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PubMed2005

Daily depression and cognitions about stress: evidence for a traitlike depressogenic cognitive style and the prediction of depressive symptoms in a prospective daily diary study.

The authors examined the stability and dynamic structure of negative cognitions made to naturalistic stressors and the prediction of depressive symptoms in a daily diary study. Young adults reported on dispositional depression vulnerabilities at baseline, including a depressogenic cognitive style, dysfunctional attitudes, rumination, neuroticism, and initial depression, and then completed short diaries recording the inferences they made to the most negative event of the day along with their experience of depressive symptoms every day for 35 consecutive days. Daily cognitions about stressors exhibited moderate stability across time. A traitlike model, rather than a contextual one, explained this pattern of stability best. Hierarchical linear modeling analyses showed that individuals' dispositional depressogenic cognitive style, neuroticism, and their daily negative cognitions about stressors predicted fluctuations in daily depressive symptoms. Dispositional neuroticism and negative cognitive style interacted with daily negative cognitions in different ways to predict daily depressive symptoms.

Adolescent↗
PubMed2000

Cognitive complexity and cognitive-affective integration: related or separate domains of adult development?

This study used a latent variable approach to describe two broad domains of adult development and their interrelations. One domain was cognitive complexity, defined by crystallized intelligence, fluid intelligence, and reflective cognition: the other domain was cognitive-affective integration, operationalized in terms of integrated and defensive coping. It was hypothesized that these 2 domains are related to each other and that they imply different developmental correlates. Structural relations among the latent variables supported a model in which integrated coping showed positive relations with crystallized intelligence and reflective cognition, whereas defensive coping showed negative relations to these cognitive factors. Age and education were significant predictors of the cognitive complexity factors, whereas evaluations of the climate in one's current family and family of origin were related to the factors of cognitive-affective integration.

Adaptation, Psychological↗
PubMed2002

Self-reported driving, cognitive status, and physician awareness of cognitive impairment.

OBJECTIVES: To assess self-reported driving rates in older people and correlate these data with cognitive status and physician recognition of cognitive impairment. DESIGN: Cross-sectional study. SETTING: A multiphysician private practice clinic in a primarily Asian-American community of Honolulu, Hawaii. PARTICIPANTS: Two hundred ninety-seven ambulatory patients aged 65 and older. MEASUREMENTS: Cognitive function was assessed by physician interview using the Cognitive Abilities Screening Instrument (CASI) and proxy informant data. Subjects' self-reported driving status. Outpatient medical records were reviewed. RESULTS: Sixty percent of the studied population reported that they currently drove. This rate decreased from 73.3% (148/202) for subjects with good CASI performance (CASI 282) to 37.5% (21/56) for subjects with intermediate CASI performance (CASI 74-81.9) and further to 23.7% (9/38)for subjects with poor CASI performance (CASI <74). Further analysis of drivers with intermediate and poor CASI performance scores revealed that almost none of their physicians recognized that these drivers had cognitive problems(4.8% (1/21) of drivers with intermediate CASI performance and 11.1% (1/9) of drivers with poor CASI performance). CONCLUSION: In this convenience sample of older drivers, driving rates dropped precipitously with poorer performance on cognitive tests, yet a significant percentage of individuals with intermediate or poor cognitive test performance reported that they currently drove. This poor performance was often unrecognized by their physicians. Low recognition rates could affect physicians' interventions to curb unsafe driving.

Aged↗
PubMed2004

The cognitive impact of epileptiform EEG-discharges; relationship with type of cognitive task.

In this study we analyzed the effect of differing task dimensions (high vs. low information demand; short vs. long testing duration) on the occurrence of epileptiform EEG-discharges and the cognitive impact of such discharges. We performed this study only in patients with focal discharges as this appears to be the most complicated group to assess any relationship between epileptiform EEG-discharges and cognitive impairment. Seventeen patients with focal discharges in the EEG and an established diagnosis of localization-related (partial) epilepsy were included. The following tasks were used: Low information demand: auditory and visual RT; high information demand: BCRT and CVST. Short testing duration: Arithmetic and Reading; long testing duration: Vocabulary and Block Design. The percentage of patients with epileptiform EEG-discharge and EEG-related cognitive impact were compared using Chi-square testing. The occurrence of epileptiform EEG-discharges was not associated with one of the experimental conditions introduced in our study, that is, high/low information demand or short/long testing period. Also the difference between computerized reaction-time measurement and more traditional 'paper and pencil tasks' such as reading was not statistically significant. The only statistical significant difference was the more frequent occurrence of epileptiform EEG-discharges during tasks that used the visual input mode. In addition, we could identify one test that appeared to be particularly sensitive to direct cognitive effects of epileptiform EEG-discharges. Only for the CVST, the computerized visual searching task, the relationship with epilepsy-related cognitive impact is statistically significant. This test is the most mentally demanding test of the tests presented in our study and measures speed of visual information processing, using complex stimulus patterns and has a long testing duration. Our results do not confirm that any of the investigated task dimensions (high vs. low information demand; short vs. long testing duration) have a dominant effect on the occurrence of epileptiform EEG-discharges and the cognitive impact of such discharges. The effect found for the CVST suggest that three factors combined are necessary to assess the impact of epileptiform EEG-discharges on cognition: visual input mode, longer testing duration and high information processing demand.

