SEARCH · PubMed Health

Results for “Cognitive Reflection”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 883 records · Page 49Linked to original sources

PubMed2000

Can depression be de-medicalized in the 21st century: scientific revolutions, counter-revolutions and the magnetic field of normal science.

This article is about our scientific investigations of the change mechanisms in cognitive therapy (CT) for depression. In a previous clinical trial, we found that so-called 'cognitive' interventions were not necessary for the success of CT: the behavioral activation (BA) component, a treatment precluding attempts to change thinking, worked as well as the entire CT package, both in maximizing acute treatment response and in relapse prevention over a two year period. We tentatively suggested at the time of publication [Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E. T., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treament for depression. Journal of Consulting and Clinical Psychology, 64, 295-304; Gortner, E. T., Gollan, J. K., Dobson, K. S., & Jacobson, N. S. (1998). Cognitive-behavioral treatment for depression: relapse prevention. Journal of Consulting and Clinical Psychology, 66, 377-384.] that the 'cognitive' components of CT may not only be unnecessary but potentially a liability, since they result in a less parsimonious treatment package that may be not be cost effective. In this article, we not only defend this contention, but counteract the skepticism expressed by some CT advocates that the quality of our CT was deficient. Finally, we describe a study designed to confirm our conclusions from the earlier trial and, in the process, reintroduce a contextual perspective on depression, one which counters the currently dominant defect models reflected in both Beck's cognitive model and in theories that emphasize biological causation.

Cognitive Behavioral Therapy↗

PubMed1993

Unilateral contraction of facial muscles do effect emotions: a "failed replication's" failure to perform a replication.

Kop, Merckelbach and Muris (1991) reported a failure to replicate Schiff and Lamon's (1989) finding that unilateral muscle contractions induce emotions and influence cognitions in a manner which reflect those emotions. However, the procedures they used were different from the original experiment in substantive ways. These differences are described and it is explained how they account for the failure to replicate. This discussion helps illustrate the nature of the phenomenon which has been shown to be both robust and clinically relevant.

Affect↗

PubMed2003

Long-term effects of donepezil on P300 auditory event-related potentials in patients with Alzheimer's disease.

The P300, one of the cognitive event-related potentials (ERPs) of the cerebral cortex, reflects the functioning of the neurochemical system involved in cognitive processes. We investigated clinical significance of the components of auditory P300 ERPs, in comparison with neuropsychologic tests including the Mini-Mental State Examination and the Japanese version of the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-J cog), for evaluating of the effect of donepezil (DPZ) (5 mg daily for 6 months), an acetylcholinesterase inhibitor, in patients with Alzheimer's disease (AD). Reduction of P300 latency associated with a parallel improvement of ADAS-J cog scores was observed after administration of 5 mg/day of DPZ in patients with AD. P300 latency gives very useful information on the progression of AD, especially in the longitudinal follow-up of patients with AD during treatment with DPZ acting on cholinergic pathways.

Aged↗

PubMed2003

Are impairments of action monitoring and executive control true dissociative dysfunctions in patients with schizophrenia?

OBJECTIVE: Impaired self-monitoring is considered a critical deficit of schizophrenia. The authors asked whether this is a specific and isolable impairment or is part of a global disturbance of cognitive and attentional functions. METHOD: Internal monitoring of erroneous actions, as well as three components of attentional control (conflict resolution, set switching, and preparatory attention) were assessed during performance of a single task by eight high-functioning patients with schizophrenia and eight comparison subjects. RESULTS: The patients exhibited no significant dysfunction of attentional control during task performance. In contrast, their ability to correct errors without external feedback and, by inference, to self-monitor their actions was markedly compromised. CONCLUSIONS: This finding suggests that dysfunction of self-monitoring in schizophrenia does not necessarily reflect a general decline in cognitive function but is evidence of disproportionately pronounced impairment of action monitoring, which may be mediated by a distinct subsystem within the brain's executive attention networks.

Adult↗

PubMed2001

Longitudinal evaluation of cognitive disorder in Huntington's disease.

