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The effects of strategy verbalization on Wisconsin card sorting test performance in patients with Schizophrenia
Abstractsfrom the 17thAnnualMeeting
61
basisof gender,age,and sourceof referral(i.e.,neurologist,attorney,neurosurgeon)resulting in a factorialANOVAdesign. Resultsdemonstratedthat patientsseen with a positivediagnosisof cerebralcompromise presentedwith similarpsychiatricprofilesas assessedby the MinnesotaMultiphasicPersonalityInvento~-2. Patients’profileswere consistentlyrepresentedby elevationson scales that portray individualswho presentwith somaticconcerns,low levels of depression,and sequelaeconsistentwiththecognitiveandphysicalcorrelatesof a post-concussivesyndrome. Severalconclusionsare drawnfrom the data. Specifically,the currentresearchspeaksto quantifiablesupport for the subjectivelyvoiced cognitiveand personalitysequelaeoften reported by patients followingbrain trauma. The data also illustratesthe need for these patientsto be psychiatricallyassessed,as well as neurologicallyassessed,followingtrauma. Thoseconcernedwith the treatmentand futurecare needsof thesepatientsshouldbe alertto the signs and symptomsof a developingpsychiatricdisorder. Burns, S. A., Adams,H., & Miller,L. S. Impact of Handedness on Schizotypic-Like Features in a Nonclinical Sample.
A relationshipbetweenhandednessand subclinicalfeaturesof schizophreniaand featuresof SchizotypalPersonalityDisorderhave been reportedas measuredby self-reportquestionnaires. Findings have suggestedthat cognitive-perceptualdysfunctionmay be linked to mixed handednessor nondextrality(Chapman& Chapman,1987;Kim, Raine,Triphon,& Green, 1992).We studiedthe majorself-reportquestionnairesfrom this literaturein a large sample of college students(N = 1962).We collected self-reportdata on the Schizotypal PersonalityQuestionnaire(SPQ) and the Chapman Scales of Impulsivity/Nonconformity (IMP), MagicalIdeation (MAG), PerceptualAberration(PER), PhysicalAnhedonia(PA), and SocialAnhedonia(SA).Similarto previousreportsusingsmallersamplesof subjects,we foundthatcomparisonson thesescalesand theirfeature-basedsubscalesrevealedsignificant differencesfollowingstatisticalcorrectionsfor multiplecomparisons(Alpha= .01). When handednesswas classifiedas right, let, or mixed, there were statisticallysignificantdifferenceson theChapmanScalesof IMP [F(2,1917)= 8.38,P < .001],MAG [F(2,1925)= 5.58, p < .004], PER [F(2,1919)= 8.24,p < .0004],and SA [F(2,1932)= 6.05,p < .003] as well as the SPQ Scale [F(2,1896)= 4.50, p < .01] and subscalesof Odd Experiences/Behavior [F(2,1934)= 17.29,p < .001],Odd Beliefs/MagicalThinking[F(2,1941)= 7.63,p < .001] and UnusualPerceptualExperiences[F(2,1941)= 6.39,p < .002],withincreasedscoresfor mixed handedness,followed by left handedness,followed by right handedness.When handednesswas classifiedas dextralor nondextral,significantdifferenceswere also found with increased scores for nondextral as compared to dextral subjects. Results support previousresearchindicatinga possiblerelationshipbetweenhandednessand a pronenessfor increasedpsychopathologyas well as the use of handednessdifferencesto supporttheories of biologicallybased differencesin subjects showing a greater proportion of multiple schizophrenicspectrumfeatures. Potterat,E. G., Perry,W., & Braff, D. The E#ects of Strategy Verbalization on Wisconsin Card Sorting TestPer$orrnancein Patients with Schizophwzia.
