The distinction of positive and negative symptoms in schizophrenia was examined in relation to demographic, clinical and neuropsychological measures.

This study utilized the Medical Symptom Validity Test (MSVT) and a set of standard neuropsychological instruments to determine the underlying construct of the MSVT that accounts for effort in mild traumatic brain injury (mTBI) patients by comparing/contrasting mTBI with dementia and an analog simulation. The results indicate that a common underlying neurocognitive construct (memory) exists between mTBI and dementia patients, which may account for poor effort as measured by the MSVT. Other underlying factors emerged for both groups, though they did not point to a common construct. This finding suggests that the overall effect of brain injury in neurologically impaired groups also impacts effort performance as measured by the MSVT. Similarly impaired performance patterns also emerged between mTBI and dementia groups in sub-groups that failed effort measures. Thus, failed effort tests may be a function of more pronounced deficits in these groups, rather than a function of effort. Finally, although similar effort profiles were noted between mTBI and analog simulators, the analog group was unable to mimic the neurocognitive effects of mTBI.

The present study was conducted to clarify and expand knowledge of cognitive functioning in chronic schizophrenia patients (N=21) as compared to a bipolar group (N=20) and a normal group (N=20).

The purpose of the current study was to explore the relationship between cognitive status and depression in a sample of geriatric patients. Participants included 282 geriatric patients ranging in age from 65 to 96 years who were classified according to diagnosis as: DAT, VaD, MCI, and Norm. All were referred for neurocognitive testing from the Geriatric Assessment Program (GAP) at the University of North Texas Health Science Center (UNTHSC) in Fort Worth, Texas. This study sought to identify factor structures for two versions of the GDS using a geriatric sample of cognitively impaired and intact patients. It then compared these factors to each other to determine whether the GDS-15 is truly a shorter version of the GDS-30. These were then compared to a previously determined factor structure. This study explored whether the four-factors of the GDS-30 are able to differentiate cognitive diagnostic groups. Further, this study sought to identify whether the severity of cognitive decline impacted GDS factor score for each of the cognitively impaired groups. Results revealed a two-factor model of the GDS - 15 and a four-factor model with the GDS - 30. The GDS-15 factors did not differ from the first two factors of the GDS-30. Comparison …

The purpose of the present study was to compare the number of perseverations on fused (no delay) versus unfused (0.5 msec delay) CV-DL tasks with measures on a battery of executive functions across three groups: Schizophrenics (SCZ), Manic-Depressives (MD), and normal controls (NC).

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.

Depression is an independent risk factor for morbidity and mortality in patients with coronary artery disease (CAD). Altered autonomic nervous system (ANS) activity, a common feature of depression, is also a risk factor for cardiac events in patients with CAD. Heart rate variability (HRV) reflects ANS activity, and reduced HRV predicts morbidity in cardiac populations. The purpose of this study was to determine whether differences in HRV exist between depressed and nondepressed patients with CAD. Twenty-one depressed inpatients, with angiographically documented CAD were retrospectively matched to 21 nondepressed CAD patients by sex, age, and smoking status. Demographic, medical, psychological interview data, and 24-hour ECG recordings were obtained. Depressed subjects had significantly lower HRV, or trends toward lower HRV, than nondepressed subjects, even after controlling for severity of CAD. Subject groups did not differ on left ventricular ejection fraction, history of myocardial infarction, or any other relevant medical variable assessed. These results suggest that depression is associated with decreased HRV in patients with CAD, and may help to explain the increased rates of cardiac events observed in CAD patients with depression.

The purpose of this study was to determine if attention-deficit/hyperactivity disorder (ADHD) subtypes (predominantly hyperactive/impulsive, ADHD-HI; predominantly inattentive, ADHD-IA; combined, ADHD-C) exhibit distinct neuropsychological profiles, using the Attention and Executive Function subtests of the Developmental Neuropsychological Assessment, (NEPSY) and the omission and commission scores obtained on the Conners' Continuous Performance Test-II (CPT-II), a test that assesses attention processes. The sample was selected using archival data collected in a neurodevelopmental clinic over the past decade and consisted of 138 children between the ages of 6 and 12 years old. Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) criteria, the children were placed in either the ADHD-HI (n = 40), ADHD-IA (n = 35), or ADHD-C (n = 36) group, or a symptom free comparison group (n = 27). It was hypothesized that children with elevations on the impulsivity/ hyperactivity (ADHD-HI and ADHD-C) scale would be impaired on measures of inhibition and those with elevations on the inattention scale (ADHD-IA and ADHD-C) would be impaired on tests of attention, vigilance, and other executive functions. A one-way multivariate analyses of variance (MANOVA) was conducted (Group X Task), with significant results for overall main effect for group on the 7 …