The study investigated longitudinal change in cognitive function in 87 patients with Huntington's disease (HD), using a range of neuropsychological tests, which tap mental manipulative abilities, memory, and frontal executive skills. Over a 1-year period the largest changes were noted in letter fluency, object recall, and Stroop Test performance, whereas no changes were noted over more than 3 years on the modified Wisconsin Card Sorting Test. Contrary to expectation, greater change was evident over 1 year for tasks with low compared to high cognitive demands. The differential sensitivity of tasks was attributed in part to inherent characteristics of the tests themselves: their capacity to detect minor gradations of change and their vulnerability to practice effects. However, the greater change for relatively automatic, speed-based tasks with low cognitive demands was interpreted as reflecting the evolution of HD, with a greater magnitude of change occurring in basal ganglia than cortical function. One purpose of the study was to identify tasks sensitive to the progression of HD and hence most suitable for the evaluation of therapies. Despite reaching statistical significance by virtue of the large group size, numerical differences in test scores over 1 year were very small, suggesting that the use of such tests to evaluate change in individuals or small groups of subjects would be problematic. The data highlight the slow progression of HD, the limitations of standard cognitive tests in detecting change over short periods, and the need for therapeutic studies that encompass a relatively prolonged time frame.

Adult↗

PubMedDate not supplied

The development of pragmatic communication skills in head injured children.

This study investigated the developmental levels of pragmatic language skills in children following head injury (HI), in comparison to their uninjured peers. Participants were 30 head-injured and 19 healthy controls, classified into a 'young' age group, 8-9 years, and an 'old' age group, 11-12 years. Participants were administered the WISC- III, a negotiating requests task and a hint task, the latter two assessing verbal reasoning skills and abilities to be indirect, respectively. It was found that negotiation and hinting strategies were rapidly developing in these age groups, where abilities to hint were less mature for all groups. Results found a main effect for injury on cognitive and functional language tasks, reflected by lower performance levels and inflexibility in reasoning for the head-injured group. Injury sustained at an earlier age consistently predicted poorer performance on the language tasks, complicating the ongoing development of generalized and higher-order communicative skills. Severity of injury did not predict performance on either language task.

Analysis of Variance↗

PubMed1997

[Information processing deficits in depression in terms of event-related potentials: in comparison with schizophrenics and normal controls].

Information processing deficits characteristic of remitted major depression, which may be a vulnerability marker for the disease, were examined from two aspects by means of visual event-related potentials (ERPs) obtained during simple and discriminative response tasks: 1. To clarify the difference in cognitive dysfunction between both depressives and schizophrenics in remission, we compared the ERPs in remitted depressive patients (n = 11) and remitted schizophrenic patients (n = 9) with those of age, and sex-matched controls (n = 10). 2. To clarify the influence of aging on information processing in remitted depression, ERPs in young remitted depressives (20-46 years old, n = 11) were compared with those in older remitted depressives (52-75 years old, n = 11) in contrast to young (n = 10) and older (n = 11) controls. The remitted schizophrenics showed a retardation in NA and N2 latencies and a reduction in P3 amplitude. However, P1 increased in amplitude exclusively in the remitted depressives. The effect of stimulus discrimination on N1 seen in the controls was absent in both patient groups. The results suggest that the remitted depressives had an attentional deficit in early information processing reflected on P1 and N1 potentials, while the remitted schizophrenics had an extensive cognitive dysfunction reflected on N1, NA, N2, and P3 potentials. Although the effect of stimulus discrimination on N1 was absent in both young and older remitted depressive patients, older patients showed no effects of normal aging on ERPs such as P1 increase or N1 increase during discrimination tasks. Significant interaction effects between diagnosis and aging were found by ANOVA only in the laterality of the P1 amplitude. Older remitted depressives showed an unbalanced right-predominance in P1 amplitude. These results suggest that older remitted depressives had the same early information-processing deficit seen in the young remitted depressives as well as an overactivation over the right hemisphere in the attentional mechanism, irrespective of normal aging.

Adult↗

PubMed2001

Cognitive correlates of supratentorial atrophy on MRI in multiple sclerosis.

