Biomedical subjects

B Schmand

Publications and source records attributed to B Schmand.

44 records · Page 3Linked to original sources

PubMed1994

Cognitive disorders and negative symptoms as correlates of motivational deficits in psychotic patients.

The problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the 'energetics' of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an 'amotivational syndrome' and its related negative symptoms. The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive-energetic model as a large effect of 'time-on-task' during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a 'computational' but of an 'energetical', i.e. motivational nature.

Adolescent↗

PubMed1992

Procedural learning of cognitive and motor skills in psychotic patients.

Two kinds of procedural learning, viz. learning of a sequence of simple motor responses and learning to solve a rather complex problem (Tower of Hanoi), as well as declarative learning (word list learning) were investigated in a group of psychotic inpatients (n = 67) and a control group of non-psychotic psychiatric inpatients (n = 19). Within the psychotic group, correlations of the task variables with positive and negative symptoms were explored. There was no difference between both groups in motor procedural learning. Psychotic patients were less efficient than controls in solving the Tower problem, but both groups again showed an equal amount of procedural learning. Consistent with the literature, however, a clear difference between both groups was found in declarative learning. The memory tasks did not correlate significantly with psychotic symptoms. These findings are interpreted as another indication that automatic information processing in psychotic patients is intact. The results are discussed with reference to neuropsychological research on procedural learning in neurological patients.

Adult↗

PubMed1992

Implicit learning in psychotic patients.

Implicit verbal learning of psychotic patients (n = 59) and non-psychotic control patients (n = 20) was studied using stem completion and association tasks in lexical and semantic priming paradigms. Performance on these tasks was contrasted with explicit memory on Rey's verbal learning test. Furthermore, correlations of these aspects of memory with positive and negative symptoms of psychosis were examined. Symptom ratings were based on an interview by a psychiatrist using the CPRS and SANS. As expected, the lexical and semantic priming effects in both patient groups were not significantly different, whereas the psychotic patients compared to the controls were impaired in explicit learning. None of the memory variables was significantly correlated with negative or positive symptoms. These findings are explained by the fact that priming effects, as opposed to explicit learning, depend on automatic memory processes, which do not require conscious effort. Moreover, the findings suggest the intactness of posterior cortical functions in psychotic patients.

Adult↗

PubMed1991

[Validity of the cognitive screening tests and the mini-mental status examination in a group of elderly hospital patients].

OBJECTIVE: To study the validity of the cognitive screening test (CST) and of the mini-mental state examination (MMS). DESIGN: Prospective administration of both CST and MMS (in balanced order) by laymen as well as by experienced users, and retrospective comparison of the scores with the clinical diagnosis and with the degree of functioning in activities of everyday life. SETTING: Clinical and outpatient departments of Geriatrics and Neurology of the Slotervaart Hospital, Amsterdam. PATIENTS AND METHOD: Ninety-five patients of the clinical and nine patients of the outpatient departments, with an acute somatic diagnostic problem and multiple pathology attending the above-named departments in the period from September 1989 to February 1990: 20 patients (group SOM) were found not to have a dementia syndrome; 25 patients (group DEM) had a dementia syndrome as the main diagnosis; 14 patients (group CVA) had a cerebrovascular accident as the main diagnosis without clinical signs of dementia; 45 patients were excluded from the comparison (30 because of main diagnosis from several groups and 15 because of pathology that might influence the test scores to an unpredictable degree). The data were analysed statistically by means of analyses of confidence and of variance. RESULTS: The CST was found to be more reliable and less time-consuming than the MMS. The sensitivities of the two tests with regard to the distinction between dementia and somatic pathology were similar (80%). However, specificity of the CST was better than that of the MMS (80% and 60%, respectively). CONCLUSION: For the screening of older patients for dementia, the CST constitutes a good alternative to the MMS.

Aged↗

PubMed1991

[The Dutch Reading Test for Adults: a measure of premorbid intelligence level].

The construction of the Dutch Adult Reading Test (DART) is described. The DART is the Dutch version of the National Adult Reading Test. Both tests consist of a series of words with an irregular pronunciation. The score on the test is a predictor of premorbid intelligence of brain damaged patients. Furthermore, results of reliability and validation studies with the DART are reported. The main findings, which were obtained with the NART, were replicated by the DART. These findings consist of a high correlation (.85) with verbal intelligence in healthy controls (n = 22) and insensitivity to cerebral deterioration in brain damaged and demented patients (n = 53). The test also appeared to be insensitive to cognitive deterioration in a group of psychotic patients (n = 43).

Adult↗

PubMed1990

Psychological development of children who were treated antenatally with corticosteroids to prevent respiratory distress syndrome.

Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a randomized, double-blind, placebo-controlled trial of betamethasone. Aspects of the children's intellectual and motor development, school achievement, and social-emotional functioning were investigated. There were no differences between the corticoid group and the placebo group on these variables, nor were there more children with learning difficulties and behavioral disturbances in either of the groups.

Betamethasone↗

PubMed1990

Physical development and medical history of children who were treated antenatally with corticosteroids to prevent respiratory distress syndrome: a 10- to 12-year follow-up.

Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a randomized, double-blind, placebo-controlled trial of betamethasone. The children had a general physical examination; parents were interviewed about the medical history of their child with special attention to infectious diseases; growth data were collected; and a developmental neurological examination, an ophthalmological examination, and a lung function test were conducted. In the corticosteroid group significantly more hospital admissions because of infectious diseases during the first years of life were reported. On the other variables no differences between the corticoid and the placebo groups were found.

Betamethasone↗

PubMedDate not supplied

Assessment of mental competency in community-dwelling elderly.

We studied the utility of a "vignette method" to assess mental competency for decision making on medical treatment and research participation. A vignette is a description of an imaginary situation in which the subject is asked to decide on a proposed treatment or on participation in research. His or her understanding of the situation and the quality of the reasoning underlying that choice are tested by a short series of questions. Subjects were participants in the Amsterdam Study of the Elderly (AMSTEL), a population-based study on cognitive decline and dementia. The sample consisted of elderly people (70-90 years), who were cognitively intact (n = 176) or had a dementia syndrome (n = 64; mostly Alzheimer disease). Dementia was diagnosed using the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) schedule. Two vignettes were used as competency assessment instruments. The answers to the vignette questions were summed to form a competency score. The reliability (internal consistency) of this score was 0.82 for both vignettes combined. After dichotomization into competent/incompetent (cutoff at the fifth centile of the control group), the agreement between the vignette method and a physician's judgment of competency was poor (kappa = 0.36) in the demented group. There was no agreement whatsoever when subjects with "minimal dementia" (n = 14) were left out of this analysis (kappa = 0.04). As expected, mean competency scores declined with increasing dementia severity. A multiple regression analysis showed that mental competency as measured by the vignette method was determined mainly by recent memory, expressive language, and abstract thinking. In the control group the competency score was only slightly related to education (r = 0.12) and verbal intelligence (r = 0.27). We conclude that the vignette method is a reliable and valid method for the assessment of mental competency in elderly people with cognitive decline. The vignette method is preferred over a physician's judgment, especially in patients with early dementia.

Aged↗