Biomedical subjects

E Helmes

Publications and source records attributed to E Helmes.

At least 19 recordsLinked to original sources

PubMed2006

Gender differences in performance of script analysis by older adults.

Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

Adolescent↗

PubMed2006

Interpersonal dependency in older adults and the risks of developing mood and mobility problems when receiving care at home.

Despite a broad interest in various types of dependency as they relate to older people (structured dependency, learned dependency, learned helplessness, and interdependency), research of dependency in older people has not included an individual difference measure of interpersonal dependency. Studies that have examined the correlates of interpersonal dependency in general populations have found links with mental health conditions such as depression and anxiety and also with physical illness. If these findings could generalise to older populations then there would be important intervention and financial implications for providers of health services to older adults. This research examined the correlates of interpersonal dependency in older adults using a new measure of interpersonal dependency-the Interpersonal Dependency Scale for Older Adults (IDS-OA). One hundred and five new clients aged 65-90 years recruited through a private home care agency responded to a postal survey requesting their completion of a questionnaire package. Interpersonal dependency was found to correlate significantly with both depression and mobility. In addition, a hierarchical regression analysis found that both higher interpersonal dependency and depression were significant positive predictors of poor mobility in older adults.

Activities of Daily Living↗

PubMed2006

A comparison of MicroCog and the Wechsler Memory Scale (3rd ed.) in older adults.

In recent years, computerized assessment of cognitive functions such as memory has increased in popularity. Here we contrast the performance of 33 community-dwelling older adults (mean age 71.2 years, SD = 7.62) on the computer-based MicroCog with the conventional Wechsler Memory Scale-3rd Edition (WMS-III). Participants were screened for possible depression using the Geriatric Depression Scale and completed both memory tests in counterbalanced order. WMS-III General Memory correlated moderately with both the MicroCog Memory index and the General Cognitive Functioning index. Correlations between the visual memory measures of the 2 tests were not statistically significant. Agreement between the tests on the classification of participants as lying within the average, below average, or above average ranges was fair at best. We conclude that the correspondence between the 2 measures is not sufficient to substitute 1 for the other for clinical decision making as to the memory functioning of older adults.

Aged↗

PubMed2004

Australian lawyers' views on competency issues in older adults.

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions.

Adult↗

PubMed2001

Does sex influence the relation between symptoms and neurocognitive functions in schizophrenia?

OBJECTIVE: A secondary analysis of our data to investigate if sex influences the specificity of the relationship between each of the 3 clinical syndromes (i.e., reality distortion, disorganization and psychomotor poverty) in schizophrenia and the neurocognitive functions that are thought to represent regional brain functions. PATIENTS AND DESIGN: Fifty-seven male and 30 female patients with a DSM-III-R diagnosis of schizophrenia were rated on the Scale for Assessment of Negative Symptoms and the Scale for Assessment of Positive Symptoms to derive scores for psychomotor poverty, disorganization, and reality distortion syndromes. All subjects completed a battery of neuropsychological tests purported to assess functioning of left temporal, right temporal, left basal frontal, right basal frontal, and dorsolateral prefrontal cortex. RESULTS: Correlation coefficients between syndrome scores and neuropsychological measures showed only word fluency (left frontal functioning) to have a statistically significant association with psychomotor poverty in women (p < 0.01). This relation was specific to psychomotor poverty syndrome. No relations between neurocognitive measures and symptoms were seen in men. CONCLUSIONS: The lack of specific relations between symptom dimensions in schizophrenia may be influenced by the fact that the neuronal circuitry associated with particular symptom dimensions may differ in men and women.

Adult↗

PubMed2001

Assessment of depression in older adult males by general practitioners. Ageism, physical problems and treatment.