Schizophrenicpatients (SCZ) show increases in perseverativeresponses (PR’s) on the WisconsinCard SortingTest (WCST).One means of assessingthe extent or “density” of their impairmentis to utilizeremediationor training strategies.These trainingprocedures typicallyresult in reduced (PR’s). However,one possibleconfoundingfactor in all of the WCSTtrainingstudiesis the significantalterationof the integrityof theWCST.In this study, we randomlyassignedSCZ patients(N= 73) to two conditions.One group (S-M)received
62
Abstractsfrom the 17thAnnualMeeting
the standardWCST (S) for 64 cards followedby a modifiedversion(M) for 64 cards.The other group receivedthe modifiedfollowedby the standardversion (M-S). The modified versionconsistedof askingthe subjects,after each card sort, to verballyexpressthe reason thattheyplacedthecard wheretheydid.No additionalfeedbackwas given.Wehypothesized that this interventionwould aid SCZ’Simpairedexecutivefunctioningand assistin characterizingthe “density”or fixednessof their impairment,withoutcontaminatingthe integrity of the WCST. We found that for the first 64 cards, the group receiving the M version performedsignificantlybetterthan the groupreceivingthe S version(PR’s:X = 22.68vs. X = 12.94).The S-MgroupshowedsignificantlyreducedPR’sduringthe second64 cardswhen theyreceivedthe M version(X= 18.27)and the M-S group showeda significantincreasein the absenceof the modifiedinstructions(X= 17.14).In addition,we foundthatthe groupthat received the modifiedversion first (M-S) performedsignificantlybetter during the M 64 cardsthanthe groupthatreceivedthe modifiedversionsecond(S-M),furthersupportingthe contentionthat modificationoffered at the outset of the test may help to improveWCST performance.Moreover,we assessedthe clinicalsymptomsof the SCZ patientsusing the Scale for Assessmentof PositiveSymptoms(SAPS) and the Scale for the Assessmentof NegativeSymptoms(SANS).We found a significantrelationshipbetween negativesymptoms and WCST PR’s. Lam, M. N., Ritchie,A. J., Rankin,E. J., & Spaulding,W. D. Estimating Premorbid Intelligence: Evaluating the Revisions to the Oklahoma Premorbid Intelligence Estimate Formulae (OPIE vs. OPIE-R) with Other Premorbid Indicators Among Schizophrenic, Brain-Injured, and Non-Neurologically Impaired Chronic Pain Patients.
The OklahomaPremorbidIntelligenceEstimate(OPIE;Krull, Scott,Sherer,& Williamson, 1995)as originallyproposeddescribedseveralformulaefrom whichan estimateof premorbid intelligenceca be based on demographicand neuropsychologicalperformancevariables believedto be residentto the effectsof brain damage(i.e., Vocabularyand PictureCompletion).The OPIEwasrevisedto takeinto accountthe greaterage-relateddecrementin Picture Completionand to minimizeany overestimationof FSIQ in nonneurologicallyimpaired subjects(OPIE-R;Williamson,Krull, & Scott, 1996).As reported elsewhere,the original OPIEformulausingboth neuropsychological performancevariableswas foundto be a better overallpredictorof premorbidintelligence(Ritchie,Lam, & Rankin,1996)whencomparing nonneurologicallyimpaired chronic pain and brain injured patients’ scores on WAIS-R, WRAT-3,Reading subtest,the NAART,OPIE, and Barona formulae.The purposeof the currentstudyis to reanalyzethe efficacyof usinga reviseddecisionruleof the OPIE-Rwhen compared to the original OPIE formulae in chronic pain and brain injured patients; in addition,these measuresand predictionformulaewere analyzedin schizopbxenicpatients. The resultsrevealedthat the OPIE and OPIE-Rwere significantlydifferentonly among chronicpain patientsbut not amongbrain injuredor schizophrenicpatients.This suggests that the OPIE formula continuesto be a better indicator of premorbid intelligencefor nonneurologicallyimpaired chronic pain patients. The OPIE-R overestimatespremorbid intelligencewhen compared to the WAIS FSIQ scores in these patients; although not statisticallysignificant,a similar trend is also observedamong brain injured and schizophrenicpatients.Patternsare differentwhen comparingWRAT-3standardscoreswith other estimatesamong patients with schizophrenia.These differencesare inconsistentwith the patterns observedamong brain injured and chronicpain patients.Implicationsfrom these differencesare discussed,includingthe role of intensivepsychosocialand cognitiverehabilitationin the treatmentof these patientswith schizophrenia.
