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Biomedical subjects

Eric Granholm

Publications and source records attributed to Eric Granholm.

17 recordsLinked to original sources
PubMed2006

Effortful cognitive resource allocation and negative symptom severity in chronic schizophrenia.

BACKGROUND: The relationship between negative symptoms, early visual information-processing deficits, and effortful processing resource allocation was investigated. METHODS: Older patients with chronic schizophrenia (n = 58) and healthy controls (n = 71) participated. Pupillary responses were recorded during performance of the span of apprehension task (blocks of 3- and 10-letter arrays) as an index of resource allocation or mental effort during the task. RESULTS: Patients and controls showed larger pupillary responses in higher relative to lower processing loads both during array processing and just prior to array onset (preparation). Both groups, therefore, invested more cognitive effort preparing for and then processing larger arrays. A subgroup of patients with abnormally small pupillary responses and impaired performance showed greater negative symptom severity relative to a subgroup of patients with normal pupillary responses. Smaller pupillary responses in the patients were also significantly correlated with greater negative symptom severity, independent of positive symptom severity. Patients with reduced effortful resource allocation, therefore, exhibited greater negative symptomatology. A subgroup of patients with normal pupillary responses still showed impaired detection accuracy relative to controls, suggesting that reduced cognitive effort or resource allocation problems cannot account for impairments in early visual information processing in this subgroup. CONCLUSIONS: The study illustrates important relationships between cognitive effort and performance that can impact conclusions about the nature of cognitive impairments and associations between negative symptoms and neurocognition in schizophrenia.

Adult↗
PubMed2006

Dual-task information processing in schizotypal personality disorder: evidence of impaired processing capacity.

Working memory theories heavily rely on the concept of processing resources and the their efficient deployment. Some recent work with schizophrenia-spectrum patients has suggested that many associated cognitive impairments may be reduced to deficits in working memory, possibly related to reductions in information-processing capacity resources. In this study, 38 patients with schizotypal personality disorder (SPD), 22 patients with other personality disorders, and 14 healthy comparison participants performed a dual-task processing assessment that was designed specifically for use in this type of study. Participants recalled lists of digits at their predetermined maximum digit span and performed box-checking tests, first alone and then in a dual-task format. Instructions included equal prioritization of both tasks. SPD patients had significantly shorter digit spans, and they also showed more deterioration on both tasks. Performance operating characteristics curves indicated that SPD patients' reduced performance was not due to abnormal resource allocation strategies leading to strategic failures. The authors discuss the implications of these processing capacity limitations for understanding both the signature of cognitive impairment within the schizophrenia spectrum and general abnormalities in working memory.

Adult↗
PubMed2005

Visual scanning deficits in schizophrenia and their relationship to executive functioning impairment.

Abnormal visual scanning of faces, objects, and line drawings has been observed in patients with schizophrenia and is thought to reflect neurocognitive impairment. In this study, a simultaneous measurement approach was used to assess whether schizophrenia patients demonstrate restricted visual scanning when confronted with a complex problem-solving stimulus, and whether visual scanning deficits are predictive of inflexible thinking. Thirty-eight schizophrenia patients and 30 comparison participants were presented with Rorschach inkblots while eye movements were monitored and verbal responses to the stimuli were recorded and scored for inflexible thinking using the Rorschach Repetition and Perseveration Scale. Schizophrenia patients demonstrated fewer and longer visual fixations and shorter total scanpath relative to comparison participants but did not differ on mean scanpath length. Among patients, fewer fixations were associated with a higher frequency of verbal perseverations. Correlations between scanning measures and symptoms showed that negative symptoms were related to a minimal scanning or "staring" approach. Results support previous findings of restricted visual scanning in schizophrenia patients, are consistent with previously observed relationships between visual scanning and symptom profiles, and suggest that visual organizational deficits during complex problem-solving tasks may be related to cognitive inflexibility and frontal-executive dysfunction.

Adult↗
PubMed2005

A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia.