Auditory Perception↗
PubMed2003

Long-term improvements in cognitive performance through computer-assisted cognitive training: a pilot study in a residential home for older people.

The aim of the present pilot study was to investigate the effects of computer-assisted cognitive training on aging-associated memory deficits, information processing speed, learning, and interference tendency in older people. Residents of a home for older people (15 women, four men; mean age 83.5; range 75-91) participated in a 14-week computer-assisted cognitive training program. The Niirnberg Aging Inventory and the California Verbal Learning Test were administered prior to the program, immediately after the program and after a period of five months to assess the effectiveness of the cognitive training. After the cognitive training program there were significant improvements in primary working memory and also secondary working memory (for verbal and visual stimuli), on parameters of information processing speed, learning and interference tendency. Improvements in the last two cognitive parameters were maintained five months after completion of the training program. The present study indicates that computerized cognitive training programs can be used in older people to achieve long-term improvements in some important aspects of fluid intelligence. It is suggested that computers could be employed more extensively to prevent and treat cognitive deficits in older people.

Aged↗
PubMed2006

Social cognition in nursing home residents with and without cognitive impairment.

Dementia affects the specific cognitive abilities underlying social functioning in ways that are just beginning to be understood. This pilot study compared the performances of 15 nursing home residents with cognitive impairment and 25 without cognitive impairment on a broad range of measures of social-cognitive functioning. The cognitively impaired group scored significantly lower than the unimpaired group on tests of face processing, person perception, and social reasoning but not on tests of affect recognition and the representation of social situations. Individuals' deficits in working memory and executive function did not fully account for their impaired performance on tests of social cognition. An improved understanding and assessment of the basic cognitive mechanisms underlying the ability of persons with dementia to interact with others would inform the design of interventions to optimize their social functioning.

Aged↗
PubMed2005

Social cognition in schizophrenia: recommendations from the measurement and treatment research to improve cognition in schizophrenia new approaches conference.

This article summarizes the discussion from a breakout group at the National Institute of Mental Health-Measurement and Treatment Research to Improve Cognition in Schizophrenia New Approaches Conference on social cognition in schizophrenia. During this discussion, the reasons for the recent growth of research on social cognition in schizophrenia were examined. The discussion group established consensus on several points, including the importance of viewing social cognition from interdisciplinary perspectives (including outcomes research, social psychology, cognitive psychology, cognitive neuroscience, and animal models) and the need for clearer definition of terms. There was also general agreement that social cognition is a valuable construct for understanding the nature and disability of schizophrenia. One of the objectives of this group was to generate recommendations for subsequent human and animal studies, and these research agendas are summarized in this report.

Animals↗
PubMed2002

The importance of cognitive self-report in early HIV-1 infection: validation of a cognitive functional status subscale.

BACKGROUND: The Medical Outcomes Study HIV (MOS-HIV) Health Survey is a widely used instrument to assess quality of life in HIV-1-infected individuals. Its cognitive functional status subscale measures functional status owing to neuropsychological (NP) impairment. OBJECTIVES: To determine the concurrent validity of the Dutch four-item MOS-HIV cognitive functional status subscale and its clinical significance in predicting NP test performance. DESIGN: Cross-sectional analysis of baseline data collected between October, 1994, and March, 1997, in the Netherlands and in Flanders, Belgium. SUBJECTS: A total of 85 HIV-1-infected homosexual men who participated in an ongoing longitudinal research project designed to study the effects of a support group. RESULTS: The MOS-HIV cognitive functional status subscale showed significant associations with NP test performance overall and, specifically, with the domains of abstraction, language and visuospatial abilities, controlling for CD4 cell count and Centers for Disease Control and Prevention (CDC) clinical disease stage. A trend toward significance was also found in the memory domain. CONCLUSIONS: To our knowledge, this is the first report of a cognitive functional status subscale used with HIV-1-infected subjects in a language other than English. The MOS-HIV cognitive functional status subscale seems particularly sensitive to changes in NP test performance in early HIV-1 infection. These results suggest the potential for clinical utility of a brief functional status self-report measure related to cognitive abilities in early HIV-1 infection for the screening and diagnosis of HIV-1 associated cognitive-motor disorders.

