Relation between language comprehension and cognitive functioning in persons with mental retardation

Research on the relation between language comprehension and cognitive functioning in persons with mental retardation is reviewed. The purpose is to evaluate the validity of the clinical practice of cognitive referencing. In cognitive referencing, an individual is considered to be a good candidate for (i.e., likely to benefit from) entry into a remedial language program only if he or she displays a mental age in advance of his or her language age. The studies reviewed concern: (a) the relation between various aspects of language comprehension (e.g., pragmatic, syntactic) and mental age, (b) the relation between different cognitive skills (e.g., sequential analysis, short term memory) and language comprehension, (c) the stability of the relation between language comprehension and cognition over development, and (d) whether remedial language services can lead to levels of comprehension that exceed mental age expectations. The evidence suggests that the theoretical assumptions underlying cognitive referencing are incorrect, with the result being that many persons with mental retardation who could benefit from remedial language services may not receive those services.     

Psychometric properties and preliminary norms of the penn facial discrimination task in adults with mental retardation

The Penn Facial Discrimination Task (PFDT) is an emotion recognition instrument consisting of a series of monochrome facial photographs of adults (Erwin et al., 1992). In addition to the emotion task, the PFDT also has a control task, in which the subject has to estimate the approximate age of the depicted person. In previous studies, the PFDT has been shown to be a valid instrument for subjects with psychiatric disorders, and it has also generated useful results in populations with mental retardation. This study was designed to explore the applicability of the PFDT in subjects with borderline cognitive functioning and mental retardation (N=105; IQs ranging from 23 to 81). Data were analyzed to generate preliminary normative data for different subgroups of adults with mental retardation (sex, IQ-levels, and lateral dominance). In addition, item analyses were conducted and psychometric properties including retest reliability, internal consistency, item-subscale correlations, concurrent validity, and content validity were examined. The PFDT was found to be a feasible experimental task for emotion recognition research in groups of subjects with mental retardation.     

Perceived Social Support and Mental Retardation: A Social–Cognitive Approach

Adults with mental retardation tend to have difficulty accurately interpreting social situations as well as the emotions of others. Predictions from a social–cognitive model of perceived social support were tested with 50 adults with mild mental retardation. Videotaped scenes portraying three levels of support were presented. The ratings of support perceptions provided by adults with mental retardation were contrasted with those of 40 staff working in the field of mental retardation and 22 community members. As hypothesized, social support and loneliness predicted perceptions of support of individuals with mental retardation, after controlling for depressed mood and receptive language ability. Individuals with mental retardation rated the videotaped interactions as more supportive than did staff and community members. This is the first study to address the contribution of cognitive level to perceived social support. Findings suggest that for those individuals with cognitive deficits, as with other groups, one's interpretations of social support are based in part on one's prior conceptions about social support.     

Emotional Disorders in Young Offenders

Problem: To estimate rates of emotional disorder in the Maryland Juvenile Justice system as a guide for planning and policy efforts.
Methods: In this cross-sectional study, psychopathology and level of functioning in a random sample of 312 committed and detained youth (60 females, 252 males) were assessed. Youth diagnostically classified met criteria for mental disorder using the Diagnostic Interview Schedule for Children (DISC) combined with a cut-off score (60 or below) on the Child Global Assessment Scale (CGAS), as established by the National Institute of Mental Health (NIMH).
Findings: Fifty-three percent were classified with diagnosable mental disorders on the DISC, but were above the cut-off scores on the CGAS. Forty-six percent met criteria for diagnosis and low functioning. Twenty-six percent of youth indicated need for immediate mental health services. Fourteen percent with serious mental disorders and substantial functional impairment were in need of a highly restrictive environment as determined by the severity of their offenses.
Conclusions: The number of youth in the Maryland Juvenile Justice System in need of mental health services indicates a need to examine treatment options that meet the requirements for security and treatment. The complexity of problems found in this sample indicates the need for collaborative efforts between mental health and juvenile justice personnel in planning for the immediate and future needs of these youth.     

Mental stimulation, neural plasticity, and aging: directions for nursing research and practice

An unprecedented increase in the number of older adults and consequent age-related cognitive declines may negatively contribute to an already overwhelmed healthcare system. Many older adults report cognitive changes and express interest in methods to maintain cognitive functioning. Mental stimulation that consists of cognitively challenging activities is a means to facilitate neural plasticity, which can increase cognitive reserve and result in maintained or improved cognitive functioning. In addition, compensatory activities may provide mental stimulation that can improve cognitive functioning and increase cognitive reserve. Several mental stimulation (e.g., education, cognitive remediation therapy) and mental compensation (e.g., spaced retrieval method, method of loci) strategies are described in this article. Because nurses have a significant amount of direct contact with older adults, these strategies have important implications for nursing practice and research.     

