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Results for “Cognitive Reflection”

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PubMed1998

Patients' experiences of Parkinson's disease.

Patients' (n = 101) experiences of Parkinson's disease (PD) were studied through structured interviews. Oblique factor analysis produced three moderately intercorrelated clusters of items reflecting reported severity of motoric, cognitive, and psychological problems, respectively. Scales formed from the factors were correlated with demographic, disease-related, and psychosocial variables. The demographic variables were not significantly correlated with the scales or with any other variables in the set. Hoehn and Yahr staging was significantly related to scores only on the motoric severity scale. Measures of functional capacity, in contrast, were significantly associated with all three scales. Although the addition of the psychosocial variables as a set significantly increased multiple Rs for each of the three scales, the specific patterns of correlation varied from scale to scale. The findings indicate that from the viewpoint of the patient the problems created by PD were not restricted to the motoric domain. Too narrow a focus by clinicians and researchers on medical symptomatology may give insufficient recognition to the multidimensional nature of the patient's experience.

Activities of Daily Living↗

PubMed1975

Temporal information processing by young and senior adults and patients with senile dementia.

Temporal discrimination by healthy young and senior adults and patients with senile dementia was studied using the measure of transmitted information and two psychophysical methods (single-stimulus-ranking and pair-comparison). The patients with senile dementia showed very severe impairment on both methods and performed much less efficiently than the healthy adults of the same age; thus the former revealed a deficit in both memory and discrimination. The healthy seniors showed less alteration of temporal judgment with significant loss only with the single-stimulus method, which reflects memory deficit alone. Temporal cognition is very sensitive to changes in brain function.

Adult↗

PubMed2000

Concussions in athletes produce brain dysfunction as revealed by event-related potentials.

We have used event-related potentials (ERP) to assess cerebral activity following mild traumatic brain injuries in 20 college athletes practising contact sports. Concussion victims showed a striking decrease in P300 amplitude, an effect presumed to reflect alterations in attentional-cognitive processes. Moreover, the degree of impairment was strongly related to the severity of post-concussion symptoms. Our data suggest that concussions cause objectively measurable changes in the electrophysiological markers of brain activity and hence in the functions of the structures from which they originate. ERPs may thus constitute a reliable method to accurately monitor the clinical course and recovery of head injuries in athletes.

Adult↗

PubMed2002

Recognition of lexically controlled words and sentences by children with normal hearing and children with cochlear implants.

OBJECTIVE: The purpose of this study was to investigate the combined lexical effects of word frequency and neighborhood density (acoustic-phonetic similarity) on the recognition of words spoken in isolation and words spoken in sentences for children with normal hearing and children with cochlear implants. DESIGN: Lexically controlled sentences were created from a subset of words obtained from the spoken vocabulary of children between the ages of 3 and 5 yr. Two sentence lists were generated, applying the definitions and procedures of Kirk, Pisoni, and Osberger (1995) in accordance with the Neighborhood Activation Model ( Luce, 1986; Luce & Pisoni, 1998). One list was composed of lexically "easy" words (those high in frequency of occurrence but phonemically dissimilar to other words) and the other list was composed of lexically "hard" words (those low in frequency of occurrence but phonemically similar to other words). Each list consisted of five practice and 20 test sentences that were syntactically correct but semantically neutral (low in predictability). Three key words were used in constructing each of the 5- to 7-word sentences, resulting in 15 practice and 60 key words per test list. In the first of three experiments, 48 normal-hearing children between the ages of 5 and 12 yr were asked to repeat the words and sentences at one of six presentation levels to establish performance-intensity functions. In the second experiment, 12 normal-hearing children between the ages of 5 and 14 yr repeated the words and sentences under spectrally degraded conditions. Twelve children with cochlear implants ages 5 to 14 yr repeated the unprocessed stimuli in a third experiment. RESULTS: The lexically easy stimuli were recognized with greater accuracy than the lexically hard stimuli for the children tested in all three experiments. Sentence scores were significantly higher than word scores for the normal-hearing children (Experiments 1 and 2) and nine high-performing children with cochlear implants (Experiment 3). Word scores were higher than sentence scores for the three low-performing children with cochlear implants. There was a statistically significant relationship between chronological age and sentence score for the normal-hearing children listening under spectrally degraded conditions. For the children with cochlear implants, the relationship between language quotient and sentence and word scores was statistically significant. CONCLUSION: Sensitivity to the combined lexical properties of word frequency and neighborhood density was evident both for words and sentences. Lexically easy stimuli were recognized with greater accuracy than lexically hard stimuli across groups, affirming the robustness of this effect and verifying that words were being organized in relation to the frequency and acoustic-phonetic properties of other words. Syntactic context facilitated word recognition for the children with normal hearing and the high-performing implant group. The three low-performing children with cochlear implants recognized words more accurately than sentences, reflecting limitations in linguistic and cognitive capacity.