OBJECTIVE: The number of older patients with chronic schizophrenia is increasing. There is a need for empirically validated psychotherapy interventions for these patients. Cognitive behavioral social skills training teaches cognitive and behavioral coping techniques, social functioning skills, problem solving, and compensatory aids for neurocognitive impairments. The authors compared treatment as usual with the combination of treatment as usual plus cognitive behavioral social skills training. METHOD: The randomized, controlled trial included 76 middle-aged and older outpatients with chronic schizophrenia, who were assigned to either treatment as usual or combined treatment. Cognitive behavioral social skills training was administered over 24 weekly group sessions. Blind raters assessed social functioning, psychotic and depressive symptoms, cognitive insight, and skill mastery. RESULTS: After treatment, the patients receiving combined treatment performed social functioning activities significantly more frequently than the patients in treatment as usual, although general skill at social functioning activities did not differ significantly. Patients receiving cognitive behavioral social skills training achieved significantly greater cognitive insight, indicating more objectivity in reappraising psychotic symptoms, and demonstrated greater skill mastery. The overall group effect was not significant for symptoms, but the greater increase in cognitive insight with combined treatment was significantly correlated with greater reduction in positive symptoms. CONCLUSIONS: With cognitive behavioral social skills training, middle-aged and older outpatients with chronic schizophrenia learned coping skills, evaluated anomalous experiences with more objectivity (achieved greater cognitive insight), and improved social functioning. Additional research is needed to determine whether cognitive insight mediates psychotic symptom change in cognitive behavior therapy for psychosis.

Activities of Daily Living↗
PubMed2005

Culture-fair cognitive ability assessment: information processing and psychophysiological approaches.

Valid assessment with diverse populations requires tools that are not influenced by cultural elements. This study investigated the relationships between culture, information processing efficiency, and general cognitive capacities in samples of Caucasian and Mexican American college students. Consistent with the neural efficiency hypothesis, pupillary responses (indexing mental effort) and detection accuracy scores on a visual backward-masking task were both significantly related to the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Full Scale scores. These measures of information processing efficiency were similar in the two groups. However, they were related only to Caucasian American, but not to a comparable sample of Mexican American, students' WAIS-R scores. Therefore, the differential validity in prediction suggests that the WAIS-R test may contain cultural influences that reduce the validity of the WAIS-R as a measure of cognitive ability for Mexican American students. Information processing and psychophysiological approaches may be helpful in developing culture-fair cognitive ability measures.

Adolescent↗
PubMed2004

Measuring cognitive insight in middle-aged and older patients with psychotic disorders.

The study examined the psychometric properties, factor structure and validity of a recently developed measure of insight, the Beck Cognitive Insight Scale (BCIS) and tested the relationship between the BCIS and psychiatric symptoms in a sample of middle-aged and older patients with schizophrenia or schizoaffective disorder. The BCIS measures the ability of respondents to observe and question their cognitive processes, whereas other insight scales focus primarily on knowledge about the presence of an illness and need for treatment. Participants were 164 middle-aged and older outpatients with schizophrenia or schizoaffective disorder who completed a battery of measures assessing insight, symptoms of schizophrenia and symptoms of depression. The results of a confirmatory factor analysis (CFA) supported the two-factor structure previously reported for the BCIS, with one factor labeled self-reflectiveness and the other labeled self-certainty. The BCIS showed adequate reliability and a moderate correlation with the Birchwood Insight Scale (IS). The BCIS correlated with some PANSS subscales measuring symptoms of schizophrenia, but did not correlate at a significant level with symptoms of depression. The findings suggest that middle-aged and older outpatients with schizophrenia or schizoaffective disorder respond on the BCIS in a manner similar to a younger inpatient population. This instrument is a promising tool for measuring the role of cognitive change in a broad range of patients experiencing psychosis.

Adult↗
PubMed2004

Psychosocial functioning on the Independent Living Skills Survey in older outpatients with schizophrenia.

Improving real-life community functioning in patients with severe mental illness has been an important recent focus of treatment outcome research. Few studies, however, have examined psychosocial functioning in older psychotic patients. The Independent Living Skills Survey (ILSS) is a measure of the basic functional living skills of individuals with severe and persistent mental illness. The self-report version of the ILSS was administered to 57 middle-aged and older community dwelling outpatients with schizophrenia and 40 age-comparable nonpsychiatric participants. Regardless of whether patients resided in assisted living or independent settings, they showed significantly impaired functioning on a majority of the functional areas assessed by the ILSS. No consistent relationship was found between symptom severity and functioning. With certain modifications, the ILSS appears to be a sensitive indicator of functional impairment in this older sample of community-dwelling outpatients with schizophrenia. Information provided by the instrument might be useful to guide rehabilitation efforts and measure functioning changes in response to treatment in this population.

Activities of Daily Living↗
PubMed2004

Pupillary responses on the visual backward masking task reflect general cognitive ability.