Social Circles of Adults with Mental Retardation as Viewed by Their Caregivers

The Social Circles Questionnaire was developed for caregivers to rate the social support provided to adults with mental retardation from their families, workers, friends, and romantic partners. The questionnaire had good internal consistency and test-retest reliability as well as adequate interrater agreement. Results based on caregiver ratings of 121 adults with mental retardation indicate that there is a paucity of social support for individuals in many residential settings, across functioning levels. Caregivers responded with greater uncertainty to questions about friends and partners than they did to questions about staff and family. Results suggest that surveying only secondary sources may provide an incomplete view of the social support system of individuals with mental retardation.     

Computer-Mediated, Self-Directed Computer Training and Skill Assessment for Individuals with Mental Retardation

By and large, people with mental retardation have not experienced the educational benefits, productivity gains, and personal enrichment that can result from the use of personal computers. Computer use has been restricted for individuals with mental retardation for several reasons, including the lack of opportunities to learn how to use computer hardware and software. One potential solution to this problem is to use the computer itself, through computer-delivered instruction, to teach basic computer skills. However, most currently available instructional software has been developed either for adults with full cognitive capacities or specifically for children. This study examined use of a multimedia software program designed for self-directed computer training and skill assessment for adults with mental retardation. Study participants with mental retardation used the software in a self-directed manner to increase their independence, speed, and accuracy in learning basic computer use skills.     

Toward an Assessment of Suitability of People with Mental Retardation for Cognitive Therapy

Forty people with mild mental retardation completed five tasks which assessed progressively their ability to identify emotions, link emotions to situations, and select either an emotion given a situation and evaluative belief, or an evaluative belief given a situation and emotion. Fewer people passed tasks including a belief than tasks assessing only an event–emotion link. Tasks involving a belief were more difficult if the belief and emotion were incongruent with the situation. We conclude that people with mild mental retardation may commonly have certain requisite skills to use cognitive therapy, yet many may require preparatory training to grasp the concept of cognitive mediation.     

Autism and mental retardation: the planning of a therapeutic environment

Autism and mental retardation are concepts of a different level. The combination of these concepts in the mentally retarded autistic child requires a specific therapeutic environment. This therapeutic environment must take full account of both the child's limited cognitive potentials and the specific needs and limitations on the basis of autism. Such an integrated approach of the mentally retarded autistic child becomes possible when all the symptoms and behaviours of the children are organized in one coherent frame of reference organized according to the main axes of child development (biological, physical, cognitive and socio-emotional). The consequences of these partly dissimilar, divergent needs and limitations of mentally retarded autistic children for the planning of a therapeutic environment are discussed. Special attention is paid to the combined effect of mental retardation and autism on the cognitive development axes.     

Psychologists' role in functional assessment of rehabilitation patients

In this study attention was paid to the psychological criteria that clinicians may use when assessing global functioning of rehabilitation patients. Global functioning was understood to be determined by physical, psychological and social factors and was operationally defined as performance in three different areas of life: work, daily activities and human relations. The psychological factors whose relationships to global functioning were studied were three components of personality dynamics:--mental health, cognitive skills and motivation. Patients' mental health, cognitive abilities, motivation and global functioning were clinically rated on the basis of data given by psychological interview, psychological test-results and other information. Correlation analysis showed that the clinicians tend to use the mental health state, the level of cognitive performance and the degree of motivation as criteria when assessing the functioning of rehabilitation patients during the rehabilitation examination. However, multiple regression analysis showed that these psychological variables explained as little as 32% of the variance in follow-up functioning. This is in agreement with the biopsychosocial view that psychological factors are only one class of events manifesting in illness, functioning and behavior.     

Altered fronto-cerebellar connectivity in alcohol-naïve youth with a family history of alcoholism

Fronto-cerebellar connections are thought to be involved in higher-order cognitive functioning. It is suspected that damage to this network may contribute to cognitive deficits in chronic alcoholics. However, it remains to be elucidated if fronto-cerebellar circuitry is altered in high-risk individuals even prior to alcohol use onset. The current study used functional connectivity MRI (fcMRI) to examine fronto-cerebellar circuitry in 13 alcohol-na?ve, at-risk youth with a family history of alcoholism (FH+) and 14 age-matched controls. In addition, we examined how white matter microstructure, as evidenced by fractional anisotropy (FA), related to fcMRI. FH+youth showed significantly reduced functional connectivity between bilateral anterior prefrontal cortices and contralateral cerebellar seed regions compared to controls. We found that this reduction in connectivity significantly correlated with reduced FA in the anterior limb of the internal capsule and the superior longitudinal fasciculus. Taken together, our findings reflect associated aberrant functional and structural connectivity in substance-na?ve FH+adolescents, perhaps suggesting an identifiable neurophenotypic precursor to substance use. Given the role of frontal and cerebellar brain regions in subserving executive functioning, the presence of premorbid abnormalities in fronto-cerebellar circuitry may heighten the risk for developing an alcohol use disorder in FH+youth through atypical control processing.     

