Biomedical subjects

Steffen Moritz

Publications and source records attributed to Steffen Moritz.

At least 37 records · Page 2Linked to original sources

PubMed2005

Severity of subjective cognitive impairment in patients with obsessive-compulsive disorder and depression.

Previous research on obsessive-compulsive disorder (OCD) has consistently found cognitive impairments in the domains of executive and nonverbal (memory) functioning, particularly in patients with comorbid depressive symptoms. In contrast, little is known about the degree to which such deficits are cognizant to patients or the degree to which these impairments interfere with daily activities. The aim of the present study was to assess prevalence and specificity of subjective cognitive dysfunction in OCD patients. A self-rating scale, the Subjective Neurocognition Inventory (SNI), was administered to 67 OCD patients upon admission to hospital. Forty healthy and 30 depressed participants served as controls. Relative to healthy participants, OCD patients reported greater impairment on SNI subscales measuring psychomotor speed, selective and divided attention. Impairments in the OCD group were particularly pronounced in patients with severe OCD or depressive psychopathology. OCD patients were no more disturbed than depressed participants on any of the domains tested. Memory problems were only reported by a minority of OCD patients-even in patients with checking compulsions. In conjunction with prior studies showing few memory difficulties in non-depressed OCD patients, present findings further challenge the memory deficit hypothesis which claims that checking compulsions are a dysfunctional compensation for real or imagined forgetfulness.

Adult↗

PubMed2005

Investigation of mood-congruent false and true memory recognition in depression.

The present study investigated the extent of mood-congruent false and true memory recognition in depression. A group of 25 patients with depression and 28 healthy controls completed a variant of the Deese-Roediger McDermott task. Four lists were read to participants in sequence, followed by a recognition task. The words in each list were associated with a central but unmentioned theme word that was either depression-relevant (i.e., loneliness), delusion-relevant (betrayal), positive (holidays), or neutral (window). Whereas it was expected to replicate the conventional mood-congruent effect in depression (better recognition of depression-relevant items), the available literature did not allow strong predictions to be made on the extent of mood-congruent false recognition in depression. Results showed that depressed patients learned emotionally charged material equally well as healthy participants but forgot significantly more neutral material. A conventional mood-congruent memory bias was not found, but relative to healthy controls, patients with depression committed more false recognition errors for emotionally charged words, particularly for depression-relevant items. The results confirm that depressed patients are biased toward emotional material. Reasons for the absence of the expected mood-congruent memory bias are discussed. It is suggested that researchers as well as clinicians should pay more attention to mood-congruent false recollection, because it may undermine the validity of autobiographic reports in depressive patients and may represent a maintenance factor for the disorder.

Adult↗

PubMed2005

Neurocognitive impairment does not predict treatment outcome in obsessive-compulsive disorder.

There is conflicting evidence pertaining to whether or not neurocognitive task performance at baseline predicts treatment response in obsessive-compulsive disorder (OCD). In the present study, we administered a set of executive neurocognitive tests with a putative sensitivity for treatment outcome to a sample of 138 OCD patients. Additionally, subjective neurocognitive dysfunction was determined via a questionnaire. All patients participated in a cognitive-behavioural treatment program (CBT). Results showed that responders (n = 73) did not differ from non-responders (n = 65) on any of the parameters except for decreased performance on the delayed alternation test (p < .1, effect size: .61). A subsidiary analysis revealed that slowing on the Trail-Making Test A and an enhanced rate of perserveration errors on the Wisconsin Card Sorting Test predicted poor outcome for the treatment of compulsions. It is concluded that neurocognitive impairment does not represent a reliable early warning sign for non-response to CBT.

Adult↗

PubMed2005

Inhibition of return in patients with obsessive-compulsive disorder.