Cognitive processing efficiency requires both an ability to attend to task-relevant stimuli with quickness and accuracy, also while filtering distracting or task-irrelevant stimuli. This study investigated cognitive processing efficiency by using pupillary responses as an index of attentional allocation to relevant target and irrelevant masks on a visual backward masking task. The relationship between attentional allocation on this task and general cognitive ability on the scholastic aptitude test (SAT) was examined in college students (n=67). A principle components analysis of the pupillary response waveform isolated a late component that appeared to index the attentional demands associated with processing masks on the backward masking task. This pupillary response index of wasteful resource allocation to the mask accounted for significant variance in SAT scores over and above that accounted for by socio-economic status and target detection accuracy scores. Consistent with the neural efficiency hypothesis, individuals who allocated more resources to processing irrelevant information performed more poorly on cognitive ability tests.

Adult↗
PubMed2004

Pupillary responses and attentional allocation problems on the backward masking task in schizophrenia.

Early visual information processing impairment has consistently been found on the backward masking task in patients with schizophrenia, but the nature of this impairment remains unclear. Pupillometry was used to measure attentional allocation during visual backward masking task performance in patients with schizophrenia (n=16) and nonpsychiatric controls (n=16). The extent of pupil dilation recorded during a cognitive task reflects the processing load placed on the nervous system by the task. Schizophrenia patients detected significantly fewer targets than controls only when the stimulus onset asynchrony (SOA) between targets and masks reached 317 ms. For both groups, peak pupil dilation responses were also significantly larger in the 317 ms SOA condition relative to a no-mask condition, suggesting that the processing load of the 317 SOA masking condition was greater than the no-mask condition. In addition, a principal components analysis of pupillary response waveforms identified time-related factors that appeared to differentially index attentional allocation to targets vs. masks. Patients with schizophrenia showed less dilation than controls on a middle factor that appeared to index attentional allocation to targets, but patients showed greater dilation than controls on a late factor that appeared to index attentional allocation to masks. That is, controls attended more to targets than to masks, but patients attended more to masks than to targets. These findings suggest that masking impairments at SOA intervals greater than 100-200 ms may be due abnormalities in attentional allocation mechanisms.

Attention↗
PubMed2004

Pupillary dilation to simple vs. complex tasks and its relationship to thought disturbance in schizophrenia patients.

Task-evoked pupil dilation is a measure of attentional allocation. Schizophrenia patients have pupil dilation deficits during high cognitive load tasks, which have been attributed to attentional resource deficits. Moreover, this attentional impairment is thought to be linked to cognitive fragmentation and thought disturbance. Previous attempts to associate attentional deficits to thought disturbance have typically measured these domains at distinct times, incorrectly assuming that both are static variables. In this study, we compared the pupil dilation of 24 schizophrenia patients to 15 non-patients during complex (Rorschach blots) vs. simple visual (line drawings) processing tasks while simultaneously assessing their verbal responses for thought disturbance. Schizophrenia patients' dilation to the simple stimuli was similar to the non-patients; however, they demonstrated significantly less dilation to the complex stimuli. Reduced dilation was also significantly correlated with reduced response complexity and more severe thought disorder. The results suggest that, in the face of complex problem-solving situations, greater attentional impairment and cognitive overload in schizophrenia is associated with higher levels of disturbed and impoverished thinking. These findings support the 'resource limitations hypothesis' of schizophrenia and underscore the utility of a simultaneous paradigm when studying the relationship between attentional deficits and thought disturbance.

Adolescent↗
PubMed2003

Tropicamide effects on pupil size and pupillary light reflexes in Alzheimer's and Parkinson's disease.

Diagnostic tests for Alzheimer's disease (AD) involving tropicamide blockade of cholinergic oculomotor functions were examined in AD patients (n=15), Parkinson's disease (PD) patients (n=15), and non-clinical control (NC) participants (n=15). Pupillographic methods were used to measure pupil diameter and pupillary light reflexes after double-blind ocular administration of dilute tropicamide (0.01%) in one eye and saline in the other eye. Changes in pupil size were measured in bright background light and near-darkness. Tropicamide increased pupil diameter to a similar extent in all three groups in light and darkness. Tropicamide also reduced the amplitude and latency of the pupillary light reflex to a similar extent for all three groups. Tropicamide pupillary response tests, therefore, were not sensitive or specific diagnostic tests for AD. Peak constriction amplitude of the pupillary light reflex was significantly reduced in both eyes in AD and PD groups relative to non-clinical controls, but AD and PD groups did not differ significantly. The pupillary light reflex test, therefore, was sensitive to AD, but lacked adequate specificity. Finally, peak constriction amplitude correlated significantly with dementia severity and donepezil treatment may have partially normalized pupillary light reflex abnormalities in AD patients. The pupillary light reflex test, therefore, may index central cholinergic dysfunction associated with disease progression and improvement in cholinergic function associated with pharmacologic treatment response in AD.

