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Concurrent validity of the cognitive component of schizophrenia: relationship of PANSS scores to neuropsychological assessments.

Cognitive symptoms of schizophrenia may represent a separate component of the disorder that is distinct from positive or negative syndromes. In a previous study, we reported a factor analysis of the Positive and Negative Syndrome Scale (PANSS) that revealed five components, one of which we labeled the Cognitive component. In the present study, we explored the validity of the PANSS Cognitive component by examining correlations between neuropsychological measures and the five factor-analytically derived PANSS scores for 147 subjects with diagnoses of schizophrenia or schizoaffective disorder. Higher scores on the PANSS Cognitive component were significantly correlated with poorer performance on all neuropsychological tests, including the Wisconsin Card Sorting Test (WCST), the Digit Symbol Substitution Task, the Slosson Intelligence Test, and the Gorham Proverbs Test. Multiple regression revealed that these test scores explained 37% of the variance in the Cognitive component score. Neuropsychological tests have very limited associations with the other PANSS components. These results suggest that the Cognitive component of the PANSS is a valid measure of cognitive deficits in schizophrenia, and they support the hypothesis that Cognitive impairment is a distinctive feature of schizophrenia independent of positive and negative syndromes.

Adult↗

Long-term neurodevelopmental outcome of 167 children after intrauterine laser treatment for severe twin-twin transfusion syndrome.

OBJECTIVE: This study was undertaken to investigate long-term neurodevelopmental outcome of children born after intrauterine laser coagulation for severe twin-twin transfusion syndrome. STUDY DESIGN: One hundred sixty-seven surviving infants treated between June 1997 and September 1999 were investigated at a median age of 3 years and 2 months. All children underwent a detailed standardized physical and neurologic examination and a standardized developmental test (Griffiths' Developmental Test Scales and Snijders-Oomen Non-Verbal-Intelligence Test). RESULTS: One hundred forty-five infants (86.8%) showed normal development, 12 infants (7.2%) showed minor neurologic abnormalities, and 10 infants (6.0%) major neurologic abnormalities. There was no difference in outcome for the former donors/recipients (P = .349) and between infants who were born as twins or singletons (P = .088). CONCLUSION: With a high rate (86.8%) of normal neurodevelopmental outcome and an incidence of only 6.0% of major neurologic deficiencies, intrauterine laser coagulation seems to be the best treatment option for severe twin-twin transfusion syndrome.

Child Development↗

The person who outperforms me is a genius: maintaining perceived competence in upward social comparison.

People have many ways of protecting themselves against unfavorable social comparisons. Sometimes, however, the unfavorableness of a comparison is too unambiguous to deny. In such circumstances, people may indirectly protect their self-images by exaggerating the ability of those who outperform them. Aggrandizing the outperformer is conceived to be a construal mechanism that permits inferior performers to deflect the self-esteem threat of being outperformed while maintaining believability. The tendency to exaggerate an outperformer's ability was demonstrated in a context in which subjects learned they had been outperformed by a confederate on a perceptual intelligence test. Subjects' and observers' ratings of the confederate's intelligence showed that subjects consistently rated the confederate more favorably than did observers. Using a similar methodology in which subjects outperformed confederates, another study showed that subjects exaggerated the ability of the people they outperformed. The conditions in which these effects are most likely to be obtained are discussed.

Achievement↗

Working memory and intelligence: the same or different constructs?

Several investigators have claimed over the past decade that working memory (WM) and general intelligence (g) are identical, or nearly identical, constructs, from an individual-differences perspective. Although memory measures are commonly included in intelligence tests, and memory abilities are included in theories of intelligence, the identity between WM and intelligence has not been evaluated comprehensively. The authors conducted a meta-analysis of 86 samples that relate WM to intelligence. The average correlation between true-score estimates of WM and g is substantially less than unity (p=.479). The authors also focus on the distinction between short-term memory and WM with respect to intelligence with a supplemental meta-analysis. The authors discuss how consideration of psychometric and theoretical perspectives better informs the discussion of WM-intelligence relations.

Aged↗

Intellectual outcomes of patients with congenital hypothyroidism not detected by neonatal screening.

