Cognitive processes underlying reading and naming deficits in dyslexic readers

In addition to phonological deficits, difficulties at the level of the visual recognition system (i. e. , the mechanisms that could affect the induction of orthographic representations or the connection of visual to lexical codes) constitute potential sources of the poor reading and visual naming that characterize dyslexia.

Children’s Friendships and Learning in School: Cognitive Enhancement Through Social Interaction?

Background. Recent literature has identified that children's performance on cognitive (or problem-solving) tasks can be enhanced when undertaken as a joint activity among pairs of pupils. Performance on this ‘social’ activity will require quality relationships between pupils, leading some researchers to argue that friendships are characterized by these quality relationships and, therefore, that friendship grouping should be used more frequently within classrooms. Aims. Children's friendship grouping may appear to be a reasonable basis for cognitive development in classrooms, although there is only inconsistent evidence to support this argument. The inconsistency may be explained by the various bases for friendship, and how friendship is affected by cultural contexts of gender and schooling. This study questions whether classroom-based friendship pairings will perform consistently better on a cognitive task than acquaintance pairings, taking into account gender, age, and ability level of children. The study also explores the nature of school-based friendship described by young children. Sample. 72 children were paired to undertake science reasoning tasks (SRTs). Pairings represented friendship (versus acquaintance), sex (male and female pairings), ability (teacher-assessed high, medium, and low), and age (children in Years 1, 3, and 5 in a primary school). Method. A small-scale quasi-experimental design was used to assess (friendship- or acquaintance-based) paired performance on SRTs. Friendship pairs were later interviewed about qualities and activities that characterized their friendships. Results. Girls' friendship pairings were found to perform at the highest SRT levels and boys' friendship pairing performed at the lowest levels. Both boy and girl acquaintance pairings performed at mid-SRT levels. These findings were consistent across Year (in school) levels and ability levels. Interviews revealed that male and female friendship pairs were likely to participate in different types of activity, with girls being school-inclusive and boys being school-exclusive. Conclusion. Recommendations to use friendship as a basis for classroom grouping for cognitive tasks may facilitate performance of some pairings, but may also inhibit the performance of others. This is shown very clearly with regard to gender. Some of the difference in cognitive task performance may be explained by distinct, cultural (and social capital) orientations to friendship activities, with girls integrating school and educational considerations into friendship, and boys excluding school and educational considerations.

Case-series Evaluating a Transdiagnostic Cognitive-behavioral Treatment For Co-occurring Anxiety Disorders.

Background. Patients with anxiety disorder diagnoses commonly have more than one anxiety diagnosis. While cognitive-behavioral interventions have proven efficacy in treating single anxiety disorder diagnoses, there has been little investigation of their efficacy in treating cooccurring anxiety disorders. Aims. To evaluate the efficacy of a transdiagnostic cognitive-behavioral intervention for treating co-occurring anxiety disorders. Methods. An A-B single case study design (N = 6) was used to evaluate the efficacy of a 12 to 13 session modular transdiagnostic cognitive-behavioral intervention for treating co-occurring anxiety disorders across patients with at least two of the following diagnoses: GAD, Social Phobia, Panic Disorder and/or OCD. Results. Five of the six participants completed treatment. At post-treatment assessment the five treatment completers achieved diagnostic and symptomatic change with three participants being diagnosis free. All participants who completed treatment no longer met criteria for any DSM-IV-TR Axis-I diagnosis at the three-month follow-up assessment, and demonstrated reliable and clinically-significant improvements in symptoms. Across the participants, statistically significant improvements from pre- to post-intervention were found on measures of anxiety, depression and general well-being, and all improvements were maintained at three-month follow-up. Conclusions. Results suggest that transdiagnostic cognitive behavioral interventions can be of benefit to patients with co-occurring anxiety disorders.

Reinforcement learning across development in humans

Tese de mestrado, Neurociências, Faculdade de Medicina, Universidade de Lisboa, 2015

Applying gaze-contingent training within community settings to infants from diverse SES backgrounds

Even in infancy children from low-SES backgrounds differ in frontal cortex functioning and, by the start of preschool, they frequently show poor performance on executive functions including attention control. These differences may causally mediate later difficulties in academic learning. Here, we present a study to assess the feasibility of using computerized paradigms to train attention control in infants, delivered weekly over five sessions in early intervention centres for low-SES families. Thirty-three 12-month-old infants were recruited, of whom 23 completed the training. Our results showed the feasibility of repeat-visit cognitive training within community settings. Training-related improvements were found, relative to active controls, on tasks assessing visual sustained attention, saccadic reaction time, and rule learning, whereas trend improvements were found on assessments of short-term memory. No significant improvements were found in task switching. These results warrant further investigation into the potential of this method for targeting ‘at-risk’ infants in community settings.