Child, Preschool↗

PubMed1991

Clinical effects of methylphenidate and thioridazine in intellectually subaverage children.

Thirty children with subaverage IQs and psychiatric diagnoses of attention deficit disorder and/or or conduct disorder took part in a double-blind study of placebo, methylphenidate, and thioridazine, which were given for 3 weeks each. The results showed a consistent and highly significant effect of methylphenidate in reducing teacher ratings of problem behavior. Parent ratings showed no behavioral effects for the group as a whole. An attentional model of stimulant drug response was used to divide subjects according to a cognitive maturity domain presumed to reflect selective attention. When divided according to breadth of attention, mental age, and IQ level, higher functioning subjects were found to show a generally favorable response to methylphenidate on both teacher and parent rating scales, whereas children of low functional level typically showed an adverse or indifferent response. The present data suggest that mental age and IQ may be important determinants of drug response; below a given level, there was a greatly reduced likelihood of responding positively. Clinical response to thioridazine was substantially less than the response to methylphenidate, with significant improvements confined to conduct and hyperactivity problems on teacher ratings.

Adolescent↗

PubMed1998

How much do novel antipsychotics benefit the patients?

Although great advances have been made in the pharmacotherapy of schizophrenia, many patients are still not taking full advantage of the beneficial effects of antipsychotic drugs. This is largely a result of the low levels of compliance. Conventional antipsychotics have little efficacy against negative symptoms, and so many patients with schizophrenia are refractory to treatment with these drugs. Additionally, clinically effective doses of conventional antipsychotics can actually aggravate negative symptoms through the development of extrapyramidal symptoms (EPS). Patients taking these drugs, therefore, often felt that the treatment was making them worse instead of better, and were reluctant to continue with it. The novel antipsychotics offer great potential for improving compliance. Clinical trials have shown that atypical drugs such as sertindole do not induce EPS, are effective against negative as well as positive symptoms and do not affect cognition. These observations have been reflected in postmarketing clinical experience, leading to recommendations that novel antipsychotics, such as sertindole, should be prescribed to first-episode patients. These patients would then not experience EPS and would be more likely to continue with their medication in the long term and thus avoid relapse. The major problems affecting compliance with pharmacotherapy for schizophrenia are outlined here showing, by means of case histories, how sertindole has benefited schizophrenic patients.

Adult↗

PubMed2006

Outcomes of long-term outpatient tinnitus-coping therapy: psychometric changes and value of tinnitus-control instruments.

