The use of the neurobehavioral cognitive status examination with geriatric rehabilitation patients.

Objective: To provide normative data for 3 commonly encountered rehabilitation diagnostic groups and examine demographic influences on the Neurobehavioral Cognitive Status Examination (NCSE, now called Cognistat). Design: Normative data are presented along with correlational associations to demographic variables. Analysis of variance was used to examine test scores between the 3 diagnostic groups. Particoants: Eighty-six urban geriatric rehabilitation patients (34 recent total joint replacements, 22 with general medical conditions, and 30 with diagnosed neurological disorders). Results: Scores on many of the NCSE scales are associated with level of education. Five subtests evidenced performance differences between the joint replacement and neurologic groups. Conclusions: The NCSE has utility in detecting cognitive dysfunction with geriatric rehabilitation patients, although caution is suggested in NCSE interpretation in a lesser educated, older population because of educational effects on test performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationships among rehabilitation staff members' reports of cognitive dysfunction and neuropsychological assessment in an acute rehabilitation population.

Purpose/Objective: To examine the relationships among rehabilitation staff members' observations of the extent to which attention and memory functioning interfered with participants' rehabilitation progress and the relationship between these observations and neuropsychological testing. Research Method/Design: Participants were 39 adults admitted to a Commission on Accreditation of Rehabilitation Facilities-accredited, acute physical medicine rehabilitation unit who were referred for neuropsychological assessment. For study purposes, participants were administered the Mental Control subtest of the Wechsler Memory Scale-Third Edition (D. Wechsler, 1997) and the Neuropsychological Assessment Battery (R. A. Stern & T. White, 2003). Occupational therapists, physical therapists, and nurses were asked to rate the extent to which participants' attention/concentration and memory interfered with their progress in rehabilitation. Results: Staff ratings of participants' attention or memory functioning interfering with rehabilitation progress were strongly and most closely related to their own ratings of the other cognitive domain. Objective attention and memory test performance were weakly and nonsignificantly correlated with each other. Relationships between staff observations and test data were also weak. Conclusions/Implications: Rehabilitation staff members may be viewing cognition as a unitary construct rather than identifying the independent contributions of different cognitive domains as they apply to rehabilitation performance and progress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The current status of the drug abuse problem in Russia

The statistic data evidence for rapid increase of the number of narcomanias, especially in juveniles and young people nowadays in Russia. The spectrum of psychoactive preparations used became also wider. On the basis of medico-biological studies the conception concerning main pathogenetic mechanisms of the development of psychoactive substances dependence was formulated. Enzyme immuno assays either for diagnosis of long-term opiate administration or for determination of blood serum methadone level were elaborated. Clinical studies demonstrated pathomorphism of the symptoms of dependence upon well-known narcotics. Clinical pattern of dependence upon new psychoactive preparations which cause dependence syndrome was also investigated. New differentiated methods of treatment of various types of narcomanias are proposed. There is underlined that a comprehensive program of narcomanias prophylaxis in Russia is needed.     

Effect of neurocognitive status and personality functioning on length of stay in residential substance abuse treatment: An integrative study.

Administered a battery of neuropsychological tests and the Millon Clinical Multiaxial Inventory-II (MCMI-II) to 246 patients (aged 17–53 yrs) admitted to a long-term residential substance abuse treatment facility. Ss who displayed general cognitive impairment scored higher on the Avoidant, Antisocial, Paranoid, and Thought Disorder scales than those who did not have such impairment. Cognitive status and personality functioning, particularly an antisocial personality style, were independently and interactively related to program participation. Ss with elevations on the MCMI-II scale measuring antisocial personality style and who had cognitive impairment stayed in the program a shorter amount of time, were rated as less positively participatory by clinical staff, and were removed more frequently from treatment for rule violations than other residents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A pilot study of the neuropsychological benefits of computerized cognitive rehabilitation in Ugandan children with HIV.

Objective: Because antiretroviral treatment (ART) fails to improve neurocognitive impairment in children with HIV, we completed a pilot study evaluating the feasibility and cognitive benefit of computerized cognitive rehabilitation therapy (CCRT) in Ugandan children with HIV. Method: Sixty Ugandan children with HIV (23 on ART) were randomly assigned to 10 sessions of Captain's Log CCRT (Sandford, 2007) training configured for attention and memory skills or no intervention. Kaufman Assessment Battery for Children (2nd ed., KABC–2; Kaufman & Kaufman, 2004) performance at baseline indicated pervasive neurocognitive impairment. Cognitive ability was assessed before and after training using the Cogstate computerized neuropsychological test (Darby, Maruff, Collie, & McStephen, 2002). Viral load along with CD4 and CD8 absolute and activation levels also were measured posttest. Results: CCRT was well received with a 95% adherence rate to scheduled training sessions. CCRT intervention children showed greater improvement on a Cogstate card detection task of simple attention (p = .02), and speed of correct moves on a Groton Maze Learning Task (p     

Outcome of different treatment mixes in a multidimensional neuropsychological rehabilitation program.

