Neuropsychological test performance of children with ADHD relative to test norms and parent behavioral ratings.

Neuropsychological test performance relative to published norms and parent ratings was assessed archivally among 78 children with attention deficit hyperactivity disorder (ADHD). Despite average to low average IQs and academic achievement, the children performed poorly relative to test norms on most measures sensitive to fronto-executive functioning (span of attention, sustained attention, response inhibition, and working memory). They also performed poorly on most memory tests requiring free recall/retrieval, a skill dependent in part on intact frontal/subcortical functioning. In contrast, performance fell within the average to low average range on all measures of retention, although some mean scores fell significantly below normative means. In addition, higher levels of inattention or hyperactivity as assessed from parent reports were associated with worse performance on neuropsychological tests. That is, correlations calculated between neuropsychological test scores and parent ratings on the Adaptive Behavior Scale (ABS) were both significant at the P<.05 level and in the expected direction in 33% of the analyses for ratings of attention, in 43% of the analyses for ratings of hyperactivity, and in 5% of the analyses for ratings of persistence.     

The Symptoms of Trauma Scale (SOTS): Psychometric evaluation and gender differences with adults diagnosed with serious mental illness

A new clinician rating measure, the Symptoms of Trauma Scale (SOTS), was administered to adult psychiatric outpatients (46 men, 47 women) with severe mental illness who reported a history of trauma exposure and had recently been discharged from inpatient psychiatric treatment. SOTS composite severity scores for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, posttraumatic stress disorder (PTSD), complex PTSD (cPTSD), and total PTSD/cPTSD severity had acceptable internal consistency reliability. SOTS scores’ construct and convergent validity was supported by correlations with self-report measures of childhood and adult trauma history and PTSD, dissociation, and anger symptoms. For men, SOTS scores were associated with childhood sexual and emotional abuse and self-reported anger problems, whereas for women SOTS scores were most consistently and strongly associated with childhood family adversity and self-reported PTSD symptoms. Results provide preliminary support for the reliability and validity of the SOTS with adults with severe mental illness and suggest directions for replication, measure refinement, and research on gender differences.     

Attention, learning, and memory performances and intellectual resources in Vietnam veterans: PTSD and no disorder comparisons

Attention, learning, memory, and estimated intellectual potential were examined in 26 Vietnam veterans diagnosed with posttraumatic stress disorder (PTSD) and in 21 Vietnam veterans without mental disorders. Results revealed PTSD-associated cognitive deficits on tasks of sustained attention, working memory, initial learning, and estimated premorbid intelligence but not on measures of focus of attention, shift of attention, or memory savings. Cognitive task performances adjusted for estimated native intelligence remained negatively correlated with PTSD severity. An intellectual measure adjusted for cognitive task performances was negatively correlated with PTSD severity, even after the authors statistically controlled the level of combat exposure. Results suggested that although intellectual resources may constitute a vulnerability-protective factor for PTSD development, PTSD was associated with cognitive impairment independent of intellectual functioning.     

PTSD after traumatic injury: an investigation of the impact of injury severity and peritraumatic moderators

Presence of injury is often examined as a risk factor for posttraumatic stress disorder (PTSD); however, results have been mixed regarding the relationship between injury severity and PTSD symptoms (PTSS). The present study examined subjective and objective injury severity ratings in traumatic injury victims to determine if they differentially predict PTSS. Results demonstrated that subjective, not objective, injury severity predicted PTSS at six weeks and three months post-trauma. The moderating impact of peritraumatic factors was also examined. Peritraumatic dissociation moderated the impact of subjective injury severity on PTSS. Findings indicate that subjective injury severity should be incorporated into early screeners for PTSD risk.     