OBJECTIVES: Increasing tinnitus compliance and coping are desirable aims of successful treatment in chronic tinnitus. However, application of established procedures such as tinnitus retraining therapy (TRT) is often relatively short. In addition, the value of tinnitus control instruments (TCI) is questionable, especially for minor severity levels of tinnitus, and the comparability of treatment results is low. To evaluate long-term changes of tinnitus-related distress, defined psychometric data were collected in patients with compensated tinnitus (cT) or decompensated tinnitus (dT) during a standardized 2-yr outpatient tinnitus-coping therapy (TCT). DESIGN: In a prospective clinical investigation, the data of 70 tinnitus patients were recorded at the beginning and at 6-mo intervals, with a final investigation after 24 mo. The first group consisted of 40 patients with cT and dT who were randomly assigned to a treatment group and a waiting-list control group. After a period of 12 mo without treatment, the control group was treated similarly. The tinnitus questionnaire (TQ) of Goebel and Hiller, visual analog scales (VAS), and a severity questionnaire for tinnitus-associated complaints were used as psychodiagnostic instruments. Therapy components consisted of counseling, fitting patients with TCIs (TCI provision), auditory and relaxation training, and psychosomatic care if necessary. A second group of 30 patients with cT receiving TCT without TCI devices was investigated to evaluate the additive efficacy of TCI in cT. RESULTS: The initial TQ score did not differ between the treatment group and the waiting-list control group. After 12 mo, the control group did not show any significant changes, but the treatment group had improved significantly. During TCT, the combined data of both groups showed a statistically significant decrease of the TQ score in dT (59.1 to 34.8) and cT (32.8 to 24.0). These changes were especially reflected by the subscales of cognitive and emotional distress and also by the VAS and the severity questionnaire. dT patients benefitted without dependence on age or duration of pre-existing tinnitus; for cT patients, this was true mainly of the younger and older subjects and for tinnitus lasting for less than 1 yr. TCI provision improved the efficacy of TCT in patients with cT. CONCLUSIONS: The psychometric changes demonstrate a clear decrease of tinnitus-related distress in all severity levels of sufficiently treated chronic tinnitus. Long-term TCT induces improvement even up to the time of 24 mo. With TCIs established particularly in patients with dT, our results suggest that a supporting adjustment of TCI devices is helpful in cT to foster quicker rehabilitation. The outpatient interdisciplinary TCT, consisting of cognitive tinnitus desensitization, TCI provision, and psychosomatic support if required, represents a successful treatment strategy for both dT and cT patients.

Adaptation, Psychological↗

PubMed2003

Postprocedure pain management of interventional radiology patients.

Postprocedure pain management of patients after interventional procedures has to take into account residual drug actions from pre- and intraprocedure medications. A variety of sedatives, narcotics, local anesthetics, nonopioid analgesics, and nonsteroidal antiinflammatory agents can be adjusted to the patient's needs and risk factors. The article addresses the safe use of these agents in addition to reflections on assessment and the cognitive elements of the pain experience.

Analgesia, Patient-Controlled↗

PubMed2006

Event rate and event-related potentials in ADHD.

BACKGROUND: It has been repeatedly found that performance of children with attention deficit hyperactivity disorder (ADHD) is more impaired when a long inter-stimulus interval (ISI) is used than when a short ISI is used. According to the cognitive-energetic model, this may reflect difficulty in remaining in an optimal motor activation state because of insufficient effort allocation. METHOD: Event-related potentials (ERPs) were evaluated during a Go/No-Go task that incorporates a condition with a fast and a slow presentation rate. RESULTS: ADHD, whether or not comorbid with oppositional defiant/conduct disorder (ODD/CD), was associated with a steeper increase in reaction time (RT) from the fast to the slow condition accompanied by a missing increment of the parietal P3. Speed of responding was found to be correlated with P3 amplitude. In the fast condition, children with ADHD made more errors of commission, accompanied by a smaller No-Go N2, a component thought to be related to inhibition; however, after controlling for ODD/CD these differences disappeared. CONCLUSIONS: The association between the steeper increase in RT and reduced parietal P3s may indicate that the children with ADHD did not allocate enough extra effort to adjust to a potentially under-activated state. However, the event rate effects could not account for all of the differences between groups and also early automatic information processing stages seem disturbed in this disorder as indexed by larger P2 amplitudes. Alternative explanations are discussed.

Adolescent↗

PubMed2006

Neuromagnetic responses to binaural beat in human cerebral cortex.

The dichotic presentation of two sinusoids with a slight difference in frequency elicits subjective fluctuations called binaural beat (BB). BBs provide a classic example of binaural interaction considered to result from neural interaction in the central auditory pathway that receives input from both ears. To explore the cortical representation of the fluctuation of BB, we recorded magnetic fields evoked by slow BB of 4.00 or 6.66 Hz in nine normal subjects. The fields showed small amplitudes; however, they were strong enough to be distinguished from the noise accompanying the recordings. Spectral analyses of the magnetic fields recorded on single channels revealed that the responses evoked by BBs contained a specific spectral component of BB frequency, and the magnetic fields were confirmed to represent an auditory steady-state response (ASSR) to BB. The analyses of spatial distribution of BB-synchronized responses and minimum-norm current estimates revealed multiple BB ASSR sources in the parietal and frontal cortices in addition to the temporal areas, including auditory cortices. The phase of synchronized waveforms showed great variability, suggesting that BB ASSR does not represent changing interaural phase differences (IPD) per se, but instead it reflects a higher-order cognitive process corresponding to subjective fluctuations of BB. Our findings confirm that the activity of the human cerebral cortex can be synchronized with slow BB by using information on the IPD.