Mental retardation is a major sequela of delayed treatment of congenital hypothyroidism. In this study, we investigated the intellectual outcomes of patients with congenital hypothyroidism diagnosed before a nationwide screening project started. Eighty-two patients had intelligence tests done while in the euthyroid state. Their mean intelligence quotient (IQ) was 78 +/- 21 (+/- SD) (n = 79). The mean verbal IQ was significantly higher than the mean full-scale IQ. The mean IQs of both ectopic thyroid (84 +/- 21, n = 28) and dyshormonogenic patients (85 +/- 14, n = 18) were significantly higher than that of patients with athyrosis (64 +/- 18, n = 19) (p < 0.05). Patients who were treated before 3 months of age had significantly higher mean IQs (90 +/- 16, n = 16) than those treated after 3 months (75 +/- 21, n = 63) (p < 0.01). Our results confirm that both patients with ectopic thyroids and those with dyshormonogenesis have better intellectual outcomes than athyrotic patients do, and that early treatment improves the intellectual outcome of patients with congenital hypothyroidism.

Adolescent↗

Reliability and validity of a measure of emotional intelligence in an Iranian sample.

The purpose of this study was to investigate the reliability and validity of the Mayer-Salovey-Caruso Emotional Intelligence Test, Version 2.0, in the Iranian culture. The sample included 353 students (168 male, 185 female) from senior high schools in Shiraz, ranging in age between 16 and 18 years (M=17.1), SD=.5), and 394 students (113 male, 281 female) from Shiraz University, ranging in age between 19 and 25 years (M=21.3, SD= 1.7). The subscale-total score correlations were in the upper fifties. Cronbach coefficient alpha was .86 for the full score and ranged from .58 to .86 for the 4 subscales of the test. The factor analysis supported 1- and 2-factor solutions of the emotional intelligence domain. The results generally supported the reliability of the test at the total score level for research in the Iranian culture.

Adolescent↗

A long-term study with co-dergocrine mesylate (Hydergine) in healthy pensioners. Results after 3 years.

Started in 1976, a long-term study in healthy pensioners is now in progress in Basel, Switzerland, to investigate medical, psychological, and electrophysiological aspects of the normal aging process and to establish whether these can be influenced by drug treatment. The subjects are receiving co-dergocrine mesylate (Hydergine) 1.5 three times daily or placebo orally under double-blind conditions. At 1-year intervals each subject's case history is reviewed, a clinical examination and laboratory tests are carried out, an ECG and an EEG are recorded, and a shortened form of the Hamburg-Wechsler Intelligence Test for Adults (German version of the WAIS, i.e., the Wechsler Adult Intelligence Scale), the Raven Coloured Progressive Matrices Test, and the Maudsley Personality Inventory are administered. Treatment compliance is being monitored by pill counting and determination of drug plasma levels. The results after 3 years of the study are presented. The subjects included in this evaluation are those who have undergone all examinations under double-blind conditions (n = 99). During the 3-year period, 27 of the 148 subjects (64 women and 84 men, mean age 63 years) initially recruited for the study have withdrawn, mainly because serious illness has supervened. Three subjects in the placebo group and 1 in the co-dergocrine mesylate group have died. The double-blind code has been broken for medical reasons in 18 cases; these subjects have continued to participate under open conditions. During this 3-year period, the following changes have been observed: A slight but statistically significant rise in systolic and diastolic blood pressure in the sample as a whole (mean increase 12 mm Hg). A decrease in systolic blood pressure in subjects with high initial values (mean decrease 6 mm Hg in the placebo group, and 18 mm Hg in the co-dergocrine mesylate group). An increase in systolic blood pressure in subjects with low initial values (mean increase 17 mm Hg in the placebo group and 16 mm Hg in the co-dergocrine mesylate group). A significant decrease in pulse rate in all subjects (mean decrease 7 beats/min). An increase in the number of subjects with pathological ECGs. A significant decrease in mean serum creatinine and lipid levels (all subjects) and a decrease of about 70% in the number of subjects with pathologically raised values. A decrease in the number of subjects from both groups with pathological signs in the EEG.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

Pediatric otolaryngological relations of velopharyngeal insufficiency.

