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PubMed1997

On the factorial and construct validity of the Intrinsic Motivation Inventory: conceptual and operational concerns.

The Intrinsic Motivation Inventory (IMI) has been gaining acceptance in the sport and exercise domain since the publication of research by McAuley, Duncan, and Tammen (1989) and McAuley, Wraith, and Duncan (1991), which reported confirmatory support for the factorial validity of a hierarchical model of intrinsic motivation. Authors of the present study argue that the results of these studies did not conclusively support the hierarchical model and that the model did not accurately reflect the tenets of cognitive evaluation theory (Deci & Ryan, 1985) from which the IMI is drawn. It is also argued that a measure of perceived locus of causality is required to model intrinsic motivation properly. The development of a perceived locus of causality for exercise scale is described, and alternative models, in which perceived competence and perceived locus of causality are held to have causal influences on intrinsic motivation, are compared with an oblique confirmatory factor analytic model in which the constructs are held at the same conceptual level. Structural equation modeling showed support for a causal model in which perceived locus of causality mediates the effects of perceived competence on pressure-tension, interest-enjoyment, and effort-importance. It is argued that conceptual and operational problems with the IMI, as currently used, should be addressed before it becomes established as the instrument of choice for assessing levels of intrinsic motivation.

Adult↗
PubMed1999

A psychological approach to understanding the social and language impairments in autism.

This paper surveys current research on the social and communicative impairments in autism. In diagnostic schemes, the criteria for identifying autism in these domains include overlapping features. One approach to interpreting this overlap is to consider that social and communicative impairments reflect the same underlying cognitive deficit, referred to as the 'theory of mind' hypothesis of autism. On this view autism involves primary difficulties in identifying mental states in other people, and in interpreting behavior and action in relation to a person's mental state. Studies on the relationship between social behavior, communicative functioning, and theory of mind in children with autism are reviewed, emphasizing the connections between these areas of impairment that are central to the definition of the autistic syndrome.

Journal Article↗
PubMed1994

Measuring the functional impact of fatigue: initial validation of the fatigue impact scale.

The fatigue impact scale (FIS) was developed to improve our understanding of the effects of fatigue on quality of life. The FIS examines patients' perceptions of the functional limitations that fatigue has caused over the past month. FIS items reflect perceived impact on cognitive, physical, and psychosocial functioning. This study compared 145 patients referred for investigation of chronic fatigue (ChF) with 105 patients with multiple sclerosis (MS) and 34 patients with mild hypertension (HT). Internal consistency for the FIS and its three subscales was > .87 for all analyses. Fatigue impact was highest for the ChF group although the MS group's reported fatigue also exceeded that of the HT group. Discriminant function analysis correctly classified 80.0% of the ChF group and 78.1% of the MS group when these groups were compared. This initial validation study indicates that the FIS has considerable merit as a measure of patient's attribution of functional limitations to symptoms of fatigue.

Adult↗
PubMed1997

Management of the patient with disruptive vocalization.

Disruptive vocalization (DV) is a common problem in the management of cognitively and physically impaired older people. This article reports the results of a consensus meeting convened to provide guidelines for clinicians and recommendations for researchers in this difficult and little-studied behavioral problem. DV arises largely in people with cognitive impairment and generally reflects an underlying need or discomfort. A variety of factors can precipitate and aggravate DV; the key to management is appropriate identification of all possible factors and development of an individualized treatment plan.

Aged↗
PubMed2003

The schizophrenia prodrome revisited: a neurodevelopmental perspective.

