problems,Mindfulness, and Therapy Outcome in an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder

Objective: To better understand the role interpersonal problems play in response to two treatments for generalized anxiety disorder (GAD); an acceptance-based behavior therapy (ABBT) and applied relaxation (AR), and to examine how the development of mindfulness may be related to change in interpersonal problems over treatment and at follow-up. Method: Eighty-one individuals diagnosed with GAD (65.4% female, 80.2% identified as white, average age 32.92) were randomized to receive 16 sessions of either ABBT or AR. GAD severity, interpersonal problems, and mindfulness were measured at pre-treatment, post-treatment, 6-month follow-up, and 12-month follow-up. Results: Mixed effect regression models did not reveal any significant effects of pre-treatment interpersonal problems on GAD severity over treatment. After controlling for post-treatment GAD severity, remaining post-treatment interpersonal problems predicted 6- but not 12-month GAD severity. Participants in both conditions experienced a large decrease in interpersonal problems over treatment. Increases in mindfulness over treatment and through follow-up were associated with decreases in interpersonal problems, even when accounting for reductions in overall GAD severity. Conclusions: Interpersonal problems may be an important target of treatment in GAD, even if pre-treatment interpersonal problems are not predictive of outcome. Developing mindfulness in individuals with GAD may help ameliorate interpersonal difficulties among this population.