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[Aging and schizophrenia: the relation of age to clinical symptoms and cognitive functions in schizophrenia].

OBJECTIVE: The course of clinical symptoms and cognitive functions with aging in schizophrenia is still unclear. The aim of this study was to investigate the effects of age on psychopathological symptoms and cognitive functions in schizophrenia. METHOD: Forty-one patients with schizophrenia and 22 healthy subjects as a control group were included in the study. The relation of age to the severity of the symptoms and the cognitive functions were investigated in patients with schizophrenia. The age related variations in cognitive functions among patients and healthy subjects were analyzed by separating each group into young (18-34 years) and older (35-60 years) age groups. RESULTS: There was a negative correlation between age and positive scores of the Positive and Negative Syndrome Scale. Age was negatively correlated to the Digit Span Test in patients with schizophrenia and the Rey Verbal Learning and Memory Test and Controlled Word Association Test in healthy subjects. There was a significant age related difference between the two groups in the Controlled Word Association Test. CONCLUSION: The results of this study revealed that age had an influence on attention but not on any other domains in patients with schizophrenia, and on verbal learning-memory and verbal fluency in the control group. This might show a cognitive impairment that does not significantly change with aging in schizophrenia. This study also demonstrated an improvement in positive symptoms with aging.

Adolescent↗

Associative thinking in schizophrenia: a contextualist approach.

Explored the question of whether responses that appeared to be highly pathological on the basis of the word association test did indeed reflect an underlying aberrant associative process or whether the associations actually had a greater degree of meaning than was evident from the test (N = 60). Utilizing contextualist techniques designed by the authors, which were analogous to the word association test but yet measured schizophrenic associative thinking in specific contexts that more closely approximated natural language situations, the quality and purposiveness of the schizophrenics' associations were examined. The word association test technique was judged to be inadequate by itself to account for underlying associative processes involved in schizophrenic associative thought disorder. A majority of responses (70% schizophrenic, 81% nonschizophrenic) judged to be pathological on the basis of the word association test alone became meaningful in the context of a sentence created by the Ss to explain purposively their associations. The schizophrenics' experience of a stimulus word and consequent associations to that word became clearer when placed within an appropriate context (i.e., a sentence), rather than examined as isolated semantic features (as in the word association test).

Adult↗

Mayo's Older African Americans Normative Studies: norms for Boston Naming Test, Controlled Oral Word Association, Category Fluency, Animal Naming, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Test, and Judgment of Line Orientation.

Normative data for older African Americans are presented for several clinical neuropsychological measures, including Boston Naming Test, Controlled Oral Word Association, Category Fluency, Token Test, WRAT-3 Reading, Trail Making Test, Stroop Color and Word Test, and Judgment of Line Orientation. Age-adjusted norms were derived from a sample of 309 cognitively normal, community-dwelling individuals, aged 56 through 94, participating in Mayo's Older African Americans Normative Studies (MOAANS). Years of education were modelled on age-scaled scores to derive regression Equations that may be applied for further demographic correction. These data should enhance interpretation of individual test performances and facilitate analysis of neuropsychological profile patterns in older African American patients who present for dementia evaluations.

Black or African American↗

Evaluation of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

Patients expect to receive an anesthetic that prevents the formation of memories during the intraoperative period. Unfortunately, explicit memory formation occurs 40,000 times per year in the United States, while the incidence of implicit memory is thought to be greater. The purpose of the study was to evaluate the effectiveness of word associations as a reliable postoperative indicator of implicit memory formation during the intraoperative period. Forty-eight participants scheduled to undergo general anesthesia for an elective procedure were selected. During the administration of 0.77 +/- .18 microgram/kg per minute of remifentanyl and 0.31 +/- .04 end-tidal volume percent of sevoflurane in air/oxygen, word associations in the form of "Trivial Pursuit" (Hasbro, Inc, Pawtucket, RI) game statements were presented via headphones. Within 24 hours of surgery, each participant was given a postoperative word association test that included the experimental and control word associations. No reports of explicit memory were noted. The experimental word associations were correctly answered 19.3% of the time, while the control word associations were correctly answered 12.8% of the time (P = .014). The findings illustrated that the word association test in the form of Trivial Pursuit game statements/answers may serve as a reliable postoperative indicator of implicit memory formation during the intraoperative period.

Adult↗

The Word Association Implications Test.

