Biomedical subjects

Kyle Boone

Publications and source records attributed to Kyle Boone.

10 recordsLinked to original sources

PubMed2006

Ecological validity of neuropsychological assessment and perceived employability.

Ecological validity studies that have examined the relationship between cognitive abilities and employment in psychiatric and medical populations have found that a wide range of cognitive domains predict employability, although memory and executive skills appear to be the most important. However, no information is available regarding a patient's self-perceived work attributes and objective neuropsychological performance, and whether the same cognitive domains associated with successful employment are also related to a patient's self-perception of work competence. In the present study, 73 medical and psychiatric patients underwent comprehensive neuropsychological assessment. Step-wise multiple regression analyses revealed that the visual-spatial domain was the only significant predictor of self-perceived work attributes and work competence as measured by the Working Inventory (WI) and the Work Adjustment Inventory (WAI), accounting for 7% to 10% of inventory score variability. The results raise the intriguing possibility that targeting of visual spatial skills for remediation and development might play a separate and unique role in the vocational rehabilitation of a lower SES population, specifically, by leading to enhanced self-perception of work competence as these individuals attempt to enter the job market.

Adult↗

PubMed2006

Discordance between WMS-III Word Lists subtest and RAVLT scores in older patients: four case examples.

To examine the adequacy of the WMS-III in the identification of memory deficits in older individuals, we administered the Word Lists subtest, along with a comparison measure, the Rey Auditory Verbal Learning Test (RAVLT), to four patients referred for assessment of dementia. Although the number of words recalled by the patients on the delayed trials of the Word Lists subtest and RAVLT were nearly identical, norms for the Word Lists subtest indicated that memory performance was within normal limits (i.e., low average or higher), while the RAVLT norms accurately characterized performance as impaired. We suspect that normative data for the WMS-III were compromised by inadvertent inclusion of older subjects with dementia or mild cognitive impairment. The findings from our cases call into question the use of the WMS-III Word Lists for older patients.

Aged↗

PubMed2005

Relationship between criminal arrest and community treatment history among patients with bipolar disorder.

OBJECTIVE: This study examined the relationship between criminal arrest and gender, substance use disorder, and use of community mental health services among patients with bipolar I disorder. METHODS: Los Angeles County's computerized management information system was used to retrospectively identify all inmates with a DSM-IV diagnosis of bipolar I disorder who were evaluated over a seven-month period in the psychiatric division of Los Angeles County Jail and had a history of psychiatric hospitalization in the community. Patients without a history of arrest who were involuntarily hospitalized in the community and treated for bipolar I disorder over the same seven-month period served as a comparison group. The use of community mental health services that inmates received before their arrest was quantified and compared with the services that patients in the comparison group received before their involuntary hospitalization. RESULTS: Patients who had been arrested (N = 66) were more likely than patients in the comparison group (N = 52) to be male (55 percent compared with 31 percent) and to have a history of substance use disorder (76 percent compared with 19 percent) but were less likely to have a history of treatment while under a mental health conservatorship (8 percent compared with 29 percent). In contrast to patients in the comparison group, patients who had been arrested were hospitalized more frequently (a mean of 3.4 hospitalizations per year compared with a mean of 1.1 hospitalizations per year) and had a briefer average length of stay (a mean of 9.2 days compared with a mean of 16.4 days). CONCLUSIONS: In contrast to patients in the comparison group, patients who had been arrested were more likely to be male, to have comorbid substance use disorder, and to have a treatment history characterized by more frequent, briefer hospitalizations.

Adolescent↗

PubMed2004

Executive dysfunction and visuospatial ability among depressed elders in a community setting.