Within a clinical demonstration program, 59 traumatically brain-injured patients were treated with 1 of 3 mixes of treatment. Mix 1 included cognitive remediation (CGR), small-group interpersonal (SGI) communication training, therapeutic community activities, and personal counseling. Mix 2 was similar to Mix 1 but stressed SGI exercises and eliminated CGR. Mix 3 emphasized CGR and eliminated SGI exercises. The efficacy of the treatment mixes was evaluated with performance on neuropsychological tests, improved independence in functional activities, measures of intra- and interpersonal functioning, and vocational outcome. Ss' participation in the program, irrespective of treatment mix, yielded improvements in (1) self-image, (2) quality of interpersonal relatedness and interaction, (3) involvement with others in naturalistic settings, and (4) vocational outcome. Overall, data point to the superiority of the balanced mix (Mix 1) over Mixes 2 and 3. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between depression, fatigue, subjective cognitive impairment, and objective neuropsychological functioning in patients with multiple sclerosis.

Objective: This study explored the influence of depression and fatigue on subjective cognitive complaints and objective neuropsychological impairment in patients with multiple sclerosis (MS). Methods: Data for this study were taken from a randomized controlled trial, comparing 16 weeks of telephone-administered cognitive-behavioral therapy and telephone-administered supportive emotion focused therapy for the treatment of depression. The sample includes 127 patients with MS. The following self-report measures were collected pre- and posttreatment: Perceived Deficits Questionnaire, Beck Depression Inventory-II, and Modified Fatigue Impact Scale. Measures of objective cognitive functioning and the Hamilton Rating Scale for Depression were administered over the telephone. Results: Our results showed that changes in depression and fatigue significantly predicted changes in subjective cognitive complaints from pre- to posttreatment, with patients perceiving fewer cognitive problems at posttreatment (β = .36, p     

Changes in neuropsychological functioning over 10 years following adolescent substance abuse treatment.

Previously, Anderson, Ramo, Cummins, and Brown (2010) described six distinct patterns of alcohol and other drug (AOD) use during the decade following adolescents' treatment for alcohol and other substance use disorders (A/SUD). This time period represents a phase of significant neurodevelopment, and the influence of substance use on the brain is a concern. In the present study, we examined patterns of neuropsychological function over these 10 years in relation to the AOD trajectories identified for youth as they transition into their twenties. Participants were part of a longitudinal research project following adolescents with and without A/SUD who received neuropsychological examinations at baseline and up to 7 times thereafter spanning 10 years (N = 213; 46% female at baseline). Neuropsychological trajectories were significantly related to substance involvement patterns over time on measures of verbal learning and memory (ps = .011 to p = .0002), and verbal attention/working memory (p = .020), with heavier use patterns generally followed by poorer cognition. Heavy use of alcohol alone was independently associated with poorer verbal memory over time. Furthermore, substance withdrawal symptoms during each follow-up time point were related to poorer verbal learning and memory scores (ps     

Addressing executive functioning and cognitive rehabilitation in the treatment of schizophrenia.

ABSTRACT. Schizophrenia spectrum disorders are currently viewed as having a neuropsychological basis included in the etiology. Cognitive deficits that occur in schizophrenia are primarily observed in the areas of attention–concentration, memory, and planning. These abilities are commonly viewed under the broader spectrum of executive functioning. Research has shown that these executive functioning skills can be improved through the use of cognitive rehabilitation interventions. This article includes a case study documenting the use of cognitive rehabilitation strategies with a patient diagnosed with schizophrenia who possessed documented deficits in executive functioning. The discussion illustrates the possible progress that may be made in the treatment of schizophrenia when this additional tier of intervention is used. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American productivity: The devastating effect of alcoholism and drug abuse.

