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Biomedical subjects

Milton E Strauss

Publications and source records attributed to Milton E Strauss.

12 recordsLinked to original sources
PubMed2006

The cognitive origins of specific types of schizophrenic speech disturbances.

OBJECTIVE: Cognitive impairments associated with schizophrenia might be expected to have a marked impact on the ability to produce coherent speech, yet associations between cognitive performance and speech disorder have typically been weak. Findings on this question may have been limited by measurement methods and by the heterogeneity of speech disorder. This study examined the contributions of impairments in sustained attention and sequencing abilities to schizophrenic speech disorder, measured in terms of communication failures and divided into different types of disorder. METHOD: Samples of natural speech were collected from severely ill inpatients with schizophrenia and nonpsychiatric comparison subjects and rated for frequencies of six types of communication failures: four structural and two nonstructural types. Subjects also completed a battery of cognitive tests assessing several facets of attention and sequencing ability. Hierarchical regression was used to identify cognitive contributors to communication failures. RESULTS: Impaired sustained attention was associated with more frequent structural and nonstructural communication failures. As predicted, impaired sequencing, and in particular conceptual sequencing, also made a substantial contribution to the structural communication failures, but not to the nonstructural ones. These findings held when global level of impairment was controlled statistically. Performance on the tests of attention and sequencing explained 56% of the variance in structural speech disorder. CONCLUSIONS: Schizophrenic speech disorder is heterogeneous in form and in cognitive underpinnings. Impairments in attention and sequencing abilities are highly predictive of communication failures related to language structure.

Adult↗
PubMed2005

Associations between dementia/mild cognitive impairment and cognitive performance and activity levels in youth.

OBJECTIVES: To study the associations between dementia/mild cognitive impairment (MCI) and cognitive performance and activity levels in youth. DESIGN: Retrospective cohort study. SETTING: Research volunteers living throughout the United States. PARTICIPANTS: A total of 396 persons (mean age 75) who were graduates of the same high school in the mid-1940s. MEASUREMENTS: Adolescent intelligence quotient (IQ) scores were gathered from archived student records, and activity levels were determined from yearbooks. A two-stage telephone screening procedure (Modified Telephone Interview for Cognitive Status or Informant Questionnaire on Cognitive Decline in the Elderly followed by Dementia Questionnaire) was used to determine adult cognitive status. Data were analyzed using logistic regression to model the risk of cognitive impairment (dementia/MCI) versus no cognitive impairment as a function of IQ and activity level, adjusting for sex and education. RESULTS: High adolescent IQ and greater activity level were each independently associated with a lower risk for dementia/MCI (odds ratio (OR) for a 1-standard deviation increase in IQ=0.51, 95% confidence interval (CI)=0.32-0.79; OR for a unit increase in activity=0.32, 95% CI=0.12-0.84). No association was found between sex or education and adult cognitive status in this model. CONCLUSION: High IQ and greater activity levels in youth reduce the risk for cognitive impairments in aging. The mechanism(s) underlying these associations are unknown, but intelligence may be a marker for cognitive/neurological "reserve," and involvement in activities may contribute to "reserve." Early neuropathology and ascertainment bias are also possible explanations for the observed associations.

Adolescent↗
PubMed2005

Gender identity and implications for recovery among men and women with schizophrenia.

The concept of gender considers masculinity and femininity as a cultural construct that varies along a continuum. Subjectively perceived, gender may affect the experience of illness among persons with schizophrenia and may have an impact on treatment and recovery. This study evaluated gender identity, according to the Bem Sex Role Inventory, among 90 men and women with schizophrenia and schizoaffective disorders. The findings indicate that persons with schizophrenia experience their gender identity in ways that vary from culturally normative standards. Both men and women scored lower on traditional masculine descriptive measures compared with persons without schizophrenia. This finding has important implications for recovery.

Adult↗
PubMed2005

Prevalence of apathy, dysphoria, and depression in relation to dementia severity in Alzheimer's disease.

Apathy is common in Alzheimer's disease (AD) but may be confused with depression due to overlap in symptoms queried in depression assessments. Depression and dysphoria appear to occur less frequently in AD but are better researched. This study examined the relative frequency of these syndromes and their relation to disease characteristics in 131 research participants with probable or possible AD. Apathy was more prevalent than dysphoria or major depression and was more strongly associated with global disease severity, cognitive impairment, and functional deficits. Accurate differential diagnosis of apathy and depression is key to appropriate family education and effective treatment.

Aged↗
PubMed2005

Subjective experience of recovery from schizophrenia-related disorders and atypical antipsychotics.

AIMS: This article investigates the subjective experience of the process of improvement and recovery from the point of view of persons diagnosed (according to research diagnostic criteria) with schizophrenia and schizo-affective disorders. METHODS: A community study of persons using psychiatric services was conducted for a sample of ninety subjects taking atypical antipsychotic medications. Sociodemographic data and clinical ratings were collected to complement the qualitatively developed Subjective Experience of Medication Interview (SEMI), which elicits narrative data on everyday activities, medication and treatment, management of symptoms, expectations concerning recovery, stigma, and quality of life. RESULTS: Recovery was observed through: (1) relatively low ratings of psychiatrically observed symptomatology through BPRS scores; (2) the subjective sense among the majority (77.4%) of participants that taking medication plays a critical role in managing symptoms and avoiding hospitalization; and (3) the subjective sense articulated by the vast majority (80%) that they would recover from their illness and that the quality of their lives would improve (70.6%). CONCLUSION: The overall quality of improvement and recovery is best characterized as an incremental, yet definitively discernable, subjective process.

