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.

The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.

Two hundred twenty individuals participated in the present study from a university population. The study examined the relationship among attachment styles to caregivers, relationship with God, depressive symptomology, and depressive experiences. Attachment theorists have suggested a connection between childhood attachment to caregivers and current attachment to God through the idea that individuals have "working models" that form how they interpret present relationships. For the most part, the results of the current study supported the idea of correspondence between attachment to caregiver and attachment to God. Individual attachment styles to caregivers matched their attachment style to God. However, when caregiver religiousness was included as a moderating variable, results supported the theory of combined compensation-correspondence for those with insecure attachments to caregivers. Individuals with insecure attachment to caregivers were more likely to compensate for their insecure attachment bonds through participation in religious activity, whereas their internal, private relationship with God corresponded with their previous insecure attachment bonds. Individuals with insecure attachment to caregivers were more likely to endorse symptoms of depression and report introjective, but not anaclitic, depressive experiences. With respect to attachment to God, introjective depressive experiences were positively related to both anxious and avoidant attachments, whereas, anaclitic depressive experiences were …

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. …

This two-part study investigates the effectiveness of neurofeedback training for reducing behavioral problems commonly observed in abused/neglected children, and compares its efficacy to other treatment interventions with this population. Neuro-developmental sequelae of early relationship trauma are explored as an etiological framework for understanding disturbed affect-regulation, which appears central to the behavioral and emotional difficulties commonly experienced by this pediatric population. It is suggested that neurofeedback teaches children to self-regulate brain rhythmicity mechanisms, which in turn affects global improvements in behavior and mood. The pilot study utilizes records of 20 children removed from their biological homes by Child Protective Services. Children were assessed prior to treatment using the Child Behavior Checklist (CBCL) and the Test of Variables of Attention (TOVA), and again after 30 sessions of individualized, qEEG-guided neurofeedback training. A t-test analysis of pre- and post-scores was computed, and indicated significant improvements following treatment. A meta-analysis of existing literature on treatment interventions with abused/neglected children provides individual and aggregate effect sizes for 33 outcome studies with this clinical population, and contextualizes the results of the present pilot study within other empirically validated treatment modalities. Establishment of an overall effect size for treatment for this pediatric population provides a needed method …

As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of …

Dementia is prevalent among elderly people. As the world population ages, it is projected that the number of people affected by dementia may triple in the next 50 years. Over the last two decades, research has focused on identifying potentially modifiable risk factors in development and progression of dementia, such as vitamin B12 and folate. Results concerning the effects of low folate and vitamin B12 on cognitive performance are mixed. The main objective of the present study was to investigate the effects of vitamin deficiency on cognitive functioning in a clinical sample of elderly individuals with cognitive problems using a comprehensive neuropsychological assessment. A retrospective chart-review was performed on the 102 records of patients from the Geriatrics Clinic at the University of North Texas Health Science Center who presented with cognitive deficits. Charts were reviewed to obtain data on vitamin supplementation, vitamin status, history of chronic conditions and other biochemical data. The available database was used to obtain data on neuropsychological assessment. The study demonstrated mild association between vitamin B12 and folate status and cognitive deficits. There appeared to be a higher cut-off level that is above the traditionally used levels for vitamin B12 and folate deficiency concentrations at which …

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 …

Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean …

Neuropsychological rehabilitation following acquired brain injury is increasingly recognized as essential with the advancements in research evidence of its effectiveness, particularly as current estimates of disability following the most common forms of brain injury (traumatic brain injury and cerebrovascular accident) are so high. Improvements in predictive capabilities of researchers and clinicians are paramount in designing effective interventions. As many variables associated with outcome following brain injury are not controllable (e.g. severity of the injury, age, education), it is essential that rehabilitation programs design interventions to target those variables that are susceptible to amelioration. While personality factors have been shown to affect outcome in other medical illnesses, only a few studies have examined the influence of personality on outcome following neurorehabilitation for acquired brain injury. The results of these studies have been mixed. This study used the Millon Behavioral Medicine Diagnostic (MBMD) to predict outcome as measured by the Mayo-Portland Adaptability Index (MPAI-4) following brain injury rehabilitation in a heterogeneous sample of persons with acquired brain injuries (N = 50). It was hypothesized that specific coping styles scales from the MBMD (Introversive, Dejected, Oppositional), which are based on Millon's personality system, would predict outcome. Results indicated that both the Introversive and …

The present study evaluated the utility of heart rhythm coherence (HRC) feedback to reduce the reported pain intensity of patients enrolled in a multimodal pain management program. Participants were recruited and assigned to a usual treatment group (UT) or a heart rhythm coherence feedback group (UT+HRC). It was hypothesized that UT+HRC participants who achieved heart rhythm coherence would report a reduction of pain intensity, as measured by the McGill Pain Inventory. For those whose pain intensity decreased, it was also expected that their self reported levels of depression as measured by the Beck Depression Inventory-Second Edition and state anger as measured by the State Trait Anger Inventory would decrease. It is also hypothesized that with a reduction in pain levels, anger, and depression, blood pressure would also decrease among those who had high blood pressure prior to the intervention. Multivariate analyses of variance (MANOVA) were used to investigate the relationship between treatment condition, coherence status and pain levels. A series of independent t-tests were utilized to investigate the change in pain, depression, and state anger from baseline to posttest, followed by Pearson product moment correlation coefficients on difference scores to understand the relationship between the outcome variables for Hypothesis 2. …

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.