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Biomedical subjects

M L Silverstein

Publications and source records attributed to M L Silverstein.

At least 37 records · Page 2Linked to original sources
PubMed1989

Lateralized cerebral dysfunction in schizophrenia and depression: gender and medication effects.

The neuropsychological functioning of 52 schizophrenic and 39 major depressive patients was examined using the four Luria-Nebraska Neuropsychological Battery lateralization scales, with the effects of gender and medication status examined alone and in interaction with diagnosis and laterality variables. Comparisons between the diagnostic groups revealed that gender influences some aspects of neuropsychological performance, particularly those involving bilateral complex cognitive-perceptual rather than sensorimotor skills. This effect was more distinct for depressives than schizophrenics when cerebral lateralization differences were present. There was no significant left hemisphere disadvantage for schizophrenics which was gender-related. Medication status revealed no appreciable effects for depressives, although both male and female schizophrenics receiving neuroleptics showed a greater degree of complex perceptual-cognitive dysfunction compared to unmedicated schizophrenics. Level of cerebral impairment was equivalent for the right and left hemispheres for both groups. Consequently, these data are not consistent with other findings demonstrating differential hemispheric disadvantages between schizophrenia and depression.

Journal Article↗
PubMed1988

Personality trait characteristics in relation to neuropsychological dysfunction in schizophrenia and depression.

Knowledge of the personality trait and psychopathology variables that differentiate neuropsychologically impaired and nonimpaired psychiatric patients has been limited relative to the study of higher cortical functions. This study reports findings from the Millon Clinical Multiaxial Inventory (MCMI) developed by Millon (1982) in a sample of hospitalized schizophrenics and depressives who also received the Luria-Nebraska Neuropsychological Battery. The principal findings indicate that neuropsychological dysfunction may be related to substance abuse, including its underlying personality dimensions, in schizophrenia, but only modest support is indicated for the construct of negative symptoms in schizophrenics with neuropsychological dysfunction. Further, the findings do not support the view that psychosis is a characteristic feature of depressives with impaired neuropsychological performance.

Adult↗
PubMed1988

Differential patterns of neuropsychological deficit in psychiatric disorders.

This report investigated differential cerebral impairment on the Luria-Nebraska Neuropsychological Battery in schizophrenia, schizoaffective, and depressive disorders (N = 106). Results indicated impaired tactile-stereognostic processing in schizoaffective and depressive disorder patients and verbal memory deficits in the schizophrenic and schizoaffective disorder patients. These findings question the specificity of functional neuropsychological deficit areas in schizophrenia and depression.

Adult↗
PubMed1987

Neuropsychological test performance among major clinical subtypes of depression.

Thirty-six patients with diagnoses of major depression were administered the Luria-Nebraska Neuropsychological Battery. Comparisons were made on six dichotomous subtypes of depression: agitated-nonagitated, endogenous-nonendogenous, primary-secondary, psychotic-nonpsychotic, retarded-nonretarded, and unipolar-bipolar. The psychotic depressives were more impaired than the nonpsychotics on the Profile Elevation and Impairment scales. No differences were found for other subtype comparisons on these global measures of neuropsychological dysfunction. Analysis of age effects indicated that older depressives performed more slowly on timed performance items and significant subtype differences on these items occurred for subtype diagnoses of psychotic, primary, and retarded depression. Localization and Lateralization scales revealed significant impairment for the psychotic and retarded patients, with less impairment for other subtypes. The relevance of these findings for neuropsychological evaluation are discussed, particularly with regard to the potentially confounding effects of depression on test performance.

Journal Article↗
PubMed1986

A longitudinal study of thought disorder in manic patients.

To study the persistence of thought disorder in manic patients, 34 manic patients were compared with 30 schizophrenic and 30 nonpsychotic patients on four indexes of thought pathology at two phases of disorder: during the acute inpatient phase and one year after hospitalization. Patients were also compared with a control sample of 34 normal subjects. The data indicated that during the acute in hospital phase, both manic and schizophrenic patients were severely thought disordered; at follow-up, a subsample of manic patients showed severe thought disorder; despite the severe thought disorder found at follow-up in some manic and schizophrenic patients, both groups showed a significant reduction of thought pathology at follow-up; and there was a trend for a larger reduction of thought disorder in manic than in schizophrenic patients. The difference, however, was not significant when initial levels of severity were controlled.

Adolescent↗
PubMed1985

Neuropsychological dysfunction in schizophrenia. Relation to associative thought disorder.

Recent evidence suggests that cerebral atrophy with cognitive deficits is associated with negative schizophrenic symptoms, including poverty of speech and speech content. This report investigates the relationship between specific measures of neuropsychological dysfunction and four major indices of associative thought disorder in schizophrenia, to ascertain whether neuropsychologically impaired schizophrenics show more associative disturbance than neuropsychologically intact schizophrenics. Twenty neuropsychologically intact and 12 impaired schizophrenics, rigorously diagnosed by the Research Diagnostic Criteria, were administered the Luria-Nebraska Neuropsychological Battery. These two groups of schizophrenics were compared on a continuous word-association test, which included two nonverbal and two verbal measures of associative disturbance. The neuropsychologically impaired schizophrenics had slower reaction times (p less than .05), but did not differ from the neuropsychologically intact schizophrenics on the verbal measures. Results indicated a stronger relationship between neuropsychological functions and the nonverbal dimensions (p less than .02), than with the verbal measures. This challenges the assumption that a left hemisphere abnormality in schizophrenia is particularly associated with cognitive disturbance, and suggests that neuropsychologically impaired schizophrenics may show greater potential for negative schizophrenic symptoms.

