18 research outputs found
Diagnostic assessment of psychiatric patients: A contextual perspective on executive functioning
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129549.pdf (Publisher’s version ) (Open Access)Radboud Universiteit Nijmegen, 17 januari 2014Promotores : Egger, J.I.M., Witteman, C.L.M. Co-promotor : Mey, H.R.A. De184 p
Assessment of executive functioning in psychiatric disorders: Functional diagnosis as the ouverture of treatment
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55537.pdf (Publisher’s version ) (Open Access)6 p
EPA-0533 - Psychopathology and aging: Executive function performance on the cambridge neuropsychological test automated battery (CANTAB)
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135832.pdf (Publisher’s version ) (Closed access)Introduction
Early detection of cognitive change is essential for the diagnosis and timely onset of treatment in a variety of neuropsychiatric disorders. Since changes in executive function (EF) are contingent upon age and may compromise assessment accuracy, psychiatric patients and normal controls were compared in terms of cognitive decline rates. EF is measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), that has adapted several standard cognitive tests for computerized administration and scoring.
Objectives
Specification of the relation between psychopathology, cognition and aging.
Aims
Cross sectional examination of the age related executive changes in a sample of adults with a history of psychiatric illness using the CANTAB.
Methods
A total of 406 patients (18-72 years), diagnosed with (a) affective disorders (N=153), (b) substance related disorders (N=112), (c) personality disorders (N=82), or (d) pervasive developmental disorders (N=59), completed CANTAB executive function tests of working memory (SWM), strategic planning (SOC) and set shifting (IED). Test performances were compared with those of 52 healthy adults.
Results
Both in the patient groups and the healthy participants, similar rates of executive decline were found.
Conclusions
The present research indicates that the decline of executive skills in populations with psychiatric conditions does not exceed the age related executive changes typically seen in healthy aging adults. Still, compared with the latter, patients seem to earlier reach the critical threshold at which functional deficits emerge, notwithstanding the comparable decline rates. Understanding aging and its interaction with cognition in later life may refine treatment design for the elderly patient.1 p
Executieve functies en de behandeling van psychiatrische stoornissen: Functionele diagnostiek als Leitmotiv
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124325.pdf (Publisher’s version ) (Open Access)In deze bijdrage wordt de functionele benadering bij de diagnose van verschillende psychiatrische aandoeningen gepresenteerd als noodzakelijke stap naast de traditionele classificerende diagnostiek. Meer in het bijzonder wordt een lans gebroken voor een gedragsanalytische focus bij de diagnostiek van executieve functies (EF). De huidige neuropsychologische methoden zijn nuttig bij het analyseren van problemen in de executieve functies. Aan de hand van een voorbeeld wordt getoond dat ze echter nog onvoldoende zicht geven op de precieze bijdrage van efdeelfuncties (bijvoorbeeld inhibitie, monitoring, updating) aan de psychiatrische stoornis en aan het opstellen van een behandelplan daarvoor. Een functionele benadering wordt beschreven en bediscussieerd met het oog op de bijdrage hiervan aan de diagnostiek van verschillende psychiatrische aandoeningen. Tot slot wordt een onderzoekslijn voorgesteld teneinde de diagnostische accuratesse te verbeteren en bij te dragen aan differentiële diagnostiek, indicatiestelling en behandeling
Feasibility of a cognitive-behavioral-therapy-based addiction intervention for relapse prevention for patients with alcohol-related cognitive impairments: A controlled pilot study
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325164.pdf (Publisher’s version ) (Open Access)Background: Cognitive disorders are highly prevalent in individuals with alcohol use disorder. Treatments have so far mainly focused on the amelioration of the cognitive impairments, but interventions to prevent relapse tailored to people with alcohol-related cognitive disorders are lacking. Here we present a new intervention aimed at people with alcohol-related cognitive disorders. Methods: In total, 59 inpatients with alcohol-related cognitive impairments participated in this study. A total of 37 completed the Relapse Prevention for patients with Alcohol-related Cognitive Disorder (RP-ACD) intervention and 22 received treatment as usual (TAU). The RP-ACD is a tailored group intervention for substance use disorder consisting of 12 one-hour group sessions. Outcome measures were the Alcohol Abstinence Self-Efficacy Measure (AASE-12), the Alcohol Urge Questionnaire (AUQ) and the Social Support Questionnaire (SSQ6). The overall experience was explored using a short in-house developed questionnaire. Results: Post-treatment, patients reported an improved self-efficacy compared to the pre-treatment baseline, but no differences were found on the other measures. No significant changes were found in the TAU group. Overall experiences and acceptability were rated positively. Conclusions: The RP-ACD intervention is a feasible and promising group-based addiction treatment for patients with alcohol-related cognitive impairment. A randomized and controlled study in a larger sample is required to establish its efficacy and effectiveness.12 p
Celeration of executive functioning while solving the Tower of Hanoi: Two single case studies using protocol analysis
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89988.pdf (Publisher’s version ) (Open Access)The present study was designed to systematically explore individual learning abilities by an in depth analysis of the performances of two single participants on the five disk Tower of Hanoi. Verbal protocols were obtained to provide us with a detailed picture of strategy development and learning. Correct and incorrect responses were plotted on a Standard Celeration Chart in order to analyze the growth of learning across time (i.e., celeration). Protocol analysis revealed that both participants formulated rules, indicating the presence of previously learned problem-solving strategies or "schemas," but also showed a substantial difference in adequately adapting these rules to modify their executive behaviour. Furthermore, celeration trends indicated a markedly increase of speed and accuracy level for performances of participant A, whereas performances of participant B showed no (significant) changes in behaviour accuracy. We concluded that a systematic investigation of the actual processes that underlie the acquisition of strategies using protocol analysis, can provide us with a detailed picture of individual differences on EF. Additionally, the Standard Celeration Chart proved to be a good assessment method to monitor behavioural changes and individual learning. On the critical side, further investigation of the differential effects of age, gender and pathology on individual performance seems to be warranted.22 p
