Impact of treatment on the core deficit pathology

1996 ◽  
Vol 11 ◽  
pp. 251s
Author(s):  
William T. Carpenter
Keyword(s):  
The Core ◽  
Core Deficit

Comorbidity: Cognition and biology count!

2010 ◽  
Vol 33 (2-3) ◽  
pp. 168-170 ◽  
Author(s):  
Orly Rubinsten ◽  
Avishai Henik
Keyword(s):  
Behavioral Disorders ◽  
The Core ◽  
Brain Levels ◽  
Core Deficit

AbstractWe agree with Cramer et al. that pure cases of behavioral disorders with no symptom overlaps are rare. However, we argue that disorders do exist and the network idea is limited and limiting. Networks of symptoms are observed mainly at behavioral levels. The core deficit is commonly at the cognitive or brain levels, and there the story is completely different.

Developmental Dyscalculia in Adults: Beyond Numerical Magnitude Impairment

2017 ◽  
Vol 51 (6) ◽  
pp. 600-611 ◽  
Author(s):  
Alice De Visscher ◽  
Marie-Pascale Noël ◽  
Mauro Pesenti ◽  
Valérie Dormal
Keyword(s):  
Mental Representation ◽  
Healthy Adults ◽  
Numerical Magnitude ◽  
Developmental Dyscalculia ◽  
Common System ◽  
The Core ◽  
Magnitude Processing ◽  
Core Deficit ◽  
Face Categorization ◽  
Numerical Magnitudes

Numerous studies have tried to identify the core deficit of developmental dyscalculia (DD), mainly by assessing a possible deficit of the mental representation of numerical magnitude. Research in healthy adults has shown that numerosity, duration, and space share a partly common system of magnitude processing and representation. However, in DD, numerosity processing has until now received much more attention than the processing of other non-numerical magnitudes. To assess whether or not the processing of non-numerical magnitudes is impaired in DD, the performance of 15 adults with DD and 15 control participants was compared in four categorization tasks using numerosities, lengths, durations, and faces (as non-magnitude-based control stimuli). Results showed that adults with DD were impaired in processing numerosity and duration, while their performance in length and face categorization did not differ from controls’ performance. Our findings support the idea of a nonsymbolic magnitude deficit in DD, affecting numerosity and duration processing but not length processing.

scholarly journals The Pathogenesis and Treatment of Emotion Dysregulation in Borderline Personality Disorder

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Andreas Laddis
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Efficacy Study ◽  
Emotional Lability ◽  
Imaging Findings ◽  
The Core ◽  
Core Deficit ◽  
Key Factor

Uncontrollable emotional lability and impulsivity are a paramount phenomenon of Borderline Personality Disorder (BPD). This paper aims to review theories that entertain emotion dysregulation as the core deficit of BPD and a key factor in the etiology of BPD, in order, then, to propose the author’s own theory, which arguably transcends certain limitations of the earlier ones. The author asserts that his psychodynamic theory explains the symptoms of BPD more thoroughly and it inspires a more parsimonious interpretation of brain imaging findings. In closing, the author draws implications of the proposed theory for clinical practice. He reports an efficacy study for treatment of emotion dysregulation based on that theory.

scholarly journals Beyond the Core-Deficit Hypothesis in Developmental Disorders

2020 ◽  
Vol 29 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Duncan E. Astle ◽  
Sue Fletcher-Watson
Keyword(s):  
Developmental Disorders ◽  
Developmental Psychology ◽  
Learning Difficulties ◽  
Diagnostic Category ◽  
Case Control ◽  
Deficit Thinking ◽  
The Core ◽  
Core Deficit ◽  
And Behavior ◽  
Control Designs

Developmental disorders and childhood learning difficulties encompass complex constellations of relative strengths and weaknesses across multiple aspects of learning, cognition, and behavior. Historically, debate in developmental psychology has been focused largely on the existence and nature of core deficits—the shared mechanistic origin from which all observed profiles within a diagnostic category emerge. The pitfalls of this theoretical approach have been articulated multiple times, but reductionist, core-deficit accounts remain remarkably prevalent. They persist because developmental science still follows the methodological template that accompanies core-deficit theories—highly selective samples, case-control designs, and voxel-wise neuroimaging methods. Fully moving beyond “core-deficit” thinking will require more than identifying its theoretical flaws. It will require a wholesale rethink about the way we design, collect, and analyze developmental data.