Three experiments (N = 144 college students) tested and documented the relationship between incidental learning of diagnostic schemata with performance on the Word Association Implications Test (WAIT). Moreover, Experiment 1 showed that instruction in diagnostic cues did not improve WAIT scores, although an incentive did. Experiment 2 supported the "developing schemata" concept by showing that subjects need to interpret WAIT protocols before they can generate possible diagnostic clues. Experiment 3 showed that inductive reasoning and viewing the task as more play- and game-like (vs. work- and test-like) predicted WAIT scores over and above the influence of incidental learning of schemata, in sum, results suggest that an heuristic discovery-oriented approach is most successful in learning "to read between the lines" of word associations. Discussion addresses the value of heuristic versus algorithmic approaches to the learning of personality assessment.

Journal Article↗

Event-related potentials and neuropsychological tests in obsessive-compulsive disorder.

OBJECTIVE: Previous studies have provided evidence from event-related potentials (ERPs) and neuropsychological testing of abnormal cognitive processing in obsessive-compulsive disorder (OCD). The aim of this study was to further characterize the cognitive functions of the patients with OCD by utilizing ERPs and neuropsychological tests. METHODS: ERPs were recorded in a group of 31 drug-free OCD patients without depression and 30 normal controls following verbal auditory stimuli using an oddball paradigm. The specific neuropsychological tests administered to assess cognitive functions in all participants were the Stroop Test, Trail Making Test, Design Fluency Test, Controlled Word Association Test (Verbal Fluency test). RESULTS: The patient group showed shorter P300 duration compared to normal controls. In neuropsychological tests, no significant differences were found between the two groups. Negative correlations between Stroop duration and P300 amplitudes in occipital, parietal, and temporal anterior regions were observed. CONCLUSION: Shorter P300 duration may indicate an acceleration in the P300 process, and speeding of cognitive processing, dysfunction of cortico-subcortical circuits, or some combination of all of the above.

Adolescent↗

Assessment of changes in psychomotor performance of elderly subjects.

1. The repeatability of a computerised psychomotor test battery on a day-to-day and week-to-week basis was assessed by determining its test-retest reliability and variations in group-means and intraindividual psychomotor performance scores of elderly people. 2. Psychomotor performance was assessed in 50 well-screened elderly subjects (21 males, 29 females; mean age 70.4 +/- 5.0 (s.d.) years) on 5 consecutive days and over 4 weeks in standardised test conditions. 3. The psychomotor test battery consisted of computerised versions of symbol digit substitution test (SDST), continuous attention test (CAT), choice reaction time (CRT), critical flicker fusion test (CFFT), cognitive flexibility test (FLEX), paired word association test (PWAT) and inspection time (INSP). 4. Main outcome measures were test-retest reliability, group variability and intraindividual variability. 5. There was no significant variation in group-means for all components of the test battery over 5 days or 4 weeks on two way analysis of variance. The intraindividual coefficient of variation was low for SDST, CRT, CFFT, FLEX, PWAT and INSP during the period of assessment. Test retest reliability was greater than 0.8 for SDST, CAT, CRT and PWAT. 6. Tests in the Automated Psychomotor Test Battery are reliable and repeatable measures of psychomotor performance on a day-to-day and week-to-week basis.

Aged↗

Complex partial and secondarily generalized seizure patients: cognitive functioning prior to treatment with antiepileptic medication. VA Epilepsy Cooperative Study 264 Group.

This investigation of cognitive functioning in patients with symptomatic localization-related (partial) epilepsy prior to administration of antiepileptic medication is part of a nationwide prospective, double-blind study of drug efficacy and longitudinal changes in cognition associated with seizure disorders. Recently-diagnosed patients with complex partial or secondarily generalized tonic clonic seizures, equated for age, education and IQ, were compared with normal controls on a battery of neuropsychological tests: verbal and figural memory measures (Rey auditory verbal learning test, Rey Osterrieth complex figure), and a brief behavioral toxicity battery comprising measures of motor function, concentration and mental flexibility (Lafayette grooved pegboard, controlled word association test, Stroop, paced auditory serial addition test [PASAT]). Control subjects perform significantly better than both groups of seizure patients on several measures of motor speed/integration and memory, specifically the pegboard and the RAVLT learning (3-5) and recall trials. Secondarily generalized seizure patients show greatest impairment. They perform significantly worse than patients with complex partial seizures and control subjects on the controlled word association test and the most demanding Stroop color word trial, both measures of concentration and mental flexibility. These findings document deficits in memory as well as concentration and motor function in complex partial and in secondarily generalized seizure patients prior to treatment with antiepileptic medication.

Adult↗

Recognition memory and verbal fluency differentiate probable Alzheimer disease from subcortical ischemic vascular dementia.

