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Biomedical subjects

Gerald Goldstein

Publications and source records attributed to Gerald Goldstein.

At least 19 recordsLinked to original sources
PubMed2006

The profile of memory function in children with autism.

A clinical memory test was administered to 38 high-functioning children with autism and 38 individually matched normal controls, 8-16 years of age. The resulting profile of memory abilities in the children with autism was characterized by relatively poor memory for complex visual and verbal information and spatial working memory with relatively intact associative learning ability, verbal working memory, and recognition memory. A stepwise discriminant function analysis of the subtests found that the Finger Windows subtest, a measure of spatial working memory, discriminated most accurately between the autism and normal control groups. A principal components analysis indicated that the factor structure of the subtests differed substantially between the children with autism and controls, suggesting differing organizations of memory ability.

Adolescent↗
PubMed2006

Neuropsychologic functioning in children with autism: further evidence for disordered complex information-processing.

A wide range of abilities was assessed in 56 high-functioning children with autism and 56 age- and IQ-matched controls. Stepwise discriminant analyses produced good group discrimination for sensory-perceptual, motor, complex language, and complex memory domains but lower agreement for the reasoning domain than previously obtained for adults. Group discrimination did not occur for attention, simple language, simple memory, and visuospatial domains. Findings provide additional support for a complex information-processing model for autism, previously based on adult data, demonstrating a pattern across domains of selective impairments on measures with high demands for integration of information and sparing when demands were low. Children as compared to adults with autism exhibited more prominent sensory-perceptual symptoms and less pronounced reasoning deficits reflecting brain maturation.

Adolescent↗
PubMed2006

The cycle of schizoaffective disorder, cognitive ability, alcoholism, and suicidality.

In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-TV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a history of suicide attempts or suicidal ideation. Discriminant analysis was used to identify cognitive test performance measures that distinguished those with versus those without suicidal behavior. None of the cognitive measures discriminated between the two groups. The rates of suicidal behavior (suicidal ideation and suicide attempts) did not differ between participants with versus those without comorbid alcohol use. An association was found between suicidal behavior and the diagnosis of schizoaffective disorder. It was concluded that the history of prominent mood syndromes characteristic of schizoaffective disorder contributes to increased risk of suicidal behaviors. Cognitive dysfunction and/or alcoholism did not contribute additionally to risk in this study.

Adult↗
PubMed2005

The effects of antipsychotic medication on factor and cluster structure of neurologic examination abnormalities in schizophrenia.

This study extends a previous study of the factor structure of the neurologic examination in unmedicated schizophrenia, utilizing cluster analysis and adding a medicated condition. We administered a modified version of the Neurologic Evaluation Scale (NES) on two occasions to 80 patients with schizophrenia or schizoaffective disorder, once while on antipsychotic medications and once while off medication. Data were distilled by combining right- and left-side scores, and by excluding rarely abnormal and unreliable items from the analysis. Principal components analysis yielded an intuitive four-factor solution in the unmedicated condition, but an inscrutable five-factor solution during medication. Cluster analysis revealed three groups: normal, cognitively impaired, and diffusely impaired. These results were also less interpretable with data from the medicated condition. Neurologic performance was better in the medicated than in the unmedicated condition. As is the case with other domains of symptoms and performance in schizophrenia, relationships among neurologic exam variables are altered by the presence of antipsychotic medication.

Adult↗
PubMed2005

Indicators of genetic liability to schizophrenia: a sibling study of neuropsychological performance.

Despite clear evidence of important genetic influences on schizophrenia, identifying the genes involved has been difficult because of the genetic complexity of the phenotype. The use of additional phenotypic measures that are more sensitive to the genetic liability than is the clinical diagnosis should enhance the power to detect small individual genetic effects. The present study assessed the neuropsychological performance of 30 male schizophrenia probands, 30 of their unaffected male siblings, and 20 well controls matched on age, sex, and education in order to identify measures that may be particularly sensitive to the genetic liability to schizophrenia and thus may be useful in gene mapping studies. Siblings showed impaired neuropsychological performance compared to controls on four out of the five measures used. Additional results suggested that Trails B was especially effective at discriminating index siblings from controls, thus supporting its potential utility as a candidate quantitative phenotype to aid in gene mapping studies of the disorder.

