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Biomedical subjects

Catherine A Mateer

Publications and source records attributed to Catherine A Mateer.

11 recordsLinked to original sources

The effect of reinforcement variables on inhibition in children with ADHD.

Behavioral inhibition, often cited as a central deficit in children with ADHD, has been shown to change in response to reinforcement. In this preliminary investigation, children with ADHD (n= 20) and matched controls (ages 7 to 12) completed a new version of the stop signal paradigm, the Fire Fighter Game, a measure of inhibition of a prepotent motor response, under three conditions: (1) no reinforcement; (2) immediate reinforcement; and (3) delayed reinforcement. In all conditions, the stop signal reaction time (SSRT) of children with ADHD was consistently longer than controls. Both groups improved significantly with reinforcement, and there was no strong evidence that immediate reinforcement was more effective than delayed reinforcement. However, it appeared that the reason for the changes in SSRT in response to reinforcement differed between the groups. Children in the control group responded faster on go trials, whereas children with ADHD improved their ability to inhibit responding with shorter stop delays. The relevance of these findings is discussed in terms of current theories of ADHD.

Analysis of Variance↗

Neuropsychological deficits, syndromes, and cognitive competency in schizophrenia.

INTRODUCTION: Neuropsychological functioning connects neuropathology and symptoms in schizophrenia. Previous work suggests that deficient initiation and inhibition underlie the psychomotor poverty and disorganisation syndromes, respectively. Furthermore, although the syndromes are associated with impairments in everyday functioning, cognitive competency (CC; cognitive skills for independent living) has been neglected as an outcome. This study tested a three-level model of schizophrenia pathology (Neuropsychological dysfunction --> Syndromes --> CC), using unstructured neuropsychological tasks to measure initiation and inhibition. METHODS: Participants were 40 adults with schizophrenia. A verbal picture description and the Tinkertoy test yielded initiation and inhibition measures with good interrater reliability. Symptoms were rated using the SANS and SAPS, and an insight scale was administered. The Cognitive Competency Test utilised simulated situations to assess CC. RESULTS: Initiation failed to predict psychomotor poverty, but affected CC directly. Only one indicator of disinhibition (intermingling of personal material into speech) predicted disorganisation, which, through mediation, led to CC deficits. Insight correlated with disorganisation and contributed to CC. Unique effects of initiation, disorganisation, and insight, combined, explained 58% of CC variance. CONCLUSIONS: Partial support for the three-level model was obtained. Specific neuropsychological abilities and symptoms explain a substantial proportion of the variance in cognitive competency.

Journal Article↗

Evidence of utilization behavior in children with ADHD.

The purpose of this study was to investigate whether inappropriate/excessive motor activity seen in children with Attention Deficit Hyperactivity Disorder (ADHD) could be characterized as Utilization Behavior (UB). Given evidence that the neuropathology of ADHD may involve frontal-striatal systems, we investigated the possibility that children with ADHD may demonstrate "utilization behavior." Utilization Behavior (UB) is a neurobehavioral syndrome documented in individuals with damage or dysfunction in the frontal areas of the brain; patients exhibiting UB are often described as reaching out and utilizing objects in the environment in an automatic and inappropriate manner. The sample consisted of two group of children; children with ADHD (n = 32) and control children (n = 31). Children were assessed individually in a testing room where various objects, selected to elicit UB, were present. They completed cognitive tests and also were allowed to engage in an unsupervised activity. Testing sessions were videotaped and instances of physical activity (i.e., upper limb motor activity and utilization of objects) were counted by two raters. Results indicated high levels of object utilization in approximately one-half of the children with ADHD, whereas almost no such behavior was observed in controls. This behavior did not appear to be a result of generally heightened activity levels or due to instruction set, but differed according to object familiarity and object visibility. Levels of UB were statistically associated with the severity of hyperactivity, as reported by parents, of children with ADHD. This study suggests that inappropriate/excessive motor activity may, at least in part, be characterized as UB in some children with ADHD.

Attention Deficit and Disruptive Behavior Disorder↗

Sexually intrusive behaviour following brain injury: approaches to assessment and rehabilitation.

Sexually intrusive behaviour, which may range from inappropriate commentary to rape, is often observed following a traumatic brain injury. It may represent novel behaviour patterns or an exacerbation of pre-injury personality traits, attitudes, and tendencies. Sexually intrusive behaviour poses a risk to staff and residents of residential facilities and to the community at large, and the development of a sound assessment and treatment plan for sexually intrusive behaviour is therefore very important. A comprehensive evaluation is best served by drawing on the fields of neuropsychology, forensic psychology, and cognitive rehabilitation. The paper discusses the types of brain damage that commonly lead to sexually intrusive behaviour, provides guidance for its assessment, and presents a three-stage treatment model. The importance of a multidisciplinary approach to both assessment and treatment is emphasized. Finally, a case example is provided to illustrate the problem and the possibilities for successful management.

Adult↗

Self-awareness after traumatic brain injury: a comparison of measures and their relationship to executive functions.