Fear extinction in rats: implications for human brain imaging and anxiety disorders

Fear extinction is the decrease in conditioned fear responses that normally occurs when a conditioned stimulus (CS) is repeatedly presented in the absence of the aversive unconditioned stimulus (US). Extinction does not erase the initial CS-US association, but is thought to form a new memory. After extinction training, extinction memory competes with conditioning memory for control of fear expression. Deficits in fear extinction are thought to contribute to post-traumatic stress disorder (PTSD). Herein, we review studies performed in rats showing that the medial prefrontal cortex plays a critical role in the retention and expression of extinction memory. We also review human studies indicating that prefrontal areas homologous to those critical for extinction in rats are structurally and functionally deficient in patients with PTSD. We then discuss how findings from rat studies may allow us to: (1) develop new fear extinction paradigms in humans, (2) make specific predictions as to the location of extinction-related areas in humans, and (3) improve current extinction-based behavioral therapies for anxiety disorders.     

The TM-Sidhi programme, age, and brief tests of perceptual-motor speed and nonverbal intelligence

Three brief tests that assess perceptual-motor speed and two that assess nonverbal intelligence were administered to individuals who were practicing the Transcendental Meditation and TM-Sidhi programme. Multiple regression analyses showed that when motivation (measured on a 5-point self-rating scale), age, sex, education, and duration of practice of the Transcendental Meditation technique were held constant, number of months of practice of the TM-Sidhi programme significantly predicted higher performance on two of the perceptual-motor speed tests and both tests of intelligence. Age predicted lower scores on the same tests.     

Age and individual differences in letter fluency

Letter fluency tests are widely used to assess executive function, yet the cognitive processes underlying fluency performance are poorly understood. In this article, age differences in fluency were investigated in relation to “low‐level speed” and “frontal‐executive” theories of aging and intelligence. Age differences in fluency related to motor speed; intelligence predicted the use of retrieval strategies in fluency tasks. In contrast to literature on patients with frontal lobe lesions, individuals with lower intelligence test scores could not efficiently utilize a cued fluency strategy. Both age and intelligence predicted strategy use in a more novel fluency task requiring the generation of figural responses. Comparison with neuropsychological literature suggests different causes for poor fluency in older adults, those with low intelligence test scores, and patients with frontal lobe lesions.     

Biobehavioral basis of coronary-prone behavior in middle-age men. Part II: Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity.

Prior research suggests that the Type A behavior pattern, Cook and Medley Hostility (Ho) scores, and Total Serum Cholesterol (TSC) are positively associated with physiological changes to behavioral stressors. The objective of the present study was to determine whether TSC interacts with the Type A behavior pattern and hostility to affect cardiovascular and neurohormonal responses to a mental arithmetic task (MATH). For Type A individuals, elevated TSC was associated with larger catecholamine and cortisol responses to MATH. In contrast, for Type B subjects, cholesterol was negatively associated with neurohormonal responses. The interaction between Ho score and TSC predicted a similar pattern of responses whereby, in high hostile men only, TSC was positively associated with MATH-induced changes in catecholamines and heart rate. While the mechanisms responsible for the differences in the lipid-reactivity association as a function of coronary-prone behavior measures remain to be elucidated, this differential association may play a role in the heightened risk of coronary disease among hostile Type A men.     

Overinclusion,broad scanning,and picture recognition in schizophrenics

Difficulty of picture and word recognition was manipulated to test the hypothesis that schizophrenics have adequate recognition memories and to determine whether overinclusion is related to a good visual recognition memory. Good and poor premorbid, acute and chronic schizophrenics were compared to nonpsychotic psychiatric patients and to hospital aides. Both Payne's Object Classification Test and Goldstein-Scheerer's Object Sorting Test were given to all the patients, but only the former differentiated among the diagnostic subgroups and was related to good picture memory. When the measures of overinclusion, chronicity, premorbidity and intelligence were used as independent variables in a multiple regression, only Payne NonA predicted success on the picture task. Good premorbid schizophrenics recognized pictures as well as normals and nonpsychotics, but poor premorbids' picture memory was significantly worse. No experimental variable predicted word performance in a multiple regression, and good premorbids did not differ from poor premorbids on their word recognition. The authors favored the interpretation that the pattern of performance of overinclusive schizophrenics reflects their tendency to scan broadly both important and unimportant features of stimuli.     

