The falls efficacy scale international (FES-I): a comprehensive longitudinal validation study

Method: five hundred community-dwelling older people (70-90 years) were assessed on the FES-I in conjunction with demographic, physiological and neuropsychological measures at baseline and at 12 months. Falls were monitored monthly and fear of falling every 3 months. Results: the overall structure and measurement properties of both FES-I scales, as evaluated with item response theory, were good. Discriminative ability on physiological and neuropsychological measures indicated excellent validity, both at baseline (n = 500, convergent validity) and at 1-year follow-up (n = 463, predictive validity). The longitudinal follow-up suggested that FES-I scores increased over time regardless of any fall event, with a trend for a stronger increase in FES-I scores when a person suffered multiple falls in a 3-month period. Additionally, using receiver-operating characteristic (ROC) curves, cut-points were defined to differentiate between lower and higher levels of concern. Conclusions: the current study builds on the previously established psychometric properties of the FES-I. Both scales have acceptable structures, good validity and reliability and can be recommended for research and clinical purposes. Future studies should explore the FES-I's responsiveness to change during intervention studies and confirm suggested cut-points in other settings, larger samples and across different cultures

Contrasting prefrontal cortex contributions to episodic memory dysfunction in behavioural variant frontotemporal dementia and alzheimer's disease

Recent evidence has questioned the integrity of episodic memory in behavioural variant frontotemporal dementia (bvFTD), where recall performance is impaired to the same extent as in Alzheimer's disease (AD). While these deficits appear to be mediated by divergent patterns of brain atrophy, there is evidence to suggest that certain prefrontal regions are implicated across both patient groups. In this study we sought to further elucidate the dorsolateral (DLPFC) and ventromedial (VMPFC) prefrontal contributions to episodic memory impairment in bvFTD and AD. Performance on episodic memory tasks and neuropsychological measures typically tapping into either DLPFC or VMPFC functions was assessed in 22 bvFTD, 32 AD patients and 35 age- and education-matched controls. Behaviourally, patient groups did not differ on measures of episodic memory recall or DLPFC-mediated executive functions. BvFTD patients were significantly more impaired on measures of VMPFC-mediated executive functions. Composite measures of the recall, DLPFC and VMPFC task scores were covaried against the T1 MRI scans of all participants to identify regions of atrophy correlating with performance on these tasks. Imaging analysis showed that impaired recall performance is associated with divergent patterns of PFC atrophy in bvFTD and AD. Whereas in bvFTD, PFC atrophy covariates for recall encompassed both DLPFC and VMPFC regions, only the DLPFC was implicated in AD. Our results suggest that episodic memory deficits in bvFTD and AD are underpinned by divergent prefrontal mechanisms. Moreover, we argue that these differences are not adequately captured by existing neuropsychological measures

Cognitive support at encoding attenuates age differences in recollective experience among adults of lower frontal lobe function

Free recall and recollective experience were investigated in relation to neuropsychological measures of frontal lobe function (FLF) among 105 healthy adults divided into three age groups; young (M = 21.82 years), young-old (M = 64.69 years), and old-old (M = 70.69 years). Participants were tested on free recall and recognition of word lists in each of two study conditions. In the first, semantically related words were organizable into one of four taxonomic categories, whereas in the second (random) condition, words were semantically unrelated. Results in respect of free recall showed memory performance was inferior with increasing age, lower FLF, and random encoding condition. There were no interactions involving those variables. With regard to recollective experience, a similar pattern of results was obtained. However, analyses also identified a significant interaction, suggesting old-old adults of lower FLF to exhibit poorer recollective experience. This interaction was significantly modified when semantic organization was available at study. Recognition measures classified as familiar did not vary as a function of age, neuropsychological function, or encoding condition. The results are consistent with the view that autonoetic consciousness, supported by the neural systems of the prefrontal cortex, underpins recollective experience. Further, among older adults, cognitive support at encoding attenuates the detrimental effects of individual differences in those neural systems, in relation to recognition performance

Aspects of the neuropsychological development and assessment of New Zealand children : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand

