Intraindividual Variability in Cognitive Performance in Persons With Chronic Fatigue Syndrome

Studies of cognitive performance among persons with chronic fatigue syndrome (CFS) have yielded inconsistent results. We sought to contribute to findings in this area by examining intraindividual variability as well as level of performance in cognitive functioning. A battery of cognitive measures was administered to 14 CFS patients and 16 healthy individuals on 10 weekly occasions. Analyses comparing the two groups in terms of level of performance defined by latency and accuracy scores revealed that the CFS patients were slower but not less accurate than healthy persons. The CFS group showed greater intraindividual variability (as measured by intraindividual standard deviations and coefficients of variation) than the healthy group, although the results varied by task and time frame. Intraindividual variability was found to be stable across time and correlated across tasks at each testing occasion. Intraindividual variability also uniquely differentiated the groups. The present findings support the proposition that intraindividual variability is a meaningful indicator of cognitive functioning in CFS patients.     

The Assessment of Executive Functioning in Children

Background: Executive functioning is increasingly seen as incorporating several component sub‐skills and clinical assessments should reflect this complexity. Method: Tools for assessing executive functioning in children are reviewed within five key areas, across verbal and visuospatial abilities, with emphasis on batteries of tests. Results: There are many appropriate tests for children, although the choice is more limited for those under the age of 8 years. Conclusions: Whilst there are several batteries of executive functioning suitable for children, clinicians may prefer to cherry‐pick from a broader range of measures that assess specific components of executive functioning.     

The Relationship Between Cognitive Reserve and Functional Ability is Mediated by Executive Functioning in Older Adults

It has been noted in the literature that cognitive reserve (CR) predicts future functional ability (FA), but the association between CR and current FA is rather limited. This investigation aimed to explicate this relationship, and hypothesized it would be mediated by executive functioning (EF). To best understand the relationship between CR and FA, we recruited and tested independent community-dwelling older adults (OAs). Bivariate correlations and hierarchical regressions were completed to determine the association between CR and FA. Both individual CR measures and a composite CR score were used. Mediation analyses were completed to examine our hypothesis that EF would mediate the CR and FA relationship. All measures of CR were positively related to and predictive of FA. Although the highest zero-order correlation across the independent CR proxies was between income and FA (r = .417), education accounted for the greatest amount of variance in FA, 8.3% after controlling for age and Mini-Mental State Examination performance. Furthermore, the CR composite had a higher correlation (r = .447) and accounted for more variance than any of the independent proxies. Complete mediation was found between a CR composite and FA via an internally consistent D-KEFS composite score (Cronbach’s α = .795). This suggests that as CR increases so does EF, which in turn improves FA. Thus, future investigations could determine the effect on FA in OAs by improving EF.     

Empirically Defined Patterns of Executive Function Deficits in Schizophrenia and Their Relation to Everyday Functioning: A Person-Centered Approach

Executive function (EF) deficits in schizophrenia (SZ) are well documented, although much less is known about patterns of EF deficits and their association to differential impairments in everyday functioning. The present study empirically defined SZ groups based on measures of various EF abilities and then compared these EF groups on everyday action errors. Participants (n?=?45) completed various subtests from the Delis–Kaplan Executive Function System (D-KEFS) and the Naturalistic Action Test (NAT), a performance-based measure of everyday action that yields scores reflecting total errors and a range of different error types (e.g., omission, perseveration). Results of a latent class analysis revealed three distinct EF groups, characterized by (a) multiple EF deficits, (b) relatively spared EF, and (c) perseverative responding. Follow-up analyses revealed that the classes differed significantly on NAT total errors, total commission errors, and total perseveration errors; the two classes with EF impairment performed comparably on the NAT but performed worse than the class with relatively spared EF. In sum, people with SZ demonstrate variable patterns of EF deficits, and distinct aspects of these EF deficit patterns (i.e., poor mental control abilities) may be associated with everyday functioning capabilities.     

The Verbal Clock Test: Preliminary Validation of a Brief,Vision- and Motor-Free Measure of Executive Function in a Clinical Sample

Assessment of executive functions is frequently time-consuming, and although some brief measures exist they are subject to problems associated with limited education, culture of origin, impairments of motor or visual systems, and tolerability. Preliminary validation of a newly developed measure, the Verbal Clock Test (VCT), was conducted in a clinical sample of 294 patients who underwent neuropsychological evaluation. The evidence supports the interpretation of VCT scores as demonstrating construct validity, criterion-related validity, and sound internal consistency. Performance does not vary substantially with gender or mood, and variability associated with age, education, and ethnicity is modest. Confounding effects of motor and visual impairments are eliminated. Initial data suggest the VCT represents a reasonable method of assessing abstract reasoning and concept formation when clinical circumstances limit the use of currently available measures.     