The purpose of the present study was to investigate the psychophysiological effects of exercise on measures of cardiovascular fitness, depression, self-esteem, and anxiety. The 1.5 mile run (Cooper, 1972) was used to determine changes in cardiovascular fitness. The Zung Self-Rating Depression Scale was used to measure varying levels of depression. The Rosenberg Self-Esteem Scale was used to measure self-esteem. The Spielberger State-Trait Anxiety Inventory was used to measure state anxiety. An Electromyographic Assay and Digital Skin Temperature were performed on the Experimental and Corrective Therapy Groups in order to measure physiological concomitants of anxiety. A Body Composition Assay was performed in order to measure changes in body composition.

Individuals undergoing forensic neuropsychological evaluation frequently stand to gain in some manner if neurocognitive dysfunction is diagnosed. As a result, neuropsychologists are customarily asked to test for neurocognitive feigning during the assessment. The current study employed an analogue design with a clinical comparison group to examine the utility of the TOCA (Rogers, 1996) as a measure of feigned neurocognitive impairment. Two groups of simulators (one cautioned about the presence of detection strategies and one not cautioned) were compared to clinical and normal control groups. Fourteen scales were developed based on five detection strategies: symptom validity testing, performance curve, magnitude of error, response time, and floor effect. Each was employed during both verbal and nonverbal tasks. Significant differences were revealed among groups when subjected to ANOVA. Classification rates from subsequent utility estimates and discriminant function analyses on the scales ranged from 58.8% to 100%. Combining strategies yielded a classification rate of 95.7%. The effect of cautioning simulators was modest; however, a trend was noted on some scales for cautioned simulators to appear less obviously impaired than noncautioned. Although the results require crossvalidation, preliminary data suggest that the TOCA is a sensitive and specific measure of feigned neurocognitive performance. Strengths and weaknesses …

The current study utilized structural equation modeling (SEM) to examine the factor-to-factor relations and temporal associations between disturbances in negative affect (NA) and positive symptoms of psychosis (PP). Data were drawn from a large, public-domain data set (MacArthur Violence Risk Assessment Study). A dimensional approach was used to conceptualize and identify latent variables of NA (depression, anxiety, and guilt) and PP (hallucinations, delusions, and thought disorder) among individuals with a diagnosis of primary psychotic disorder. Results showed that anxiety, guilt, and depressed mood modeled an NA latent variable, and that hallucinations and unusual thought content modeled a PP latent variable. As predicted, results revealed strong, significant cross-sectional (synchronous) associations between NA and PP at each measured time-frame, suggesting that NA and PP occurred concurrently within the sample. Contrary to predictions, no significant cross-lagged effect between NA and PP was identified (10 weeks and 20 weeks respectively).

The capacity of Raven's Standard Progressive Matrices (SPM) and the Booklet Category Test (BCT) to discriminate between groups of brain-injured, simulated malingering, and normal participants was investigated in this study. Exploratory analyses were also conducted to examine the differences between groups categorized as sophisticated and naive fakers. Clinical decision rules and discriminant function analyses were utilized to identify malingerers. Clinical decision rules ranged in hit rates from 41% to 78%, in sensitivity from 2% to 100%, and in specificity from 86% to 100%. Discriminant functions ranged in hit rates from 81% to 86%, in sensitivity from 68% to 73% and in specificity from 82% to 87%. Overall, the least helpful detection method examined was below chance responding on either measure, while the most efficient was gross errors for SPM.

Previous research examining the impact of training and practice effects on modifying performance of fluid intelligence tasks (Gf) and crystallized intelligence tasks (Gc) were extended to include self-rated performance attributions among non-depressed and depressed older persons. The following general questions were addressed. How does level of depression affect performance on Gf and Gc measures and performance attributions? How does level of depression and degree of benefit from either training or practice relate to changes in attributional styles? The framework used for predicting shifts in attributional styles was the reformulated learned helplessness model. Three hundred twenty-five community-dwelling older persons completed the Gf/Gc Sampler, Beck Depression Inventory, and Attributions for Success/Failure Questionnaire at pretest, posttest (one week), and follow-up (one month). Between the pretest and posttest sessions, subjects participated in one of three experimental conditions; (a) cognitive (induction) training, (b) stress inoculation training, and (c) no-contact control groups. The results from univariate and multivariate analysis of covariance procedures provided partial support for the hypotheses. At pretest, both non-depressed and depressed older persons had internal attributional styles, although based on differential performance outcomes. The depressed persons were found to have more failure experiences as a result of their significantly poorer performance on Gf …

Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.