The present study is aimed at replicating and extending previous results by Nelson et al. [Psychiatry Res. 49 (1993) 183], who found decreased inhibition of return (IOR) in patients with obsessive-compulsive disorder (OCD). Thirty OCD patients, 14 psychiatric, and 14 healthy controls participated in a visual cueing experiment. The task required detection of a target stimulus at one of two possible locations. Prior to the target, an uninformative cue appeared at one of these two locations. The Stimulus Onset Asynchrony (SOA) between the cue and the target was systematically varied. We were especially interested in whether severity of OCD symptoms would be negatively correlated with inhibition for previously occupied locations. In accordance with prior research on healthy participants all groups displayed a comparable response pattern: facilitation at the short SOA condition and increasing IOR for the longer SOA conditions. Medication, comorbid depression, and OCD severity did not consistently moderate these effects.

Adult↗

PubMed2005

Extent, profile and specificity of visuospatial impairment in obsessive-compulsive disorder (OCD).

Recent reviews on the neurocognitive profile of patients diagnosed with obsessive-compulsive disorder (OCD) have converged on the assumption that both visuospatial and especially nonverbal memory performance are impaired in OCD. However, as most prior studies have contrasted performance of OCD patients with healthy controls only, no inferences can yet be drawn about the specificity of these deficits to OCD. Further, the administration of complex and multifunctional tasks limit conclusions about clearly defined cognitive deficits. The present study compared 71 OCD patients to 30 healthy and 33 psychiatric control participants on a large battery of visuospatial and nonverbal memory tasks at two time-points. In addition, a visuospatial battery (VS battery), which assesses a wide range of elementary visuospatial functions, was administered. While OCD patients performed worse than healthy controls on some complex tasks (e.g., Block Design), no visuospatial component proved to be impaired specifically in OCD. OCD patients and controls performed similarly on parameters of nonverbal memory. Regarding organizational strategy, OCD patients performed worse than healthy (but not psychiatric) control participants on two out of three Rey-figure trials (copy and immediate). It is suggested that prior research overestimated the severity and significance of visuospatial and nonverbal memory impairment in OCD.

Adult↗

PubMed2005

Confidence in errors as a possible basis for delusions in schizophrenia.

In two previous studies, it was observed that schizophrenic patients display increased confidence in memory errors compared with controls. The patient group displayed an increased proportion of errors in their knowledge system, quantified as the percentage of high-confident responses that are errors. The latter phenomenon has been termed knowledge corruption and is put forward as a risk factor for the emergence of delusions. In the present study, knowledge corruption was analyzed separately for different aspects of memory errors. A source-monitoring task was used, for which participants (30 schizophrenic patients with past or current paranoid ideas and 15 healthy controls) were asked to provide associates for each of 20 prime words. Later, participants were required to recognize studied words among distractor words, judge the original source, and provide a confidence rating for the most recent decision. Schizophrenic patients displayed greater confidence in memory errors compared with controls. Knowledge corruption was observed to be significantly greater in schizophrenic patients relative to controls for false-positive and false-negative judgments. It is proposed that reliance on false knowledge represents a candidate mechanism for the emergence of fixed false beliefs (i.e., delusions).

Adult↗

PubMed2005

Posttraumatic stress disorder and memory problems after female genital mutilation.

OBJECTIVE: This pilot study investigated the mental health status of women after genital mutilation. Although experts have assumed that circumcised women are more prone to developing psychiatric illnesses than the general population, there has been little research to confirm this claim. It was predicted that female genital mutilation is associated with a high rate of posttraumatic stress disorder (PTSD). METHOD: The psychological impact of female genital mutilation was assessed in 23 circumcised Senegalese women in Dakar. Twenty-four uncircumcised Senegalese women served as comparison subjects. A neuropsychiatric interview and further questionnaires were used to assess traumatization and psychiatric illnesses. RESULTS: The circumcised women showed a significantly higher prevalence of PTSD (30.4%) and other psychiatric syndromes (47.9%) than the uncircumcised women. PTSD was accompanied by memory problems. CONCLUSIONS: Within the circumcised group, a mental health problem exists that may furnish the first evidence of the severe psychological consequences of female genital mutilation.