BACKGROUND: Depressive symptoms are common among older people. This study evaluated whether the combination of age and the presence of a physical illness would influence the recognition, treatment and further investigation by general practitioners of possible depression in older adult males. METHOD: A 2 x 2 factorial design involving four vignettes of a male with depression was used. The variables involved two age levels and the presence or absence of heart disease. The sample consisted of 189 Perth GPs. RESULT: Depression was recognised by up to 95% of the GPs. Although the recognition of uncomplicated depressive symptoms was lower in the 76 year old male compared with the 56 year old, health recognition seemed the same for both. There were no effects for recommended treatment, prognosis, perceived competency to treat or further investigation. Antidepressant medication and counselling by the GP were the recommended treatments. CONCLUSION: Depressive symptoms were recognised by more GPs in this study than in the existing literature, but with less likelihood of recognition for the older male.

Aged↗

PubMed1997

Neuropsychological correlates of syndromes in schizophrenia.

BACKGROUND: On the basis of Liddle's three-syndrome model of schizophrenia, it was predicted that: (1) symptoms of psychomotor poverty would be particularly correlated with impaired performance on neuropsychological tests likely to reflect functioning of the dorsolateral prefrontal cortex; (2) disorganisation would be particularly correlated with impaired performance on tests sensitive to medio-basal prefrontal functioning; and (3) reality distortion would be particularly correlated with measures sensitive to temporal lobe functioning. METHOD: The above hypotheses were tested on 87 subjects with a confirmed diagnosis of schizophrenia. Patients' symptoms were scored for each of the three syndromes. Patients completed six neuropsychological tests designed to measure impairment in specific areas of the brain. RESULTS: There was no support for the first two hypotheses. There was, however, evidence of a specific relationship between reality distortion and neuropsychological performance usually considered to be related to left temporal lobe functioning. CONCLUSIONS: Although not directly supporting the first two hypotheses; the results are, in general, consistent with there being different cortical-subcortical circuits associated with each of psychomotor poverty and disorganisation. Temporal lobe functioning appears to have particular significance for the reality distortion syndrome.

Adult↗

PubMed1997

EEG coherence and syndromes in schizophrenia.

BACKGROUND: Frith et al (1995) and others have hypothesised that disruptions in the connection between left frontal and temporal areas of the brain are a central deficit in schizophrenia. In this paper we examine whether such connectivity as assessed by EEG coherence is related to level of symptoms in patients with schizophrenia. METHOD: For 73 patients with schizophrenia, assessment of the EEG coherence between frontal and temporal regions were carried out under conditions of activation by a mathematical task, and between frontal and occipital regions when performing a visuo-spatial task. We then examined the relationship between these coherence measures and the reality distortion, disorganisation and psychomotor poverty dimensions of symptomatology. RESULTS: Only left frontal-temporal connectivity was found to have a significant negative relationship to symptomatology. This relationship was, however, specific to reality distortion rather than to symptoms of disorganisation or psychomotor poverty, and may be more characteristic of males than females. CONCLUSIONS: Disruption of frontal-temporal connectivity appears to have a specific relationship to reality distortion symptoms in schizophrenia.

Adult↗

PubMed1995

Patterns of deterioration in senile dementia of the Alzheimer type.

OBJECTIVE: To determine rates of decline in Alzheimer's disease. DESIGN: A longitudinal review of patients diagnosed as having dementia during life, tested serially with the Extended Scale for Dementia, and confirmed by autopsy as having Alzheimer's disease. SUBJECTS AND SETTING: Twenty-nine dead patients with Alzheimer's disease from the participants in the University of Western Ontario Dementia Study Project, confirmed at autopsy as having Alzheimer's disease. METHODS: Analysis of the Extended Scale for Dementia data according to a trilinear model. FINDINGS: In the middle phase of the trilinear model, there was a mean annual change of 13% (range, 2.5% to 51.7%). CONCLUSIONS: It is likely that the common method of averaging a group of different individual scores from the initial and middle phases of observation of Alzheimer's disease collapses together individuals at different stages of the disorder, some of whom are in the initial plateau phase and whose conditions are not declining rapidly. The trilinear model of decline avoids this difficulty and the present study provides postmortem confirmed figures on rate of change.

Aged↗

PubMed1995

A questionnaire to evaluate disability in osteoporotic patients with vertebral compression fractures.