Despite the widespread acceptance of the neurodevelopmental model of schizophrenia, its application to research concerned with the prodromal phase of illness is limited. Little recognition has been given to the concept of an enduring biological vulnerability to illness that may be responsive to early intervention. Rather, the focus of most prodromal studies is on emerging positive symptoms. The Recognition and Prevention (RAP) program follows the strategy of being equally concerned with the nonspecific symptoms reflecting the core of schizophrenia and those directly related to psychosis. Data were collected from 62 adolescents (mean age = 16.4 years) during the initial 3-year pilot phase of the RAP program (1998-2001). Subjects were divided into three clinical high-risk groups, characterized by (1) negative and nonspecific symptoms (e.g., social isolation, school failures), the earliest prodrome stage; (2) emerging attenuated positive symptoms of moderate intensity; and (3) severe attenuated (but subpsychotic) positive symptoms, considered most proximal to psychosis. Four risk factors, derived from the neurodevelopmental literature, were selected to reflect the vulnerability core: cognitive deficits, affective disturbances, social isolation, and school failure. All four domains were equally impaired across the three risk groups, supporting the presence of the underlying vulnerability core regardless of the magnitude of emerging positive symptoms. An observational pilot study was also conducted to identify the medications typically used to treat emerging positive symptoms. Antidepressants were used as frequently as antipsychotics to treat adolescents presenting with moderate attenuated positive symptoms. Regardless of type of medication, moderately symptomatic youngsters did quite well over the approximately 1-year followup period. By contrast, adolescents presenting with more severe (but nonpsychotic) attenuated symptoms were treated with antipsychotics, often in combination with other agents. Outcome for the more symptomatic youngsters was, however, more guarded, with nearly half (i.e., 47%) of the group converting to a schizophrenia spectrum psychotic disorder. Nonadherence to medication appeared to be a major risk factor in this group. We conclude that a neurodevelopmental model of schizophrenia is supported by our data and that a range of novel treatment strategies may be neuroprotective by directly affecting the disorder's vulnerability core.

Adolescent↗
PubMed2002

Pre-perceptual pain sensory responses (N1 component) in type 1 diabetes mellitus.

We investigated the integrity of the ascending pathways for pain sensitivity in the early stage of type 1 diabetes mellitus, by measuring the N1 component and the conventional N2/P2 vertex potentials of laser evoked potentials (LEPs). Brain responses to laser stimuli were obtained in 21 healthy volunteers and 21 type 1 diabetic patients, without either clinical neuropathy or electrophysiological evidence of large-fiber damage. In diabetic patients N1 and P2 latencies were prolonged and the N1 and N2/P2 amplitudes were decreased after foot stimulation. A significant reduction of the conduction velocity of Adelta fibers in the lower limbs was also observed. LEPs reveal an early, subclinical and selective damage of pain sensation in diabetic patients. N1 and P2 potentials are delayed and decreased in parallel giving evidence that LEP abnormalities are not secondary to a cognitive dysfunction and mostly reflect a small-fiber dysfunction.

Afferent Pathways↗
PubMed2004

Sex-differential brain activation during exposure to female and male faces.

Sex-discriminating facial features are examples of visual information involved in guiding social behavior. We used functional magnetic resonance imaging (fMRI) to assess brain responses in face-relevant brain areas in men and women during exposure to neutral male and female faces. An increased fMRI signal was found in the left amygdala and adjacent anterior temporal regions in men, but not in women, during exposure to faces of the opposite versus the same sex. These data indicate that the relationship between the sex of the subject and the sex of the face affects activity in the inferior temporal lobe. The sex-differential nature of this activation pattern may reflect sex differences in cognitive style and attentional processes when confronting faces of the opposite sex.

Adult↗
PubMed2005

A simulator-based curriculum to promote comparative and reflective analysis in an internal medicine clerkship.