OBJECTIVES: We aimed to investigate associations between neuropsychological indices and normalized volumes of supratentorial structures, and the area of the corpus callosum. MATERIALS AND METHODS: We studied 40 patients with clinically definite MS, using 3D-acquired MRI (MPRAGE, Magnetization Prepared Rapid Acquisition Gradient Echo) and stereology. Subjects underwent a neuropsychological battery interrogating multiple cognitive domains, from which a global Cognitive Index Score (CIS) was derived. RESULTS: White matter volumes were significantly correlated with CIS (rho= -0.59, P<0.0001) and with many of the individual cognitive tests. CIS was also significantly correlated with the corpus callosal area (rho= -0.49, P<0.002). Grey matter volumes did not significantly correlate with any cognitive test. CONCLUSIONS: These volume/function relationships presumably reflect the effects of subcortical axonal and myelin loss on the neural networks that subserve cognition. If serial MRI volume estimations can index accumulating cognitive deficits, this simple technique may be useful in therapeutic trials.

Adult↗

PubMed2003

Rate of cognitive decline in preclinical Alzheimer's disease: the role of comorbidity.

We investigated the influence of individual-difference variables implicated as risk factors for Alzheimer's disease (AD) or known to be related to cognitive performance in normal aging (e.g., age, sex, years of education, previous and recent diseases, apolipoprotein E status, social network, and substance use) on rate of cognitive change from preclinical to clinical AD. With the use of data from a population-based study, 230 persons who were nondemented at baseline and diagnosed with AD at a 3-year follow-up were examined with the Mini-Mental State Examination (MMSE). Of all predictor variables examined, only number of diseases resulting in hospital admission during the follow-up period made an independent contribution to rate of MMSE change. These results suggest that many variables affecting the onset of the degenerative process as well as cognitive functioning in normal aging exert little influence on rate of cognitive change in preclinical AD. This may reflect the fact that the emerging dementia disease overshadows the role of these variables for cognitive functioning. A possible exception to this pattern is that an increasing number of concomitant health conditions may exacerbate the rate of cognitive decline during the final portion of the preclinical phase in AD.

Aged↗

PubMed1993

Cognitive risk factors and neuropsychological performance in HIV infection.

Almost all investigations examining the effects of early HIV infection on neuropsychological functioning in homosexual males have excluded subjects with cognitive risk factors such as recreational drug use and head injury. While insuring that results reflect the influence of the virus on cognition, this selection bias limits the ability to generalize findings. Comprehensive neuropsychological evaluations were compared between two groups of homosexual males with a variety of cognitive risk factors. Subjects were 132 HIV seropositive males (108 CDC class II & III and 24 CDC class IVA & IVC2) and 65 HIV seronegative controls. Recreational drug use in the six months prior to exam was found to interact with HIV infection and was associated with selective areas of cognitive decline and a significantly worse overall neuropsychological performance. Although significantly lower functioning in the domains of Verbal Memory and Attention and Speed of Information processing was noted for subjects with CDC class IVA and IVC2 compared to seropositives with CDC class II & III, overall neuropsychological performance was similar in these two groups. At this early stage of HIV infection, we did not find indication of association between neuropsychological performance and decreased immunological status. A history of head injury and recent recreational drug use emerged as primary cognitive risk factors associated with decreased neuropsychological performance. As 50% of our HIV seropositive subjects reported active recreational drug use, this cognitive risk factor in particular may contribute to the appearance of HIV-related cognitive deficits during early stages of HIV infection.

Cognition Disorders↗

PubMed1998

Left frontal EEG coherence reflects modality independent language processes.

Previous studies showed that distinct components of higher cognitive processes like memorizing of words could be correlated with changes in different frequency bands of the human EEG. This study was designed in order to find out if 1) some frequency bands show power and coherence changes only due to the modality of presented stimuli (either auditory or visual) and 2) if other frequency bands show modality independent effects which should reflect real cognitive-linguistic differences between word classes (either concrete and abstract nouns). EEG was recorded from sixteen right-handed females which had to memorize auditorily and visually presented concrete and abstract nouns. Results show the alpha-1 band to reveal no differences between word classes but demonstrate an influence of modality of stimulus presentation. The only modality independent differences between concrete and abstract noun processing were found in the delta, theta and beta-1 band at left frontal electrodes.

Alpha Rhythm↗

PubMed2002

Perceptual and cognitive event-related potentials in neuropsychopharmacology: methodological aspects and clinical applications (pharmaco-ERP topography and tomography).