Acoustic Stimulation↗

PubMed2006

Space-time relativity in self-motion reproduction.

Experiments on reproducing imposed self-motion showed that not only final distance or angle of motion, but also the temporal profile are reproduced. Reproduction errors have been attributed to sensory inputs, inaccurate memorization of the motion variable, or motor errors. However, another possible source of error has so far been neglected. The internal time base for path integration or movement memorization may be distorted and thus not reflect physical time. Because additional cognitive load was previously shown to affect subjective estimation of duration, we used a dual-task paradigm during either the stimulation or reproduction phase of three different movement reproduction tasks. We asked subjects 1) on a rotating chair to reproduce imposed passive whole body rotations by controlling the chair with a joystick, 2) on a treadmill to actively reproduce locomotion with respect to the treadmill, and 3) while blindfolded to reproduce a previously walked straight trajectory. The cognitive load changed the distance of reproduced self-motion by about 25% depending on whether the mental task was performed while experiencing or reproducing the motion. Although imposed velocity was reproduced accurately in all conditions, reproduced movement duration was affected in the same way as distance. This result implies that for the perception of distance traveled, perceptual space and time are closely interrelated. The findings are consistent with shared processing of temporal and spatial information. A computational model of motion reproduction including a discrete path integrator is proposed that is able to explain the experimental results within one coherent framework.

Adult↗

PubMed1995

Effect of frontal and temporal seizure foci on P50 auditory evoked potentials.

Event-related potentials have been occasionally investigated in epilepsy. We recorded P50 auditory evoked potentials in 25 patients with complex partial seizures of frontal and temporal lobe origin. P50 was significantly reduced in amplitude and prolonged in latency in temporal lobe seizure patients as compared to controls. Patients with complex partial seizures originating in the frontal lobes did not differ from controls in P50 amplitude. P50 attenuation differences may be related to interictal behavioral or cognitive changes, but could also reflect medication effects. Event-related potentials may be helpful in differentiating frontal and temporal seizure foci.

Adolescent↗

PubMed2002

Memory functioning following traumatic brain injury in children with premorbid learning problems.

This study examines the memory functioning of 25 children who sustained a traumatic brain injury (TBI) and who had prior learning problems, 48 children with TBI who did not have prior learning problems, and 23 noninjured controls. The children with TBI and prior learning problems displayed significantly worse memory abilities than both the control participants and the children with TBI and no prior learning problems. They differed significantly from these 2 groups on measures of general memory, verbal memory, sound-symbol learning, and attention. The results suggest that children with premorbid learning problems who sustain TBI have less cognitive reserve and a lower threshold for the expression of cognitive impairments in areas that reflect preexisting learning and language problems, compared to children without premorbid learning problems.

Adolescent↗

PubMed2001

Social identification and gender-related ideology in women and men.

The nature of women's and men's gender-derived social identification was examined with a focus on the relationships between aspects of identity and gender-related ideology. Measures of social identification, sex-role ideology, and the perception of women's collective disadvantage were completed by 171 women and 91 men who categorized themselves as either traditional, non-traditional or feminist. Factor analysis provided support for a multidimensional conception of gender-derived social identification, with viable subscales reflecting in-group ties, cognitive centrality, and in-group affect. For self-identified non-traditional and feminist women, the cognitive centrality of gender was greater, and more consistently related to gender-related ideology, than for traditional women. Traditional men reported stronger in-group ties and more positive gender-linked affect than did non-traditional men, but men's levels of identification were generally weakly related to gender-related ideology. The utility of considering both multiple dimensions and ideological correlates of group identification is discussed with reference to social identity theory.

Adult↗

PubMed2003

Stroke hemiplegia and specular image: lessons from self-portraits.