Adolescent↗
PubMed2005

Confirmatory factor analysis of the Neurological Evaluation Scale in unmedicated schizophrenia.

Factor structure of the Neurological Evaluation Scale (NES) was evaluated in 95 unmedicated patients with schizophrenia using confirmatory factor analysis (CFA). CFA was used to test four competing models that were based on prior empirical work examining the factor structure of the NES, as well as on theoretical considerations. A three-factor solution composed of "repetitive motor," "cognitive-perceptual," and "balance-tandem" factors best accounted for the data. These findings are consistent with prior exploratory studies that have suggested the NES is a multidimensional procedure that assesses diverse neurological domains. The current results contribute to the development of empirical subscales for neurological assessment procedures to be used in psychiatric conditions.

Adult↗
PubMed2005

The application of short forms of the Wechsler Intelligence scales in adults and children with high functioning autism.

We evaluated the predictive accuracy of short forms of the Wechsler intelligence scales for individuals with high functioning autism. Several short forms were derived from participants who had received the full procedure. Stepwise multiple regression analyses were performed to determine the strength of association between the subtests included in the short form and IQ scores based upon the full test. These analyses were performed for all participants, and also for autism participants with atypical subtest profiles. In all analyses the percentages of explained variance were typically in the .8-.9 range. It was concluded that short forms may be used with good predictive accuracy in individuals with high functioning autism, even when the subtest profile is atypical.

Adolescent↗
PubMed2005

Verbal and spatial working memory in autism.

Verbal and spatial working memory were examined in high-functioning children, adolescents, and adults with autism compared to age and cognitive-matched controls. No deficit was found in verbal working memory in the individuals with autism using an N-back letter task and standardized measures. The distinction between the N-back task and others used previously to infer a working memory deficit in autism is that this task does not involve a complex cognitive demand. Deficits were found in spatial working memory. Understanding the basis for the dissociation between intact verbal working memory and impaired spatial working memory and the breakdown that occurs in verbal working memory as information processing demands are increased will likely provide valuable insights into the neural basis of autism.

Adolescent↗
PubMed2005

Impaired memory for faces and social scenes in autism: clinical implications of memory dysfunction.

A clinical memory test, the Wechsler Memory Scale-III (WMS-III), was used to study the auditory and visual memory of 29 high-functioning adults with autism and 34 group-matched normal controls. The individuals with autism performed as well as the controls on immediate and delayed memory for word pairs and stories and on a verbal working memory task. The autism group was impaired on immediate and delayed recall of faces and of family scenes and had impaired spatial working memory. The integrity of verbal working memory and impaired spatial working memory is consistent with the findings of other studies and may reflect the greater computational demands of the spatial task. Most importantly, the deficits in memory for faces and common social scenes, complex visual/spatial stimuli, demonstrate the contribution of memory dysfunction in autism to deficits in real life function.

Adolescent↗
PubMed2005

Cognitive function in schizoaffective disorder and clinical subtypes of schizophrenia.

Cognitive studies of patients with Schizoaffective Disorder typically indicate that the cognitive function of these patients resembles that of patients with Schizophrenic Disorder more than it does patients with nonpsychotic Mood Disorder. In this study patients with Schizoaffective Disorder were compared with patients with Paranoid, Undifferentiated and Residual clinical subtypes on a number of measures of cognitive function. Multivariate analyses of variance indicated that the cognitive function of Schizoaffective and Paranoid patients had more intact cognitive function that did Undifferentiated and Residual patients. Application of cluster analysis indicated that there were relative high percentages of Schizoaffective and Paranoid patients in a "Neuropsychologically Normal" cluster. It was concluded that Schizoaffective Disorder as well as other clinical subtypes of schizophrenia are cognitively heterogeneous, and it was suggested that a subgroup of patients with Schizoaffective Disorder may not differ in cognitive ability from patients with nonpsychotic Mood Disorder.

Adult↗
PubMed2004

Malingering indexes for the Halstead Category Test.