BACKGROUND: Alzheimer disease (AD) and vascular dementia are among the most frequently occurring causes of dementia in the world, and their accurate differentiation is important because different pharmaceutical strategies may modify the course of each disease. OBJECTIVE: To determine which of 10 neuropsychological test scores can accurately differentiate patients with probable AD from those with subcortical ischemic vascular dementia (SIVD) for use in evidence-based clinical practice. DESIGN: Patients with suspected dementia were referred to the study by family physicians, geriatricians, and neurologists. All participants received a thorough assessment according to standard diagnostic guidelines. Diagnoses of probable AD (n = 31) and probable SIVD (n = 31) were made according to consensus criteria. The diagnosticians were blind to the results of the 10 neuropsychological test scores. RESULTS: There were no significant differences between the groups in age or Mini-Mental State Examination scores. Logistic regression analyses identified 2 neuropsychological tests that best distinguished the groups (sensitivity = 81%; specificity = 84%; positive likelihood ratio = 5.1). These were the recognition memory subtest of the Rey Auditory Verbal Learning Test and the Controlled Oral Word Association Test. The AD group performed better on the oral association test, whereas the SIVD group did better on the recognition memory test. CONCLUSION: Patients with probable AD and probable SIVD can be distinguished with a high degree of accuracy using these 2 neuropsychological tests.

Aged↗

Assessment of executive function in patients with mild traumatic brain injury.

BACKGROUND: The nature of functional deficit after mild traumatic brain injury (TBI) defined by Glasgow Coma Score of 13-15 is not fully described. This study explored the sensitivity of several neuropsychological tests to identify sequelae of mild traumatic brain injury (TBI). METHODS: Eleven adult patients with mild TBI admitted to a Level 1 trauma center were studied. The battery of tests included the Wechsler Intelligence Scale for Children -Revised: Mazes Subtest, Trails A and B, the Boston Naming Test, The Multilingual Aphasia Examination: Controlled Oral Word Association Test, and the Paced Auditory Serial Addition Task. RESULTS: Control subjects performed significantly better than patients with mild TBI on Trails A and B, the Controlled Oral Word Association Test, and Paced Auditory Serial Addition Task (subtests 2-4). No significant differences in performances between patients and controls was found for the Wechsler Intelligence Scale for Children -Revised: Mazes Subtest, Boston Naming Test, and Paced Auditory Serial Addition Task Subtest 1. CONCLUSION: The results suggest that tests of specific frontal lobe executive functions are valuable in diagnosing and monitoring recovery from mild TBI.

Adult↗

Mood-independent aberrancies in associative processes in bipolar affective disorder: an apparent stabilizing effect of lithium.

Forty-eight patients from an affective disorders clinic were tested twice with a word association test. They gave significantly fewer repetitions of common responses than did 29 normal controls. This difference was not related to subgroup diagnosis (bipolar I, bipolar II, unipolar, schizoaffective, and cyclothymic personality), to mood state at the time of testing, or to cycling frequency. The total number of repeated responses was directly correlated with serum lithium level (r = 0.44, p less than 0.01, especially in those judged good lithium responders (r = 0.71, p less than 0.05). This finding may reflect a normalizing effect of lithium on associative processes in affective illness.

Adult↗

Dysnomia in dementia and in stroke patients: different underlying cognitive deficits.

The performance of 11 Alzheimer's (DAT) and 8 anomic aphasic stroke patients is contrasted with that of 32 normal elderly subjects on both the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COW), a letter-category verbal-fluency test. While both tests require phonological processing, only the BNT requires semantic processing (object recognition). Both DAT and anomic aphasic stroke patients were significantly impaired on the BNT, with mean z scores (based on the performance of the normals) of -4.08 and -2.57, respectively; the DAT patients were significantly farther from normal than were the anomic aphasics. Their relative levels of impairment on the COW were reversed: The anomic aphasics' performance (z = 1.79) was worse than that of the DATs (z = -0.66). This pattern of performance on the two tests is consistent with the hypothesis that impaired word finding reflects impaired processing mainly of semantic information for the DAT subjects, mainly of lexical-phonological information for the anomic aphasic subjects.

Aged↗

Paired-associate learning and priming effects in amnesia: a neuropsychological study.