Middle latency and late components of event-related brain potential (ERPs) are closely related to perceptual and cognitive information processing, respectively. In a double-blind, placebo-controlled study, the acute effects of lorazepam (2 mg), haloperidol (3 mg), methylphenidate (20 mg) and citalopram (20 mg) on ERP latencies, amplitudes, topographies and tomographies were investigated in 20 healthy subjects of 23-34 years of age. After automatic artifact minimization and rejection, standard N1 and P2 and target N2 and P300 components were determined. The tranquilizer lorazepam prolonged P300 latency, which indicates an impairment of stimulus evaluation time. Low-resolution brain electromagnetic tomography (LORETA) revealed decreases in N1 and P300 source strength in those brain regions with relevant generators of these components, which reflects impairments of attentional and cognitive processing resources. The neuroleptic haloperidol decreased N1 and P300 source strength predominantly in those brain regions not involved in the generation of these components, suggesting a shift of resources. The psychostimulant methylphenidate increased P300 source strength in brain regions with major P3b generators, indicating increases in energetic resources associated with stimulus encoding. The antidepressant citalopram increased N1 and P3b source strength in multiple brain regions specifically in the left prefrontal cortex, a brain region in which reduced blood flow and metabolism was found in depressed patients.

Adult↗

PubMedDate not supplied

Cognitive impairments in depression.

Depressed patients perform poorly on memory tests. This may reflect a failure to employ encoding strategies that facilitate recall or a generalized inability to allocate cognitive effort to more difficult tasks. Inpatients with major depression or personality disorders and age- and IQ-matched normal controls were administered an automatic frequency of occurrence test and verbal paired associated recall and recognition memory tests. There was no difference in frequency judgments among the subject groups. Both depressed and personality disordered groups recalled and recognized fewer words than normal subjects, with the depressed subjects tending to recall and recognize the fewest words. There was a strong effect of task difficulty on memory performance but this effect was consistent across subject groups. These findings suggest that the poorer performance of depressed patients on memory tests reflect basic memory impairments rather than a general inability to allocate cognitive effort to more demanding tasks. However, these impairments may not be specific to depression but may reflect general effects of psychopathology on memory.

Adult↗

PubMed2001

Postmarketing experience with topiramate and cognition.

Ideal antiepileptic drugs (AEDs) are designed to stop seizures with limited central nervous system (CNS) side effects. However, CNS-related treatment-emergent adverse events (TEAEs) often occur in patients receiving AEDs. Topiramate (TPM) is an AED proven to be safe and effective as adjunctive treatment for epilepsy patients with partial seizures. Double-blind, placebo-controlled, multicenter trials demonstrated potential effects on cognition. The P.A.D.S. (post-marketing antiepileptic drug survey) group, a cooperative group of 14 epilepsy centers that collaborate on obtaining data about new AEDs and devices, prospectively collected standardized data forms before and during treatment with TPM for epilepsy, and analyzed the postmarketing experience of CNS TEAEs with TPM. Our results from 701 treated patients show that cognitive complaints were the most common reason to discontinue TPM. The presence of complaints did have predictive value if the patient would discontinue TPM, although was not specific as to when discontinuation would occur. The spectrum of complaints in our open-label prospective multicenter postmarketing study was similar to those observed in controlled clinical trials. We were unable to demonstrate a specific population, dose titration, or concomitant AED that was at risk to discontinue treatment. We conclude that most patients treated with TPM will continue therapy beyond 6 months. Cognitive complaints and not efficacy reflect the primary reason for discontinuing therapy. Psychomotor slowing was the most common complaint, yet most patients elect to continue treatment, with "better" or "much better" ratings of both seizure and global improvement during treatment.

Adolescent↗

PubMed2002

Cognitive impairment after stroke.

The concept of vascular dementia is undergoing revision. The multi-infarct model and the Alzheimer's model of dementia, usually referred to as 'multi-infarct dementia', are gradually being replaced by a much broader concept of vascular cognitive impairment. This conceptual evolution reflects a more profound understanding of the pathogenic mechanisms that underlie this complex syndrome. As a consequence of this revision new diagnostic criteria have been established during the past 25 years, resulting in new problems with regard to precise disease definition and limited inter-rater reliability. The particular criteria chosen by a clinician or investigator to diagnose vascular dementia have a major impact on epidemiology, disease management and health economic estimates.

