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     

Hyperactivity in boys with attention deficit/hyperactivity disorder (ADHD): The association between deficient behavioral inhibition,attentional processes,and objectively measured activity

Contemporary models of ADHD hypothesize that hyperactivity reflects a byproduct of inhibition deficits. The current study investigated the relationship between children's motor activity and behavioral inhibition by experimentally manipulating demands placed on the limited-resource inhibition system. Twenty-two boys (ADHD = 11, TD = 11) between the ages of 8 and 12 years completed a conventional stop-signal task, two choice-task variants (no-tone, ignore-tone), and control tasks while their motor activity was measured objectively by actigraphs placed on their nondominant wrist and ankles. All children exhibited significantly higher activity rates under all three experimental tasks relative to control conditions, and children with ADHD moved significantly more than typically developing children across conditions. No differences in activity level were observed between the inhibition and noninhibition experimental tasks for either group, indicating that activity level was primarily associated with basic attentional rather than behavioral inhibition processes.     

Performances on Symbol Digit Modalities Test,Color Trails Test,and modified Stroop test in a healthy,elderly Danish sample

ABSTRACT

This study presents Danish data for the Symbol Digit Modalities Test (SDMT), Color Trails Test (CTT), and a modified Stroop test from 100 subjects aged 60–87 years. Among the included demographic variables, age had the highest impact on test performances. Thus, the study presents separate data for different age groups. For SDMT and CTT1, Danish Adult Reading Test (DART) score also had a significant impact on test performances. The incongruent version of the modified Stroop test was significantly correlated to education. Moderate and significant correlations were found between the three tests. Even though the three tests are commonly used, few normative data for elderly exists. SDMT and CTT performances from this study were in the same range as previously published international norms, but the validity of the result from the modified Stroop test could not be investigated.     

Credo Unam Sanctam Ecclesiam: The Relationship between the Catholic and the Protestant Principles in Fundamental Ecclesiology

Abstract

This article treats of characteristically Catholic and Protestant ecclesial principles and reflects on Anglicanism within this context. Where the Catholic ‘principle’ is concerned for the structural unity of the Church, the Protestant ‘principle’ focuses on the Church as a dynamic, Spirit-given reality. In turn, Anglican comprehensiveness is assumed to reflect the concern to achieve a harmonious balance between these principles. Having traced key developments that brought Catholic and Protestant principles into creative relationship in the 20th century and more recent developments, that threaten once again to oppose them, this article argues – through reflection on the unity and holiness of the Church – for their necessary interrelationship and concludes that realising this in practice represents the central ecumenical challenge of our age. En route, attention falls on the relationship between the local and the universal Church, on the importance of keeping communion with the breadth of the tradition and on the doxological dimension of ecumenism.     

Is continuous sedation at the end of life an ethically preferable alternative to physician-assisted suicide?

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this "argument of preferable alternative." Our goal is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS.     

Estlund on Epistocracy: A Critique

An influential anti-democratic argument says: ??(1) Answers to political questions are truth-apt. (2) A small elite only??the epistocrats??knows these truths. (3) If answers to political questions are truth-apt, then those with this knowledge about these matters should rule. (4) Thus, epistocrats should rule.?? Many democrats have responded by denying (1), arguing that, say, answers to political questions are a matter of sheer personal preference. Others have rejected (2), contending that knowledge of the true answers to political questions is evenly distributed. David Estlund finds neither of these replies conclusive. Instead, he attacks (3) arguing that there can be no agreement between qualified people as to who the epistocrats are and that people are not subject to being ruled by experts, whose status as such they can reasonably dispute. Critically, I argue that this argument does not block all forms of epistocratic argument and that Estlund fails to consider the full range of plausible epistocratic views. More constructively, I offer a modest argument for why greater expertise does not necessarily warrant greater political authority. Presumably, the set of feasible options might differ, depending on what procedure is used, and a sub-optimal choice by nonepistocrats from a better set might be superior to the optimal choice by epistocrats from a worse set. In such cases, the mere fact of greater expertise does not warrant political authority, i.e., (3) is false.     

An extension of the keyword method facilitates the acquisition of simple Spanish sentences

Subjects were taught Spanish-English paired-associates by using the keyword method. The item pairs ranged in length from one to four words. Subjects using the keyword method recalled many more constituents of n-a-v-n Spanish sentences than subjects spontaneously using rehearsal, but no more than subjects spontaneously using imagery. The results of the study suggest that the keyword method facilitates recall by inducing subjects to process item-specific information for individual words.     

Changes in alertness and processing capacity in a serial learning task

Second-to-second changes in processing capacity were examined using a concurrent task paradigm involving serial learning and simple reaction time (RT) in two experiments. Experiment 1 demonstrated the feasibility of combining probe RT with a slow-paced serial learning task including perceptually isolated items. Experiment 2 employed the same concurrent tasks to compare cardiac interbeat interval (IBI, the reciprocal of heart rate) with probe RT. Second-to-second changes during item processing were found consistently for both measures. However, these changes appeared to be more related to observing and response requirements than to the specific cognitive processes required by the tasks. Correctly anticipated items were associated with (l)RT changes, suggesting heightened allocation of capacity, and (2)a cardiac IBI response of episodic cardiac deceleration imposed upon the task-induced cardiac speeding. The probe RT and cardiac IBI measures showed reasonable convergence in assessing the allocation of processing capacity. The concept of the accessibility of allocated capacity was introduced in considering instances of the divergence of probe RT and cardiac IBI.     

Pharmacotherapy of seasonal affective disorder

Seasonal affective disorder is a common variant of recurrent major depressive disorder or bipolar disorder. Treatment with bright artificial light has been found to be effective in this condition. However, for patients who do not respond to light therapy or those who lack compliance, conventional drug treatment with antidepressants also has been proposed. Substances with selective serotonergic or noradrenergic mechanisms should be preferred over older antidepressants. Although there are a number of open and controlled studies evaluating different compounds, these studies were often limited by relatively small sample sizes. Furthermore, there are no studies specifically addressing bipolar seasonal depression. This article will review the published literature on pharmacotherapy of seasonal affective disorder.     

Efficacy of noradrenergic-selective agents in the treatment of neuropsychiatric diseases

In recent years, a number of antidepressants with varying degrees of selectivity for the noradrenergic neurotransmitter system have become available. However, these agents represent a pharmacologically heterogeneous group and differ in terms of their precise side-effect profile and, possibly, their clinical efficacy. Bupropion, which is thought to act on both the dopamine and norepinephrine (NE) systems, has not been widely used as an antidepressant and has more recently been licensed as adjunctive therapy for smoking cessation. The serotonin-NE reuptake inhibitors venlafaxine and nefazodone, the noradrenergic and specific serotonergic antidepressant mirtazapine, and the selective NE reuptake inhibitor reboxetine (the only truly NE-selective agent available) have all demonstrated efficacy in the treatment of depressive disorders. Evidence is now emerging for their use in the treatment of anxiety and panic disorders. There is some suggestion of a role for noradrenergic agents in other disorders, including attention-deficit/hyperactivity disorder and social phobia. The full range of disorders for which noradrenergic agents can be used remains to be seen and further research in this area is necessary.