scholarly journals The Core Deficit of “Classical” Schizophrenia Cuts Across the Psychosis Spectrum

2020 ◽  
Vol 65 (4) ◽  
pp. 231-234 ◽  
Author(s):  
Matcheri S. Keshavan ◽  
Sinead Kelly ◽  
Mei-Hua Hall
Keyword(s):  
The Core ◽  
Core Deficit

scholarly journals Quantfying the disorganization and the core deficit in classical schizophrenia

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S283-S283
Author(s):  
Mohan Rathnaiah ◽  
Elizabeth B Liddle ◽  
Lauren Gascoyne ◽  
Jyothika Kumar ◽  
Mohammad Zia Ul-Haq Katshu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Patient Group ◽  
Schizoaffective Disorder ◽  
Latent Variable ◽  
Rating Scales ◽  
Healthy Controls ◽  
Single Factor ◽  
Role Function ◽  
The Core ◽  
Core Deficit

AimsTo derive scores for mental disorganization and impoverishment from commonly used rating scales, and test the hypothesis that disorganization and impoverishment, along with impaired cognition and role-function reflect a latent variable that is a plausible candidate for the putative core deficit.BackgroundFor more than 100 years, disorganization and impoverishment of mental activity have been recognised as fundamental symptoms of schizophrenia. These symptoms may reflect a core brain process underlying persisting disability. Delusions and hallucinations have been regarded as accessory features. The psychopathological processes predisposing to persisting disability in schizophrenia are poorly understood. The delineation of a core deficit underlying persisting disability would be potentially of great value in predicting outcome and developing improved treatment.MethodPatients aged 18–55 years were included if: they satisfied DSM IV criteria for schizophrenia or schizoaffective disorder. Healthy controls were recruited by public advertisement and selected to match the patient group in age and sex. Study sample included 39 participants with schizophrenia, 1 with schizoaffective disorder and 44 matched healthy controls. We derived disorganization and impoverishment scores from three symptom scales: PANSS, SSPI and CASH. We computed composite scores for disorganization and for impoverishment and employed Confirmatory Factor Analysis to test the hypothesis that a single factor accounts for the relationships between disorganization, impoverishment, cognitive impairment and impaired role function. We assessed the relationship between this latent “core deficit” and diminished Post Movement Beta Rebound (PMBR), an electrophysiological measure from Magnetoencephalography (MEG), associated with persisting brain disorders.ResultFit indices for the single factor model from CFA indicated a good fit: χ2(2) = 1.817, p = .403; RMSEA <.001 GFI = .979. PMBR was significantly reduced in the schizophrenia group compared to healthy controls, t (68) = 3.55, p < .001. Within the patient group, PMBR was significantly and negatively correlated with the CFA factor scores representing the Core Deficit score, r=−.543, p < .01, indicating that high core deficit scores were associated with reduced PMBR. PMBR was significantly correlated with the composite Disorganization score, r=−.521, p < .001.ConclusionOur findings demonstrate that the shared variance between impoverishment (psychomotor poverty); disorganization; cognitive impairment; and impaired role function can be accounted for by a latent variable that can reasonably be described as the core deficit of classical schizophrenia. The demonstration that the severity of the putative core deficit is correlated with the reduction in PMBR provides evidence that the core deficit is associated with an identifiable abnormality of brain dysfunction.

scholarly journals Progressive Decline of Semantic Memory with Preservation of Number Processing and Calculation

1993 ◽  
Vol 6 (4) ◽  
pp. 239-242 ◽  
Author(s):  
H. F. A. Diesfeldt
Keyword(s):  
Formal Education ◽  
Word Comprehension ◽  
Progressive Decline ◽  
Multiplication Tables ◽  
The Core ◽  
Arithmetic Fact ◽  
Core Deficit ◽  
Calculation System ◽  
Selective Preservation ◽  
Fact Retrieval