Adolescent↗
PubMed1993

A critique of research on cognition and cognitive processes.

In this article it is pointed out that there exists a methodological contradiction in most research on cognition and cognitive processes, which makes such research invalid in the strongest meaning of the term. When the aim is to study cognitive processes very often the researcher uses attributes of the learning material to be the standard or the template against which any outcome of the subjects can be analysed and made the ground for inferences about cognition and cognitive processes. This way of doing research is considered to be based on false theoretical assumptions and also proven invalid by a number of empirical studies. It is suggested in the article that the researcher must distinguish between an educational and a cognitive perspective and avoid mixing them in order to carry out successfully research on cognitive processes.

Child↗
PubMed1997

Duration of cognitive dysfunction after concussion, and cognitive dysfunction as a risk factor: a population study of young men.

OBJECTIVES: To establish how long cognitive dysfunction lasts after concussion, and the extent to which it may be a predisposing risk factor for concussion, by examining the prevalence of cognitive dysfunction among young men who have sustained concussion. DESIGN: Observational study. SETTING: Denmark. SUBJECTS: 1220 young men who had been admitted to hospital for concussion between the ages of 16 and 24 (identified in a national register of admissions) and who had also been cognitively tested by the Danish conscription draft board. MAIN OUTCOME MEASURE: Score on the draft board's cognitive screening test, dichotomised as dysfunctional or non-dysfunctional (20.4% of the general population of Danish men appearing before the draft board had a dysfunctional score). RESULTS: 700 of the 1220 men had been tested after sustaining concussion; 520 had been tested before concussion. Four (50%) of the eight men who were tested less than seven days after the injury had a dysfunctional score. Among groups of the remaining 692 men who were tested at later time points after injury, the rates were only marginally raised (range 21.4% to 26.5%) above the population level. Among men tested before injury, the rate of dysfunctional scores was higher (30.4% (158/520)). Apart from suggesting cognitive dysfunction as a risk factor for concussion, this higher proportion seems to relate to the fact that they were typically injured as young adults, whereas those men who were tested after concussion had more often been injured as adolescents. The relative risk for concussion in the presence of cognitive dysfunction is estimated to be 1.57 (95% confidence interval 1.32 to 1.86). CONCLUSIONS: Cognitive dysfunction is not only a short term consequence of concussion but also a predisposing risk factor for concussion, more so for young adults than for adolescents.

Adolescent↗
PubMed1994

Cognitive distortions and adolescent affective disorder. Validity of the CNCEQ in an inpatient sample. Children's Negative Cognitive Error Questionnaire.

Despite a proliferation of recent research examining childhood and adolescent depression, the area still lags behind the adult depression field, particularly in the investigation of cognitive correlates of affective psychopathology. To advance cognitive research with youth, the Children's Negative Cognitive Error Questionnaire (CNCEQ) was developed to provide a measure of cognitive distortions or errors in children and adolescents. Yet, few studies have employed the CNCEQ and no evidence exists supporting the validity of its four component cognitive error scales. The purpose of the present study was to examine the construct validity of the CNCEQ and its constituent scales through the use of factor analysis and criterion-group comparisons. Groups of adolescent psychiatric inpatients, diagnosed as affective or disruptive disordered, completed the CNCEQ following admission. Results failed to support the implicit four-factor structure of the CNCEQ, instead suggesting the appropriateness of a single-factor solution labeled "negative thinking." Despite no diagnostic group differences on the CNCEQ total or other scale scores, affective disordered patients evinced more cognitive errors on the Overgeneralizing scale. Findings suggest that the CNCEQ in its current stage of development holds promise, yet requires refinement to produce a valid measure of cognitive functioning in youth.

Adolescent↗
PubMed2005

Subjective cognitive complaints relate to mild impairment of cognition in multiple sclerosis.