The Questionnaire of Family Functioning: A Preliminary Validation of a Standardized Instrument to Evaluate Psychoeducational Family Treatments

The aim of the study was to develop and preliminarily validate a self-completed questionnaire that could help in the assessment of families before and during psycho-educational interventions. The questionnaire was developed according to the cognitive-behavioural psycho-educational model. From an initial 38-item version of the questionnaire, a final shorter 24-item version was derived. The validation study of the final version was conducted on relatives of schizophrenic and schizoaffective patients: 31 for the test–retest reliability study and 92 for the confirmation of the subscales and convergent validity study vs. SF-36 and the questionnaire on Family Problems, PF. The final questionnaire showed good psychometric properties. The three-core dimensions of Problem-Solving, Communication Skills, and Personal Goals were clearly outlined in the items correlation analysis. The association with family burden and health-related quality of life was as expected. The FF provides a promising assessment of the family functioning pattern that is the object of psychoeducational family interventions. Further studies are needed to confirm the validity of the instrument, that could be helpful both in planning and in monitoring psycho-educational interventions and in mental health promotion projects. Rita Roncone, Monica Mazza, Donatella Ussorio, Rocco Pollice, Ian R.H. Falloon, Pierluigi Morosini and Massimo Casacchia are affiliated with the Department of Experimental Medicine-Psychiatry, University of L'Aquila, Via Vetoio, Coppito2, I- 67100, L'Aquila, Italy Massimo Casacchia is also affiliated with National Health Institute, Surveillance, and Health Promotion, Viale Regina Elena 299, I - 00161, Roma, Italy Address correspondence to Rita Roncone, M.D., Department of Experimental Medicine-Psychiatry, University of L'Aquila, Via Vetoio, Coppito2 I- 67100, L'Aquila, Italy; e-mail: rita.roncone@cc.univaq.it Ian R.H. Falloon - Deceased author     

The Relationship of Self-reported Executive Functioning to Suicide Ideation and Attempts: Findings from a Large U.S.-based Online Sample

An increasing number of studies demonstrate that individuals with a history of suicidality exhibit impaired executive functioning abilities. The current study examines whether these differences are linked to suicidal thoughts or suicidal acts—a crucial distinction given that most people who think about suicide will not act on their thoughts. A large online sample of U.S. participants with a history of suicide ideation (n = 197), suicide attempts (n = 166), and no suicidality (n = 180) completed self-report measures assessing executive functioning, suicide ideation and attempts; in addition, depression, self-efficacy, and history of drug abuse and brain injury were assessed as potential covariates. Individuals with recent suicide attempts reported significantly worse executive functioning than ideators. This difference was not accounted for by depression, self-efficacy, history of drug abuse or brain injury. Self-reported executive functioning may represent an important short-term risk factor for suicide attempts.     

The Role of Executive Cognitive Functions in Changing Substance Use: What We Know and What We Need to Know

Background  Executive cognitive functions (ECF) have been linked to skills such as planning, organizing, problem solving, decision-making, initiating and self-regulating behavior, working memory, and motivation; critical activities needed to monitor and change substance use behavior. Purpose  The purpose of this study is to investigate how ECF may impact important variables associated with changing substance use behavior. Methods  This study is a critical review of the extant literature about how ECF may influence substance abuse treatment outcomes and behavior change. Results  A review of the literature found evidence that poorer ECF likely hinders substance use behavior change and is often associated with behavior labeled as denial. However, the relationship between ECF and substance abuse appears to be highly complex. Conclusions  Traditional methods of substance abuse assessment, interpretation of behavior, and intervention may need to be reconsidered in light of new research about executive cognitive dysfunction. Implications for future research are discussed.     

Executive control in long-term abstinent alcoholics with mild to borderline intellectual disability: The relationship with IQ and severity of alcohol use-related problems

Deficits in executive control might be related to alcohol abuse in individuals with mild to borderline intellectual disability (MBID). The goal of the present study was to test the relationship between executive control (i.e., working memory capacity, inhibitory control and delay discounting), IQ and chronic alcohol use. Participants (N = 40) were divided into four groups based on IQ and severity of alcohol use-related problems (heavy and light drinkers with and without MBID). They were all admitted to a psychiatric treatment facility and long-term abstinent at the time of testing. Contrary to the expectations, executive control was not consistently impaired among individuals with MBID. Results showed that working memory capacity did seem to be impaired, whereas inhibitory control and delay discounting did not. Moreover, there were no differences between heavy and light drinkers on any of the parameters and having a dual diagnosis (heavy drinkers with MBID) did not result in additive negative effects on executive control. It is suggested that alcohol-related cognitive impairment is temporary and decreases over time after cessation of drinking.     

The Potential for New Understandings of Normal and Abnormal Cognition by Integration of Neuroimaging and Behavioral Data: Not an Exercise in Carrying Coals to Newcastle

Discovering the means to prevent and cure schizophrenia is a vision that motivates many scientists. But in order to achieve this goal, we need to understand its neurobiological basis. The emergent metadiscipline of cognitive neuroscience fields an impressive array of tools that can be marshaled towards achieving this goal, including powerful new methods of imaging the brain (both structural and functional) as well as assessments of perceptual and cognitive capacities based on psychophysical procedures, experimental tasks and models developed by cognitive science. We believe that the integration of data from this array of tools offers the greatest possibilities and potential for advancing understanding of the neural basis of not only normal cognition but also the cognitive impairments that are fundamental to schizophrenia. Since sufficient expertise in the application of these tools and methods rarely reside in a single individual, or even a single laboratory, collaboration is a key element in this endeavor. Here, we review some of the products of our integrative efforts in collaboration with our colleagues on the East Coast of Australia and Pacific Rim. This research focuses on the neural basis of executive function deficits and impairments in early auditory processing in patients using various combinations of performance indices (from perceptual and cognitive paradigms), ERPs, fMRI and sMRI. In each case, integration of two or more sources of information provides more information than any one source alone by revealing new insights into structure-function relationships. Furthermore, the addition of other imaging methodologies (such as DTI) and approaches (such as computational models of cognition) offers new horizons in human brain imaging research and in understanding human behavior.