A review of hippocampal activation in post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is often characterized by deficits in memory encoding and retrieval and aberrant fear and extinction learning. The hippocampus plays a critical role in memory and contextual processing and has been implicated in intrinsic functional connectivity networks involved in self-referential thought and memory-related processes. This review focuses on hippocampal activation findings during memory and fear and extinction learning tasks, as well as resting state hippocampal connectivity in individuals with PTSD. A preponderance of functional neuroimaging studies to date, using memory, fear learning, and extinction tasks, report decreased or “controls comparable” hippocampal activation in individuals with PTSD, which is usually associated with poorer performance on the task imaged. Existing evidence thus raises the possibility that greater hippocampal recruitment in PTSD participants may be required for similar performance levels. Studies of resting state functional connectivity in PTSD predominantly report reduced within-network connectivity in the default mode network (DMN), as well as greater coupling between the DMN and salience network (SN) via the hippocampus. Together, these findings suggest that deficient hippocampal activation in PTSD may be associated with poorer performance during memory, extinction recall, and fear renewal tasks. Furthermore, studies of resting state connectivity implicate the hippocampus in decreased within-network DMN connectivity and greater coupling with SN regions characteristic of PTSD.     

Rapid eye movement fragmentation,not slow‐wave sleep,predicts neutral declarative memory consolidation in posttraumatic stress disorder

Individuals diagnosed with posttraumatic stress disorder (PTSD) experience disruption at both slow‐wave sleep (SWS) and rapid‐eye movement (REM) sleep stages and demonstrate marked memory impairment. A small group of studies suggests that, within the disorder, there is a mechanistic relation between these sleep and memory impairments. This study sought to extend that literature by examining whether, in PTSD‐diagnosed individuals, memory‐retention deficits are present after a sleep‐filled (but not after a wake‐filled) delay (i.e., whether memory deficits can be traced to interruptions of sleep‐dependent memory consolidation). Moreover, we investigated whether SWS‐ or REM‐based disturbances, or both, contribute to retention deficits. We recruited participants into three groups: PTSD (n = 21), trauma‐exposed non‐PTSD (TE; n = 19) and healthy control (HC; n = 20). Using a crossover design, we assessed memory recall before and after an 8‐hr period of polysomnography‐monitored sleep and an 8‐hr period of regular waking activity. PTSD‐diagnosed participants retained less information than controls over the sleep‐filled (but not wake‐filled) delay. Furthermore, increased REM fragmentation predicted postsleep memory retention in PTSD‐diagnosed individuals only. No SWS parameter was associated with or predictive of the amount of information retained postsleep. We conclude that specific REM‐related changes in PTSD‐diagnosed individuals affected sleep‐dependent neutral declarative memory consolidation. Generally, these findings extend the literature suggesting that the co‐occurrence of sleep and memory difficulties in PTSD is not accidental, but that these two symptom clusters are meaningfully related. Specifically, the study illustrates that subtle REM‐related disruptions contribute most strongly to memory impairment in PTSD.     

Morphometric and psychometric comparisons between non-substance-abusing patients with posttraumatic stress disorder and normal controls

BACKGROUND: Hippocampal decrease in size in response to posttraumatic stress disorder (PTSD) is still a subject of controversy. The aims of this study were to: (1) confirm previous hippocampus findings in PTSD patients compared to controls, using ethnically similar study groups where alcohol and drug abuse were non-existent; (2) test influence of disease duration as well as depression scores on possible morphological changes; (3) test whether the voxel-based morphometry (VBM) data confirm the group differences seen in the region of interest (ROI) analysis, and (4) test the associations between the cognitive test scores and the morphological changes. METHODS: VBM and ROI-based analysis were applied in 23 patients and 17 healthy controls. Culture-neutral cognitive tests were used. RESULTS: The ROI-based method showed significantly decreased gray matter volumes for global hippocampal volume, as in a separate analysis of left and right sides in the PTSD group. Total volume of the hippocampus was significantly decreased on the left side, as in the global assessment. A multiple regression VBM model showed significant voxel clusters for group affiliation in the right hippocampus, modelling lowering of gray matter associated with the PTSD group. Disease duration was shown to be negatively correlated to bilateral hippocampal volume and high depression score to bilateral gray matter parahippocampal volume. No significant correlations were found between hippocampal or parahippocampal volumes and cognitive functions. CONCLUSION: The present and previous studies showed that morphologic differences do not appear to be due to drug or alcohol abuse. The VBM data partially confirm the group differences seen in the ROI-based method in the medial temporal lobe. The fact that the significantly lower score on the short-term memory test in the PTSD group is not correlated to hippocampal volume may suggest a more general basis for such memory impairment.     