Intimate partner violence is endemic in the United States. According to the American Medical Association (1992), one-fifth to one-third of women will sustain violence from a partner or ex-partner in their lifetime. The relevant literature was organized by ICD-9-CM categories. This study examined the health consequences of partner abuse in a sample of community women using a sample consisting of 564 women in three ethnic groups. Because prior research has failed to account for variations by type of abuse on health consequences, this study assessed psychological abuse, violence and sexual aggression by women's partners. To determine whether or not different types of abuse had an effect on women's health, hierarchical regression analyses were conducted. The regression equations were calculated for women within each ethnic group to facilitate identification of similarities and differences and to control for ethnic differences in risk for specific diseases. The results were consistent with past research on health consequences of abuse and extended the prior literature by showing that psychological abuse had a pervasive effect on health conditions, distress and use of health care resources. Additionally, ethnic differences emerged. As expected, ethnicity appeared to function as a moderator. Clinical implications and recommendations are made for future …

Failure to acknowledge their mental illness occurs in approximately half of all psychotic patients. Interest has been recently been refocused on insight (i.e., awareness of mental illness), and its associations with treatment compliance and better prognosis. Researchers have called into question the traditional factor structure of insight, instead viewing and defining it as a multidimensional and continuous construct. While factor analytic research has suggested that insight is an independent feature of psychotic disorders rather than a secondary manifestation of psychotic symptoms, several factor analytic studies have identified only one higher-order factor. Furthermore, a significant amount of the research literature has assessed insight or analyzed its relationships using only a single insight score. The current study evaluated the structural model of insight and assessed the associations between the different proposed dimensions of insight and psychotic symptoms. One hundred and six participants recruited from both inpatient and outpatient settings with a diagnosis of schizophrenia, schizoaffective disorder, psychotic disorder NOS, or bipolar disorder with psychotic features were rated on David's Schedule for Assessing Insight-Expanded Version (SAI-E), Birchwood's Insight Scale (IS), and the Brief Psychiatric Rating Scale (BPRS) or the Positive and Negative Syndrome Scale (PANSS). Structural equation modeling (SEM) was utilized to provide …

This study investigated the relationship between stress and pain crisis incidence in pediatric Sickle Cell Anemia (SCA). It was hypothesized that SCA children were exposed to higher levels of stress than healthy children. It was also hypothesized that a significant positive correlation existed between level of stress and pain crisis incidence both within and between years. The sample consisted of 20 Black elementary school children with SCA. There were 12 female and 8 male children. The period of investigation included the calendar years 1983 and 1984. Pain crisis incidence was determined through parent interviews and verified by a review of medical records.

The purpose of this study is to replicate and extend earlier work involving cluster analysis of MMPI profiles among persons with chronic low back pain. There are two specific goals. The first goal is to demonstrate the existence in a new sample of four distinct and homogenous profile clusters that have been found in previous research. The second goal is to investigate the relationship of the four profiles to the subjects, self-reported pain history and response to treatment. This study concludes that four distinct MMPI profiles can be identified among chronic low back pain patients. Further, these profiles are the same for males and females, and are the same profiles found in previous research. These profiles are significantly related to subjects' history of behaviors in dealing with pain. However, no relationship to treatment response was found. It was inferred that the MMPI is of value in understanding the nature of patients' pain coping behaviors, but that further research is needed before any statements can be made regarding the utility of the MMPI in understanding their response to treatment.

Individuals diagnosed with schizotypal personality disorder (SPD) exhibit patterns of cognitive deficits, neuromotor disturbances, and behavior problems similar to individuals with schizophrenia, and thus SPD is thought to represent one point on the continuum of schizophrenia spectrum disorders (SSDs). Deficits in behavior, cognition, and motor functioning have been implicated as childhood precursors of SSDs and appear to also vary as a function of gender and family history of psychopathology. As such, studies of youth may help in further identification of individuals at risk for SSDs. The current study examined the prospective associations between problem behaviors, neuromotor and neurocognitive functioning, as well as SSD symptoms, at baseline and 2-year follow-up in youth meeting criteria for SPD, other personality disorders, or healthy controls. The neuromotor and neurocognitive measures were able to significantly predict SSD symptoms and behavior problems above and beyond baseline predictors. Overall, the findings provide further support for the role of subcortical motor centers operating together with prefrontal cortical areas in the regulation of higher-order cognitive functioning and in producing the psychiatric features of SSDs. Significant correlations between gender, family history of schizophrenia, and history of head injury with symptoms, behavior, cognition, and motor functioning were also found and highlight …

The Behavioral Medicine Questionnare (BMQ) is a 44- item instrument administered via a computer CRT display or pencil and paper. The BMQ was designed to help primary care physicians treating spinal disorders to screen for emotional factors which warrant further psychological evaluation. The test is composed of three scales: Anxiety, Depression, and Somatization. Concurrent validity for each scale was determined through comparisons with subject (n = 133) scores on clinician judgement ratings, pain drawings, and the MMPI. The psychometric properties of the test were supported through statistical analysis. Significant correlations were found between the BMQ, MMPI, and clinician ratings, with the latter showing relationships of lesser strength. The only significant correlation to subject generated pain drawings was to the BMQ depression scale. Analysis indicated the need for seperate norms for males and females. Further research is needed to facilitate measurement and interpretation of the BMQ.

