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

Research has consistently shown schizophrenics to perform significantly poorer than normal controls on commonly used measures of neuropsychological functioning. Research on the neuropsychological functioning of first-degree relatives of schizophrenics who do not themselves have schizophrenia is comparatively sparse but suggests the likelihood of deficits in this group as well. A battery of standard neuropsychological tests was administered to three groups: first-degree relatives of schizophrenics who do not themselves have schizophrenia (FDR-SCZ), first-degree relatives of persons with major depression and bipolar disorder (FDR-MOOD), and normal controls (NC). The FDRSCZ group was not found to demonstrate significantly impaired performance relative to the other two groups on any of the hypothesized or exploratory analyses. These implications of these findings are discussed with reference to previous studies and future research.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR …

The treatment of schizophrenia today consists of a multi-component system of services. Mental health professionals generally agree that anti-psychotic medications are an essential treatment for schizophrenia. However, adherence to medication regimens by patients with schizophrenia is notoriously poor. To identify correlates and predictors of medication compliance, the Schedule for Affective Disorders and Schizophrenia (SADS), a semi-structured diagnostic interview, was administered to 90 outpatients with schizophrenia. The results suggest that there are specific variables (i.e., mood symptoms, psychotic symptoms, and socio-demographic variables) that predict medication compliance. In addition, the confirmation of these variables was effective (90.0%) at identifying non-compliant patients. The results suggest that schizophrenia is a complex disorder composed of heterogeneous symptoms. However, a specific group of symptoms is proposed which may provide a screening measure for predicting patients who are likely to be non-compliant with their medications.

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.

Depression received much attention in the professional literature as a stimulus both for experimental as well as applied research. It continued to be the subject of much controversy in respect to its definition, identification, and classification. Attempts were made to objectify the assessment of depression using self-report scales to tap various aspects though to be related to its etiology as well as its symptomology. Two of the most popular and reportedly well-validated self-report scales identified in the literature for determining and quantifying depressive symptoms were the Beck Depression Inventory (Beck) and the Zung Self-Rating Depression Scale (Zung).The present study was designed to determine if there were factors in common between the Beck and the Zung scales and, in addition, to test whether these factors would differentiate subjects by sex class membership, diagnostic category, and by some linear combination of biographical or life-history information. The major purpose was the identification of outstanding charactersitics of depression predicted from biographical data and the determination of the relationship of these data to self-rating psychometric measures of depression. This study makes it clear that the Beck and Zung scales are measuring different aspects of depression and thus are likely based on separate constructs. The need …

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 issue of effortful patient performance has been an area of clinical interest in individuals with minor traumatic brain injury (mTBI). Clinical attention to this area has increased largely because of an increase in the number of worker's compensation claims, injury-related lawsuits and/or insanity defense pleas. As patients are presented with the opportunity for secondary gain, the issue of optimum performance on neuropsychological measures becomes salient. In addition to neurocognitive deficits, there are psychological characteristics associated with mTBI including depression, emotional disturbance, personality changes, and other psychopathology. This study utilized the MSVT, a set of standard neuropsychological instruments, and the Minnesota Multiphasic Inventory-2 (MMPI-2) to investigate the relationships between effort, psychological characteristics, and neuropsychological functioning in individuals with minor traumatic brain injuries. The first objective of this study was to determine which psychological factors were related to effort in mTBI. The second objective was to determine if there were differences between groups that performed poorly on effort testing and groups that performed adequately on effort testing, based on relevant psychological characteristics. The results of the analyses supported the first hypothesis. Hysteria was inversely related to effort, and Mania was positively related to effort on one of five measures of effort. …

The clinical utility of the Intermediate Category Test, a measure of executive functioning in children 9 to 14 years of age, is currently limited by the availability of only a Total Error score for normative interpretation. The Process Scoring System (PSS) was developed to provide a standardized method of assessing specific processing patterns and problem-solving errors. The purpose of this study was to determine the ability of the PSS scores to discriminate between children with and without suspected executive deficits, thereby providing evidence of criterion-related validity.

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 …

Cognitive impairment is common in multiple sclerosis (MS), with as many as 70% of patients with MS affected. Individuals with MS who experience cognitive deficits are less likely to be employed, and may have more difficulty performing independent activities of daily living. Most commonly, deficits are observed in processing speed, complex attention, and memory. Because lesion location varies widely among individuals, no clear pattern of cognitive dysfunction in MS has emerged. However, a number of risk and protective factors may influence the likelihood of individuals to develop and/or express dysfunction, though the contribution of each to specific domains of cognition has not been fully explored. Recently, support for the cognitive reserve hypothesis (i.e., enriching life experiences protect against cognitive decline despite disease burden) has emerged in the MS literature. The current study investigated the contributions of cognitive reserve to learning and memory functioning in MS and the interaction of cognitive reserve variables and risk factors known to impact cognitive functioning in individuals with MS. Finding revealed cognitive reserve protects against decline in the domains of processing speed and complex attention. Furthermore, indirect protective effects of cognitive reserve through these domains were observed for verbal learning and memory. Finally, in line …

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.