Adolescent↗

PubMed2005

Jumping to conclusions in delusional and non-delusional schizophrenic patients.

OBJECTIVE: Several studies have provided evidence for the claim that a subgroup of (schizophrenic) patients with current delusions share a jumping to conclusions (JTC) bias. The primary aim of the present study was to investigate whether currently deluded and non-deluded schizophrenic patients perform differently on three tasks tapping probabilistic reasoning. METHOD: Probabilistic reasoning was assessed in 31 schizophrenic patients, 28 psychiatric controls, and 17 healthy controls. In addition to the traditional draws to decision procedure, we employed two tasks for which participants had to judge, at each stage, the likelihood that beads come from either container (graded estimates procedure). Reaction times were recorded for the graded estimates procedure. RESULTS: A JTC bias was displayed by 42% of the schizophrenic patients in the draws to decision condition, while 7% of the psychiatric patients and none of the healthy controls reached a decision after only one bead. A similar pattern of results was observed for the graded estimates procedure. This bias was more pronounced in deluded schizophrenic patients, although currently non-deluded patients also showed evidence for earlier decisions. A bias to over-adjust when confronted with potentially disconfirmatory evidence was confined to deluded schizophrenic participants. There was also evidence for an increase in JTC in the deluded group over the course of the tasks. No substantial group differences occurred with respect to reaction time parameters indicating that results are not attributable to impulsivity. DISCUSSION: The findings provide further evidence for state and trait characteristics of abnormal reasoning in paranoid schizophrenia. Results are discussed in light of several competing explanations for JTC in schizophrenia.

Adult↗

PubMed2004

Late-onset depression with mild cognitive deficits: electrophysiological evidences for a preclinical dementia syndrome.

Mild cognitive impairment (MCI) is present in up to 60% of patients with late-onset depression and constitutes a major diagnostic problem in geriatric psychiatry. Searching for sensitive markers for the detection of early brain changes suggestive of dementia, we compared this depressive risk population with mildly to moderately demented patients and cognitively unimpaired depressed patients using EEG power and coherence. We found a considerable similarity between Alzheimer's disease patients and cognitively impaired depressed patients regarding the cognitive profile and EEG pattern. Changes in EEG power and coherence at frontotemporal leads in depressive patients with MCI thereby allowed discrimination from cognitively unimpaired patients with a sensitivity of 88% and a specifity of 81%.

Age of Onset↗

PubMed2004

Dimensional structure of the Hamilton Depression Rating Scale in patients with obsessive-compulsive disorder.

Comorbid depression is frequent in obsessive-compulsive disorder (OCD) and is acknowledged as a major confound in biological and neurocognitive investigations in OCD. The aim of the present study was to assess the distribution of depressive symptoms in a large OCD sample (n=162) and to analyze the dimensional structure of the Hamilton Depression Rating Scale (HDRS) in OCD. Major depressive disorder according to DSM-IV criteria was apparent in approximately one third of the patients. Frequent symptoms were depressed mood, reduced ability to work, anxiety symptoms and guilt feelings. HDRS scores were submitted to a varimax-rotated factor analysis. In accordance with studies conducted with depressed samples, multi-dimensional solutions suggesting three to six factors emerged. Subsequent confirmatory factor analysis revealed satisfactory fit indices for a four-factorial solution comprising core depressive symptoms, sleep disturbance, anxiety and gastrointestinal problems. Aggression-related obsessions as well as the overall severity of obsessions were related to core depressive symptoms. Anxiety symptoms were associated with excessive rituals. Greater recognition of depressive sub-components may help to raise the replicability of empirical findings in OCD research as there is evidence from both depression and OCD samples that distinct depressive syndromes have different biological correlates.

Adult↗

PubMed2004

Positive schizotypal symptoms predict treatment outcome in obsessive-compulsive disorder.