Adult↗
PubMed1984

Examining the Chapman and Chapman theory of schizophrenia through continuous word association with two nosological systems.

Examined the Chapman and Chapman (1973) theory of excessive yielding to normal response biases in schizophrenia by using the technique of continuous word association. The word association stimulus list included items with single and multiple meanings (homographs) in order to investigate differential response characteristics between single- and multiple-meaning items and the relative neglect of nondominant meaning responses. Several word association variables were examined, including logical relatedness, reaction time, and response productivity. Further, two discrete samples were studied: A DSM-II-diagnosed sample of schizophrenic and non-schizophrenic Ss (N = 61) and a sample (N = 60) diagnosed according to the more contemporary Research Diagnostic Criteria of Spitzer, Endicott, and Robins (1978) with schizophrenic, manic, and schizoaffective disorder diagnoses. Results were not in accord with predictions derived from the Chapmans' theory using either diagnostic approach.

Bipolar Disorder↗
PubMed1983

Word association: multiple measures and multiple meanings.

Investigated the interrelationships between reaction time and three major verbal word association variables (response commonality, idiosyncratic responses, and degree of logical relatedness) in schizophrenics (N = 42) and nonschizophrenic psychiatric controls (N = 30). This study investigated the degree to which these four measures assess similar or different components of associative thought disorder in the same Ss, using both verbal associative measures and a nonverbal performance measure. Results indicated that reaction time was largely independent of all verbal measures in schizophrenics. These data were discussed in regard to the meaning and interpretation of word association test data as a function of choice of dependent variables for measuring associative thought disturbance.

Humans↗
PubMed1983

Goal-directed thinking in schizophrenics' associations.

The relationships between associative structure and higher order cognitive processes in schizophrenia were investigated with a continuous word association technique. The chaining hypothesis involves the derailment of organized thought by response-produced stimuli, and the continuity hypothesis postulates a progressive disorganization of connotative meaning. Neither hypothesis was confirmed, as both schizophrenics and nonschizophrenics maintained the set of guiding responses according to the starting stimuli. Further, both groups showed progressive response disorganization despite the overall higher degree of relatedness in the nonschizophrenics. There was also no differential performance observed when comparing schizophrenics subgrouped by paranoid status and premorbid adjustment.

Adult↗
PubMed1982

Thought pathology in manic and schizophrenic patients. Its occurrence at hospital admission and seven weeks later.

To evaluate the extent and persistence of thought pathology in manic patients, 113 manic, schizophrenic, and nonpsychotic patients were assessed at the acute phase, and a subsample was reevaluated seven weeks later. Another subsample of 55 patients was assessed medication free at the acute phase. Three major indices of thought disorder were used. The data indicate that (1) most hospitalized manics are severely thought disordered; (2) hospitalized manics are as thought disordered as schizophrenics; (3) unmedicated manics are as severely thought disordered as unmedicated schizophrenics; (4) both manics' and schizophrenics' thought disorders improve after the acute phase; (5) even after the acute phase, some manics show severe thought pathology. The results support formulations that thought disorder is not unique to schizophrenia. Some factors involved in manic and schizophrenic thought pathology are similar. There may be a general psychosis factor that cuts across psychotic diagnoses.

Adolescent↗
PubMed1982

Associative thinking in schizophrenia: a contextualist approach.

Explored the question of whether responses that appeared to be highly pathological on the basis of the word association test did indeed reflect an underlying aberrant associative process or whether the associations actually had a greater degree of meaning than was evident from the test (N = 60). Utilizing contextualist techniques designed by the authors, which were analogous to the word association test but yet measured schizophrenic associative thinking in specific contexts that more closely approximated natural language situations, the quality and purposiveness of the schizophrenics' associations were examined. The word association test technique was judged to be inadequate by itself to account for underlying associative processes involved in schizophrenic associative thought disorder. A majority of responses (70% schizophrenic, 81% nonschizophrenic) judged to be pathological on the basis of the word association test alone became meaningful in the context of a sentence created by the Ss to explain purposively their associations. The schizophrenics' experience of a stimulus word and consequent associations to that word became clearer when placed within an appropriate context (i.e., a sentence), rather than examined as isolated semantic features (as in the word association test).

Adult↗
PubMed1981

Schneiderian first-rank symptoms in schizophrenia.

Schneider's first-rank symptoms (FRS) are recognized by many psychiatrists worldwide as definitive criteria for establishing the diagnosis of schizophrenia. The relationships between FRS and major aspects of psychopathology were examined. Clinical course and outcome, indices of current functioning and symptom severity, premorbid adjustment, and prognostic indicators were assessed. Major comparisons were made between schizophrenics with FRS at follow-up and schizophrenics with psychotic symptoms exclusive of FRS. Positive findings in select areas of outcome functioning argue for the utility of FRS. However, several findings indicated that FRS were not more effective than non-Schneiderian psychotic symptoms in delineating central characteristics of the schizophrenic syndrome; they may identify a subgroup of schizophrenics with a more chronic course, but they do not appear to have the unique importance or diagnostic specificity that has been accorded them.

Humans↗
PubMed1980

Relevance of modern neuropsychology to psychiatry.

This review of new developments in clinical neuropsychology is intended to acquaint the practicing psychiatrist with the current status of the field, focusing on its applicability to a variety of psychiatric situations. The approach of Luria is described in some detail, essentially because this represents one of the major formulations of the functional organization of the brain, which is now available for standardized assessment purposes as the Luria-Nebraska Neuropsychological Battery. At this juncture, it is relevant for psychiatry to gain familiarity with these new approaches, as an important adjunct to the diagnostic, therapeutic, and prognostic problems of brain damage in the psychiatric patient.

Brain Damage, Chronic↗