Despite severe deficits of recall and recognition, amnesic patients can exhibit normal priming effects. Amnesic patients have also been reported to perform well on tests of paired-associate learning that involve related word pairs (e.g., table-chair). The present study investigated the role of priming effects in paired-associate learning. Experiment 1 illustrated the distinction between the memory impairment of amnesic patients and their intact priming ability. Amnesic patients were markedly deficient in learning unrelated word pairs, despite exhibiting normal priming as measured by a word-completion test involving the same words. In Experiment 2A, amnesic patients showed good paired-associate learning for related word pairs, though control subjects still performed significantly better. In addition, the good performance by amnesic patients was short-lived, and performance fell to baseline after a 2-hr delay. Control subjects performed well above baseline at all delay conditions. Experiment 2B showed that the forgetting of related word pairs by amnesic patients followed the same time course as the decay of word priming. Experiment 3 showed that amnesic patients were as good as control subjects at learning related word pairs when incidental learning and test procedures were used (a word-association test). The advantage of control subjects over amnesic patients in Experiments 2A and 2B could therefore be attributed to the explicit learning instructions that are standard in paired-associate tests. Finally, Experiment 4 showed that amnesic patients exhibited normal priming when they were asked to "free associate" to words (e.g., child) that were semantically related to previously presented words (e.g., baby). The results indicate that both priming effects and paired-associate learning of related word pairs depend on activation, a process that is preserved in amnesia. Activation can account for the findings of good performance by amnesic patients on tests of word priming (Experiments 1 and 2B), related paired associates (Experiments 2A and 2B), and word association (Experiments 3 and 4). Activation is a transient phenomenon presumed to operate on and facilitate access to preexisting representations. Control subjects can establish new associations and can strengthen preexisting associations by engaging processes that are impaired in amnesia. As a result, when explicit learning instructions are used to test paired-associate learning of related word pairs, control subjects can learn better and can remember longer than can amnesic patients (Experiments 2A and 2B).(ABSTRACT TRUNCATED AT 400 WORDS)

Alcohol Amnestic Disorder↗

Lexical but not semantic priming in Alzheimer's disease.

The hypothesis that patients with Alzheimer's disease (AD) have a disturbance in semantic processing was tested using a new lexical-priming task, threshold oral reading. Healthy elderly controls showed significant effects of priming for word pairs that are associatively related (words that reliably co-occur in word association tests) and for word pairs that are semantically related (high-frequency exemplars that belong to the same superordinate category but are not high-frequency associates). AD patients showed effects of priming for associatively related words but not for word pairs that are related only by shared semantic features. These results are consistent with the hypothesis that semantic processing is impaired in AD and suggest that independent networks of relationships among words and among concepts in semantic memory may be differentially disrupted with various forms of brain damage.

Aged↗

Interactions among affect, cognition, and visuomotor coordination as measured in words and symbols.

The associative frequencies of responses to stimulus words during free and controlled forced-choice word-association tests correlate well with each other and with assessments of the affective character (emotional content) of the stimulus words for the test subjects (Osgood Index) for three samples of volunteer French undergraduate students (ns = 200, 64, and 72). These indices correlate negatively with the subjects' performance on Digit Symbol Substitution tests. Neisser's theory of schemata and Edelman's theory of neuronal group selection may provide insight into this relationship. If the associative frequency of a subject's response decreased, the affective content of the word stimulus (as perceived by the subject) diminished as well. This relationship was associated with a relatively higher score on Digit Symbol Substitution. Conversely, it was observed that subjects whose responses were characterized by high associative frequencies (whether the response was spontaneous or forced-choice) rated the stimulus words as having a relatively stronger affective content or emotional character and performed less well on Digit Symbol Substitution.

Adult↗

Relationships between verbal and nonverbal fluency measures: implications for assessment of executive functioning.

This experiment evaluated the relationship between verbal and nonverbal fluency measures commonly employed in neuropsychological assessment. Three fluency measures, the Controlled Oral Word Association Test, the Design Fluency Test, and the Ruff Figural Fluency Test, were administered to a sample of 61 men and 73 women in college. Analyses indicated that scores on the Controlled Oral Word Association Test were significantly correlated with scores on the Fixed but not the Free Condition of the Design Fluency Test. Scores on the Ruff test were significantly more closely correlated with the Fixed versus the Free Condition, although they were also correlated with the total scores on the Design Fluency Test. Differential correlations are discussed in terms of the varying structure inherent in the measures of fluency and their presumed taxing of frontally mediated executive processes.

Adolescent↗

Effects of personality and loss of anonymity on aggression: a reevaluation of deindividuation.

Zimbardo's deindividuation hypothesis was reexamined by individuating some subjects. Twelve four-person groups administered shock to a confederate in a 2 x 2 x 2 factorial design with two levels of social individuation (subjects' level of anonymity to group members), two levels of nonsocial individuation (subjects' opportunity to give identifying information to the experimenter on a word association test) and two levels of individual differences. It was found that subjects, who individuated themselves by giving information to the experimenter on the word association test showed more, not less, antisocial behavior. Furthermore, this increased antisocial behavior was exhibited only by externally oriented subjects: those with an external locus of control and a low mysticism score. Some of those more antisocial subjects were also more likely to report feeling like they stood out from the group. It was concluded that antisocial behavior in this paradigm may thus be a response to experimenter demand felt most strongly when subjects felt most identifiable.

Aggression↗