61
basisof gender,age,and sourceof referral(i.e.,neurologist,attorney,neurosurgeon)resulting in a factorialANOVAdesign. Resultsdemonstratedthat patientsseen with a positivediagnosisof cerebralcompromise presentedwith similarpsychiatricprofilesas assessedby the MinnesotaMultiphasicPersonalityInvento~-2. Patients’profileswere consistentlyrepresentedby elevationson scales that portray individualswho presentwith somaticconcerns,low levels of depression,and sequelaeconsistentwiththecognitiveandphysicalcorrelatesof a post-concussivesyndrome. Severalconclusionsare drawnfrom the data. Specifically,the currentresearchspeaksto quantifiablesupport for the subjectivelyvoiced cognitiveand personalitysequelaeoften reported by patients followingbrain trauma. The data also illustratesthe need for these patientsto be psychiatricallyassessed,as well as neurologicallyassessed,followingtrauma. Thoseconcernedwith the treatmentand futurecare needsof thesepatientsshouldbe alertto the signs and symptomsof a developingpsychiatricdisorder. Burns, S. A., Adams,H., & Miller,L. S. Impact of Handedness on Schizotypic-Like Features in a Nonclinical Sample.
A relationshipbetweenhandednessand subclinicalfeaturesof schizophreniaand featuresof SchizotypalPersonalityDisorderhave been reportedas measuredby self-reportquestionnaires. Findings have suggestedthat cognitive-perceptualdysfunctionmay be linked to mixed handednessor nondextrality(Chapman& Chapman,1987;Kim, Raine,Triphon,& Green, 1992).We studiedthe majorself-reportquestionnairesfrom this literaturein a large sample of college students(N = 1962).We collected self-reportdata on the Schizotypal PersonalityQuestionnaire(SPQ) and the Chapman Scales of Impulsivity/Nonconformity (IMP), MagicalIdeation (MAG), PerceptualAberration(PER), PhysicalAnhedonia(PA), and SocialAnhedonia(SA).Similarto previousreportsusingsmallersamplesof subjects,we foundthatcomparisonson thesescalesand theirfeature-basedsubscalesrevealedsignificant differencesfollowingstatisticalcorrectionsfor multiplecomparisons(Alpha= .01). When handednesswas classifiedas right, let, or mixed, there were statisticallysignificantdifferenceson theChapmanScalesof IMP [F(2,1917)= 8.38,P < .001],MAG [F(2,1925)= 5.58, p < .004], PER [F(2,1919)= 8.24,p < .0004],and SA [F(2,1932)= 6.05,p < .003] as well as the SPQ Scale [F(2,1896)= 4.50, p < .01] and subscalesof Odd Experiences/Behavior [F(2,1934)= 17.29,p < .001],Odd Beliefs/MagicalThinking[F(2,1941)= 7.63,p < .001] and UnusualPerceptualExperiences[F(2,1941)= 6.39,p < .002],withincreasedscoresfor mixed handedness,followed by left handedness,followed by right handedness.When handednesswas classifiedas dextralor nondextral,significantdifferenceswere also found with increased scores for nondextral as compared to dextral subjects. Results support previousresearchindicatinga possiblerelationshipbetweenhandednessand a pronenessfor increasedpsychopathologyas well as the use of handednessdifferencesto supporttheories of biologicallybased differencesin subjects showing a greater proportion of multiple schizophrenicspectrumfeatures. Potterat,E. G., Perry,W., & Braff, D. The E#ects of Strategy Verbalization on Wisconsin Card Sorting TestPer$orrnancein Patients with Schizophwzia.