A 75-year-old man with seven years of formal education displayed a syndrome of progressive and severe lexical impairments to word comprehension and production (semantic dementia). While he lost the ability to recognize written arithmetical signs, he could still retrieve the arithmetical facts for addition and subtraction of all number combinations of 1 to 9 and 11 to 19, though his mastery of multiplication tables (2 to 9) was unreliable. Calculation procedures were intact. Over the course of 18 months the components of the calculation system dissolved selectively: arithmetical procedures and number reading were spared, despite increasing damage to the arithmetic fact store. He retained the ability to read the time on analogue clocks. Selective preservation of components of the calculation system in the context of severe language deficits and dementia, supports the independent status of numerical abilities. The dissociation between intact arithmetical procedures and impaired table fact retrieval was paralleled by a dissociation between preserved procedures of phonology and syntax of language and impaired retrieval of content words, suggesting that the core deficit was a degradation of the central semantic store of learned knowledge of both words and arithmetic table facts.

scholarly journals Quantifying the Core Deficit in Classical Schizophrenia

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mohanbabu Rathnaiah ◽  
Elizabeth B Liddle ◽  
Lauren Gascoyne ◽  
Jyothika Kumar ◽  
Mohammad Zia Ul Haq Katshu ◽  
...  
Keyword(s):  
Latent Variable ◽  
Factor Model ◽  
Mental Activity ◽  
Brain Disorders ◽  
Role Function ◽  
The Core ◽  
Core Deficit ◽  
Confirmatory Factor ◽  
Predicting Outcome ◽  
Impaired Cognition

Abstract In the classical descriptions of schizophrenia, Kraepelin and Bleuler recognized disorganization and impoverishment of mental activity as fundamental symptoms. Their classical descriptions also included a tendency to persisting disability. The psychopathological processes underlying persisting disability in schizophrenia remain poorly understood. The delineation of a core deficit underlying persisting disability would be of value in predicting outcome and enhancing treatment. We tested the hypothesis that mental disorganization and impoverishment are associated with persisting impairments of cognition and role function, and together reflect a latent core deficit that is discernible in cases diagnosed by modern criteria. We used Confirmatory Factor Analysis to determine whether measures of disorganization, mental impoverishment, impaired cognition, and role functioning in 40 patients with schizophrenia represent a single latent variable. Disorganization scores were computed from the variance shared between disorganization measures from 3 commonly used symptom scales. Mental impoverishment scores were computed similarly. A single factor model exhibited a good fit, supporting the hypothesis that these measures reflect a core deficit. Persisting brain disorders are associated with a reduction in post-movement beta rebound (PMBR), the characteristic increase in electrophysiological beta amplitude that follows a motor response. Patients had significantly reduced PMBR compared with healthy controls. PMBR was negatively correlated with core deficit score. While the symptoms constituting impoverished and disorganized mental activity are dissociable in schizophrenia, nonetheless, the variance that these 2 symptom domains share with impaired cognition and role function, appears to reflect a pathophysiological process that might be described as the core deficit of classical schizophrenia.

scholarly journals The Core Deficit of Classical Schizophrenia: Implications for Predicting the Functional Outcome of Psychotic Illness and Developing Effective Treatments

2019 ◽  
pp. 070674371987051 ◽  
Author(s):  
Peter F. Liddle
Keyword(s):  
At Risk ◽  
Brain Plasticity ◽  
Early Stage ◽  
Adult Life ◽  
Pathological Process ◽  
Long Term Outcome ◽  
The Core ◽  
Core Deficit ◽  
The Brain ◽  
Effective Treatments