Non-Invasive Human Brain Stimulation in Cognitive Neuroscience: A Primer

The use of non-invasive brain stimulation is widespread in studies of human cognitive neuroscience. This has led to some genuine advances in understanding perception and cognition, and has raised some hopes of applying the knowledge in clinical contexts. There are now several forms of stimulation, the ability to combine these with other methods, and ethical questions that are special to brain stimulation. In this Primer, we aim to give the users of these methods a starting point and perspective from which to view the key questions and usefulness of the different forms of non-invasive brain stimulation. We have done so by taking a critical view of recent highlights in the literature, selected case studies to illustrate the elements necessary and sufficient for good experiments, and pointed to questions and findings that can only be addressed using interference methods

Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study

Psychosocial interventions have proven to be effective in treating social cognition in people with psychotic disorders. The current study aimed to determine the effects of a metacognitive and social cognition training (MSCT) program, designed to both remediate deficits and correct biases in social cognition. Thirty-five clinically stable outpatients were recruited and assigned to the MSCT program (n = 19) for 10 weeks (18 sessions) or to the TAU group (n = 16), and they all completed pre- and post-treatment assessments of social cognition, cognitive biases, functioning and symptoms. The MSCT group demonstrated a significant improvement in theory of mind, social perception, emotion recognition and social functioning. Additionally, the tendency to jump to conclusions was significantly reduced among the MSCT group after training. There were no differential benefits regarding clinical symptoms except for one trend group effect for general psychopathology. The results support the efficacy of the MSCT format, but further development of the training program is required to increase the benefits related to attributional style.

Sexual functioning in people with stable chronic diseases

Backgound - In developed countries people are living longer and the incidence of chronic disease is increasing. Chronic disease and its treatments can have a negative impact on sexual functioning and sexual satisfaction. Aim of study - To explore and to compare sexual function and sexual satisfaction in people with stable chronic diseases.

Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect-size analysis of controlled studies

Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect-size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory-of-mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30-.52). The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32-.40). The majority of trials were randomized (13/16), selected active control conditions (11/16) and included at least 30 participants (12/16). Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.

Validação e aplicação clínica de uma escala de cognição social na esquizofrenia = Validation and clinical use of a measure of social cognition in schizophrenia

RESUMO: A cognição social encontra-se frequentemente alterada na esquizofrenia. Esta alteração relaciona-se com a diminuição do funcionamento social,caracterizando-se quer por défices quer por vieses cognitivos sociais. No entanto, existem poucos instrumentos fiáveis e válidos para avaliar a cognição social na esquizofrenia, nomeadamente capazes de medir os vieses cognitivos sociais e a cognição social auto-relevante. Adicionalmente, as bases biológicas da disfunção social não estão totalmente esclarecidas. Evidências recentes sugerem que o peptídeo oxitocina (OXT) influencia o funcionamento social, e que esta relação poderá ser mediada pela cognição social. Este Trabalho de Projecto descreve a contribuição do autor para o desenvolvimento e avaliação psicométrica inicial de um novo instrumento de avaliação da cognição social, e a utilidade desta escala na investigação das associações entre a OXT e a capacidade e vieses cognitivos sociais. A Waiting Room Task (WRT), uma escala constituída por 26 vídeos sequenciais que simulam a experiência de observar outra pessoa numa sala de espera, foi administrada num estudo transversal com 61 doentes com esquizofrenia e 20 controlos saudáveis. Observou-se uma menor capacidade cognitiva social e um aumento dos vieses cognitivos sociais nos doentes com esquizofrenia, comparativamente aos controlos. Nos controlos e doentes com delírios, o desempenho na WRT correlacionou-se significativamente com os níveis de OXT. Esta correlação não se observou nos doentes sem delírios, sugerindo que o papel da OXT na cognição social poderá encontrar-se atenuado neste grupo. Estes achados fornecem suporte inicial para a adequação da WRT como instrumento de avaliação da cognição social na esquizofrenia, podendo ainda ser útil na investigação da sua base biológica. ------------ ABSTRACT: Social cognition is often impaired in schizophrenia. This impairment is related to poor social functioning and is characterized by both social cognitive deficits and biases. However, there are few reliable and valid measures of social cognition in schizophrenia, particularly measures of social cognitive bias and of self-relevant social cognition. Also, the biological bases of social dysfunction are not well understood. Emerging evidence suggests that the peptide oxytocin (OXT) influences social functioning, and that this relationship may be mediated by social cognition. This Research Project describes the author’s contribution to the development and initial psychometric testing of a new measure of social cognition, and the utility of this instrument to examine associations between OXT and social cognitive capacity and bias. The Waiting Room Task WRT), a video-based test comprising 26 sequential videos simulating the experience of facing another person in a waiting room, was administered in a cross-sectional study involving 61 patients with schizophrenia and 20 healthy controls. Social cognitive capacity was lower and social cognitive bias was increased in patients with schizophrenia compared with controls. Among controls and patients with delusions, performance on the WRT was significantly correlated with OXT level. This correlation was not found in patients without delusions suggesting that OXT’s role in social cognition may be blunted in this group. These findings provide initial support for the adequacy of the WRT as a measure for assessing social cognition in schizophrenia that may also be useful in understanding its biological underpinnings.