Two studies were conducted to evaluate potential malingering indexes on the Halstead Category Test. The aim of the first study was that of documenting that groups of individuals with established cognitive impairment did not score positively on the proposed indexes. Of the indexes considered, it was found that these groups made very few errors on subtests I and II of the test and improved their performance on subtest VI relative to V. Subtests I and II are very simple and both subtest V and VI involve the same principle. It was proposed that malingerers would make excessive numbers of errors on subtests I and II, and would not show improvement on subtest VI over subtest V. The second study compared the performance of patients with brain damage to students who were either trained to malinger or encouraged to perform as well as they could on the Category Test. Comparisons were made on the malingering indexes among these groups showing that mean scores of the patients with brain damage on several of the indexes did not differ from those of the students encouraged to do well, but both of these groups did significantly better than the student malingerers. A discriminant analysis of the set of malingering indexes classified 20% of the student malingerers as brain damaged, and 3.4% of the patients with brain damage as malingerers. A stepwise analysis indicated that number of errors on subtests I and II and Total Errors were particularly sensitive to malingering.

Adult↗
PubMed2004

Relationships between cognitive and neurological performance in neuroleptic-naïve psychosis.

The authors explored relationships between neuropsychological performance and neurological exam abnormalities in 86 never-medicated patients with nonorganic psychosis (59 with schizophrenia or schizoaffective disorder) and 51 healthy subjects. Assessments include a reliable subset of the Neurological Evaluation Scale (rNES) and several neuropsychological tests of attention, executive function, memory, and current and premorbid intelligence. Principal components analysis of the rNES yielded two main factors. Of these, CogPer (consisting of more cognitively demanding perceptual tasks) showed stronger relationships than RepMot (consisting of repetitive manual motor tasks) to neuropsychological measures. Customarily, frontal neuropsychological tasks also relate more strongly to CogPer than to RepMot. Approximately one-half of the variability in these cognitive and neurological assessments is shared.

Adult↗
PubMed2003

A retrospective study of premorbid ability and aging differences in cognitive clusters of schizophrenia.

This retrospective, cross-sectional study evaluated whether age-related differences in patterns of cognitive deficit exist among four cognitively based schizophrenia subgroups. These subgroups had previously been identified through cluster analyses of a battery of abstraction and problem-solving tests in large samples. Evaluation of estimated premorbid intellectual ability and postmorbid cognitive functioning stratified by decade from the twenties through the fifties revealed different patterns across the schizophrenia subgroups and a clinical comparison sample. A near normal cognitive subgroup demonstrated relatively high premorbid intellectual ability and a pattern of age differences similar to the comparison sample, with the exception of deficits on the Wisconsin Card Sorting Test that were detectable in the twenties and remained stable thereafter. In contrast, a subgroup characterized by severe, pervasive cognitive deficit demonstrated low premorbid intellectual ability and extremely low test scores across the four decades studied. The remaining clusters were characterized by moderate cognitive impairment and showed age differences suggestive of a decline in cognitive function around the time of illness onset that remained stable. Results provide further support for the validity of these subgroups and encourage continued efforts to identify cognitively based candidate schizophrenia subtypes.

Adult↗
PubMed2003

A consideration of neuropsychologically normal schizophrenia.

Neuropsychological deficits are considered by many to be core features of schizophrenia. However, about 20% of patients with schizophrenia appear to have normal neuropsychological function. This study investigates this subgroup by comparing a "neuropsychologically normal" schizophrenia group to a non-schizophrenic, non-brain damaged patient comparison (PC) sample, and to patients with definitive brain damage who performed normally on neuropsychological testing. All patients completed the Halstead-Reitan Neuropsychological Test Battery and were classified as neuropsychologically normal or impaired using the Average Impairment Rating (AIR). In a sample of 113 patients with schizophrenia, 19.5% were classified as neuropsychologically normal. The brain damaged neuropsychologically normal group (BD-NN) consisted of 14.3% of 124 subjects. These groups were compared with a patient non-schizophrenic, non-brain damaged group who were selected on the basis of having an Average Impairment Rating in the neuropsychologically normal range. The neuropsychologically normal schizophrenic group performed less well than the non-brain damaged, non-schizophrenic patient comparison group on a number of tests, indicating that patients in this group may not be completely neuropsychologically normal, and would be better characterized as "high-functioning" or near normal. The results are discussed in regard to possible neurobiological differences between neuropsychologically impaired and intact schizophrenic patients, and implications for course and outcome.