Visuospatial ability is frequently compromised among elderly depressed patients, but it is unclear whether the impairment is a consequence of a visuospatial memory deficit or of an executive dysfunction that impacts visuospatial ability. The Boston Qualitative Scoring System is a method of scoring the Rey-Osterrieth Complex Figure (ROCF) that assesses the process used to draw the figure, the executive aspect of the task, as well as the accuracy and location of the completed elements. The hypotheses that executive scores as measured by the BQSS would separate diagnostic groups and that executive function would mediate the relationship between depression and nonverbal recall were tested using a between groups design with elderly depressed volunteers (N = 31) and healthy controls (N = 31). Participants were screened for other Axis I disorders with the Structured Clinical Interview for DSM-IV Diagnosis, diagnosed for major depression per DSM-IV criteria, and administered the ROCF. The copy and recall drawings were scored using BQSS criteria, and scores were grouped into executive and drawing scores from both copy and recall phases. Executive scores during the copy phase and drawing scores from the recall phase separated the diagnostic groups [F(1,59), = 4.14, P = .05] and [F(1,59) = 6.88, P = .01], respectively. Follow-up ANCOVAS showed that copy Planning, the score that quantified the process by which the figure was drawn, separated the diagnostic groups. Planning also mediated the association between depression and the percent of the figure recalled after the short delay (Z = 1.84, P < .05). The significance of the depression-to-recall pathway was eliminated when Planning was controlled for, but Planning remained related to percent recalled [B = -6.90, P < .007]. A dimension of executive dysfunction, represented here by Planning, may be one underlying source of the observed decline in nonverbal recall among elderly depressed patients. This result is consistent with the theory that dysfunction of the prefrontal cortex is a critical feature of late-life depression.

Aged↗

PubMed2003

Apathy and cognitive performance in older adults with depression.

OBJECTIVES: Recent studies have linked apathy to frontal lobe dysfunction in persons with dementia, but few studies have explored this relationship in older, depressed persons without dementia. We examined the association between apathy and cognitive function in a group of older persons with major depression using standardized neuropsychological tests. We hypothesized that presence of apathy in depression is associated with poorer frontal executive performance. METHODS: We analyzed data from 89 older adults with major depression. We defined apathy using four items from the Hamilton Psychiatric Rating Scale for Depression which reflect the clinical state of apathy, including 'diminished work/interest,' 'psychomotor retardation,' 'anergy' and 'lack of insight.' RESULTS: Apathy most strongly correlated with two verbal executive measures (Stroop C and FAS), a nonverbal executive measure (Wisconsin Card Sorting Test-Other Responses), and a measure of information processing speed (Stroop B). Apathy was not associated with age, sex, education, medical illness burden, Mini-Mental State Examination score and Full Scale IQ score. Stepwise regression analyses of significant cognitive tests showed that apathy alone or apathy plus depression severity, age, or education accounted for a significant amount of the variance. CONCLUSIONS: The results of this study provide support for an apathy syndrome associated with poorer executive function in older adults with major depression.

Affective Symptoms↗

PubMed2003

Relationships between eight measures of suspect effort.

Previous studies have recommended that multiple measures be employed concurrently to provide converging evidence regarding the presence of suspect effort during neuropsychological assessment. However, if the tests are highly correlated they do not represent independent sources of information. To date, no study has examined correspondence between effort tests. The present study assessed the relationships between eight measures which can be used to assess effort (Rey 15-item, Rey Dot Counting Test, Rey Word Recognition Test, RAVLT recognition trial, Rey-Osterrieth Complex Figure Test effort equation, Digit Span, Warrington Recognition Memory Test-Words, and "b" Test) in a sample of 105 patients in litigation or attempting to obtain/maintain disability compensation and who displayed noncredible symptoms based on psychometric performance and behavioral criteria. Modest to moderate correlations were observed between test summary scores with only two measures sharing more than 50% score variance (Digit Span and Dot Counting). Moderate correlations were also observed between individual test scores reflecting indices of response time, free recall, recognition, and false positive errors, providing possible evidence that patients may use specific strategies when producing noncredible performances. Overall the results suggest that the use of these various tests generally provides nonredundant data regarding patient credibility in neuropsychological evaluations.

Adolescent↗

PubMed2002

The effects of tamoxifen and estrogen on brain metabolism in elderly women.