PURPOSE: To develop and evaluate a novel curricular framework using high-fidelity patient simulation in an internal medicine clerkship. METHOD: Two 90-minute simulator-based modules of ischemic heart failure and hypoxemic respiratory failure were developed from adult and experiential learning principles. Three short simulated cases focused on each pathophysiologic concept were intermixed with two short teaching sessions and a period of comparative analysis. In 2002-03, the program was piloted among 90 third-year medical students at Harvard Medical School assigned to complete their core internal medicine clerk-ship. An entry and two follow-up questionnaires were used to assess the process. The instructors conducted quantitative and qualitative data analysis and directly observed students' performances. RESULTS: Instructors consistently noted students' ability to appropriately extract a history, perform a basic examination, and order appropriate tests. However, students demonstrated repeated errors in the application of knowledge to the clinical circumstance. A final comparative discussion was essential to new learning and students recognized this integrative analysis as the most critical component of the exercise. Every student reported the experience as useful. Ninety-four percent (n = 85) felt the simulator should become a routine part of the clerkship and 68% (n = 71) desired three or more sessions during their internal medicine clerkship. CONCLUSIONS: Simulator-based curricular modules are feasible in an internal medicine clerkship and can successfully complement existing curricula. By comparing similar cases in a compressed time frame, students may achieve enhanced efficiencies in reflective and meta-cognitive learning. As medical simulation is increasingly available, such a curriculum may represent valuable additions to the internal medicine educational environment.

Boston↗
PubMed2001

Sex, bowers and brains.

Inter- and intraspecific variations in the sizes of specific avian brain regions correspond to the complexity of the behaviour that they govern. However, no study has demonstrated a relationship between gross brain size and behavioural complexity, a hypothesis that has been proposed to explain the unusually large human brain. I show, using X-rays of museum specimens, that species of bowerbirds that build bowers have relatively larger brains than both related and ecologically similar but unrelated species that do not build bowers. Bower design varies across species from simple cleared courts to ornate, hut-like structures large enough to contain a small child. Furthermore, species building more complex bowers have relatively larger brains, both within each of the two different bower-building clades and across the family as a whole, controlling for phylogeny. Such gross differences in brain size are surprising and may reflect the range of cognitive processes necessary for successful bower building, The relationships are strongest for males, the bower-building sex, although there is a similar trend in females. Because the size and complexity of bower design is targeted by female choice, the observation that relative brain size is related to bower complexity suggests that sexual selection may drive gross brain enlargement.

Animals↗
PubMed1982

Do lorazeam-induced deficits in learning result from impaired rehearsal, reduced motivation or increased sedation?

1 The effects of 1.0 mg and 2.5 mg lorazepam on learning performance were examined in a double-blind cross-over study using student volunteers. 2 Test conditions were manipulated to prevent rehearsal and to vary the subjects' motivation to perform well. Self-ratings of alertness, motivation to perform well and state anxiety were obtained prior to each test. 3 Performance in arithmetic tasks of varying difficulty was also studied. 4 Lorazepam produced dose-related deficits in verbal and nonsense-syllable learning tasks. A greater proportion of errors in the number of problems attempted in the arithmetic tests reflected an impairment in cognitive function. Lorazepam reduced the number of arithmetic problems that were correctly solved as well as increasing the percentage of errors in the problems attempted. 5 Lorazepam did not significantly decrease motivation to perform well and the lorazepam impairment was found even when the test conditions were manipulated so as to prevent rehearsal. Therefore the learning deficits cannot be explained solely by changes in motivation or impairments in rehearsal. 6 Performance in the learning tasks correlated with ratings of alertness and therefore the deficits observed after administration of lorazepam seem likely to result from the non-specific sedative effect of the drug.

Adult↗
PubMed1983

Remediation of cognitive deficits: a critical appraisal of the Feuerstein model.

It has been reported that the Instrumental Enrichment (IE) programme can successfully modify the cognitive structures of retarded disadvantaged adolescents. The research from both Israeli and American studies was reviewed to determine how strongly those claims for success were supported. Though the research yielded some statistically significant results in favour of the Instrumental Enrichment group, the importance of those findings are challenged on the grounds of research design, the relatively unimportant magnitude of mean differences that are reported as significant, and the failure of score changes on measures of cognitive ability to be reflected in school performance. It is concluded that claims that research leads 'substantial support' to the effectiveness of the IE programme must be rejected.

Achievement↗
PubMed2004

The distributed neuronal systems supporting choice-making in real-life situations: differences between men and women when choosing groceries detected using magnetoencephalography.