Adult↗
PubMed2004

Factor structure of the CERAD neuropsychological battery.

The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery was developed to evaluate cognitive impairments associated with Alzheimer's disease (AD). Previous studies have suggested that the battery is multi-dimensional, represented by either 3 or 5 dimensions. In this study a principal factor analysis was conducted using contemporary quantitative methods for determining the number of factors. Exploratory factor analysis of the CERAD battery and MMSE was conducted using one-half of the CERAD database (total N = 969). Glorfeld's modification of Horn's parallel analysis method suggested that there was 1 common factor in the variable matrix. Characterization of patterns of deficits in AD requires supplementation of measures derived from the CERAD and MMSE with other tests.

Aged↗
PubMed2004

Respiratory sinus arrhythmia as an index of emotional response in young adults.

The relationship between respiratory sinus arrhythmia (RSA) and valence and arousal remains unclear. In the present study, the associations between emotion responses and tonic or task-related changes in RSA were assessed. Specifically, the sensitivities of changes in interbeat interval, RSA, and skin conductance to the valence and arousal values of emotional stimuli were examined. This study also explored the association between tonic RSA and subjective, expressive, and physiological emotional responses. Response measures were collected from 56 adults during baseline and film-viewing periods. Tonic RSA was not significantly related to any of the response measures. Increased skin conductance and decreased RSA were associated with arousal independent of valence. Interbeat interval was related to affective valence and not arousal. These findings suggest that RSA may be a useful adjunct to skin conductance measures in assessing emotional arousal.

Adolescent↗
PubMed2003

Comparison of inpatients with major mental illness who do and do not consent to low-risk research.

The generalizability of research data depends on the degree to which the studied sample represents the larger population of interest. By influencing the likelihood of research participation, socio-demographic and clinical factors could bias a sample. To evaluate this, we retrospectively identified 155 consecutive admissions over an 18-month period to a general acute male psychiatry inpatient unit in a Veterans Affairs Hospital on which all competent patients were offered the opportunity to participate in low-risk clinical research. Male inpatients who did (N=70) and did not consent (N=85) were compared on 17 variables. Patients who consented to research were somewhat younger (M(difference)=4.6 year) and were significantly more likely to carry a diagnosis of schizophrenia. The groups did not differ in financial resources, living situation or alcohol/drug abuse. We conclude that at least in this setting, general socio-demographic and clinical variables were not major influences on sample selection.

Adult↗
PubMed2002

An informant-based assessment of apathy in Alzheimer disease.

OBJECTIVE: To standardize a new rating scale for the assessment of apathy in Alzheimer disease (AD) and report on its reliability, structure, and relation to other clinical features of AD. BACKGROUND: apathy is a common prominent behavioral syndrome accompanying AD and is associated with excess disability and increased caregiver burden. Current instruments for the assessment of apathy in AD do not explicitly and systematically attempt to differentiate limited activity and engagement due to lack of interest from inability or longstanding, premorbid personality traits. The present assessment, the Dementia Apathy Interview and Rating (DAIR), was developed taking these discriminations into account in question construction and interview format. METHODS: One hundred participants (50% women) in the University Memory and Aging Center Research Registry with Probable or Possible AD (by NINCDS-ADRDA criteria) were assessed through caregiver interview or direct patient assessment for apathy, depression, and severity of cognitive and functional deficits. Item distribution characteristics, factor analysis, and evaluation of reliability were used to develop the final item set for the DAIR, and correlations with other measures were examined. RESULTS: A 16-item unidimensional apathy scale with excellent internal consistency (alpha = 0.89) and temporal reliability ( = 0.85 over 2 months) was developed. Individual differences in apathy on the DAIR were unrelated to dysphoria. Apathy was significantly associated with functional and cognitive impairment, while depression was not. CONCLUSIONS: The DAIR is a reliable informant-based assessment of apathy in persons with AD. Although apathy is assessed with respect to behaviors within the repertoire of patients, this behavioral syndrome remains associated with more severe deficits in cognitive and adaptive functioning. Associations between depression and dementia severity reported in some studies may reflect the confounding of apathy and depression in some assessment instruments.

Activities of Daily Living↗
PubMed2000

Evaluation of a model of attention with confirmatory factor analysis.

Structural equation modeling (specifically, analysis of moment structures; J. L. Arbuckle, 1996) was used to evaluate the goodness of fit of a model of components of attention (A. F. Mirsky, B. J. Anthony, C. C. Duncan, M. B. Aheam, & S. G. Kellam, 1991) to neuropsychological test data from 2 samples. One sample consisted of psychiatrically normal persons with and without sleep-disordered breathing, and the other sample consisted of the adults studied by A. F. Mirsky et al. (1991), who gave rise to this model. That sample included psychiatric patients as well as normals. An exploratory data reduction procedure, principal-components analysis, suggested that attention might be conceptualized as composed of 4 independent elements or components: focus-execute, sustain, shift, and encode. Neither the proposed orthogonal model nor a model permitting correlated factors adequately fit either data set, suggesting that these 4 attention constructs are as yet not clearly validated in the measures used to assess them.

Adult↗