Cognitive impairment is common in multiple sclerosis (MS), but cannot be reliably predicted by physical impairment. The negative impact of cognitive impairment makes early detection important, but subjective cognitive complaints may be attributed to depression. We examined the relationship between subjectively reported and objectively measured cognitive impairment in MS, adjusting for mood. A neuropsychological battery, the Multiple Sclerosis Functional Composite (MSFC), the Mental Health Inventory (MHI), the Modified Fatigue Impact Scale (MFIS), the Perceived Deficits Questionnaire (PDQ) were administered to 136 patients. Demographically-adjusted cognitive scores were calculated. Subjective impairment was defined as PDQ score >2 standard deviations above that for healthy persons. We modeled the relationship of cognitive scores (independent variables) to being subjectively impaired (dependent variable) using logistic regression. Immediate Memory (IM) and Processing Speed Index (PSI) scores were non-linearly related to subjective impairment Patients were less likely to report subjective impairment if their PSI was normal (OR =0.11; 0.02-0.73) or markedly impaired (OR =0.17; 0.03-0.91), compared to mildly reduced PSI. In young patients decreases in IM were associated with increased subjective impairment (OR = 1.25; 1.07-1.47). Subjectively reported impairment reflects subtle declines in PSI and IM independent of mood, fatigue, and physical impairment Cognitive complaints should not be discounted due to depression.

Adult↗
PubMed2005

Cognitive and adaptive outcome in low-grade pediatric cerebellar astrocytomas: evidence of diminished cognitive and adaptive functioning in National Collaborative Research Studies (CCG 9891/POG 9130).

PURPOSE: Clinicians often assume that children with posterior fossa tumors are at minimal risk for cognitive or adaptive deficits if they do not undergo cranial irradiation. However, small case series have called that assumption into question, and have also suggested that nonirradiated cerebellar tumors can cause location-specific cognitive and adaptive impairment. This study (1) assessed whether resected but not irradiated pediatric cerebellar tumors are associated with cognitive and adaptive functioning deficits, and (2) examined the effect of tumor location and medical complications on cognitive and adaptive functioning. PATIENTS AND METHODS: The sample was composed of 103 children aged 3 to 18 years with low-grade cerebellar astrocytomas, who underwent only surgical treatment as part of Children's Cancer Group protocol 9891 or Pediatric Oncology Group protocol 9130. The sample was divided into three groups based on primary tumor location: vermis, left hemisphere, or right hemisphere. Data were collected prospectively on intelligence, academic achievement, adaptive skills, behavioral functioning, and pre-, peri-, and postsurgical medical complications. RESULTS: The sample as a whole displayed an elevated risk for cognitive and adaptive impairment that was not associated consistently with medical complications. Within this group of children with cerebellar tumors, tumor location had little effect on cognitive, adaptive, or medical outcome. CONCLUSION: We did not replicate previous findings of location-specific effects on cognitive or adaptive outcome. However, the elevated risk of deficits in this population runs contrary to clinical lore, and suggests that clinicians should attend to the functional outcomes of children who undergo only surgical treatment for cerebellar tumors.

Adaptation, Psychological↗
PubMed2005

Cognitive processes in the reflective-impulsive cognitive style.

In this study, the authors improved the understanding of the cognitive processes underlying the reflective-impulsive cognitive style (RI), which was initially measured by J. Kagan, B. L. Rosman, D. Day, J. Albert, and W. Phillips (1964) on the Matching Familiar Figures Test (MFFT). The authors determined the relationships between the RI style and the cognitive factors, which would be likely to explain different MFFT solving modes-field dependence or independence as a cognitive style, the g factor, the spatial factor, and a metacognitive control index, which the authors developed for this study. The hypotheses were largely based on various studies (J. P. Ancillotti, 1984, 1985; J. Kagan, B. L. Rosman, D. Day, J. Albert, & W. Phillips, 1964; T. Zelniker & W. E. Jeffrey, 1976; T. Zelniker, A. Renan, I. Sorer, & Y. Shavit, 1977). The results are presented separately for each of four groups: (a) reflective individuals, who implement an analytic process and are cognitively mature; (b) impulsive individuals, who use a holistic process and are cognitively immature; (c) fast-accurate individuals, who are capable of implementing both analytic and holistic processes and exhibit cognitive maturity; and (d) slow-inaccurate individuals, who exhibit good metacognitive control but have trouble implementing both types of processing.

Adolescent↗
PubMed1999

The role of maternal cognitions in infant sleep problems as assessed by a new instrument, the maternal cognitions about infant sleep questionnaire.