The current study discussed the development and validation of the Checklist for Differential Diagnosis of Attentional Problems (CDDAP), a tool for use with adults seeking diagnosis and treatment of an Attention Deficit Hyperactivity Disorder. Normative data are provided on three subject groups (ADHD adults, controls, and adults with other psychiatric disorders). Convergent validity was established with the SCL-90, and criterion validity established through comparing scaled scores with final diagnoses. Overall, this measure was accurate at differentiating adults with ADHD from controls and adults with other psychiatric disorders. Results indicated that the CDDAP was also able to identify other psychiatric disorders with 71 to 92% accuracy, depending on the disorder.

Compromised validity of test data due to exaggeration or fabrication of cognitive deficits inhibits the capacity to establish appropriate conclusions and recommendations in neuropsychological examinations. Detection of feigned neurocognitive impairment presents a formidable challenge, particularly for evaluations involving possibilities of significant secondary gain. Among specific populations examined in this domain, litigating mild traumatic brain injury (mTBI) samples are among the most researched. One subpopulation with potential to contribute significantly to this body of literature is that of retired athletes undergoing fixed-battery neuropsychological evaluations within an assessment program. Given the considerable prevalence of concussions sustained by athletes in this sport and the substantial monetary incentives within this program, a unique opportunity exists to establish rates of feigning within this population to be compared to similar forensic mTBI samples. Further, a fixed battery with multiple validity tests (VT) offers a chance to evaluate the classification accuracy of an aggregated VT failure paradigm, as uncertainty abounds regarding the optimal approach to the recommended use of multiple VTs for effort assessment. The current study seeks to examine rates of feigned neurocognitive impairment in this population, demonstrate prediction accuracy equivalence between models based on aggregated VT failures and logistic regression, and compare classification performance of …

A study was conducted in which a computerized battery of information processing tasks (called the COGLAB) was administered to three subject groups: patients with schizophrenia, patients with bipolar disorder, and normal controls. The tasks included Mueller-Lyer illusion, reaction time, size estimation, Wisconsin Card Sort, backward masking. and Asarnow Continuous Performance.

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.

Reitan and Wolfson's General Neuropsychological Deficit Scale and Left and Right Neuropsychological Deficit Scales were applied to Halstead-Reitan test data of individuals with psychotic or substance abuse disorders with and without a head injury.

This study examined the effectiveness of cautioning and education on simulating a mild traumatic brain injury on several neuropsychological measures. The measures used included the Word Memory Test (WMT), Wechsler Adult Intelligence Scales® - Third Edition (WAIS®-III), Wechsler Memory Scales®-3rd Edition instrument (WMS®-III), 16-item version of the Rey Memory Test, and a self-report symptom checklist. Five experimental groups were used including clinical and non-clinical controls, as well as three simulation groups. The design and implementation of this study also attempted to correct several methodological short comings of prior research by increasing the incentives for participants, expanding the generalizability of findings and examining research compliance and participant self-perception through debriefing. Discriminant analysis was utilized to determine if specific functions existed that would correctly classify and distinguish each experimental group. Several discriminant functions had at least moderate canonical correlations and good classification accuracy. Results also include utility estimates given projected varying base rates of malingering.

Individual differences of cognitive organization and content were investigated as they relate to adaptation to remote, recent, and immediate life stress. Outside the field of stress, prior researchers have implicated cognitive organization with adjustment and cognitive content with specific psychopathology. As for behavioral adaptation to life stress, cognitive organization was viewed as a major factor in emotional vulnerability and adjustment, and cognitive content as a major factor in the mood disturbance of depression. Behavioral adaptation was defined in terms of current emotional vulnerability, adjustment and negative changes in the immediate (last six months), recent (over six months), and remote (over one year) past.

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 …

Research indicates that some college students may be strongly motivated to feign AHDD symptoms for desired external incentives, such as stimulant medication or academic accommodations. To date, literature examining feigned ADHD has been primarily focused on ADHD specific self-report measures (e.g., CAARS) and continuous performance tests (e.g., CPTs); however, little attention has been devoted to the use of multi-scale inventories in detecting feigned ADHD. For CPT measures, virtually no literature exists on the effectiveness of the TOVA to identify feigned ADHD, despite its frequent clinical use for establishing this diagnosis. The current study utilized a between-subjects simulation design to validate feigning cut scores on ADHD-specific measures using 66 feigners and 51 confirmed ADHD cases. As prior literature suggested, the results convincingly demonstrated that face-valid ADHD assessment measures were easily faked. Across both TOVA modalities (e.g., Auditory and Visual), the ADHD simulators performed significantly poorer than those diagnosed with ADHD. As an innovative approach, a Dissimulation-ADHD (Ds-ADHD) scale was developed and initially validated. The Ds-ADHD is composed of ten MMPI-2-RF items mistakenly believed to be clinical characteristics associated with ADHD. Requiring cross-validation, Ds-ADHD optimized cut scores and classification of ADHD feigners appears promising. They were clearly distinguishable from ADHD client, as …