Memory functioning and emotional changes in early phase multiple sclerosis.

Memory functioning and emotional changes were evaluated in 26 early phase multiple sclerosis (MS) patients, as compared with 24 healthy controls. There were no significant differences between the groups with respect to age, education, verbal intelligence, or general visual information processing abilities. The MS group performed significantly below controls on the recognition of nonsense visual stimuli. On most verbal memory test indicators, the MS group did not perform deficiently, but there emerged a between-group difference at trend level on a measure reflecting sensitivity to proactive inhibition. The MS patients reported emotional changes and increased levels of psychological symptoms in several areas. Memory task performance was not significantly correlated with subjective complaints of memory impairment, depressive symptoms, or degree of physical disability. However, subjective complaints of memory impairment were related to depression.     

A developmental analysis of contextual fear conditioning

Contextual fear conditioning by 18- and 23-day-old rats was compared in two training contexts, a transparent Plexiglas chamber or a black Plexiglas chamber. As measured by a conditioned defensive freezing response, older rats displayed more contextual fear than younger rats. At both ages conditioning was (a) stronger in the black chamber than in the clear chamber, (b) a nonmonotonic function of retention interval, with freezing being greater at the immediate and 24-hr retention interval than at the 10-min interval, and (c) preexposure to the context 24 hr before conditioning enhanced conditioned freezing observed at the 10-min retention interval. Additional experiments suggest that rats at both ages acquire independent representations of the visual and tactile features of the context. These results support Rudy and Morledge's (1994) hypothesis that contextual fear conditioning is mediated by both a short-term and a long-term memory system and that long-term memory for contextual fear requires the consolidation of a representation of the context. They challenge their view that there is a qualitative developmental difference in long-term memory processes between 18- and 23-day-old rats. © 1996 John Wiley & Sons, Inc.     

条件性恐惧记忆再巩固的神经分子机制研究

<正>创伤后应激障碍(post-traumatic stress disorder,PTSD)是经历强烈创伤性事件的个体再次暴露在相似创伤情境时出现以恐惧记忆重复体验为核心症状的反应性精神障碍~([1])。正常的恐惧记忆和恐惧反应是人和动物重要的生存活动,可以帮助机体启动防御机制。然而对于PTSD患者来说,这种恐惧记忆引起的恐惧反应被某些神经生理机制扩大并长期巩固,对患者造成了严重的身心伤害。近年来随着恐     

Relationships among Type A behavior,employment experiences,and gender: The Minnesota heart survey

Previous studies indicate that Type A behavior is more prevalent among men than women. This sex difference may reflect variations in men's and women's job experiences, some of which may act as catalysts for Type A behavior. This study examines the relationship of Type A behavior (measured by the Jenkins Activity Survey) to men's and women's work hours, occupational mobility, and job-related interactions, using data from a population-based survey of 2512 employed men and women conducted in Minneapolis-St. Paul, Minnesota, between 1980 and 1982. Among both sexes, Type A behavior is related to long work hours, high occupational mobility, and nonsupportive interactions with co-workers, all job experiences more common for men than for women. No sex differences are found in the relationships between Type A behavior and these job experiences. Also, no sex difference is observed in the unadjusted Type A scores or in these scores when either age, education, or marital status is taken into account. The expected direction of the sex difference in Type A behavior is reversed when work hours are controlled: women have a higher Type A score than men when work hours are considered.This work was supported in part by Grants 2T32-HL07328 and 2R01-HL23727 from the National: Heart, Lung, and Blood Institute. This work was completed while the lead author was a. postdoctoral fellow at the University of Minnesota, Division of Epidemiology, School of Public Health.     