Asserts that a number of factors have contributed to a general productivity slowdown in the US since World War II. These include (1) current labor laws that have created an adversarial atmosphere between management and labor, (2) increases in the price of energy since the oil embargo of 1973, and (3) a proliferation of government regulations throughout the 1970's, especially in the areas of consumer product safety, pollution control, and occupational safety, that have resulted in the diversion of capital investment into equipment that does not necessarily increase output. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training drug abuse treatment personnel in therapeutic community methodologies.

Describes the therapeutic community (TC) philosophy, which is based on the social learning model, and examines the various types of training that the TC personnel bring to the community. Clients in TCs have tasks assigned to them, and they attain status by earning the respect of fellow clients and by working through 4 levels of competence. The rapid growth of TCs in the last 20 yrs has led to an increase in the number of professional mental health workers in this field. Thus, most TCs now have both TC-recovered personnel and mental health personnel on their staff, and these 2 groups must learn from each other, despite any resistance they might feel. A basic training format and curriculum guide are presented for training TC personnel. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of a split in WAIS-R VIQ and PIQ scores on patients with cognitive impairment and psychiatric illness

To determine the most effective treatment for acrodermatitis chronica atrophicans, several clinical trials were undertaken in recent years to evaluate whether a 2-week course of ceftriaxone would be superior to oral antibiotics. Of the 46 patients suffering from acrodermatitis chronica atrophicans, 14 were treated with ceftriaxone 2g for 15 days. The remaining patients received either oral penicillin V 1.5 million IU t.i.d. or doxycycline 100 mg b.i.d. for 20 to 30 days. Patients were followed up for at least 1 year. Of the 14 ceftriaxone-treated patients four showed incomplete regression of the inflammatory skin changes after 6 to 12 months. Two out of five patients who were monitored for Borrelia burgdorferi DNA excretion were still positive after 12 months as compared to none of six patients who were treated orally for 20-30 days. Six out of 11 patients treated orally for only 20 days needed retreatment after 6 months because of continuing skin manifestations, neuropathy or arthralgia. A 30-day duration of treatment with oral antibiotics and not the chosen antibiotic is crucial for curing acrodermatitis chronica atrophicans. The duration of treatment with ceftriaxone needed for eradication of Borrelia in acrodermatitis chronica atrophicans has yet to be determined in future studies.     

The interdisciplinary status of rehabilitation psychology.

Examines the field of rehabilitation psychology from the perspectives of other social science disciplines. Each discipline is associated with certain assumptions, particular meanings of disability, and distinctive remedies. Rehabilitation psychologists overdetermine disability problems in terms of individual traits and dynamics. In this way, they may alienate citizens with disabilities who formulate their difficulties in terms of civil rights, environmental obstacles, and social pathology. The individualism that permeates psychology is criticized with formulations drawn from political science, sociology, economics, linguistics, and insights from philosophies of social science. A more inclusive perspective on disability would enable rehabilitationists to relate better to the emerging consumerism and political activism stirring among persons with handicaps. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Kohut's theory of narcissism and adolescent drug abuse treatment.

Examined whether changes in narcissism among adolescents occurred during treatment for substance abuse and determined if and how narcissism might relate to progress and persistence in such treatment. Ss were 95 13–21 yr olds entering or already in long-term treatment for drug abuse, surveyed 3 times over 6 mo. Narcissism was measured by 2 instruments based on H. Kohut's (1971 and 1977) theory of narcissistic development. Findings indicated that many, but not all, narcissistic characteristics did change during treatment. Theorized relations were found between narcissism scores and progress in treatment for most narcissistic manifestations. The ability to relinquish angry acting-out behavior distinguished dropouts from persisters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detection of neuropsychological impairment among substance-abusing patients: Accuracy of the Neurobehavioral Cognitive Status Examination.

The accuracy of the Neurobehavioral Cognitive Status Examination (NCSE) in detecting the presence of cognitive impairment among substance-abusing patients was examined. The NCSE and the Neuropsychological Screening Battery (NSB), which has been shown in previous studies to discriminate reliably between cognitively impaired and intact substance abusing patients, were administered to 51 detoxified patients. Using participants' performances on the NSB as the criterion measure, 22 (43%) were found to be cognitively impaired. The NCSE identified only 8 of these 22 patients (36%) as being impaired; additionally, 4 of the 29 patients found to be cognitively intact by the NSB (14%) were classified as impaired by the NCSE. Thus, the false-negative rate of the NCSE is too high to recommend its use with substance-abusing patients (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies.

