RESUMEN
BACKGROUND: To investigate the associations between the Neuro-Quality of Life (NQOL) Depression and Anxiety measures with an objective emotional inventory (Personality Assessment Inventory; PAI), and demonstrate the clinical utility of the NQOL as screening measures for depression and anxiety in persons with epilepsy (PWE). METHODS: PWE (N=72) were concurrently administered the NQOL Depression and Anxiety measures and the PAI. Pearson product moment correlations were used to determine the relationships between the NQOL measures and the respective PAI scales (i.e., depression, anxiety). One-way ANOVAs were conducted comparing NQOL scores between patients with elevated levels of depression and anxiety (T-score≥65 on the PAI) to profiles that were within normal limits. Using sensitivity and specificity analyses, optimal cut-scores on the NQOL measures were determined. RESULTS: Participants were primarily Caucasian (89%), female (60%), and ~35 years old. The NQOL Depression measure was significantly correlated with the PAI Depression total score (r=.747; p<0.001) and its subscales (p's<0.001). Similarly, the NQOL Anxiety measure was significantly correlated with the PAI Anxiety total score (r=.750; p<0.001) and its subscales (p's<0.001). Compared to profiles that were within normal limits, individuals with elevated depressive symptoms on the PAI had significantly higher NQOL Depression scores (F(1,71)=48.2, p<0.001, d=1.6). Similarly, those who endorsed elevated anxiety on the PAI had significantly higher NQOL Anxiety scores (F(1,71)=32.2, p<0.001, d=1.5). Cut-off scores of 19 on the NQOL Depression and 24 on the NQOL Anxiety measures adequately detected depression (sensitivity=0.67; specificity=0.93; PPV=0.91; NPV=0.74) and anxiety symptoms (sensitivity=0.77; specificity=0.82; PPV=0.81; NPV=0.78) in PWE. CONCLUSIONS: The NQOL Depression and Anxiety measures evidenced strong associations with the PAI Depression and Anxiety scales and may be effective in detecting depressive and anxiety symptoms in PWE using the provided cut-scores.
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Ansiedad/psicología , Depresión/psicología , Epilepsia/psicología , Pruebas Neuropsicológicas , Determinación de la Personalidad , Calidad de Vida/psicología , Adulto , Ansiedad/diagnóstico , Ansiedad/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Epilepsia/diagnóstico , Epilepsia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas/normas , Determinación de la Personalidad/normas , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
OBJECTIVE: This study aims to expand upon previous research by characterizing the attitudes/preferences of referring providers who utilize neuropsychological services. METHOD: A 31-question survey link, along with a description of the rationale, was disseminated across several professional listservs and email lists, and data was collected over a 6-month period from individuals who refer for neuropsychological services (N = 81). Survey questions included referring provider preferences (e.g., ideal time frame for receiving the neuropsychological report, preferred length/format of the report, sections of the report they read and consider essential, comfort level with recommendations, and open responses regarding other general preferences) as well as narrative details about useful aspects of neuropsychological services versus areas of desired change. RESULTS: The represented referring providers included epileptologists (18), neurologists (12), psychologists (11), other various physician specialties (10), social workers (9), non-physician medical providers (9), psychiatrists (8), and legal services (4). Most referring providers prefer shorter reports (2-4 pages), in bullet-point/table format for ease of readability, and receipt of the completed report within 2 weeks. Approximately half of the respondents reported reading the entire neuropsychological report, with the background, developmental/medical, and educational histories being the least frequently read sections. Nearly all respondents indicated they are satisfied with neuropsychological services overall and agree that the referral question is satisfactorily answered, the findings are communicated clearly, and the diagnostic impressions are logical. Referring providers appreciate most recommendations by neuropsychologists, with the exception of those regarding laboratory work, medications, and other medical procedures. The most useful aspects of neuropsychological services included the thoroughness and integration of the evaluation/report, along with the impressions, diagnoses, and recommendations. Recommendations for future practice included shorter reports, increased availability of neuropsychological services, and more concise impressions and recommendations. Generally speaking, few differences in preferences and satisfaction were noted across provider specialties, patient populations, or practice settings. CONCLUSION: These findings are generally consistent with prior literature that referring providers are satisfied with neuropsychological services overall. The current findings also expand upon the previous research, specifically, that referring providers prefer reports to include bullet-point/table format due to ease of reading and do not read some sections of the report, most likely due to already having an adequate understanding of their patients' background. Illuminating aspects of neuropsychological services perceived to be the most and least useful by consumers of these services provides valuable information to practitioners, particularly in the context of rapidly changing institutional and healthcare demands.