Adult↗
PubMed2003

Diagnostic specificity and neuroanatomical validity of neurological abnormalities in first-episode psychoses.

OBJECTIVE: Neurological abnormalities are frequently seen in patients with first-episode psychotic disorders but are generally considered to be diagnostically nonspecific, neurologically nonlocalizing, and, hence, "soft." This study examined the neuroanatomical correlates and diagnostic specificity of abnormal findings on the neurological examination in first-episode schizophrenia and other psychotic disorders. METHOD: Neuroleptic-naive patients with schizophrenia (N=90) and with nonschizophrenia psychoses (N=39) and carefully matched healthy subjects (N=93) were compared on total and factor scores for a reliable subset of Neurological Evaluation Scale items. The relationship between neurological examination abnormalities and alterations in the relevant brain structures as assessed by magnetic resonance imaging was examined in a subset of subjects. RESULTS: Factor scores for repetitive motor task abnormalities were higher in both patient groups, relative to the healthy group, and did not distinguish between the patient groups. Factor scores for abnormalities in cognitively demanding and perceptual tasks were markedly higher in the schizophrenia group, relative to both comparison groups, and were not different between the nonschizophrenia psychoses group and the healthy comparison group. Higher scores for the cognitive/perceptual abnormalities factor were correlated with smaller volumes of the left heteromodal association cortex. CONCLUSIONS: Neurological signs may serve as expedient bedside measures that are potentially useful in the assessment of idiopathic psychoses, and cognitive/perceptual neurological signs may have a measure of diagnostic specificity. These findings provide neurobiological validation of abnormal findings on the neurological examination. These abnormalities may reflect discrete neuroanatomical alterations in schizophrenia and may have a localizing value.

Adult↗
PubMed2002

Abstract reasoning in autism: a dissociation between concept formation and concept identification.

The concept identification and concept formation aspects of abstract reasoning were examined in 90 nonmentally retarded individuals with autism and 107 normal controls. It was hypothesized that pronounced deficits would be found on concept formation tests, whereas performance on concept identification tests would be relatively intact. There was a significant difference between individuals with autism and individuals from a matched control group on all abstract reasoning tasks, but, with the exception of the Wisconsin Card Sorting Test (R. K. Heaton et al., 1993), differences on concept identification tests were not clinically significant. Factor analyses showed that concept formation and concept identification tasks loaded on separate factors in the autism group but not in the control group. Stepwise discriminant function analyses revealed that 2 tests of concept formation correctly classified 78.4% of cases, whereas concept identification tasks did not pass the tolerance test.

Adult↗
PubMed2002

Sensory-perceptual dysfunction in patients with schizophrenia and comorbid alcoholism.

We studied the effects of aging and comorbid alcoholism on sensory-perceptual dysfunction in patients with schizophrenia. Using sensory-perceptual tests from the Halstead-Reitan Neuropsychological Battery included in the Russell, Neuringer, and Goldstein (1970) Perceptual Disorders Index, samples were compared of 54 patients with comorbid schizophrenia and alcoholism, 234 patients with schizophrenia but no history of alcoholism, 132 patients with chronic alcoholism and 171 patient controls. Data were analyzed by one-way analyses of variance followed by Scheffe multiple comparison tests. Numerous significant differences were found among groups, with the comorbid schizophrenia group doing more poorly than the other groups on measures of touch perception and suppression, finger agnosia, and fingertip number writing. Multiple regression analyses using the sensory-perceptual tests as predictor variables and age as the dependent variable indicated that the strength of association between age and the multivariate set of sensory-perceptual test scores was greater in the comorbid schizophrenia group than the noncomorbid schizophrenia, alcoholism and patient control groups. The preponderance of age-related deficits was left-sided, suggesting accelerated decline in right hemispheric function. A comparison of groups across ages on a single Perceptual Disorders Index score showed a substantially larger age effect in the comorbid schizophrenia group relative to the other groups.

Age Factors↗