In this work, magnetoencephalography was used to study the temporal dynamics of neural responses in 16 subjects (eight women, eight men) choosing among different day-to-day consumer items. At short latencies (< 150 ms), the evoked responses showed striate and extrastriate cortical activation common to the processing of general objects. At about 300 ms, women activated preferentially left posterior cortices, whereas men activated preferentially right temporal cortices. This may reflect sex/gender differences in cognitive strategies, emphasizing category-specific knowledge in women and spatial memories in men. At latencies greater than 500 ms, right parietal cortices were preferentially activated when previously bought or used items were chosen. In contrast, left inferior and right orbital cortices were preferentially activated when selecting less-known items. This may be interpreted as representing the neural correlates of decisions where the outcome is consistent with previous experience, and of choices which are 'difficult' in some sense. Analysis of coherent gamma-oscillations (20-45 Hz) revealed neural activity over left anterior and right dorsolateral cortices at long latency (> 1500 ms) when brand knowledge is low. This is consistent with the late binding of (brand) memories and evaluation of multiple sources of information when a choice is not obvious. gamma-Activity showed that women may activate larger neural networks when preference is high, suggesting that men and women exhibit different patterns of neural activity even though their overt performances are similar.

Adult↗
PubMed1996

Tracking early and late stages of information processing: contributions of startle eyeblink reflex modification.

Startle eyeblink modification was examined as a measure of information processing. College students were presented with tones of 5 and 7 s duration of either high or low pitch, followed by startle-eliciting stimuli at lead intervals of 120, 2,000, 4,500, or 6,000 ms. Attention to tones was manipulated by instructing the task group to count the longer tones of either pitch. The no-task group had no instructed task. Startle eyeblink was inhibited at the short lead interval and facilitated at the long lead intervals in both groups. The task group showed greater inhibition and facilitation during attended than during ignored tones, indicating that early and late controlled processing was occurring. In the task group, the degree of facilitation appeared to reflect the degree of cognitive demands of the task. Startle eyeblink modification may provide a sensitive measure of the nature and timing of stages of processing in active and passive attentional conditions.

Adult↗
PubMed2006

The Sexual Arousal and Desire Inventory (SADI): a multidimensional scale to assess subjective sexual arousal and desire.

INTRODUCTION: Sexual arousal and desire are integral parts of the human sexual response that reflect physiological, emotional, and cognitive processes. Although subjective and physiological aspects of arousal and desire tend to be experienced concurrently, their differences become apparent in certain experimental and clinical populations in which one or more of these aspects are impaired. There are few subjective scales that assess sexual arousal and desire specifically in both men and women. AIMS: (i) To develop a multidimensional, descriptor-based Sexual Arousal and Desire Inventory (SADI) to assess subjective sexual arousal and desire in men and women; (ii) to evaluate convergent and divergent validity of the SADI; and (iii) to assess whether scores on the SADI would be altered when erotic fantasy or exposure to an erotic film was used to increase subjective arousal. METHODS: Adult men (N = 195) and women (N = 195) rated 54 descriptors as they applied to their normative experience of arousal and desire on a 5-point Likert scale. Another sample of men (N = 40) and women (N = 40) completed the SADI and other measures after viewing a 3-minute female-centered erotic film or engaging in a 3-minute period of erotic fantasy. MAIN OUTCOME MEASURES: Principal components analyses derived factors that the scale descriptors loaded onto. These factors were categorized as subscales of the SADI, and gender differences in ratings and internal validity were analyzed statistically. Factors were considered subscales of the SADI, and mean ratings for each subscale were generated and related to the other scales used to assess convergent and divergent validity. These scales included the Feeling Scale, the Multiple Indicators of Subjective Sexual Arousal, the Sexual Desire Inventory, and the Attitudes Toward Erotica Questionnaire, the Beck Depression Inventory (BDI)-II, and the Beck Anxiety Inventory. RESULTS: Descriptors loaded onto four factors that accounted for 41.3% of the variance. Analysis of descriptor loadings > or = 0.30 revealed an Evaluative factor, a Physiological factor, a Motivational factor, and a Negative/Aversive factor based on the meaning of the descriptors. Men's and women's subjective experiences of sexual desire and arousal on the Physiological and Motivational factors were not significantly different, although on the Evaluative and Negative factors, statistically significant differences were found between the genders. Mean scores on the Evaluative factor were higher for men than for women, whereas mean scores on the Negative factor were higher for women than for men. Internal consistency estimates of the SADI and its subscales confirmed strong reliability. Mean scores on the Evaluative, Motivational, and Physiological subscales of the SADI were significantly higher in the fantasy condition than in the erotic clip condition. Women had significantly higher mean scores than men on the Physiological subscale in the fantasy condition. Cronbach's alpha coefficients demonstrated excellent reliability of the SADI subscales. Evidence of convergent validity between the SADI subscales and other scales that measured the same constructs was strong. Divergent validity was also confirmed between the SADI subscales and the other scales that did not measure levels of sexual arousal, desire, or affect, such as the BDI-II. CONCLUSION: The SADI is a valid and reliable research tool to evaluate both state and trait aspects of subjective sexual arousal and desire in men and women.