A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents

Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms.     

Psychological and behavioral moderators of the relationship between trauma severity and HIV transmission risk behavior among MSM with a history of childhood sexual abuse

Childhood sexual abuse (CSA) is associated with post-traumatic stress disorder (PTSD), which can be associated with condomless sex among men who have sex with men (MSM). However, the impact of moderating factors on the relationship between PTSD symptom severity and condomless sex is poorly understood. We examined whether PTSD symptom severity was associated with condomless sex among MSM with CSA histories, and whether substance dependence, self-esteem, and distress tolerance moderated that relationship (n = 288). Notably, no direct relationship between PTSD symptom severity and condomless sex was found. Adjusted models indicated that condomless sex was differentially impacted by PTSD symptom severity among those without substance dependence (ΔR² = 0.03, p = 0.034) and, counterintuitively, those with high self-esteem (ΔR² = 0.07, p = 0.005). PTSD symptom severity was associated with condomless sex across levels of distress tolerance. Findings indicate that substance use, self-esteem, and distress tolerance should be targeted in high-risk MSM with CSA even if they do not have PTSD.     

Losses in gross brain volume and cerebral blood flow account for age-related differences in speed but not in fluid intelligence

Age-related gross head size; adjusted age-related change in brain volume and carotid and basilar blood flow; as well as scores on 3 tests of fluid intelligence (gf), 2 tests of information-processing speed, 2 memory tests, and 3 tests of executive function were obtained from 69 volunteers aged from 62 to 84 years. Brain volume negatively predicted scores on all 10 cognitive tasks, accounting for up to 78% of age-related variance in scores on the speed tasks and on 1 executive task. Cerebral blood flow (CBF) negatively predicted scores on 8 cognitive tasks, accounting for up to 36% of age-related variance in speed scores. However, neither brain volume nor CBF accounted for significant age-related variance between individuals on any of 3 gf tests. We conclude that speed, but not gf, is an exceptionally sensitive behavioral index of the progress of gross brain changes that affect cognition in old age and that speed and gf do not reflect integrity of the same functional systems.     

Hormone replacement therapy and cognitive function in postmenopausal women

ObjectivesThe study investigated the effect of hormone replacement therapy (HRT) on cognitive processes in healthy, naturally postmenopausal women.MethodParticipants were 64 volunteer postmenopausal women (27 in HRT, 37 in non-HRT group). Groups were matched for age, level of education and postmenopausal period. Duration of HRT was more than 12 months. Cognitive processes were measured through 44 scores obtained from Wechsler Memory Scale-Revised, Line Orientation Test, Cancellation Test and Raven Standard Progressive Matrices. All of these tests had been studied with respect to their psychometric properties in the Turkish culture [for review, Karakaş S. BİLNOT battery: research and development of neuropsychological tests. Ankara, Turkey: Dizayn Ofset; 2004].ResultsMultivariate analysis of variance was performed where HRT and estradiol level were predictive (independent) variables and test scores were predicted (dependent) variables. The studied variables did not have a significant effect on a broad spectrum of neuropsychological scores that measured immediate and delayed visual and verbal memory, visuospatial perception and orientation, sustained attention/vigilance, visual search and scan, impulsivity and response speed, executive functions and general intelligence. Logistic regression analysis demonstrated a prediction rate of 86.89% of HRT status; the model was, however, based on four scores whose scientific relevance could not at this point be ascertained.ConclusionThe research design of the present observational study applied control techniques to demographic (age, level of education), menopausal (length of menopausal period, duration of HRT), and hormonal variables. The cognitive changes that some studies found concerning the effect of replacement therapy could not be found when the potentially confounding variables were thus controlled.