Schizophrenicpatients (SCZ) show increases in perseverativeresponses (PR’s) on the WisconsinCard SortingTest (WCST).One means of assessingthe extent or “density” of their impairmentis to utilizeremediationor training strategies.These trainingprocedures typicallyresult in reduced (PR’s). However,one possibleconfoundingfactor in all of the WCSTtrainingstudiesis the significantalterationof the integrityof theWCST.In this study, we randomlyassignedSCZ patients(N= 73) to two conditions.One group (S-M)received
62
Abstractsfrom the 17thAnnualMeeting
the standardWCST (S) for 64 cards followedby a modifiedversion(M) for 64 cards.The other group receivedthe modifiedfollowedby the standardversion (M-S). The modified versionconsistedof askingthe subjects,after each card sort, to verballyexpressthe reason thattheyplacedthecard wheretheydid.No additionalfeedbackwas given.Wehypothesized that this interventionwould aid SCZ’Simpairedexecutivefunctioningand assistin characterizingthe “density”or fixednessof their impairment,withoutcontaminatingthe integrity of the WCST. We found that for the first 64 cards, the group receiving the M version performedsignificantlybetterthan the groupreceivingthe S version(PR’s:X = 22.68vs. X = 12.94).The S-MgroupshowedsignificantlyreducedPR’sduringthe second64 cardswhen theyreceivedthe M version(X= 18.27)and the M-S group showeda significantincreasein the absenceof the modifiedinstructions(X= 17.14).In addition,we foundthatthe groupthat received the modifiedversion first (M-S) performedsignificantlybetter during the M 64 cardsthanthe groupthatreceivedthe modifiedversionsecond(S-M),furthersupportingthe contentionthat modificationoffered at the outset of the test may help to improveWCST performance.Moreover,we assessedthe clinicalsymptomsof the SCZ patientsusing the Scale for Assessmentof PositiveSymptoms(SAPS) and the Scale for the Assessmentof NegativeSymptoms(SANS).We found a significantrelationshipbetween negativesymptoms and WCST PR’s. Lam, M. N., Ritchie,A. J., Rankin,E. J., & Spaulding,W. D. Estimating Premorbid Intelligence: Evaluating the Revisions to the Oklahoma Premorbid Intelligence Estimate Formulae (OPIE vs. OPIE-R) with Other Premorbid Indicators Among Schizophrenic, Brain-Injured, and Non-Neurologically Impaired Chronic Pain Patients.
The OklahomaPremorbidIntelligenceEstimate(OPIE;Krull, Scott,Sherer,& Williamson, 1995)as originallyproposeddescribedseveralformulaefrom whichan estimateof premorbid intelligenceca be based on demographicand neuropsychologicalperformancevariables believedto be residentto the effectsof brain damage(i.e., Vocabularyand PictureCompletion).The OPIEwasrevisedto takeinto accountthe greaterage-relateddecrementin Picture Completionand to minimizeany overestimationof FSIQ in nonneurologicallyimpaired subjects(OPIE-R;Williamson,Krull, & Scott, 1996).As reported elsewhere,the original OPIEformulausingboth neuropsychological performancevariableswas foundto be a better overallpredictorof premorbidintelligence(Ritchie,Lam, & Rankin,1996)whencomparing nonneurologicallyimpaired chronic pain and brain injured patients’ scores on WAIS-R, WRAT-3,Reading subtest,the NAART,OPIE, and Barona formulae.The purposeof the currentstudyis to reanalyzethe efficacyof usinga reviseddecisionruleof the OPIE-Rwhen compared to the original OPIE formulae in chronic pain and brain injured patients; in addition,these measuresand predictionformulaewere analyzedin schizopbxenicpatients. The resultsrevealedthat the OPIE and OPIE-Rwere significantlydifferentonly among chronicpain patientsbut not amongbrain injuredor schizophrenicpatients.This suggests that the OPIE formula continuesto be a better indicator of premorbid intelligencefor nonneurologicallyimpaired chronic pain patients. The OPIE-R overestimatespremorbid intelligencewhen compared to the WAIS FSIQ scores in these patients; although not statisticallysignificant,a similar trend is also observedamong brain injured and schizophrenicpatients.Patternsare differentwhen comparingWRAT-3standardscoreswith other estimatesamong patients with schizophrenia.These differencesare inconsistentwith the patterns observedamong brain injured and chronicpain patients.Implicationsfrom these differencesare discussed,includingthe role of intensivepsychosocialand cognitiverehabilitationin the treatmentof these patientswith schizophrenia.