Many people suffering from psychotic illnesses experience persisting impairment of occupational and social function. Evidence assembled since the classical description of schizophrenia over a century ago indicates that both disorganization and impoverishment of mental activity are associated with persisting impairment. Longitudinal studies of young people at risk of schizophrenia reveal that both mental impoverishment and disorganization predict poor long-term outcome. These clinical features are related to cognitive impairments. Evidence from brain imaging indicates overlap in the brain abnormalities implicated in these phenomena, including impaired function of long-range connections between sensory cortex and the salience network, a network engaged in recruiting cerebral systems for processing of information salient to current circumstances. The evidence suggests that the common features underlying these two groups of symptoms might reflect a core pathological process distinguishing nonaffective from affective psychosis. This pathological process might therefore justifiably be designated the “core deficit” of classical schizophrenia. To develop more effective treatments to prevent persisting disability, we require the ability to identify individuals at risk at an early stage. Recent studies provide pointers toward effective strategies for identifying cases at risk of poor outcome. Accumulating evidence confirms that appreciable potential for neuroplastic change in the brain persists into adult life. Furthermore, brain function can be enhanced by targeted neuromodulation treatments. We now have promising tools not only for investigating the psychological and neural mechanisms that underlie persisting functional impairment but also for identifying individuals at risk and for harnessing brain plasticity to improve treatment.

scholarly journals T90. QUANTIFYING THE CORE DEFICIT IN CLASSICAL SCHIZOPHRENIA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S265-S266 ◽  
Author(s):  
Mohanbabu Rathnaiah ◽  
Elizabeth Liddle ◽  
Lauren Gascoyne ◽  
Jyothika Kumar ◽  
Mohammad Katshu ◽  
...  
Keyword(s):  
Latent Variables ◽  
Latent Variable ◽  
Rating Scales ◽  
Mental Activity ◽  
Digit Symbol Substitution Test ◽  
Role Function ◽  
The Core ◽  
Plausible Candidate ◽  
Core Deficit ◽  
Impaired Cognition

Abstract Background For more than 100 years, disorganization and impoverishment of mental activity have been recognised as fundamental symptoms of schizophrenia. These symptoms may reflect a core brain process underlying persisting disability. Predisposition to persisting disability is a clinically important aspect of schizophrenia, yet the psychopathological processes predisposing to persisting disability are poorly understood. The delineation of a putative core deficit associated with persisting disability would be of potentially great value in delineating the underlying pathological processes and eventually in enhancing treatment. Aims To derive scores for mental disorganization and impoverishment from commonly used rating scales, and test the hypothesis that disorganization and impoverishment, along with impaired cognition and role-function reflect a latent variable that is a plausible candidate for the putative core deficit. Methods In a group of 40 patients with schizophrenia, we tested the hypothesis that mental disorganization and impoverishment, along with impaired cognition and role-function reflect a latent variable that is a plausible candidate for the core deficit. We derived disorganization and impoverishment factors from three symptom scales: PANSS, SSPI and CASH. For each of the three scales, we demonstrated significant correlation between these factors and impaired role function assessed using the Social and Occupational Functioning Scale (SOFAS) and cognitive impairment measured using the Digit Symbol Substitution Test (DSST). We then assessed the relationship between this latent “core deficit” variable and Post Movement Beta Rebound (PMBR), measured using magnetoencephalography and associated with persisting brain disorders. Results A single factor model provided excellent fit for the four features of core deficit, requiring no further modifications. Results were consistently similar for measures from all three scales. χ2 value was non-significant (range: 0.30 to 2.13, df = 2, p &gt; 0.35), GFI met the threshold of greater than 0.9 (range = .976 to .996) and RMSEA was lesser than 0.06 (range = 0.000 to 0.040). PMBR was found to be significantly reduced in the schizophrenia group compared to healthy controls (t (28) =44.2 ± 12.1, p = 0.001). PMBR was strongly correlated with disorganization (r (40) = .600, p=0.001). In the hierarchical regression, neither age nor medication dose were significant predictors, but PMBR did predict the severity of the core deficit (F (1, 23) = 12.6, P=0.002, R² = -.592). Discussion Scores for the two latent variables representing impoverishment and disorganization of mental activity in schizophrenia can be derived from each of three symptom rating scales. A composite measure of impoverishment, disorganization, impaired cognition and impaired role function reflects an underlying psychopathological process that might be described as the core deficit of classical schizophrenia.

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