BACKGROUND: Few studies have reported on the functional disability due to vertebral compression factors in osteoporosis. The Osteoporosis Functional Disability Questionnaire (OFDQ) was developed to assess disability in patients with osteoporosis and back pain due to vertebral fractures. The domains of the OFDQ include: quantitative indices of pain, a standard 20-item depression scale, 26 items relating to functional abilities, a scale of social activities, and confidence in the ability of prescribed osteoporosis treatment to reverse disability. METHODS: Reliability of the OFDQ was assessed using test-retest and internal consistency methods. Criterion validity was demonstrated by correlating disability against radiographic evidence of vertebral fractures. Construct validity was demonstrated through comparisons of 81 patients with osteoporosis and fractures to 37 healthy age-matched controls. Additional evidence was found in comparing 45 of the 81 cases who were actively engaged in an exercise program with 36 cases who were sedentary. RESULTS: The test-retest reliabilities ranged from .76 to .93, with internal consistencies from .57 to .96. The OFDQ correlated significantly with relevant spinal pathology, and showed significant improvements in activities of daily living and socialization when active exercisers were compared to inactive patients with osteoporosis. CONCLUSIONS: The OFDQ is a reliable instrument which correlates well with objective measures of osteoporotic spinal damage. It is also sensitive to changes in disability brought about by participation in our aerobic exercise program. The OFDQ may be a useful adjunct to measuring outcomes in other osteoporotic treatment protocols.

Activities of Daily Living↗

PubMed1994

Are schizophrenic symptoms different in patients with higher education?

Ratings of 87 symptoms on a Canadian sample of 108 DSM-III schizophrenics (41 men, 67 women) were unrelated (point biserial coefficients) to their education. The only exceptions to this trend were weak correlations with ratings of apathy, insight, and of premorbid adjustment. Patients with higher education were less frequently labelled as apathetic (r = .28) or as lacking insight (r = .26) and their premorbid adjustment was better (r = .25). None of the symptoms traditionally considered as markers specific for schizophrenia was significantly related to education.

Adult↗

PubMed1993

Type A personality and marital intimacy in amputees.

The specific characteristics of the Type A personality have generated a great deal of recent attention due to the prevalence of these characteristics in persons suffering from coronary heart disease. Type A individuals are more likely to be involved in serious accidents and experience more secondary complications when faced with serious illness. They are also less apt to incorporate appropriate coping strategies to help deal with pain and discomfort, or to enlist the help of others for such purposes. These studies are particularly interesting for those involved in health care, as such personality characteristics may influence health and healing. The present study examines the Type A personality construct and marital intimacy in a sample of 34 lower extremity amputees. The Survey of Work Styles (SWS) was used to measure Type A behaviour patterns, and the Waring Intimacy Questionnaire (WIQ) to assess the marital relationship. When compared to a group of age- and sex-matched controls, lower extremity amputees showed higher prevalence of some Type A behaviour patterns, and, in males, lower levels of marital intimacy. The low return rate of questionnaires in this study limits its generalizability, but results remain consistent with predictions for Type A behaviour patterns.

Adult↗

PubMed1992

An examination of psychometric properties of the extended scale for dementia in three different populations.

The Extended Scale for Dementia (ESD), a development of the Mattis Dementia Rating Scale, has been used in the evaluation of dementia and aging and has shown substantial clinical utility. We report on analyses of its properties and internal structure in three samples of older people: 153 normals, 101 psychiatric hospital residents, and 114 patients with Alzheimer disease. The results showed good internal consistency in the two clinical samples, with much lower reliability in the normals, for whom the test was too easy. A review of the item statistics led to the use of 17 of the 23 ESD items in item component analyses in the three samples. Use of Horn's parallel analysis criterion led to the retention of three components in the normal group and one in both the hospital and Alzheimer groups. The results are compared with other work and are in accordance with the view that cognitive structure becomes more simple with increasing dementia.

Aged↗

PubMed1992

A comparison of psychosocial functioning and personality in amputee and chronic pain populations.