Poor awareness of deficit is common after brain injury. Recent literature has examined various tools for measurement of this phenomenon; the most widely used being self-other rating scales. Although self-other scale measures have face validity, their criterion-related validity has not been adequately demonstrated, and there is little information as to whether and how they relate to other neuropsychological measures. The present study compared measurement of awareness by the Dysexecutive (DEX) Questionnaire self-other rating scale with the Self-Awareness of Deficits Interview (SADI), a semistructured interview measure. Evaluation of awareness by these measures was compared to tests of executive functioning and IQ. Results indicated significant, albeit marginal relationships between the two measures, and better correlation of the SADI with measures of frontal lobe functioning. The SADI also predicted injury severity.

Adult↗

Victoria Symptom Validity Test scores of patients with profound memory impairment: nonlitigants case studies.

Victoria Symptom Validity Test (VSVT) scores from six nonlitigants with neurological illness accompanied by dense anterograde amnesia or severe memory impairment are presented. All of these patients obtained perfect or near perfect scores on the VSVT. These data add to the literature suggesting that the VSVT is insensitive to genuine neurologically-based memory impairment and provide an additional floor-level clinical benchmark against which to compare the performance of litigants.

Adult↗

Prosthetic systems for addressing problems with initiation: guidelines for selection, training, and measuring efficacy.

In this paper we address the practical considerations for rehabilitation of problems with initiation. A variety of rehabilitation strategies for clients who have problems with initiation are discussed, as are our recommendations for the use of an external cueing system with these clients. Available external cueing systems are reviewed, including those that have been shown to be effective for prospective memory deficits. We identify important factors involved in selecting a particular external cueing device, and we provide guidelines for training to both respond to and program external cues. Finally, we discuss ways to monitor the efficacy of rehabilitation of problems with initiation. Throughout we provide an illustrative case example describing implementation of an external cueing system with a client who has difficulties with initiation, other aspects of executive function, and anterograde amnesia.

Humans↗

The effectiveness of constraint induced movement therapy in two young children with hemiplegia.

Constraint induced movement therapy (CIMT) for hemiplegia involves constraining use of the unaffected limb while providing intensive shaping and practice of movements in the hemiplegic limb. The technique had been shown to be highly effective in improving upper limb function in adults following stroke, but there is only a limited literature on the use of this intervention in children. This paper provides a brief overview of the theory and background of this procedure, and reviews the literature on use of the technique in children. It then provides detailed case reports for two hemiplegic children, ages 19 and 38 months, each of whom underwent a trial of CIMT. Both children made significant gains in upper arm function that were reflected in a variety of domains, including aspects of everyday functional limb use. Gains persisted to variable degrees and some unexpected new gains were noted following cessation of CIMT. Practical challenges for the children, parents, and therapists in implementing this intensive but promising intervention are also discussed.

Child, Preschool↗

Putting Humpty Dumpty together again: the importance of integrating cognitive and emotional interventions.

Acquired brain injury commonly results in both cognitive and emotional sequela, and it is increasingly recognized that these domains of functioning interact. Consequently, interventions directed at only or primarily one domain may be confounded by this interaction. To maximize treatment potential, we believe cognitive rehabilitation must integrate both cognitive and emotional interventions, and attend to belief systems about, and affective responses to, cognitive challenges. We review the scant literature addressing the impact of combined interventions for clients with acquired brain injury. Integrated with these reviews are 2 case studies that appear to break treatment "myths." Specifically, we address the notion that emotion-focused treatments are appropriate only for clients with awareness or insight and the notion that cognitive interventions are ineffective, and potentially even contraindicated, for clients whose profile suggests emotional distress and functional, as opposed to neurological, impairments. In each of these cases, we demonstrate that combining cognitive and emotional interventions was not only effective but also even more valuable than previous treatment approaches aimed exclusively at one domain. We conclude by emphasizing the importance of understanding emotional response to, and beliefs about, cognitive difficulties in developing effective interventions.

Adaptation, Psychological↗

Awareness, emotional adjustment, and injury severity in postacute brain injury.

OBJECTIVE: Relationships among awareness of deficits, injury severity, and emotional adjustment in patients with traumatic brain injury were explored. PARTICIPANTS: One hundred sixty-six individuals were referred for postacute neurocognitive assessment. DESIGN: Retrospective file analysis identified injury severity, and data from the Patient Competency Rating Scale and Katz Adjustment Scale-Revised, utilizing self-ratings and significant others' ratings, were gathered. RESULTS: Significant others described emotional adjustment difficulties, regardless of the severity of injury. A positive association was noted between patients' acknowledgment of neurobehavioral problems and ratings of their emotional adjustment. CONCLUSIONS: Severity of TBI appeared less important than emotional adjustment in the awareness of deficit; mildly injured patients were more likely to report neurobehavioral deficits than were moderately and severely injured patients, relative to the reports of significant others.

Adaptation, Psychological↗

Constraint-based therapies as a proposed model for cognitive rehabilitation.

This article proposes that constraint-induced therapy represents a theoretical model of rehabilitation emerging from basic research with implications for cognitive remediation attempts. It provides an overview of current work on constraint-induced therapies with a focus on the most widely used of these techniques, constraint-induced movement therapy (CIMT). An example from recent research in the cognitive sciences demonstrates how underlying principles of the CIMT could be used to guide rehabilitative efforts for cognitive dysfunction. Limitations and obstacles of applying such an approach are discussed.

Animals↗