Material (Chapter Nine) removed from thesis for copyright reasons: Ross-McAlpine, K.S., Leathem, J.M., & Flett, R.A. (2018). A survey of psychologists administering cognitive and neuropsychological assessments with New Zealand children, New Zealand Journal of Psychology, 47(1), 13-22. www.psychology.org.nz/wp-content/uploads/A-survey-of-psychologists.pdfTypical neuropsychological development in school age children is an under-researched area. There is insufficient research on age effects on performance, relationships between multiple cognitive abilities and between these abilities and academic achievement. In addition to this, there has been no research conducted on neuropsychological assessment practices with children in New Zealand (NZ). This thesis explored patterns of neuropsychological development in typically developing children and provides clarity on the current practices of psychologists conducting neuropsychological assessment with children in NZ. Study 1 explored the age effects on neuropsychological measures for typically developing children aged 6 to 11 years. Firstly, the scaled scores of NZ children were compared with overseas normative groups and found to be within ±0.4 of a standard deviation for all tests except for finger tapping and animal sorting (NEPSY-II). Secondly, age effects were found for all measures of cognitive abilities which is consistent with previous research. Post-hoc findings identified that the most significant improvement occurred between ages 6 and 9 years. The existence of differences between NZ and USA samples, specifically found for animal sorting and finger tapping (NEPSY-II), indicates that New Zealand normative data would be beneficial for some subtests used in neuropsychological assessments. Study 2 investigated the relationships between cognitive domains and school achievement in typically developing New Zealand children. Correlational analyses found that the majority of the relationships between the cognitive domains were moderate to weak, which is consistent with overseas literature. The findings were mixed in regards to the relationships between neuropsychological ability and school achievement. Most significant relationships with overall school achievement were found in the domains of social perception and working memory, followed by processing speed, executive functioning and language. While this was congruent with the hypothesis of the study and with the literature, the finding of a non-significant relationship between motor skills and academic achievement was incongruent. Investigating these relationships across age groups revealed that age 6, 10 and 11 years are the periods of middle childhood with the strongest relationships between neuropsychological ability and achievement. Study 3 was a survey of psychologists who routinely undertook cognitive and neuropsychological assessments with New Zealand children. The WISC-IV was the most commonly used comprehensive measure to assess cognitive and neuropsychological function of New Zealand children and the most commonly used rating scales are the ABAS, CBCL and CCBRS. The results of the survey indicated that test selection appears to be based on familiarity and access. The focus on the diversity of New Zealand culture in the literature was reflected in the finding that the majority of the survey respondents considered it important to obtain normative data for New Zealand children (80.3%). In summary, these findings provide clarity around patterns of performance of typically developing children and informs the practice of neuropsychological assessment with New Zealand children

An Investigation of Neurological soft signs as a discriminating factor between Veterans with Post-traumatic Stress Disorder, mild Traumatic Brain Injury, and co-occurring Post-traumatic Stress Disorder and mild Traumatic Brain Injury

While multiple Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans suffer from mild Traumatic Brain Injury (mTBI), Post-traumatic Stress Disorder (PTSD), and co-morbid mTBI and PTSD, there remains difficulty disentangling the specific symptoms associated with each disorder using self-report and neurocognitive assessments. We propose that neurological soft signs (NSS), which are tasks associated with general neurologic compromise, may prove useful in this regard. Based on our review of the literature we hypothesized that individuals with PTSD would present with a greater number of NSS than controls or individuals with mTBI. Further, we hypothesized a synergistic effect, such that individuals with mTBI + PTSD would present with the greatest number of NSS. To test these hypotheses, we analyzed a subset of individuals (N=238) taken from a larger study of neurocognitive functioning in veterans. Participants completed a battery of neuropsychological measures, which included the Behavioral Dyscontrol Scale (BDS), the current study’s measure of NSS. A subset of other neuropsychological measures were also included to examine the utility of NSS over and above traditional neuropsychological measures. Individuals were removed from the study if they sustained a moderate/severe TBI or did not meet validity criteria on the Green’s Word Memory Test or the Negative Impression Management subscale of the Personality Assessment Inventory. Binomial logistic and multinomial logistic regression were used to examine the ability of NSS to discriminate between the study groups, first by themselves and then after the variance explained by the traditional neuropsychological measures was accounted for. Exploratory cluster analyses were performed on neuropsychological measures and NSS to identify profiles of cognitive performance in the data set. Results indicated that individuals in the mTBI and/or PTSD group had more NSS compared to controls. Of the individual NSS items only a go/no-go task of the BDS discriminated between groups, with worse performance among individuals in the mTBI, PTSD, and mTBI + PTSD group compared to controls. In contrast, the overall BDS score and individual NSS, in general, did not discriminate between the mTBI, PTSD, and mTBI + PTSD group. Overall, the current study suggests that, when eliminating participants who do not meet validity criteria, NSS do not aid in discriminating between individuals with mTBI, PTSD, and mTBI + PTSD

Roles of Education and IQ in Cognitive Reserve in Parkinson's Disease-Mild Cognitive Impairment.