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Actitud del Personal de Salud , Pruebas Neuropsicológicas , Neuropsicología , Satisfacción Personal , Derivación y Consulta , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Factores de TiempoRESUMEN
OBJECTIVE: To determine whether premorbid IQ mediates performance on neurocognitive tests in individuals diagnosed with cocaine use disorder (CUD). METHOD: Recently abstinent cocaine users (N = 113) completed measures sensitive to the effects of cocaine on cognition: Conners' Continuous Performance Task-II (CPT-II), n-back working memory test, and Hopkins Verbal Learning Task-Revised (HVLT-R). Premorbid IQ was calculated using the Oklahoma Premorbid Intelligence Estimate, which integrates scores from the Wechsler Adult Intelligence Scale-III and demographic variables. Participants were grouped according to their premorbid IQ using commonly accepted classifications of ability level (above average [>110], average [90-109], and below average [<90]) and comparisons in neurocognitive performance were performed using one-way analysis of variance. RESULTS: Significant differences were detected between groups on the HVLT-R including Trial 1 (p = .002), total word recall across the 3 list-learning trials (p < .001), and recall following a delay (p < .001). Significant differences were also detected on the N-back, including auditory and visual accuracy (p = .022 and p < .001, respectively) and mean and maximum block length (p < .001). Although significant differences were observed between the above average and average groups (mean effect size = .418 [Cohen's d]), the magnitude of group differences was greatest between the average and below average groups (mean effect size = .716). CONCLUSIONS: These results raise questions as to whether the neurocognitive impairment observed in individuals diagnosed with CUD predated the onset of cocaine use or whether the impairments were caused by cocaine use. Because these impairments are potential risk factors for poor treatment outcomes, it is important to consider the need to modify treatment programs to account for lower premorbid IQ. (PsycINFO Database Record
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Trastornos Relacionados con Cocaína/psicología , Cocaína/efectos adversos , Trastornos del Conocimiento/etiología , Inteligencia , Memoria a Corto Plazo , Adulto , Trastornos Relacionados con Cocaína/complicaciones , Cognición , Trastornos del Conocimiento/diagnóstico , Femenino , Humanos , Masculino , Recuerdo Mental , Persona de Mediana Edad , Pruebas Neuropsicológicas , Aprendizaje Verbal , Escalas de WechslerRESUMEN
Computerized neurocognitive testing has become a growing practice across medical populations, but particularly within sports medicine and the management of sports-related concussion. Although traditional neuropsychological measures are solely administered and interpreted by neuropsychologists, computerized cognitive tests are marketed to and utilized by a wide range of professionals involved in the management of sports-related concussions, many of whom lack specialized psychometric training. Although the benefits of computerized testing allow for many youth athletes to be evaluated quickly, professionals implementing their use should be aware of the potential pitfalls and the high potential for misuse. After briefly reviewing the recommended guidelines set forth by the American Academy of Clinical Neuropsychology and the National Academy of Neuropsychology, we review the benefits/limitations of computerized testing in the management of sports-related concussion and the basic psychometric properties of some of the more widely used computerized measures. Lastly, we discuss the practical application of these devices.
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Conmoción Encefálica/complicaciones , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Diagnóstico por Computador , Humanos , Pruebas Neuropsicológicas , Deportes JuvenilesRESUMEN
OBJECTIVE: This study reviewed several topics related to post-concussion syndrome and psychological factors associated with concussion. Topics include neurobiological perspectives, psychological predictors of post-concussion syndrome including pre-morbid anxiety, anxiety sensitivity and cognitive biases and misattribution. In addition, the iatrogenic effects of excessive rest are reviewed and treatment options are discussed briefly. MAIN RESULTS: Animal models of concussion and mild traumatic brain injury suggest that a concussion can result in anxiety and fear reactions. The pathophysiology of depression following a concussion appears to be consistent with the cortico-limbic model of depression. Additionally, some individuals may be at risk for neurobiological depression and/or anxiety following a concussion. The literature also demonstrates that pre-morbid and concurrent anxiety increases the risk for prolonged concussion recovery. Cognitive biases and misattribution of symptoms contribute to lengthy recovery from concussion. In addition, medically prescribed excessive cognitive and physical rest may contribute to a protracted concussion recovery. Supervised and graduated physical activity, the introduction of anxiety reduction techniques and cognitive-behavioural therapy of cognitive biases and misattribution are effective means of shortening the length of post-concussion syndrome. CONCLUSIONS: Understanding, assessing and treating the psychological factors associated with concussion are effective means of preventing or shortening the length of post-concussion syndrome.