Post-stroke recovery of high-level cognitive function

This research explored the post-stroke cognitive ability of a 52-year male, KM, who suffered a left middle cerebral artery stroke. KM received no rehabilitation post-stroke, as clinic assessments suggested that mental functioning had returned to an acceptable level. However, KM believed that his cognitive ability had not returned to pre-stroke levels. Comparisons with pre-stroke data from an unrelated study and additional testing using sensitive cognitive measures supported his observations. This research concludes that patient observations and more sensitive testing of post-stroke cognitive functioning may reveal additional high-level cognitive deficits.     

Patients' perceptions of their pain condition across a multidisciplinary pain management program: do they change and if so does it matter?

OBJECTIVES: The primary aim of this study was to determine whether changes in cognitive processes are related to improved functional outcomes across a multidisciplinary pain management program. METHODS: A longitudinal design was employed where patients completed 6 versions of the same questionnaire at the beginning, middle, and end of the 4-week treatment program and at 1, 3, and 6 months follow-up. Seventy-six patients consented to participate in this study. Outcome was assessed using the physical and mental component scores of the Short Form Health Questionnaire. Measures of cognitive processes included the Illness Perceptions Questionnaire Revised, the Pain Catastrophizing Scale, and the Pain Vigilance and Awareness Questionnaire. Fifty-eight patients (76%) completed all 6 questionnaires. RESULTS: We found reductions in catastrophizing and beliefs about the serious consequences of pain were most strongly associated with improved physical functioning, whereas reductions in pain vigilance, emotional representations of pain, and sense of coherence about pain were the best predictors of improved mental functioning. Overall, change in cognitive processes accounted for 26% of the variance in improved physical functioning and 23% of the variance in mental functioning. DISCUSSION: These findings suggest that interventions that specifically target cognitive processes may enhance treatment effects for patients with chronic pain.     

294例凶杀案司法精神医学鉴定

目的探讨司法精神医学鉴定中精神病患者凶杀案的特征,为司法鉴定工作提供科学依据。方法对294例凶杀案司法精神医学鉴定资料进行回顾性分析。结果各类精神疾病患者占89．80％,其中以精神分裂症、癫痫及癫痫伴发精神障碍、精神发育迟滞、人格障碍、抑郁性障碍多见。中青年作案占74．15％,农民作案占74．49％。受害人中家庭成员与熟人占86．39％。结论加强精神卫生知识的宣传教育和精神卫生立法,建立预防精神病患者肇事的有效机制。     

Outcomes of Children Participating in Mental Health Residential and Intensive Family Services: Preliminary Findings

It has been estimated that approximately 20% of children experience some form of mental health problem, with 14% in the clinical range. Residential mental health treatment is often reserved for those with the most severe presentation of disorder, and intensive home-based alternatives have been developed to cope with increasing demand. The purpose of this study was to examine the long-term developmental trajectories, personal functioning, and life circumstances of the children and youth who accessed residential mental health treatment or the home-based alternative along a number of domains (e.g., clinical outcomes, school personal well-being), and determine if differences between the groups exist.     

A one year follow-up of urban young adults with mental retardation in supported employment.

There is little information available about the provision of supported employment services for individuals from diverse cultural, ethnic and economic backgrounds. To fill this gap, in relation to the specific experiences of urban youth with mental retardation, we initiated an agency based longitudinal study of our employment training programmes. Data from the first year follow up of 45 young adults with mental retardation is presented. Information regarding all phases of the job training and job placement process was examined. The major findings are that 71% of the trainees were employed during the first nine months post-training, with approximately 30% of the trainees working for six months or more. Overall, 75% of the trainees' placements were in service industries and the amount of direct support the trainees required decreased over time. Additional findings and their implications for programme development are discussed in relation to the unique needs of urban young adults with developmental disabilities.     

Evaluating Acquiescence to Yes–No Questions in Fear Assessment of Children With and Without Mental Retardation

The study examined the acquiescence response set (ARS) to yes–no questions in fear survey assessment of 75 children with mental retardation (ages 10–13 years) and 240 children without mental retardation (ages 6–13 years). The items used to assess the ARS were 10 stimuli, as part of a fear survey, with design features that are consistent with ARS assessment recommendations made by Finlay, W. M. L., and Lyons, E. (2002, Mental Retardation 40:14–29). In contrast to findings of seminal ARS studies by Sigelman and colleagues, the main finding was that there were no significant cognitive group differences in ARS scores. Additionally, for children with mental retardation, there was no significant relationship between IQ and ARS scores (r = −.16).Implications of the study are discussed. An erratum to this article is available at .     

Molecular genetics of X-linked mental retardation: a complex picture emerging

Mental retardation or intellectual disability is a heterogeneous group of disorders of the human brain affecting 2-3% of the general population. It is becoming evident that a large proportion of mental retardation is genetically determined, which means that it can be molecularly defined and thus precisely diagnosed. Building knowledge and understanding about molecular processes leading to 'malfunction of human brain' will clearly bring benefits to patient management, disease prevention and ultimately disease treatment and will also assist in tackling much harder questions of the molecular basis of human cognitive ability. In this review the current knowledge of the molecular genetics of X-chromosome-linked mental retardation and its nonspecific forms in particular is discussed, together with limitations affecting diagnosis and likely new approaches that need to be implemented.