Previous research has suggested that the presence of schizotypal personality disorder may represent a risk factor for treatment failure in obsessive-compulsive disorder (OCD). Relying on a dimensional approach, the present study investigated whether the predictive importance of schizotypal personality is shared by all of its features to the same extent or whether it is confined to a subset of symptoms. Fifty-three patients underwent multi-modal cognitive-behavioral therapy with or without adjunctive antidepressive medication. Therapy response was defined as a 35% decline of the Y-BOCS total score. At baseline assessment, patients were asked to fill out the schizotypal personality questionnaire, the perceptual aberration scale and the Beck depression inventory. Stepwise regression analysis and group comparisons conducted with the schizotypal and depression scales revealed that elevated scores in the positive schizotypal scales, especially perceptual aberrations, were highly predictive for treatment failure. Responders to treatment and non-responders did not significantly differ on other variables or on scores in two scales which measured response biases. The study provides evidence that positive schizotypal symptoms are antecendents for treatment failure in OCD. It needs to be evaluated whether these at-risk individuals benefit from additional intervention, such as the adminstration of low-dose atypical neuroleptics and specifically tailored behavorial intervention.

Adult↗

PubMed2004

Examination of emotional Stroop interference in obsessive-compulsive disorder.

Previous research has produced conflicting findings on whether or not patients with subclinical or manifest obsessive-compulsive disorder (OCD) share an attentional bias for anxiety-related material. In the present study, 35 OCD patients were compared with 20 healthy controls on their performance in an emotional Stroop paradigm. Nine different stimulus conditions were compiled, including sets for depression-related and anxiety-related words as well as stimuli from two constructs with a potential relevance for the pathogenesis and maintenance of OCD symptomatology: responsibility and conscientiousness. Patients did not show enhanced interference for any of the conditions. Syndrome subtype and severity, avoidance and speed of information processing did not moderate results. The present study concurs with most prior research that OCD patients display no interference effect for general threat words. It deserves further consideration, that emotional interference effects in OCD as seen in other anxiety disorders occur when using idiosyncratic word material with a direct relation to the individual's primary concerns.

Adult↗

PubMed2004

Memory and attention performance in psychiatric patients: lack of correspondence between clinician-rated and patient-rated functioning with neuropsychological test results.

In the present study, the correspondence between clinician-assessed and self-reported neurocognitive performance was contrasted with scores obtained from psychometric neuropsychological tests in 148 psychiatric in-patients. Results revealed that self-reported cognitive functioning was strongly associated with depressive symptomatology but was only poorly related to psychometric neurocognitive performance, particularly in schizophrenia. After illness denial was controlled for, the overall association between subjective and objective test performance was slightly increased but still failed to reach significance in six out of eight analyses. In approximately 20% to 40% of all cases, clinicians judged memory performance to be normal despite substantial impairment revealed by neuropsychological test results (attention parameters: 7-51%). Since (ecological) validity and reliability have been demonstrated for many neurocognitive paradigms, the present results question the validity of non-psychometric neurocognitive assessment and call for a complementation of clinical judgment with neurocognitive assessment. Reasons for decreased sensitivity of self-reported and clinician-assessed neurocognitive functioning are discussed.

Adult↗

PubMed2004

False memories in schizophrenia.

In prior studies, it was observed that patients with schizophrenia show abnormally high knowledge corruption (i.e., high-confident errors expressed as a percentage of all high-confident responses were increased for schizophrenic patients relative to controls). The authors examined the conditions under which excessive knowledge corruption occurred using the Deese-Roediger-McDermott paradigm. Whereas knowledge corruption in schizophrenia was significantly greater for false-negative errors relative to controls, no group difference occurred for false-positive errors. The groups showed a comparable high degree of confidence for false-positive recognition of critical lure items. Similar to findings collected in elderly participants, patients, but not controls, showed a strong positive correlation between the number of recognized studied items and false-positive recognition of the critical lure.