Serum anticholinergic activity and postoperative cognitive dysfunction in elderly patients

Background: Cerebral cholinergic transmission plays a key role in cognitive function and anticholinergic drugs are associated with impaired cognitive functions [1]. In the perioperative phase many substances with anticholinergic effects are administered and disturbed cholinergic transmission is a hypothetical cause of postoperative cognitive dysfunction (POCD). Serum anticholinergic activity (SAA; pmol/ml) may be measured as a summary marker of anticholinergic activity in an individual patient's blood. We hypothesised that an increase in SAA from preoperatively to one week postoperatively is associated with POCD in elderly patients. Methods: Thirty-two patients aged >65 yrs undergoing elective major surgery under standardized general anaesthesia (thiopental, sevoflurane, fentanyl) were investigated. Cognitive functions were measured preoperatively and 7 days postoperatively using the extended version of the Consortium to Establish a Registry for Alzheimer's Disease - Neuropsychological Assessment Battery. POCD was defined as a postoperative decline >1 z-score in at least 2 cognitive domains. SAA was measured preoperatively and 7 days postoperatively at the time of cognitive testing. Results: 50% of the investigated patients developed POCD. There were no statistically significant differences between patients with and without POCD regarding age, education, baseline cognitive function, duration of anaesthesia, SAA preoperatively (median (range) 1.0 (0.3 to 5.0) vs 1.5 (0.4 to 5.0), SAA 7 days postoperatively (median (range) 1.3 (0.1 to 7.0) vs 1.4 (0.6 to 5.5) or changes in SAA (median (range) 0.1 (-1.6 to 2.2) vs 0.2 (-1.4 to 2.8). The variability of SAA in individual patients was considerable and marked changes in SAA between the two examinations were observed in some patients. However, there was no significant relationship between changes in SAA and changes in cognitive function. Conclusion: In this preliminary analysis of a small group of patients, changes in SAA in the perioperative phase were highly variable. SAA was not associated with POCD suggesting that POCD is not simply caused by anticholinergic medications administered in the perioperative phase. A further analysis of a larger group of patients is in progress.

Long-term outcome after cognitive and behavioral regression in nonlesional epilepsy with continuous spike-waves during slow-wave sleep.

PURPOSE: To present the long-term follow-up of 10 adolescents and young adults with documented cognitive and behavioral regression as children due to nonlesional focal, mainly frontal, epilepsy with continuous spike-waves during slow wave sleep (CSWS). METHODS: Past medical and electroencephalography (EEG) data were reviewed and neuropsychological tests exploring main cognitive functions were administered. KEY FINDINGS: After a mean duration of follow-up of 15.6 years (range, 8-23 years), none of the 10 patients had recovered fully, but four regained borderline to normal intelligence and were almost independent. Patients with prolonged global intellectual regression had the worst outcome, whereas those with more specific and short-lived deficits recovered best. The marked behavioral disorders resolved in all but one patient. Executive functions were neither severely nor homogenously affected. Three patients with a frontal syndrome during the active phase (AP) disclosed only mild residual executive and social cognition deficits. The main cognitive gains occurred shortly after the AP, but qualitative improvements continued to occur. Long-term outcome correlated best with duration of CSWS. SIGNIFICANCE: Our findings emphasize that cognitive recovery after cessation of CSWS depends on the severity and duration of the initial regression. None of our patients had major executive and social cognition deficits with preserved intelligence, as reported in adults with early destructive lesions of the frontal lobes. Early recognition of epilepsy with CSWS and rapid introduction of effective therapy are crucial for a best possible outcome.