Aged↗
PubMed2003

Reduced processing resource availability in schizotypal personality disorder: evidence from a dual-task CPT study.

Performance on a dual-task information processing task was investigated in 23 schizotypal personality disorder patients (SPD), 29 patients with other noncluster A personality disorders (OPD) and 8 non-psychiatric healthy controls (NC). All participants were assessed using a computer-based visual continuous performance test (CPT) and an auditory CPT individually, and administered again simultaneously in a dual-task condition. The SPD group showed a greater increase in the number of errors of omission than the OPD group or normal controls on the CPT tasks in the dual-task conditions. Performance operating characteristics indicated that the SPD patients did not allocate their attention in a manner different from the healthy controls, suggesting that poorer performance was due to resource limitations in the dual task condition and not strategic failures. These results are similar to previous studies of patients with schizophrenia, where performance deficits on information processing tests have been shown to be related to resource limitations more than failures in effective allocation of attention.

Acoustic Stimulation↗
PubMed2002

Substance use and withdrawal: neuropsychological functioning over 8 years in youth.

This study prospectively examined neuropsychological (NP) functioning associated with adolescent substance use and withdrawal. Participants were youths with histories of substance use disorders (n = 47) and demographically comparable youths with no such lifetime histories (n = 26). They were followed with NP testing and substance involvement interviews at 7 time points spanning 8 years, from ages 16 to 24, on average. After controlling for recent use, age, education, practice effects, and baseline NP functioning, substance use over the 8-year follow-up period significantly predicted performances on tests of memory and attention at Year 8. Additionally, withdrawal symptoms during the follow-up predicted visuospatial and attention scores at Year 8. Findings suggest that use and withdrawal may differentially impact neurocognitive functioning during youth, with heavy use leading to learning, retention, and attentional difficulties, and withdrawal leading to problems with visuospatial functioning.

Adolescent↗
PubMed2002

Lateralized perceptual organization deficits on the global-local task in schizotypal personality disorder.

Right and left hemisphere contributions to perceptual organization functions were examined using a divided-attention version of the global-local task in a sample of 21 unmedicated participants diagnosed with schizotypal personality disorder (SPD) and 20 controls. The SPD participants showed an abnormal global processing advantage. When the visual angle of the hierarchical stimuli was increased from 3 degrees to 9 degrees, the controls showed an increasing local processing advantage, but the SPD participants continued to show an abnormal global processing advantage. These findings suggest a local processing deficit on divided-attention versions of the global-local task in schizophrenia spectrum disorders. Female SPD participants, who had less severe interpersonal deficit symptoms, showed a more abnormal global processing advantage. Hemispheric and processing resource mechanisms that might explain these findings are discussed.

Adult↗
PubMed1999

Hemispheric and attentional contributions to perceptual organization deficits on the global-local task in schizophrenia.

Right and left hemisphere hypotheses have been proposed to account for cognitive deficits in schizophrenia. To examine these hypotheses, perception of global-local patterns was studied in 22 patients with schizophrenia and 28 normal comparison participants. The patients with schizophrenia showed an abnormally exaggerated global processing advantage when attention was divided between global and local levels but not when participants were instructed to attend to either the local or global level. This finding suggested a local processing (left hemisphere) deficit, which was overcome through strategic attentional allocation (instructional set). When the stimulus visual angle was reduced from 9 degrees to 3 degrees, the normal participants showed a shift from a local to a global processing advantage, but the patients did not. This finding suggested a more subtle deficit in strategic attentional processes that develop through exposure to stimulus context.

Adult↗
PubMedDate not supplied

Brief integrated outpatient dual-diagnosis treatment reduces psychiatric hospitalizations.

A retrospective pilot study was conducted to determine whether a relatively brief integrated outpatient treatment for patients with dual disorders reduced inpatient hospital service utilization. Outpatients (n=44) with substance dependence and either comorbid schizophrenia, major depressive disorder, or bipolar disorder were studied. A multidisciplinary team provided relatively brief (up to 24 weeks), integrated, dual-diagnosis outpatient treatment. A significant 60% reduction in the number of psychiatric hospitalization days was found for the year after treatment as compared to the year before. Patients with schizophrenia showed the greatest reduction (74%) in hospitalization days. Thus, even brief integrated outpatient dual-diagnosis treatment can reduce inpatient psychiatric hospitalizations.

Adult↗