Hemiplegic patients suffer from difficulties in self-awareness, either due to specific neurological disturbances of body image or to psychological problems with their I images. Both types of difficulty have to do with the specular image as defined by Lacan (1966a) (i.e., the psychic structure that links the body with the symbolic and imaginary components of identity, and neutralizes the real objects involved in mother-child exchange). This study is devoted to analyzing how recent right and left brain vascular lesions affect specular image. Multivariate Analysis of 308 self-portraits of right and left brain injured stroke patients and control participants was performed. This revealed three dominant types of self-portrait: 1) Erect, complete, and clothed self-portraits were predominantly drawn by normal participants. 2) Erect self-portraits, lacking clothes, hands, and/or mouth and eyes were found in all groups of participants, predominantly in patients with speech disorders. Lack of hands and face features are indications of the challenge brought to the symbolic and imaginary aspects of identity by any sudden handicap, whether or not caused by a brain lesion, while symmetry of lacks and verticality show that body image may retain its structuring value even in brain lesions. 3) This is not the case in neurological disorders of body image, since inclined portraits with unilateral omissions were predominantly drawn by patients with right brain lesions. These unilateral omissions proved not only to result from cognitive deficiencies, but also to reflect the fragmentation of specular image, and in one case, the concomitant undue appearance of the object.

Adolescent↗

PubMed1994

Right-left orientation: development of correct use of right and left terms.

Right-left orientation includes discrimination and recognition as well as identification, the former two differentiating between symmetrical cues and the latter using the words right and left. In the present experiment involving 406 children, the evolution of the knowledge and use of the concepts of right and left were assessed. Discrimination and recognition on all tasks used in this study are mastered much earlier than verbal identification, and, at even 11 years of age, half of the subjects of the present study still did not apply the words right and left properly onto other persons in the milieu. Children use the words right and left correctly first on their own bodies as early as seven years of age, then on people facing away, and finally on people facing them around eight to nine years of age. This transition most probably reflects the slow evolution of cognitive processes which determine the way the child will use internal or external frameworks as well as the passage from egocentrism to "alteregocentrism" with ability to consider other viewpoints than one's own.

Body Image↗

PubMed1996

Right-left orientation, mental rotation, and perspective-taking: when can children imagine what people see from their own viewpoint?

Right-left orientation, mental rotation, and perspective-taking were examined in a group of 406 subjects ranging from 5 to 11 yr. of age with equal numbers of children in each age group. Immediate recognition was not a difficult task as even young children succeeded adequately on the three tasks involving different images. Right-left identification, where right and left terms are used, was harder even for the oldest subjects when associated with mental rotation. When children had to identify which image a person would see from another viewpoint, they succeeded when the person was looking away in the same direction as they were looking. When the person was facing the children (in the opposite direction of "forward"), three different behaviors emerged which indicated absence or presence of mental rotation in perspective-taking. Young subjects chose images as if the figures in the image were seeing from the subject's viewpoint; this percentage diminished slowly across increased ages. As subjects' ages increased, more chose the correct image. Even at 11 years of age, however, only half of the subjects chose correctly. Finally, an equal percentage of subjects among the different age groups understood that the person was seeing a different orientation of the persons but did not associate this with the correct right-left position of the persons on the image. This transition most probably reflects the slow evolution of cognitive processes which determine the way the child will use references to internal or external frameworks. It illustrates as well the passage from egocentrism to geocentrism with the ability to consider viewpoints other than one's own.

Child↗

PubMed2003

Alexithymia and incidental learning of emotional words.

Alexithymia is thought to reflect a deficit in the cognitive capacity to process emotions. Prior research suggests that emotional valence has a memory enhancing effect in poor conceptual learning conditions. This study addressed the question of whether incidental learning of emotional words is a function of alexithymic tendencies. Incidental learning is unintentional learning that results from other activities. The 20-item Toronto Alexithymia Scale (TAS-20) and measures of depression and verbal intelligence were administered to 30 nonclinical subjects (15 women, 15 men) whose mean age was 35.5 yr. (SD = 8.6) along with a sequential word-word evaluation task. Partial correlations indicated that the TAS-20 subscale, Difficulties identifying feelings was negatively correlated with recall of positive distractor words but not with recall of neutral distractors or recall of positive or negative target words. Emotional valence appears to have less organizational power in the memory of individuals with difficulties in recognizing their feelings.

Adult↗