On the basis of his examinations, the author presents data and gives his opinion on the classification, etiopathogenesis, diagnostics, phonosurgery, and therapy of the otological complications of velopharyngeal insufficiency (VPI). VPI may be organic or functional, produced by congenital or acquired causes, due to paresis or local disorders, but most frequently occurs as a result of cleft palate. Usually, diagnosis is evident; however, the verification of the milder cases of anatomic disproportion and/or muscular dysfunction is sometimes difficult. For the examination of dubious cases the author suggests, apart from the well-known methods (auditive evaluation, function tests, nasopharyngoscopy, velopharyngometry, supersound, X-ray, manometric measurements, speech intelligibility tests, acoustic analyses, etc.), electrophysiological and enzyme-histochemical measurements. Careful examination is most important, also on account of the possible indication of phonosurgery. An operation is to be proposed when a progressive neuro-myogenic process can thus be excluded, or when logopedic treatment is hopeless. The author has done 500 flap operations (as well as 2500 cleft palate and cleft lip ones) in the course of 30 years with a 98% result of anatomical healing. According to the pathological situation he employed 10 variants of the operation. As a result, hyperrhinophony ceased or became minimal in 90% of the cases; speech intelligibility was judged good or excellent in 74%. Functional effects can be influenced by the following: the width of the flap, the functional ability of the pharyngeal muscles, the cause of VPI, the patient's age, and the state of ears and hearing. In case of VPI otological and audiological examinations are routinely required. The author considers adenoidectomy and grommet-insertion to be alternative methods. One of the most important factors in achieving good results is teamwork, which the author discusses on the basis of the model developed at the Heim Pál Hospital for Sick Children, Budapest.

Adolescent↗

Listening and language at 4 years of age: effects of early otitis media.

The effect of early otitis media on preschoolers' listening and language abilities was examined in a cohort of prospectively followed children. At 4 years of age, children considered otitis negative and otitis positive during the first year of life were examined using a speech-in-competition task and several standardized measures of language and cognitive function. An adaptive test procedure was used, with sentence materials from the Pediatric Speech Intelligibility Test (PSI) (Jerger & Jerger, 1984). Results indicated that children with positive histories of otitis media during the first year required a more advantageous signal-to-competition ratio to perform at 50% sentence intelligibility than did their otitis-negative peers. There was no interaction between birth status (high-risk or full-term) and adaptive PSI listening task outcome. No differences between the groups were found in either receptive or expressive language abilities or in cognitive abilities. Further, there was no relationship between any language or cognitive measure and the adaptive PSI result.

Child, Preschool↗

Identifying and separating the effects of practice and of cognitive ageing during a large longitudinal study of elderly community residents.

In protracted longitudinal studies of cognitive changes in old age volunteers must be repeatedly tested. Even with intervals of several years between assessment, this raises the possibility that improvements due to practice mask other changes. This problem is much more acute in brief studies of cognitive changes associated with progressive pathologies such as Alzheimer's disease or the effects of clinical interventions. Both types of study also encounter problems of selective dropout of frail and less able individuals leaving relatively 'elite' survivors. An analysis of data from repeated testing at 2-3 years intervals on the AH4 (1) intelligence test is presented to illustrate how a random effects model can be used to identify and disassociate age-related changes and practice effects at the population level, after effects of selective dropout and of background demographical variables have been taken into consideration. This analysis also provides some new, substantive empirical findings. Age-related changes are relatively slight between 49 and 70 years but much more marked between 70 and 80 years. Even with assessment points, several years apart the population average effect of practice is large relative to that of age-related change. Variation between individuals increases as samples age, providing the first clear evidence from a longitudinal study for marked individual differences in trajectories of cognitive ageing.

Age Factors↗

Parathyroidectomy improves concentration and retentiveness in patients with primary hyperparathyroidism.

BACKGROUND: Many patients with primary hyperparathyroidism (PHPT) show symptoms of hypercalcemia syndrome, including psychologic and psychiatric disorders. The aim of this study was to find out whether parathyroidectomy improves cognitive performance with regard to concentration and retentiveness in patients with PHPT. METHODS: . Twenty patients with PHPT underwent psychologic testing preoperatively as well as 6 and 12 weeks postoperatively. Concentration under stress (timing) was proved by the d2-Test of Attention. To evaluate retentiveness, parts of the Wilde Intelligence Test were used. Patients were tested under identical circumstances with regard to time, location, and tester to minimize exterior influences. RESULTS: The patients' concentration enhanced significantly postoperatively (P <.001). The same applied to the total number of items processed (P <.01). Improvement of patients' ability to memorize numbers reached statistical significance when comparing the preoperative with the postoperative result (P =.0396); furthermore, there was a tendency to perform the tests more carefully and accurately (P =.069). CONCLUSIONS: Parathyroidectomy not only betters physical symptoms of PHPT but can also positively influence the patients' cognitive performance. These findings reflect the clinical observation of the patients' improved mental capacity after parathyroidectomy.

Adult↗

Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials.

