A Review of Symptoms Commonly Associated with Menopause: Implications for Clinical Neuropsychologists and Other Health Care Providers

Menopause is a process, either naturally or medically induced, that occurs in nearly all women at some point in life. Some of the most commonly reported symptoms associated with menopause are hot flushes/flashes, fatigue, headaches, irritability, insomnia, and depression. These symptoms overlap with symptoms commonly reported in Traumatic Brain Injury (TBI) as well as postconcussive syndrome. This overlap between symptoms commonly associated with menopause and neuropsychological conditions makes it necessary to have the base rates of these symptoms and conditions available. The purpose of the present review was to consolidate the clinical literature on the most commonly reported menopausal symptoms and to calculate the base rates associated with these symptoms.     

Luria in Uzbekistan: The Vicissitudes of Cross-Cultural Neuropsychology

If the material conditions of culture shape cognitive structures, as Luria and Vygotsky argued, the extraordinarily deep and rapid restructuring of historical forms (Luria, 1971, 265) in the Soviet Republics that followed the Bolshevik revolution of 1917 provided a natural laboratory to determine whether processes of modernization changed traditional ways of thinking. This was the purpose of Luria's 1931 expedition to the Soviet Republic of Uzbekistan in central Asia. Luria's initial reports attracted vitriolic criticism because he had allegedly belittled primitive Uzbeki culture. The lasting importance of the Uzbek expedition is its emphasis on culture as a determinant of cognitive processes that remains valid to the present: in 1984, Gilbert replicated Luria's field studies in South Africa with near-identical results. Yet current neuropsychology has been slow to recognize the need for culturally sensitive assessment.     

Psychometric appraisal of Eysenck's revised Psychoticism scale: a cross-cultural study

Psychometric characteristics of Eysenck's revised P scale were studied in a cross-cultural research. The Spanish version of the Eysenck Personality Questionnaire-Revised (EPQ-R) was administered to a Spanish sample of 527 males and 583 females. Maximum-likelihood factor analyses of the item intercorrelations and Direct Oblimin rotations of the extracted factors were carried out separately for males and females. The results revealed four factors identified as psychoticism (P), extraversion (E), neuroticism (N) and dissimulation/conformity (L). Internal consistency and test–retest reliability coefficients were satisfactory and very similar to the ones found in the original study. Skewness and kurtosis of the P scale distribution were closer to normal than on the original British revised P scale.     

Toward a cultural neuropsychology: An alternative view and a preliminary model

Any integrated theory of mind and behavior must address the dynamic interaction between neurobiological and sociocultural systems as possible causes for human action. Newer findings within the behavioral neurosciences have pointed to the brain's exceptional plasticity and flexibility and suggest that one's surroundings, including one's cultural environment, may directly influence the way the human nervous system becomes organized. In this paper, a preliminary connectionist model of culture-brain interaction is proposed in an effort to illustrate the possible contribution of cultural factors to the development of the individual human brain.     

Neuropsychological dysfunction in asthmatic children

Neuropsychological dysfunction associated with pediatric asthma is reviewed. Significant methodological confounds associated with clinical research, including problems with the objective measure of asthma, are prevalent in many studies. Most evidence does not support the belief that asthma alone results in homogeneous neuropsychological compromise. Studies of adverse reactions to asthma medications indicate medication-specific effects including slight improvements in some aspects of neuropsychological functioning, such as attention, and deficiencies in other aspects of neuropsychological functioning, such as memory. The acute neuropsychological effects of various medication regimens appears to be reversible with cessation of the asthma medication under suspicion, although no data yet exist regarding the long-term effects of therapeutic dosages of asthma medications upon a developing nervous system. The hypothetical effects of asthma on school performance have been related to non-neuropsychological variables such as a child's socioeconomic status, though there is also evidence suggesting that poorly controlled asthma is related to learning problems. Implications for pediatric neuropsychologists are discussed.     

Cognitive deficits related to major organ failure: The potential role of neuropsychological testing

Until recently, little attention has been paid to the possibility of cognitive deficits in patients with disease or failure of major organs such as the liver, kidney, or heart. However, there is a growing awareness that major organ failure often has neuropsychological sequelae. These sequelae may at times be quite subtle and not detectable under gross. examination. Nevertheless, even subtle deficits may have a major impact on adherence to medical regimens, psychosocial adjustment, and quality of life of patients. Neuropsychological assessment has a potentially valuable role to play both in research and in clinical work. It can be useful in adding to our knowledge of the cognitive effects of various types, severity and duration of major organ disease, as well as sequelae associated with treatment. It also is a potentially valuable clinical tool for identifying cognitive deficits that will affect the quality of life and probability of survival for organ failure patients.     