Cognition Disorders↗

PubMed2006

Neural substrates of cognitive and behavioral deficits in atypical Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by a progressive cognitive decline that typically affects first memory and later executive functions, language, and visuospatial skills. This sequence of cognitive deterioration is thought to reflect the progressive invasion of the cerebral cortex by the two major pathological hallmarks of AD, neurofibrillary tangles (NFT) and senile plaques (SP), as well as degree of neuronal and synaptic loss. In atypical AD, prominent and early deficits are found in language, motor abilities, frontal and executive capacities, or visuospatial skills. These atypical clinical features are associated with an unusual pattern of NFT or SP formation that predominantly involves cortical areas usually spared in the course of the degenerative process. In an attempt to classify this highly heterogeneous subgroup, the present article provides an overview of clinicopathological analyses in patients with atypical progression of AD symptomatology with special reference to the relationship between specific cognitive and behavioral deficits and hierarchical patterns of AD lesion distribution within the cerebral cortex. On the basis of these representative examples of a cortical circuit-based approach to explore the mechanisms giving rise to AD neuropsychological expression, we also critically discuss the possibility to develop a matrix linking clinical presentations to degeneration of forward and backward long corticocortical pathways in this disorder.

Adult↗

PubMed2003

The role of the fusiform face area in social cognition: implications for the pathobiology of autism.

A region in the lateral aspect of the fusiform gyrus (FG) is more engaged by human faces than any other category of image. It has come to be known as the 'fusiform face area' (FFA). The origin and extent of this specialization is currently a topic of great interest and debate. This is of special relevance to autism, because recent studies have shown that the FFA is hypoactive to faces in this disorder. In two linked functional magnetic resonance imaging (fMRI) studies of healthy young adults, we show here that the FFA is engaged by a social attribution task (SAT) involving perception of human-like interactions among three simple geometric shapes. The amygdala, temporal pole, medial prefrontal cortex, inferolateral frontal cortex and superior temporal sulci were also significantly engaged. Activation of the FFA to a task without faces challenges the received view that the FFA is restricted in its activities to the perception of faces. We speculate that abstract semantic information associated with faces is encoded in the FG region and retrieved for social computations. From this perspective, the literature on hypoactivation of the FFA in autism may be interpreted as a reflection of a core social cognitive mechanism underlying the disorder.

Adult↗

PubMed2003

Assessing the impact of pediatric epilepsy and concomitant behavioral, cognitive, and physical/neurologic disability: Impact of Childhood Neurologic Disability Scale.

Epilepsy has a significant impact on a child's life, the extent to which is based on four factors: epilepsy, cognition, behavioral, and physical/neurologic function. This study evaluates the ability of the 44-item Impact of Childhood Neurologic Disability Scale (ICND) to assess each of these four realms. Parents of children (aged 2 to 18 years) with epilepsy rated their child's overall quality of life and completed the ICND. External validation compared the ICND with (1) neurologists' reports of children's behavior, cognitive abilities, physical/neurologic disability, and epilepsy; and (2) parents, teachers, and children's ratings on six 'criterion standard' questionnaires. Families of 68 children with epilepsy only and 29 children with 'epilepsy-plus' (additional cognitive, behavioral, or physical/neurologic disability; 39 males, 58 females; mean age at testing 10 years 3 months [SD 4.5] age range 2 to 17 years) participated. Internal consistency was excellent (Cronbach's alpha=0.92) as was test-retest reliability (intraclass correlation=0.89). Caregivers distinguished the impact of each of the four realms. Scores were negatively related to quality of life (Pearson's r=-0.59). Children with high ICND scores had more difficulties at home and school. Their parents saw them as less rewarding and adaptable and the children saw themselves as less intelligent and less popular with more emotional problems. In addition, children with 'epilepsy-plus' had significantly higher total ICND scores as well as markedly elevated scores within each of the four realms when compared with the epilepsy-only group. It is concluded that the ICND is an accurate, quick measurement tool reflecting the impact of behavior, cognitive learning ability, physical/neurologic disability, and epilepsy on children and their families.

Adolescent↗