Social cognition in Korsakoff's syndrome: A meta-analysis
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325715.pdf (Publisher’s version ) (Open Access)Background and aims: Korsakoff's syndrome is an alcohol-related neurocognitive disorder characterized by episodic memory impairments, apathy, confabulations and poor illness-insight. This meta-analysis aimed to estimate mean effect sizes of performance in social cognition in people with Korsakoff's syndrome (KS) compared with controls. Method: A systematic literature search was conducted in May 2024 to identify research articles that examined social cognition in patients with KS and control groups. Weighted effect sizes (Hedges' g) were calculated for the three levels of social cognition: emotion perception, social interpretation and socio-cognitive integration. There was no restriction on setting. Instruments examining emotion perception (facial emotion recognition and prosody), interpretation (mentalizing, self-awareness and empathy) and socio-cognitive integration (moral reasoning and social knowledge) were used in the included studies. Results: Thirteen studies (n = 622; 292 KS, 330 controls) showed that individuals with KS performed statistically significantly worse across all domains of social cognition compared with controls. Large effect sizes were found in emotion perception [g = -1.14, 95% confidence interval (CI) = -1.46 to -0.81), P < 0.001, I2 = 58.5%, 8 studies, n = 372], with comparable effect sizes for facial emotion recognition and prosody. In social interpretation (g = -0.77, 95% CI = -1.34 to -0.21, P = 0.007, I2 = 96.6%, 4 studies, n = 188), a large effect was found for mentalizing (g = -1.05, 95% CI = -1.61 to -0.50, P < 0.001, I2 = 74.1%; 3 studies, n = 120). In socio-cognitive integration (g = -0.74, 95% CI = -1.11 to -0.37, P < 0.001, I2 = 0%, 3 studies, n = 184), social knowledge showed a large effect size (g = -0.81, 95% CI = -1.24 to -0.38, P < 0.001, 1 study, n = 104). Results for empathy (g = -0.43, 95% CI = -1.05 to 0.20, P = 0.18, 1 study, n = 40), self-awareness (g = -0.21, 95% CI = -0.47 to 0.05, P = 0.12, 1 study, n = 68) and moral reasoning (k = 2, g = -0.54, 95% CI = -1.28 to 0.19, P = 0.15, I2 = 0%; 2 studies, n = 80) were uncertain, with possible important differences in both directions. Conclusions: This meta-analysis shows that people with Korsakoff's syndrome perform statistically significantly worse than controls on socio-cognitive measures, with the largest effect sizes in the perception and interpretation of social information.18 november 202512 p
Knowing the ill implies knowing the healthy: Executive dysfunctioning studied in terms of regular behavioural consequences
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73042.pdf (Publisher’s version ) (Closed access)1 p
Executive dysfunctions as part of the behavioural phenotype of Aarskog-Scott syndrome
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102526.pdf (Publisher’s version ) (Closed access)Introduction
Aarskog syndrome (AAS) also called Aarskog-Scott syndrome faciodigitogenital syndrome or faciogenital dysplasia is a genetically heterogeneous developmental disorder, first described in 1970 by the Norwegian pediatrician Dagfin Aarskog and further delineated by Scott in 1971. It is a predominantly X-linked disorder, phenotypically characterized by short stature, craniofacial dysmorphisms, brachydactyly and urogenital abnormalities. The level of intelligence shows a great variability and no specific behavioural phenotype has been described so far. In about 20 percent of Aarskog families, a mutation in the FGD1 gene located in Xp11.21 can be identified.
Objectives
The delineation of the potential behavioural phenotype of AAS.
Aims
Neuropsychological and neuropsychiatric investigation of four males from one kindred.
Methods
Four affected affected males from the fourth generation of a previously published large Dutch family (Van de Vooren et al., 1983) are assessed in detail by means of an extensive neuropsychological battery and semi-structured psychiatric examination. In addition, mutation analysis was performed.
Results
A novel FGD1 missense mutation (R402W) at position 1204 (1204C>T) was demonstrated. In the patients, the level of intelligence varied between normal and severely disabled. Their behavioural profile showed, among others, elements of attention deficit hyperactivity disorder, primarily reflected by impaired executive attentional processes that may be sensitive to systematic training.
Conclusions
In AAS, dysfunctional executive cognitive processes can be considered as part of the behavioural phenotype of the syndrome. Cognitive training and structuring of daily life may therefore reduce the intensity of disinhibited behaviours that are reported in AAS patients1 p
Decline of executive function in a clinical population: Age, psychopathology, and test performance on the Cambridge Neuropsychological Test Automated Battery (CANTAB)
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129799.pdf (Publisher’s version ) (Open Access)This study presents a cross-sectional examination of the age-related executive changes in a sample of adults with a history of psychiatric illness using the Cambridge Neuropsychological Test Automated Battery. A total of 406 patients, aged 18 to 72 years old, completed executive function tests of working memory, strategic planning, and set shifting. Using current Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition criteria, patients were diagnosed with: (a) affective disorders (N = 153), (b) substance-related disorders (N = 112), (c) personality disorders (N = 82), or (d) pervasive developmental disorders (N = 59). Test performances were compared to those of 52 healthy adults. Similar rates of age-related executive decline were found for patients and healthy participants. However, as adults with a history of psychiatric illness started out with significantly lower baseline levels of executive functioning, they may require less time before reaching a critical threshold where functional deficits emerge. Limitations as well as implications for future research were discussed.10 p