OBJECTIVE: To evaluate the effect of iron supplementation on mental and motor development in children through a systematic review of randomised controlled trials (RCTs). DATA SOURCES: Electronic databases, personal files, hand search of reviews, bibliographies of books, abstracts and proceedings of international conferences. REVIEW METHODS: RCTs with interventions that included oral or parenteral iron supplementation, fortified formula milk or cereals were evaluated. The outcomes studied were mental and motor development scores and various individual development tests employed, including Bayley mental and psychomotor development indices and intelligence quotient. RESULTS: The pooled estimate (random effects model) of mental development score standardised mean difference (SMD) was 0.30 (95% confidence interval (CI) 0.15 to 0.46, P<0.001; P<0.001 for heterogeneity). Initial anaemia and iron-deficiency anaemia were significant explanatory variables for heterogeneity. The pooled estimate of Bayley Mental Development Index (weighted mean difference) in younger children (<27 months old) was 0.95 (95% CI -0.56 to 2.46, P=0.22; P=0.016 for heterogeneity). For intelligence quotient scores (> or =8 years age), the pooled SMD was 0.41 (95% CI 0.20 to 0.62, P<0.001; P=0.07 for heterogeneity). There was no effect of iron supplementation on motor development score (SMD 0.09, 95% CI -0.08 to 0.26, P=0.28; P=0.028 for heterogeneity). CONCLUSIONS: Iron supplementation improves mental development score modestly. This effect is particularly apparent for intelligence tests above 7 years of age and in initially anaemic or iron-deficient anaemic subjects. There is no convincing evidence that iron treatment has an effect on mental development in children below 27 months of age or on motor development.

Adolescent↗

Neuropsychological correlates of localized cerebral lesions in non-aphasic brain-damaged patients.

A neuropsychological test battery made up of verbal, visual-spatial, and intelligence tests was administered to 82 right and 67 on-aphasic left brain-damaged patients with localized cerebral lesions, in order to draw impairment profiles of the various subgroups. Separate analyses were undertaken on patients with unilobar and multilobar lesions. As for hemisphere effects, LH patients performed worse than RH subjects on verbal tests, while the reverse was true for visual-spatial tasks. As for lobe effects, patients with frontal lobe damage fared worse than other subgroups on word fluency, independent of the side of the lesion. RH patients with multilobar posterior lesions were significantly more impaired than other RH subgroups on the test of Copying Drawings with Landmarks, probably owing to the detrimental effect of unilateral spatial neglect on tasks requiring an accurate visual-spatial analysis.

Brain Damage, Chronic↗

Cognitive function, habitual gait speed, and late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999-2002.

BACKGROUND: Both cognitive function and gait speed are important correlates of disability. However, little is known about the combined effect of cognitive function and gait speed on multiple domains of disability as well as about the role of gait speed in the association between cognitive function and late-life disability. OBJECTIVE: To investigate (1) how cognition and habitual gait speed are related to late-life disability; (2) the role of habitual gait speed in the cognitiondisability association; and (3) the combined effect of cognitive function and habitual gait speed on late-life disability. METHOD: Participants (>60 years, n = 2,481) were from the National Health and Nutrition Examination Survey 1999-2002. Disability in activities of daily living (ADL), instrumental ADL (IADL), leisure and social activities (LSA), and lower extremity mobility (LEM) was obtained by self-report. Cognitive function was measured by a 2-min timed Digit Symbol Substitution Test (DSST), an executive function measure from the Wechsler Adult Intelligence Test. Habitual gait speed was obtained from a 20-foot timed walk. Multiple logistic regression was used to assess the association between cognitive function and disability. RESULTS: Cognitive function was associated with decreased likelihood for disability in each domain. The odds ratios (ORs) for disability in ADL, IADL, LSA, and LEM for each standard deviation (SD) increase in the DSST score were 0.47 (95% confidence interval [CI] = 0.34-0.64), 0.53 (95% CI = 0.42-0.67), 0.61 (95% CI = 0.47-0.79), and 0.73 (95% CI = 0.61-0.86), respectively, in the multi-variable models. After additional adjustment for habitual gait speed in the cognition-disability relationship, DSST score was no longer a significant correlate for LSA and LEM disability. The strength of the association between DSST score and disability in ADL/IADL was also diminished. The attenuated association between cognition and disability implies that limitation in gait speed likely mediates the association between cognitive function and disability. We found additive effects of cognition and habitual gait speed on late-life disability. The OR of disability in respective domains were lowest among participants with high-DSST score (high executive function) and with high gait speed. In contrast, the OR tended to be highest among participants with low-DSST score (low executive function) and low gait speed. CONCLUSION: Cognitive function was associated with multiple domains of disability. There was a joint effect of cognitive function and gait speed on late-life disability. This study also suggested that habitual gait speed partially mediated the inverse association between cognitive function and late-life disability, providing a mechanistic explanation in the context of disablement process.

Activities of Daily Living↗

[Socio-psychological aspects in marriages of alcoholic women].