Adolescent↗

PubMed2004

Material-specific episodic memory associates of the psychomotor poverty syndrome in schizophrenia.

INTRODUCTION: Episodic memory deficits consistently correlate with the presence of negative symptoms in schizophrenia, suggesting overlap between the underlying neural systems. Functional neuroimaging and lesion studies suggest that prefrontal hypoactivity may underlie both. The purpose of the present study was to further characterise this association in terms of functional lateralisation. A more pronounced association between psychomotor poverty and verbal memory deficits would suggest more left prefrontal overlap than right, and vice-versa for a more pronounced association with nonverbal memory deficits. METHODS: A total of 68 inpatients (48 males, 20 females) diagnosed with schizophrenia or schizoaffective disorder participated in this study. We evaluated the correlation between verbal and nonverbal memory performance (assessed using the RAVLT and BVMT, respectively) and psychomotor poverty (assessed using the SSPI). RESULTS: A trend towards a more pronounced association for nonverbal compared to verbal material was not upheld by conservative statistical testing. CONCLUSIONS: Bilateral prefrontal overlap between psychomotor poverty and episodic memory is the most conservative interpretation of these data.

Journal Article↗

PubMed2004

Task switching and backward inhibition in obsessive-compulsive disorder.

The presumed involvement of the prefrontal cortex in the pathogenesis of obsessive-compulsive disorder (OCD) has fueled growing interest in cognitive paradigms with a putative sensitivity to this brain region. Measures of inhibition and executive functioning are thought to be promising in this regard. To our knowledge, this is the first study that has investigated task switching in OCD captures an important aspect of a paradigm that executive control, namely the preparation for an upcoming task. It was speculated that task switching costs would be enhanced in OCD patients, reflecting a fundamental deficit to quickly control the stream of thoughts. In addition, the paradigm allowed the measurement of backward inhibition, that is the time costs afforded for the re-engagement of a previously irrelevant task. A sample of 40 OCD patients, 20 psychiatric controls with anxiety disorders other than OCD as well as 20 healthy controls was investigated. Contrary to expectation, task switching costs were not elevated in OCD patients. Although anxiety control patients failed to display robust backward inhibition, group comparisons did not reach significance. Implications for future research are discussed.

Adult↗

PubMed2004

Reduced negative priming in schizotypy: failure to replicate.

OBJECTIVE: The aim of the present study was to investigate the association of negative priming and schizotypal personality using a Stroop-version of the paradigm. METHODS: Negative priming was determined for 160 healthy participants. Schizotypal symptoms were assessed with several schizotypal scales. RESULTS: No significant relationship emerged between any of the schizotypal scales and negative priming. CONCLUSIONS: It is inferred that negative priming is undisturbed in schizophrenia and schizotypy when unmasked negative priming tasks are employed. Reduced negative priming in previous studies may represent an epi-phenomenon of short prime presentation times and backward masking.

Adult↗

PubMed2003

Methodological considerations regarding the association of Stroop and verbal fluency performance with the symptoms of schizophrenia.

Previous research on schizophrenia has reported conflicting findings regarding the association between Stroop performance and the disorganization syndrome, as well as performance on verbal fluency tests and the psychomotor poverty syndrome. In the present work, we consider whether these inconsistencies may be increased due to variations in test format and failures to report the appropriate test parameters. In 36 schizophrenic inpatients, we administered list and single-trial versions of the Stroop test, and report the correlation with the disorganization syndrome for both errors and speed. For verbal fluency, we separated the total score into measures of switching and clustering, and observed the relationship with psychomotor poverty. For both versions of the Stroop test, accuracy, but not speed, was correlated with disorganization. For verbal fluency, decreased cluster production relative to total words generated was associated with psychomotor poverty, but the number of switches between clusters was not. It is suggested that assessing and reporting a full range of test parameters can reduce between-study inconsistencies. Cognitive interpretations for the present set of results are discussed.

Adult↗