The Future of Neuropsychology in Medical Specialties

Although neuropsychology continues to grow as a valued service in most medical specialties, because of its multiple uses with diverse populations, it is necessary to evaluate the specialty critically in order to ensure continued future success. This article reviews areas in which neuropsychology is most firmly established, potential growth areas, and likely obstacles to success in the future. Suggestions are provided for ways in which neuropsychology can be improved/adapted in clinical, business, research, and training areas. On sabattical at Bebek University, Instanbul, Turkey     

Neurobehavioral deficits,adolescent traumatic brain injury,and transition to college

Outcome following traumatic brain injury (TBI) has been frequently evaluated for adults, although there has been minimal research on adolescents with TBI. It has been argued that TBI sequelae may be more difficult for adolescents to adjust to given developmental changes in physical (puberty), interpersonal (self-concept), and environmental domains (transition to college). In addition, it is commonly acknowledged that moderator variables such as psychiatric history, family functioning, substance use, and sexuality impact functional outcome following TBI, although it is often difficult to objectively evaluate these variables. The current study examined relationships among TBI-related deficits, moderator variables, and academic outcomes for six adolescents transitioning to college. The findings suggest that it may not be appropriate to predict functional outcome based solely on objective neuropsychological results. However, moderator variables appear to have a more direct relationship with outcome, depending on the moderator variable and the individual.     

Efficient Hessian computation using sparse matrix derivatives in RAM notation

This article proposes a new, more efficient method to compute the minus two log likelihood, its gradient, and the Hessian for structural equation models (SEMs) in reticular action model (RAM) notation. The method exploits the beneficial aspect of RAM notation that the matrix derivatives used in RAM are sparse. For an SEM with K variables, P parameters, and P′ entries in the symmetrical or asymmetrical matrix of the RAM notation filled with parameters, the asymptotical run time of the algorithm is O(P?′?K ²?+?P ² K ²?+?K ³). The naive implementation and numerical implementations are both O(P ² K ³), so that for typical applications of SEM, the proposed algorithm is asymptotically K times faster than the best previously known algorithm. A simulation comparison with a numerical algorithm shows that the asymptotical efficiency is transferred to an applied computational advantage that is crucial for the application of maximum likelihood estimation, even in small, but especially in moderate or large, SEMs.     

Relationship problems and extradyadic romantic and sexual activity in a web‐sample of Norwegian men and women

The purpose of this paper is to describe the prevalence of self‐reported types of extradyadic romantic and sexual activity among adult Norwegians and to explore the role of infidelity in breaking up a permanent relationship. The results are based on 1,001 web interviews with persons ranging in age from 18 to 67 years. The majority of respondents reported having engaged in some kind of extradyadic romantic and/or sexual activity. Forty‐five percent of the women and 39% of the men claimed they had experienced a previous breakup from a marriage or cohabiting relationship. Among those aged 50 years or older, the most important reasons for breaking up a previous relationship were infidelity (38%) and lost love (38%). More men (44%) than women (33%) reported infidelity. Respondents younger than 50 years were more motivated by boredom. Among respondents below the age of 50 years, the most frequently reported reasons for considering termination of a present relationship were quarreling (37%), poor sex life (29%), and “other” reasons (25%). Accordingly, infidelity was not identified as an essential factor for considering a breakup from the present relationship.     

Heightened religiosity and epilepsy: evidence for religious-specific neuropsychological processes

It has been hypothesised that humans may have an innate neurologic tendency towards being religiously oriented, suggesting that we possess religious-specific neuropsychological processes. Persons with epilepsy provide a unique opportunity to study these relationships given the documented hyper-religious experiences observed with epilepsy. The current study evaluated 19 individuals with epilepsy to determine if epilepsy-related religious experiences (as measured by the Bear Fedio Inventory [BFI]) are reflective of a general increase in behaviours observed with epilepsy (e.g., philosophical thoughts, emotionality), or if they are reflective of a religious-specific orientation. Spearman correlations indicated that: (1) BFI religious-orientation scales are significantly related to philosophical concerns (i.e., nature of the universe), but not measures of emotionality and (2) BFI religious-orientation scales, but not philosophical or emotionality scales, are significantly associated with other commonly used measures of spirituality. These findings suggest that individuals may possess neuropsychological processes that are specific to religious orientations.     

Relationships Among Religiousness,Spirituality, and Health for Individuals with Stroke

The current study evaluated the relationships among spiritual beliefs, religious practices, physical health, and mental health for individuals with stroke. A cross-sectional analysis of 63 individuals evaluated in outpatient settings, including 32 individuals with stroke and 31 healthy controls was conducted through administration of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and the Medical Outcomes Scale-Short Form 36 (SF-36). For individuals with stroke, the SF-36 General Mental Health scale was significantly correlated with only the BMMRS Religious and Spiritual Coping scale (r = .43; p < .05). No other BMMRS factors were significantly correlated with SF-36 mental or physical health scales. Non-significant trends indicated spiritual factors were primarily related to mental versus physical health. This study suggests spiritual belief that a higher power will assist in coping with illness/disability is associated with better mental health following stroke, but neither religious nor spiritual factors are associated with physical health outcomes. The results are consistent with research that suggests that spiritual beliefs may protect individuals with stroke from experiencing emotional distress.     

Re-conceptualizing the Factor Structure of the Brief Multidimensional Measure of Religiousness/Spirituality

Rationale This study attempted to differentiate statistically the spiritual and religious factors of the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS), which was developed based on theoretical conceptualizations that have yet to be adequately empirically validated in a population with significant health disorders. Participants One hundred sixty-four individuals with heterogeneous medical conditions [i.e., brain injury, spinal cord injury (SCI), cancer, stroke, primary care conditions]. Methods Participants completed the BMMRS as part of a pilot study on spirituality, religion, and physical and mental health. Results A principal components factor analysis with varimax rotation and Kaiser normalization identified a six-factor solution (opposed to the expected 8-factor solution) accounting for 60% of the variance in scores, labeled as: (1) Positive Spiritual Experience; (2) Negative Spiritual Experience; (3) Forgiveness; (4) Religious Practices; (5) Positive Congregational Support; and (6) Negative Congregational Support. Conclusions The results suggest the BMMRS assesses distinct positive and negative aspects of religiousness and spirituality that may be best conceptualized in a psychoneuroimmunological context as measuring: (a) Spiritual Experiences (i.e., emotional experience of feeling connected with a higher power/the universe); (b) Religious Practices (i.e., prayer, rituals, service attendance); (c) Congregational Support; and (d) Forgiveness (i.e., a specific coping strategy that can be conceptualized as religious or non-religious in context).     

Multivariate normal maximum likelihood with both ordinal and continuous variables,and data missing at random

A novel method for the maximum likelihood estimation of structural equation models (SEM) with both ordinal and continuous indicators is introduced using a flexible multivariate probit model for the ordinal indicators. A full information approach ensures unbiased estimates for data missing at random. Exceeding the capability of prior methods, up to 13 ordinal variables can be included before integration time increases beyond 1 s per row. The method relies on the axiom of conditional probability to split apart the distribution of continuous and ordinal variables. Due to the symmetry of the axiom, two similar methods are available. A simulation study provides evidence that the two similar approaches offer equal accuracy. A further simulation is used to develop a heuristic to automatically select the most computationally efficient approach. Joint ordinal continuous SEM is implemented in OpenMx, free and open-source software.