Clinical judgment in forensic neuropsychology: A comment on the risks of claiming more than can be delivered

There is a vast and growing literature in psychology demonstrating the general limits of human judgment and clinical inference. These findings clearly apply in the new specialty of clinical neuropsychology, and there is little empirical research to support the widespread belief that judgmental accuracy correlates substantially with experience, professional stature, or reputation as a neuropsychologist. However, the demand characteristics of expert testimony in the forensic arena may encourage individual neuropsychologists to state or intimate that they have unique or special expertise in understanding brain-behavior relationships, or in predicting outcomes following cerebral insult or injury. These claims will be increasingly difficult to substantiate as attorneys become more conversant with the literature on human judgment.     

One-year prediction of cognitive decline following cognitive-stimulation from real-world data

Clinical evidence based on real-world data (RWD) is accumulating exponentially providing larger sample sizes available, which demand novel methods to deal with the enhanced heterogeneity of the data. Here, we used RWD to assess the prediction of cognitive decline in a large heterogeneous sample of participants being enrolled with cognitive stimulation, a phenomenon that is of great interest to clinicians but that is riddled with difficulties and limitations. More precisely, from a multitude of neuropsychological Training Materials (TMs), we asked whether was possible to accurately predict an individual's cognitive decline one year after being tested. In particular, we performed longitudinal modelling of the scores obtained from 215 different tests, grouped into 29 cognitive domains, a total of 124,610 instances from 7902 participants (40% male, 46% female, 14% not indicated), each performing an average of 16 tests. Employing a machine learning approach based on ROC analysis and cross-validation techniques to overcome overfitting, we show that different TMs belonging to several cognitive domains can accurately predict cognitive decline, while other domains perform poorly, suggesting that the ability to predict decline one year later is not specific to any particular domain, but is rather widely distributed across domains. Moreover, when addressing the same problem between individuals with a common diagnosed label, we found that some domains had more accurate classification for conditions such as Parkinson's disease and Down syndrome, whereas they are less accurate for Alzheimer's disease or multiple sclerosis. Future research should combine similar approaches to ours with standard neuropsychological measurements to enhance interpretability and the possibility of generalizing across different cohorts.     

The Neuropsychology of Aesthetic, Spiritual, and Mystical States

An analysis of the underlying neurophysiology of aesthetics and religiousexperience allows for the development of an Aesthetic-Religious Continuum. This continuumpertains to the variety of creative and spiritual experiences available to human beings. This mayalso lead to an understanding of the neurophysiological mechanism underlying both"positive" and "negative" aesthetics. An analysis of this continuumallows for the ability to understand the neurophenomenological aspects of a variety of humanexperiences ranging from relatively simple aesthetic experiences to profound spiritual and unitarystates such as those obtained during meditation. However, it may be possible through aneuropsychological analysis to determine the similarities that exist across such experiences.Thus, certain parts of the brain may be functioning in similar ways during different experiences.It may be the case that the specific neuropsychological components of a given experience maydepend on the strength of the affectual response of the person and the ability to mark suchexperiences as significant. Further, even though similar structures may be functioning duringdifferent experiences, their inhibitory and excitatory interactions may be different. Finally, byconsidering the Aesthetic-Religious Continuum, we may eventually arrive at a betterunderstanding of how we experience and define reality.     

Maternal perinatal representations and their associations with mother–infant interaction and attachment: A longitudinal comparison of Portuguese and Brazilian dyads

Prior research in Western countries (mostly the US, Canada and northern Europe) indicates that mothers' representations are associated with mother–infant interaction quality and their child's attachment security later in the first year. Fewer studies, however, have evaluated whether these associations hold for mother–infant dyads in other countries, such as Brazil and Portugal. Although these countries share a similar language and culture, they differ on societal dimensions that may affect parenting attitudes and mother–infant relationships, such as economic stress, social organisation, social policy, and the availability of services for young families. In this longitudinal study, we followed two independent samples of Brazilian and Portuguese mother–infant dyads from the perinatal period to 12 months post-partum. We assessed mothers' perinatal representations using semi-structured interviews in the first 48 hours after the infant's birth, and evaluated the associations of these representations with mother interaction quality at 9 months and infant attachment at 12 months. Results were similar in each country, corroborating prior research in single Western countries: Mothers with more positive perinatal representations were more sensitive to their infants during free play at 9 months and were more likely to have infants classified as securely attached at 12 months.