OBJECTIVE: To compare two populations with disabling conditions, amputation and chronic pain, in terms of psychosocial functioning and personality factors. We hypothesized that the degree of disability of amputees would resemble that of patients with chronic musculoskeletal pain. We also examined the prevalence of personality characteristics stereotypic of chronic pain in the two samples. DESIGN: Survey. SETTING: Outpatients at the pain and amputee clinics of a teaching hospital. PATIENTS: Ninety-four patients (47.7% of the number approached) were selected in consecutive samples taken from records and clinics. MAIN OUTCOME MEASURES: Sickness Impact Profile (SIP) and the Millon Clinical Multiaxial Inventory (MCMI). RESULTS: The two groups did not differ on the SIP total score. Sixteen of 47 amputees reported significant pain, and this group showed higher levels of overall disability than did patients with chronic musculoskeletal pain (n = 47) and significantly greater disability than the 31 amputees reporting low levels of pain. Contrary to common perceptions of chronic pain patients, 25% showed no significant evidence of psychopathology. Only anxiety and dysthymia levels were clinically elevated in more than 50% of chronic pain patients. CONCLUSIONS: Results are discussed in terms of the dual disability of amputees with chronic pain and of the hazards of attributing common characteristics to heterogenous patient groups.

Adult↗

PubMed1991

Evidence that defence mechanisms are more related to personality than to symptoms.

The Defense Mechanisms Inventory is one of the more popular instruments for examining hypothetical dynamic mechanisms. It is known to correlate with some measures of personality and mood. We proposed that, as measures of personality and measures of defence mechanisms are considered to have a common origin in early experience, they should be more strongly correlated than measures of mood, given equal power in the measures of the dependent variables. In this connection we report the relationship which were found between scores on the subscales of the Inventory and the Hysteroid/Obsessoid Questionnaire and the Hospital Anxiety and Depression Scale. There was only a weak relationship between anxiety or depression on the one hand and the Defense Mechanisms Inventory on the other. The highest correlation noted in this regard was Pearson's r = .18, p = .065 between anxiety and the scale Turning Against Self (TAS). The Hysteroid/Obsessoid Questionnaire showed a positive relationship between high scores (hysteroid, i.e. extraverted) and the scale TAO (Turning Against the Object) and a negative relationship for the TAS scale (r = -.290, p = .003). Thus the Defense Mechanisms Inventory showed a stronger relationship with personality than with mood.

Adult↗

PubMed1990

The positive triad of schizophrenic symptoms. Its statistical properties and its relationship to 13 traditional diagnostic systems.

Using data from the WHO International Pilot Study of Schizophrenia and from our own previously reported series of 120 patients receiving treatment for schizophrenia, we ascertained the degree of agreement between 13 different systems for diagnosing schizophrenia. We identified a triad of symptoms similar to that from the International Pilot Study: auditory hallucinations, passivity feelings, and disturbances of affect. This triad correlated very strongly with the diagnosis of schizophrenia as determined by the 13 diagnostic systems, as well as with response to fluphenazine in our series. The triad should serve as a core set of symptoms in the study of schizophrenic illness. It represents the leading phenomena in a group of patients having what is generally considered to be schizophrenia, although it does not provide a definitive diagnosis. Evidence is needed on its specificity.

Dependent Personality Disorder↗

PubMed1990

A systematic inquiry into recollections of childhood experience and their relationship to adult defence mechanisms.

The relationships between childhood experience, measured by the PBI, and adult defence mechanisms, evaluated through the DMI, were examined in 114 subjects. There were modest but significant correlations between the primitive defences of 'turning against others' and 'projection' on the one hand, and a lack of parental care, as experienced by the subjects, on the other. 'Principalisation' (e.g. intellectualisation, isolation and rationalisation) and 'reversal' (e.g. negation, reaction formation, denial and repression) were positively associated with parental care. These findings account for only a small portion of the variance but show that, as with certain personality traits, actual or perceived childhood experience contributes in a recognisable fashion to the patterns of adult defences and behaviour.

Adult↗

PubMed1989

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Community Mental Health Services↗