Background/aimsThe role of cognitive reserve in Parkinson's disease (PD)-mild cognitive impairment (MCI) is incompletely understood.MethodsThe relationships between PD-MCI, years of education, and estimated premorbid IQ were examined in 119 consecutive non-demented PD patients using logistic regression models.ResultsHigher education and IQ were associated with reduced odds of PD-MCI in univariate analysis. In multivariable analysis, a higher IQ was associated with a significantly decreased odds of PD-MCI, but education was not.ConclusionThe association of higher IQ and decreased odds of PD-MCI supports a role for cognitive reserve in PD, but further studies are needed to clarify the interaction of IQ and education and the impact of other contributors such as employment and hobbies

Testing the diagnostic utility of the construct and measurement of social cognition across acquired and degenerative neurological conditions

The portfolio has three parts. Part one is a systematic literature review, in which literature relating to the sensitivity and specificity of neuropsychological measures in identifying behavioural variant Frontotemporal Dementia is reviewed. Neuropsychological measures from the following cognitive domains are reviewed: executive functioning, social cognition, episodic memory, selfreport measures and praxis ability. Part two is an empir ical paper, which explores the relationship between emotion recognition and general intellectual abilities in a population with an acquired brain injury and healthy controls. There is large debate in the literature about whether emotion recognition is a mo dular ability, or reliant on general intellectual abilities; this paper seeks to clarify this. Part three comprises the appendices, including a reflective and epistemological statement

Association between a longer duration of illness, age and lower frontal lobe grey matter volume in schizophrenia

The frontal lobe has an extended maturation period and may be vulnerable to the long-term effects of schizophrenia. We tested this hypothesis by studying the relationship between duration of illness (DoI), grey matter (GM) and cerebro-spinal fluid (CSF) volume across the whole brain. Sixty-four patients with schizophrenia and 25 healthy controls underwent structural MRI scanning and neuropsychological assessment. We performed regression analyses in patients to examine the relationship between DoI and GM and CSF volumes across the whole brain, and correlations in controls between age and GM or CSF volume of the regions where GM or CSF volumes were associated with DoI in patients. Correlations were also performed between GM volume in the regions associated with DoI and neuropsychological performance. A longer DoI was associated with lower GM volume in the left dorsomedial prefrontal cortex (PFC), right middle frontal cortex, left fusiform gyrus (FG) and left cerebellum (lobule III). Additionally, age was inversely associated with GM volume in the left dorsomedial PFC in patients, and in the left FG and CSF excess near the left cerebellum in healthy controls. Greater GM volume in the left dorsomedial PFC was associated with better working memory, attention and psychomotor speed in patients. Our findings suggest that the right middle frontal cortex is particularly vulnerable to the long-term effect of schizophrenia illness whereas the dorsomedial PFC, FG and cerebellum are affected by both a long DoI and aging. The effect of illness chronicity on GM volume in the left dorsomedial PFC may be extended to brain structure–neuropsychological function relationships

Los violadores y los que abusan de niños comparten un bajo nivel de actualización ejecutiva pero no de razonamiento fluido

Research findings suggest that sex offenders show worse performance than the general population in neuropsychological tests. Nevertheless, moderators such as age of the victim, use of antisocial control groups, and characteristics of administered measures have been highlighted. Here, 100 participants completed a battery of cognitive measures tapping fluid reasoning, verbal ability, and three basic executive processes (inhibition, switching, and updating). They were matched by educational level and classified in four groups: controls, non-sex offenders, rapists, and child abusers. The analyses revealed that rapists showed lower fluid reasoning scores than controls and child abusers. Furthermore, rapists and child abusers showed lower executive updating performance than controls and non-sex offenders. Importantly, child abusers did show fluid reasoning scores on a par with controls (controlling for updating differences), but their executive updating performance was equivalent to the one revealed by rapists (controlling for fluid intelligence differences). Implications of these findings for the design of efficient intervention programs are discussedLos datos de investigación empírica sugieren que los delincuentes sexuales presentan un peor desempeño que la población general en las pruebas neuropsicológicas. Aun así, se ha resaltado la influencia de variables moderadoras como la edad de la víctima, el uso de grupos control que incluyan individuos antisociales y las características de las medidas utilizadas. En este estudio cien participantes completaron una batería de pruebas cognitivas que evalúan razonamiento fluido, capacidad verbal y tres funciones ejecutivas básicas (inhibición, cambio y actualización). Los participantes estaban igualados en su nivel educativo y divididos en cuatro grupos: controles, delincuentes no sexuales, agresores sexuales con víctimas adultas y abusadores de menores. Los análisis revelaron que los agresores sexuales con víctimas adultas presentaban puntuaciones menores que los controles y los abusadores de menores en razonamiento fluido. Más aún, los agresores con víctimas adultas y los abusadores tenían peor desempeño que los controles y los delincuentes no sexuales en actualización ejecutiva. Es destacable que los abusadores de menores mostraran puntuaciones en razonamiento fluido equiparables a las de los controles (controlando estadísticamente las diferencias en actualización), pero su desempeño en actualización ejecutiva fue equivalente al mostrado por los agresores con víctimas adultas (controlando estadísticamente las diferencias en inteligencia fluida). Finalmente se discuten las implicaciones de estos resultados para el diseño de programas de intervención efectivo