Adult↗
PubMed1996

Visual versus auditory memory stimulation in patients with probable Alzheimer's disease. A PET study with 18 FDG.

Patients with probable Alzheimer's disease were either stimulated with a continuous visual recognition task (n = 18) or with a continuous auditory recognition task during PET measurement with 18 FDG. The PET scanner was a Siemens CTI, ECAT EXACT with 5 mm transaxial and 6 mm axial resolution. The global stimulation effects were nearly identical in both groups and increased of 4.17 +/- 8.14% in the auditory stimulated group and of 4.03 +/- 11.78% in the visual stimulated group. Beyond regional stimulation effects in both groups a common cerebellar stimulation effect was measured. It is concluded that the cerebellar stimulation effect reflects a modality independent cognitive process and that the only small enhancement of global glucose metabolism indicates disturbed stimuli processes and finally explained the patient's failure in memory tasks.

Aged↗
PubMed2000

Linguistic ability in early life and the neuropathology of Alzheimer's disease and cerebrovascular disease. Findings from the Nun Study.

Findings from the Nun Study indicate that low linguistic ability in early life has a strong association with dementia and premature death in late life. In the present study, we investigated the relationship of linguistic ability in early life to the neuropathology of Alzheimer's disease and cerebrovascular disease. The analyses were done on a subset of 74 participants in the Nun Study for whom we had handwritten autobiographies completed some time between the ages of 19 and 37 (mean = 23 years). An average of 62 years after writing the autobiographies, when the participants were 78 to 97 years old, they died and their brains were removed for our neuropathologic studies. Linguistic ability in early life was measured by the idea (proposition) density of the autobiographies, i.e., a standard measure of the content of ideas in text samples. Idea density scores from early life had strong inverse correlations with the severity of Alzheimer's disease pathology in the neocortex: Correlations between idea density scores and neurofibrillary tangle counts were -0.59 for the frontal lobe, -0.48 for the temporal lobe, and -0.49 for the parietal lobe (all p values < 0.0001). Idea density scores were unrelated to the severity of atherosclerosis of the major arteries at the base of the brain and to the presence of lacunar and large brain infarcts. Low linguistic ability in early life may reflect suboptimal neurological and cognitive development, which might increase susceptibility to the development of Alzheimer's disease pathology in late life.

Adult↗
PubMed1981

Can passive touch be better than active touch? A comparison of active and passive tactile maze learning.

In a comparison of the performance of active (n=15) and passive (n=15) mechanically yoked subjects who learned their way through a tactile maze, it was shown that active subjects mad more errors and took a greater number of trials to reach criterion than did passive subjects. In addition, the difference between active and passive performance was largely accounted for by the greater number of repeated errors made by active subjects. In a second experiment it was found that the poorer performance of active subjects could be attributed to the interfering effects of decisions about which way to move. However, the responsibility for the production of movement had no effect on performance. it was argued that the results reflected limits to the cognitive system, not the haptic system.

Adolescent↗