In a controlled study during two years we have collected psychological and sociological data on partners of chronic female alcoholics by making use of a semistandardized interview (80 items were evaluated by program Dial and the input scales of Spitzer and his decision logic), of the Freiburger-Persönlichkeits-Inventar (FPI) and of the Hawie-Dahl-test, a German abbreviated version of the Wechsler-Bellevue-Intelligence-test. Furthermore we investigated the interpersonal perception in the marriage of the female alcoholic by a semantic differential. The relatively small number of subjects and controls emphasizes the considerable problems as far to the methodial implications of such a study. Therefore we have to interpretate cautiously our results. We may plead for the hypothese, that the husband of the chronic female alcoholic already from the beginning of the marriage had fifficulties in the realisation of his male role and beyond this that the partnership of the chronic female alchoholic is evidently disturbed by distortion of the interpersonal perception. Finally the interpretation of our results is disucssed with regard to the special approach of examination.

Alcoholism↗

Concurrent validity of the Test of Nonverbal Intelligence with referred suburban and Canadian native children.

The relationship between the Test of Nonverbal Intelligence (TONI) and the WISC-R was investigated for cultural differences. The samples consisted of 30 suburban and 22 Native children who were referred for learning difficulties. The results indicated the suburban group was higher than the Native group on Verbal IQ, but not Performance IQ, Full Scale IQ, or the TONI Quotient. The correlation coefficient between the TONI Quotient and PIQ was as expected in the Native group, but unexpectedly low in the suburban group. Implications of these findings for the testing of both referred majority and Native group members are discussed.

Child↗

Inbreeding studies in Brasilian schoolchildren.

We present results of comparisons between consanguineous and control couples and their children in Southern Brasil. Multiple regression, t-test and chi 2 analyses were applied to the data. The following variables were investigated; Parents: structure of first cousin marriages, latitude and longitude of birthplaces, cohabitation time, rurality, marriage age, occupation, number of liveborn children, and frequency of twinning. Schoolchildren: clinical data as classified into 24 discontinuous traits, each one subdivided into two categories (number and severity), and seven continuous traits (weight, height, pulse rate, respiratory rate, systolic pressure, diastolic pressure, and temperature); nutrition indices and biotype; family names; intelligence tests and school performance; birth order, age, hair color, hair type, eye color, and skin color; twinning in the sibship, and infant mortality among sibs of the propositi. Our study showed a) nonrandomness of consanguineous marriages as detected on structural, racial, geographical, and temporal levels; b) a heavy mutational load of about 1.5 lethons acting on infant mortality; c) no inbreeding effect on morbidity in general (with a possible exception of "ear morbidity", including hearing deficit); d) a modest inbreeding depression on height (a decrease of 2 cm with an increase of 10% of inbreeding); 3) a suggestion of inbreeding depression on "intelligence".

Brazil↗

Cognitive correlates of ventricular enlargement and cerebral white matter lesions on magnetic resonance imaging. The Rotterdam Study.

BACKGROUND AND PURPOSE: Ventricular enlargement and white matter lesions are frequent findings on cerebral magnetic resonance imaging scans of elderly subjects. In demented subjects they seem related to the severity of the dementia, but in nondemented subjects their clinical significance is less clear. We investigated the relation of size of the lateral ventricles and white matter lesions with cognitive function in a population-based random sample of nondemented elderly persons. METHODS: The study population consisted of 90 subjects, aged 65 to 84 years, who were randomly selected from the cohort of the Rotterdam Study, and who were not demented. The presence of white matter lesions and the ventricle-to-brain ratio were assessed on magnetic resonance scans. Participants were tested with a neuropsychological battery that covered a broad range of cognitive functions. RESULTS: Ventricular enlargement and white matter lesions were both and independently associated with poorer performance on all tests. After adjustment for age and sex, ventricular enlargement was significantly associated with worse scores on tests assessing global cognitive function (Mini-Mental State Examination, P = .02; Groninger Intelligence Test, P = .01), memory (Word List Learning delayed recall, P = .03), and executive control functions (Stroop part II, P = .02; Trial Making Test B, P < .01); for white matter lesions the differences were significant for tests measuring executive control functions and mental speed (Trail Making Test A and B, P = .01 and P < .01, respectively; verbal fluency, P = .01), and memory (Word List Learning delayed recall, P = .04). CONCLUSIONS: This study suggests that white matter lesions are primarily related to impairment of subcorticofrontal functions, whereas enlargement of the lateral ventricles is associated with disturbances of cortical functions as well.

Age Factors↗