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Biomedical subjects

Rebecca J Houston

Publications and source records attributed to Rebecca J Houston.

8 recordsLinked to original sources

Depression and familial risk for substance dependence: a P300 study of young women.

The present study evaluated the effects of depression and a family history of alcohol or substance dependence on P300 event-related potentials in young women aged 14 to 20 years. Of the 130 female subjects, 29 met DSM-III-R diagnostic criteria for a lifetime history of a Major Depressive Episode. Event-related electroencephalographic potentials were recorded from each subject while she performed a complex visual oddball task. Analyses indicated a decrement in P300 amplitude in the depressed group as compared to girls with no history of depression. No effects of family history of alcoholism or drug dependence were detected. Current source density analyses, utilizing a realistic head-shape boundary element model, indicated that the difference between the depressed and non-depressed groups was maximal in the right prefrontal region. These results provide further support for the notion that the cognitive difficulties associated with depression are subtle and best detected with sensitive neurophysiological indices, such as P300.

Adolescent↗

Malingered neurocognitive dysfunction in neurotoxic exposure: an application of the Slick criteria.

Toxic torts are increasing across the country and often the results of the neuropsychological evaluation are crucial for defining damages. Therefore, the accurate differentiation of those damaged by toxic exposure from those exaggerating or fabricating deficits is important. However, there is little research on malingering in this context. Presented are four patients claiming cognitive deficits after apparent occupational neurotoxic exposure who were diagnosed as malingering using the Slick, Sherman, and Iverson criteria. The goals of this article were to (1) illustrate the application of the Slick Criteria; (2) discuss current knowledge about the neurological and neurocognitive effects of toxic substances and its impact on clinical decision-making; (3) discuss the application of the Slick Criteria, specifically, and malingering research, generally, to toxic exposure cases; and (4) propose a paradigm in which medical, toxicological and neuropsychology professionals coordinately evaluate cases of alleged neurotoxic chemical exposure.

Adult↗

Characterizing aggressive behavior.

In the research literature, aggressive behavior has traditionally been classified into two distinct subtypes, impulsive or premeditated. Impulsive aggression is defined as a hair-trigger aggressive response to provocation with loss of behavioral control. Premeditated aggression is defined as a planned or conscious aggressive act, not spontaneous or related to an agitated state. The present study outlines the development of a clinically useful self-report instrument, the Impulsive/Premeditated Aggression Scales (IPAS), designed to characterize aggressive behavior as predominately impulsive or predominately premeditated in nature. The IPAS showed strong reliability and validity. Analysis of the IPASscores demonstrated thepresence of two types of aggressive behavior, impulsive and premeditated, in men referred for anger problems. The aggression of most individuals in the present sample was characterized as predominately impulsive in nature (90%).

Adult↗

Detecting malingered performance on the Wechsler Adult Intelligence Scale. Validation of Mittenberg's approach in traumatic brain injury.

This study assesses the effectiveness of the Wechsler Adult Intelligence Scale (WAIS) performance validity markers devised by Mittenberg et al. [Prof. Psychol.: Res. Pract. 26 (1995) 491] in the detection of malingered neurocognitive dysfunction (MND). Subjects were 65 traumatic brain injury (TBI) patients referred for neuropsychological evaluation. Twenty-eight met the Slick et al. [Clin. Neuropsychol. 13 (1999) 545] criteria for at least probable MND. The control group was comprised of 37 patients without external incentive and who thus did not meet the Slick et al. criteria. All subjects completed the Wechsler Adult Intelligence Scale-Revised (WAIS-R or WAIS-III). The discriminant function score (DFS) and the vocabulary-digit span (VDS) difference score were calculated and sensitivity, specificity, and predictive power were examined for several cut-offs for each marker individually and the two combined. Classification accuracy for the DFS was acceptable and better than for VDS. The use of the two markers in combination resulted in no incremental increase in classification accuracy. Issues related to the clinical application of these techniques are discussed.

Adult↗

Detecting malingered performance with the Wisconsin card sorting test: a preliminary investigation in traumatic brain injury.

The present study examined the classification accuracy of four potential Wisconsin Card Sorting Test malingering indicators (Bernard and Suhr formulas and two types of Unique responses). Participants were 89 traumatic brain-injury (TBI) patients assigned to malingering and nonmalingering groups on the basis of the Slick, Sherman, and Iversion (1999) criteria. Individual Sensitivities were greater than .33 with acceptable Specificity. Combined Sensitivity for two of the indicators was greater than.60. Overall, this study demonstrated three distinct approaches to the WCST used by probable malingerers. The clinical relevance of these findings and directions for future research are discussed.

Adult↗

The neurobehavioural consequences of St. Louis encephalitis infection.

BACKGROUND: St. Louis encephalitis (SLE) is a relatively common cause of neurological illness, yet little is known about its cognitive and psychosocial consequences. PURPOSE: To describe the cognitive, emotional, psychophysiological, and psychosocial consequences of SLE infection. METHOD: A comprehensive neuropsychological and psychophysiological evaluation of a high functioning woman 6 weeks and 1 year after acute SLE infection is presented. The focus and course of rehabilitation is also examined. RESULTS: The primary cognitive consequences of SLE infection involved attention, working memory, speed of processing, and cognitive efficiency. Depression was also observed. Psychometric testing suggested that these deficits largely resolved after 1 year. CONCLUSIONS: SLE produces neurocognitive deficits which are reflected in both psychometric and psychophysiologic measures and functional status. Psychometric and vocational improvement were observed over 1 year. However, the normal vocational return came at a significant psychosocial cost. This case emphasizes the importance of a comprehensive neuropsychological evaluation and illustrates the importance of an integrated rehabilitation programme.

Adult↗

Temporal stability of the Wisconsin Card Sorting Test in a chronic traumatic brain injury sample.

The aim of the present study was to investigate the temporal stability of the Wisconsin Card Sorting Test (WCST) in a clinical population with documented brain pathology, stable cognitive deficits, and for whom repeated testing is common: chronic severe traumatic brain injury (TBI). Participants were 34 patients at least 1 year post severe TBI living at a large residential rehabilitation facility. The WCST was administered in standard fashion with both the standard and 64-card versions scored. All derived scores with norms were examined. Results indicated acceptable temporal stability of most scores for both the standard and short WCST, although the stability of the WCST-64 was poorer than for the standard WCST. Three sets of significant change indices are provided for clinical use.

Adult↗

Detecting malingered neurocognitive dysfunction using the reliable digit span in traumatic brain injury.

This study assessed the effectiveness of Greiffenstein's Reliable Digit Span (RDS) score for the detection of malingered neurocognitive dysfunction. Participants were 54 traumatic brain injury patients referred for neuropsychological evaluation. Twenty-four met the Slick, Sherman, and Iverson criteria for at least probable malingered neurocognitive dysfunction. The control group was composed of 30 patients without external incentive and who thus did not meet the Slick criteria. All patients completed the digit span test as part of either the WAIS-R or WAIS-III. The RDS scores were calculated, and sensitivity, specificity, and predictive power were examined for several cutoffs. Classification accuracy for the RDS was excellent. Issues related to the clinical application of this technique are discussed.

Adult↗