Cognitive therapy for the treatment of depression has generated substantial research indicating its effectiveness and it is currently considered among the most viable conceptualizations of depression. However, it has remained controversial because its methods do not directly address emotional symptoms in depressed persons. Treatment of depressed emotions is a primary focus of hypnotic mood elevating techniques. These techniques enable depressed persons to experience positive emotions during hypnosis sessions and to re-experience them daily concurrent with performance of certain specified behaviors. This study evaluated the efficacy of a multicomponent treatment which combines the techniques of cognitive therapy and hypnotic mood elevation in the treatment of depressed persons. The three treatment conditions constructed for this investigation were cognitive therapy plus hypnotic mood elevation, cognitive therapy plus pseudo-biofeedback, and no treatment waiting list.

The objective of the present study was to evaluate the relationship between a set of cofactors and severity of cognitive impairment, to determine if there were any factors which significantly predicted more severe neurocognitive deficits in persons with AIDS. Twenty-four male volunteers recruited from community groups and physician referrals participated. Subjects completed several self-report questionnaires eliciting information regarding demographics and risk factor variables, in addition to a comprehensive battery of neuropsychological tests. A severity of cognitive impairment summary score was computed for each subject, reflecting both the number of impaired tests and their distance in the impaired direction from normative data. Neither CD4 count, number of months since diagnosis of AIDS, number of AIDS-related illnesses, number of recent stressors, history of head injury/LOC, history of substance use, current or past psychiatric disorder, history of learning disability nor history of other medical illness were found to be significantly related to severity of cognitive impairment in this sample, after controlling for the effects of age, level of education, estimated premorbid IQ and mood status. However, no reliable conclusions could be drawn from this study because the small sample size resulted in an unacceptably low level of statistical power for the desired regression …

Individuals with attention deficit hyperactivity disorder (ADHD) with and without a learning disorder (LD) and a control group of clinically referred individuals with behavioral problems were compared on four neuropsychological tests of frontal lobe functioning. Test results were collected to examine if ADHD individuals with and without LD have deficits in frontal lobe functioning. Two age groups were used to examine developmental differences. In the six to ten age group there were 27 ADHD, 17 ADHD/LD and seven other clinically referred individuals. In the 11 -20 age group there were 12 ADHD, 23 ADHD/LD and 24 other clinically referred individuals. The ADHD and ADHD/LD groups performed at a lower level than the other diagnostic group on the freedom from distractibility factor of the WISC-R and the omission and commission errors of the Gordon Diagnostic system. Differences for the ADHD and ADHD/LD groups were also found on the number of correct responses for the Gordon Diagnostic system, the Speech Sounds test and the Seashore Rhythm test. The developmental differences that were found were not influenced by diagnosis. The deficits that the ADHD individuals with and without LD demonstrated were not affected by age.

This study was designed to assess the reliability of "The Psychiatric Rating Scale for Diagnostic Classification of Children and Adolescents" as an instrument for determining diagnoses congruent with DSM-III criteria. In Phase I graduate students from a University doctoral program in psychology independently rated case vignettes and completed the 64-item rating scale to arrive at Axis I or II diagnoses consistent with DSM-III classifications for Disorders Usually First Evident in Infancy, Childhood, or Adolescence. Subsequent correlations to determine individual scale reliability yielded significantly positive correlations. Clinicians practicing in three diverse metropolitan mental health settings acted as raters in Phase II of the study. Paired raters jointly interviewed a total of 54 child or adolescent patients and independently completed the rating scale to arrive at Axis I or II diagnoses. These diagnoses were subsequently correlated with diagnoses previously obtained by traditional psychometric methods. Phase II interrater agreement was 92 percent for Axis I and II combined, with a .96 correlation. Rating scale diagnoses when correlated with traditional psychometic diagnoses yielded an overall rate of agreement on Axis I of 95 percent for Rater 1 and 90 percent for Rater 2 and correlations of .96 and .95 respectively. Clinicians were asked to …