Sleeping problems in young children are very common, affecting up to 20% of 1-year-olds. Behaviour therapy is the most widely recognised treatment but a significant proportion of parents find it aversive. This suggests that parental cognitions may be important and underevaluated. The aims of this study were therefore fourfold: (1) to describe the development of a new tool to measure maternal cognitions in relation to infant sleeping problems, the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ): (2) to assess the psychometric properties of the MCISQ; (3) to test the hypothesis that maternal cognitions will be associated with, and specific to, infant sleep problems; and (4) to discuss the implications of the findings with respect to aetiological models of infant sleep problems, treatment, and future research. Results showed that maternal cognitions about setting limits, anger at the infant's demands, and doubts about parenting competence were significantly associated with infant sleep problems, whereas cognitions about infant hunger or cot death were not. It is hypothesised that these cognitive responses, if extreme, may disrupt sensitive parent-child interactions, which over time could lead to impairments in the development of infant self-regulation.

Adult↗
PubMed1993

Imipramine is effective after unsuccessful cognitive therapy: sequential use of cognitive therapy and imipramine in depressed outpatients.

As a partial test of whether the same or different patients benefit from cognitive therapy and tricyclic antidepressant agents, depressed outpatients first received cognitive therapy, then nonresponders were treated with either imipramine or placebo. If the two treatments were effective for the same subgroup of patients, imipramine should not be more effective than placebo because potential responders should already have been removed by treatment with cognitive therapy. Alternatively, if cognitive therapy and imipramine are effective for different subtypes of depressive disorder, then imipramine ought to be more effective than placebo for patients failing to benefit from cognitive therapy because some potential imipramine failures would already have been removed. Thirty-six depressed outpatients were treated with weekly cognitive therapy for 16 weeks with 17 (47%) responding. Nonresponders were then randomly assigned to imipramine or placebo for 6 weeks to a maximum dose of 300 mg of imipramine per day. Of 12 patients completing the double-blind medication trial, all 5 assigned to imipramine had a clear-cut response, whereas none of the other seven benefited from placebo (chi 2 = 12.00; p = 0.001). Although the numbers are small, these results suggest rejection of the hypothesis that imipramine is effective for the same subpopulation of depressed patients as is cognitive therapy.

Adult↗
PubMed1996

Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests.

Formal assessment of cognitive decline with cognitive tests can be difficult, requiring either two measurement points or a comparison of 'hold' with 'don't hold' tests. Informant-based assessment provides an alternative approach because informants can adopt a longitudinal perspective and directly rate cognitive change. A study was carried out to assess the validity of informant ratings collected by means of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). A community sample of 500 subjects aged 74 or over underwent four cognitive tests on two occasions 3 1/2 years apart. On the second occasion, informants filled out the IQCODE. Subjects rated as having moderate or severe decline were found to have greater change on the cognitive tests. These findings support the validity of informant ratings of cognitive decline.

Aged↗
PubMed2026

Development and Validation of a Predictive Model for Identification of Cognitive Impairment Risk in Older Adults with Subjective Cognitive Decline&#xff1a;A Longitudinal Study.

BACKGROUND: Subjective cognitive decline (SCD) is a transitional state between objective cognitive impairment and cognitively intact mental status, providing a critical window for implementing preventive interventions to delay objective cognitive decline. AIMS: We aimed to develop a predictive model for SCD progression in older adults with mild cognitive impairment (MCI). This model will facilitate the identification of risk factors and establishment of targeted interventions for community-based SCD management. METHODS: Data from the China Health and Retirement Longitudinal Study (CHARLS) was utilized in this study, extracting 18 indicators. Potential predictors selected through univariate Cox regression and LASSO regression analyses were sequentially incorporated into a multivariable Cox regression model. A nomogram was constructed to establish a predictive model. Model validation encompassed Area Under Curve (AUC) metrics for discriminative capacity, complemented by quantitative assessments using calibration curve analysis for precision verification and decision curve analysis (DCA) for clinical utility evaluation. RESULTS: A total of 1099 older adults with SCD were included in the final analysis, of whom 114 (10.3%) developed MCI. Multivariable Cox regression identified residence, marital status, educational level, social participation, gait speed, and baseline cognitive function. The model demonstrated time-dependent AUC values of 0.885, 0.830, 0.839, and 0.836 in the training set when evaluating discriminative capacity at 2-, 4-, 7-, and 9-year, respectively. The predictive model showed excellent predictive ability according to AUC, calibration curve, and DCA. CONCLUSIONS: A predictive model was created to estimate the risk of developing MCI in older individuals with SCD, offering clinician-actionable intervention benchmarks for preventive care.

Humans↗