[Correction Notice: An erratum for this article was reported in Vol 18(1) of Psychology of Addictive Behaviors (see record 2007-16711-001). On page 208, the first sentence in the note of Table 4 incorrectly reads as follows: "Numbers in parentheses are ns of respondents who provided an 'other' reason for this specific intervention." The sentence should read as follows: "Numbers in parentheses are ns of respondents whose agencies do not offer this intervention."] This study assessed acceptability, availability, and reasons for nonavailability of interventions designed to prevent drug use related harm by substituting pharmaceuticals for illicit drugs; facilitating detoxification; and reducing the occurrence of HIV transmission, relapse, and opiate overdose. A survey was mailed to a sample of 500 randomly selected American substance abuse treatment agencies. Of 435 potentially eligible respondents, 222 (51%) returned usable data. A subset of interventions--including harm reduction education, cue exposure therapy, needle exchange, substitute opiate prescribing, various detoxification regimes, and complementary therapies--were rated as somewhat or completely acceptable by 50% or more of the respondents. Regardless of their acceptability, listed interventions were generally not available from responding agencies; respondents typically attributed unavailability to lack of resources and inconsistency of an intervention with agency philosophy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in cognitive impairment between VA and community treatment center alcoholics.

Administered a battery of neuropsychological tests to 42 Veterans Administration (VA) treatment program alcoholics, 38 peer community treatment program alcoholics, and 37 peer controls. The groups differed significantly on an overall performance score: VA Ss performed the worst, community Ss were intermediate, and controls were best. VA Ss performed more poorly than community Ss on Verbal, Visuospatial, and Concept Formation factors. Community Ss performed more poorly than community controls on Verbal Memory and Concept Formation. Results suggest limitations on generalizations concerning severity of neuropsychological impairment based on VA samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer-assisted cognitive rehabilitation for the treatment of patients with substance use disorders: A randomized clinical trial.

The purpose of this study was to examine the comparative efficacy of cognitive rehabilitation as an intervention for substance misuse. Patients with substance use disorders entering long-term residential care (N = 160) were randomly assigned to one of two conditions: (a) standard treatment plus computer-assisted cognitive rehabilitation (CACR), which was designed to improve cognitive performance in areas such as problem solving, attention, memory, and information processing speed; and (b) an equally intensive attention control condition consisting of standard treatment plus a computer-assisted typing tutorial (CATT). Participants were assessed at baseline, during treatment, at treatment completion, and 3-, 6-, 9-, and 12-month follow-up. Intent-to-treat analyses showed that, compared with those randomized to CATT, patients who received CACR were significantly more engaged in treatment (e.g., higher ratings of positive participation by treatment staff, higher ratings of therapeutic alliance), more committed to treatment (e.g., longer stays in residence) and reported better long-term outcomes (e.g., higher percentage of days abstinent after treatment). Mediational analyses revealed the positive comparative effect of CACR on abstinence during the year after treatment was mediated by treatment engagement and length of stay in residence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enrolling and retaining mothers of substance-exposed infants in drug abuse treatment.

This study provided an experimental test of a drug abuse treatment enrollment and retention intervention in a sample of 103 Black mothers of substance-exposed infants. Significantly more women assigned to the Engaging Moms Program enrolled into drug abuse treatment than did women assigned to the control condition (88% vs. 46%). Sixty-seven percent of participants in the Engaging Moms Program received at least 4 weeks of drug abuse treatment compared with 38% of the control women. However, there were no differences between the groups 90 days following treatment entry. Logistic regressions revealed that readiness for treatment predicted both short-term and long-term treatment retention. The Engaging Moms Program has considerable promise in facilitating treatment entry and short-term retention, but it did not influence long-term retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement properties of the neurobehavioral cognitive status examination (Cognistat) in traumatic brain injury rehabilitation.

Objective: Evaluate measurement properties of the Neurobehavioral Cognitive Status Examination (Cognistat) using Rasch analysis. Design: Calibration of item responses from 120 individuals admitted to a rehabilitation medicine service for traumatic brain injury (TBI) and 296 community-dwelling adults with TBI. Results: Three strata of performance were differentiated despite a skewed distribution toward high performance among the community sample. Elimination of easier items created a better targeted instrument (i.e., generated more spread among individuals) without a significant increase in error. Memory and verbal reasoning were the most difficult domains for each sample; however, analyses indicated significant measurement error. Conclusions: As a screening instrument, the Cognistat reliably classifies multiple levels of cognitive status in both acute and postacute TBI settings; however, this measure is unsuitable for generating a profile of neurocognitive strengths and weaknesses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)