BACKGROUND: Tamoxifen is used to treat breast cancer and may reduce the risk of breast cancer. However, there are conflicting reports as to whether tamoxifen use is associated with changes in brain metabolism and function or cognitive impairment. Consequently, we assessed the effects of tamoxifen and estrogen on the brain chemistry of elderly women. METHODS: We used proton magnetic resonance spectroscopy to measure the concentrations of N-acetyl-containing compounds, myo-inositol (MI), total creatine (creatine plus phosphocreatine), and choline-containing compounds in the frontal white matter, basal ganglia, and hippocampus of 76 elderly women of whom 16 had received tamoxifen therapy, 27 had received estrogen as hormone replacement therapy (HRT), and 33 had received neither (control group). A two-way analysis of variance (ANOVA) was performed to determine the statistical significance of differences in cerebral metabolite concentrations among subject groups and brain regions. All statistical tests were two-sided. RESULTS: Women in the tamoxifen and HRT groups had lower concentrations of MI in all areas than women in the control group (P =.02; overall group effect on ANOVA). Compared with the control group, the tamoxifen group (P =.004) and the HRT group (P =.06) had lower concentrations of MI in their basal ganglia. The MI concentration in the basal ganglia was inversely correlated with the duration of tamoxifen treatment (rho = -.72; P =.005). CONCLUSIONS: The reduced concentrations of MI in the brains of women treated with tamoxifen and HRT, compared with those of control women, suggest that tamoxifen has an effect similar to that of estrogen. These results, if confirmed, may alleviate concerns about the safety of using tamoxifen to reduce breast cancer risk in elderly women.

Aged↗

PubMed2002

Frontotemporal dementia classification and neuropsychiatry.

BACKGROUND: Frontotemporal dementia (FTD) is a syndrome encompassing the clinical expression of frontal or temporal lobe degeneration. The many clinical phenotypes of FTD include primary progressive aphasias and a more common frontotemporal degeneration with less marked language alteration but significant behavioral changes. SUMMARY: This paper describes the clinical progression of neuropsychiatric symptoms among 62 predominantly behavioral presentations and 30 language presentations of FTD. Disinhibition and depression became common for both subject groups over the course of illness. Significantly more cases presenting with behavioral changes had apathy and disinhibition. CONCLUSIONS: Language presentations of FTD had longer latency to onset of distinct neuropsychiatric changes but eventually converge with the phenotype initially affected with behavioral change. Clinicians should anticipate such neuropsychiatric changes, prepare families for the course of illness in patients with either clinical presentation,treat symptomatically with psychotropic medications to help families cope with behaviorally disturbed patients.

Journal Article↗

PubMedDate not supplied

Klinefelter syndrome: expanding the phenotype and identifying new research directions.

PURPOSE: The purpose of this study is to summarize new data on etiology and clinical features of Klinefelter syndrome in order to derive research priorities. METHODS: This study was conducted using critical reviews of selective topics, emphasizing less well-recognized clinical findings. RESULTS AND CONCLUSIONS: The phenotype of the prototypic 47,XXY case is well recognized: seminiferous tubule dysgenesis and androgen deficiency. Less well appreciated is the varied expressivity of 47,XXY Klinefelter syndrome, in particular neurological/cognitive perturbations like language and behavioral problems. Effective therapies are available. Reproductive technologies allow 47,XXY men to sire offspring through intracytoplasmic sperm injection (ICSI); however, genetic counseling is complex and success is low. Behavioral and expressive language difficulties are amenable to treatment by androgen therapy and psychological help. Early treatment may be imperative for optimal outcome.

Biomedical Research↗

PubMedDate not supplied

Effects of cigarette smoking history on cognitive functioning in healthy older adults.

OBJECTIVE: The authors assessed the unique effect of smoking history on cognitive functioning after adjusting for demographic factors such as age, education, and gender, and presence of vascular illness. METHODS: A sample of 127 healthy older adults (29 men, 98 women) between the ages of 47 and 83 (mean: 66.9) were administered a comprehensive neuropsychological battery. Information regarding risk for vascular illness was assessed with a detailed self-report history and/or medical examination. Smoking history was gathered with a self-report questionnaire, and a composite score reflecting amount and duration of cigarette use was computed. From this composite score, three smoking groups were created: None-Light, Moderate, and Heavy smokers. RESULTS: Analyses of covariance, using age, education, gender, and vascular status as the covariates, revealed that the heavy smokers performed significantly poorer than the other groups on two scores from a test assessing executive function/problem-solving (Wisconsin Card-Sorting Test), but not on any of the other cognitive tests. CONCLUSIONS: Consistent with previous findings, smoking history did not appear to have deleterious effects on most cognitive domains. Heavy smoking history, however, did appear to affect performance on a measure of executive functioning.

Aged↗