The magnitude of neurocognitive impairment is overestimated in depression: the role of motivation, debilitating momentary influences, and the overreliance on mean differences

2022 ◽  
pp. 1-11
Author(s):  
Steffen Moritz ◽  
Jingyuan Xie ◽  
Danielle Penney ◽  
Lisa Bihl ◽  
Niklas Hlubek ◽  
...  
Keyword(s):  
Effect Size ◽  
Neurocognitive Impairment ◽  
Self Report ◽  
Medium Effect ◽  
Group Differences ◽  
Neurocognitive Deficits ◽  
Performance Deficits ◽  
Impact Performance ◽  
The Impact ◽  
Performance Scale

Abstract Background Meta-analyses agree that depression is characterized by neurocognitive dysfunctions relative to nonclinical controls. These deficits allegedly stem from impairments in functionally corresponding brain areas. Increasingly, studies suggest that some performance deficits are in part caused by negative task-taking attitudes such as poor motivation or the presence of distracting symptoms. A pilot study confirmed that these factors mediate neurocognitive deficits in depression. The validity of these results is however questionable given they were based solely on self-report measures. The present study addresses this caveat by having examiners assess influences during a neurocognitive examination, which were concurrently tested for their predictive value on performance. Methods Thirty-three patients with depression and 36 healthy controls were assessed on a battery of neurocognitive tests. The examiner completed the Impact on Performance Scale, a questionnaire evaluating mediating influences that may impact performance. Results On average, patients performed worse than controls at a large effect size. When the total score of the Impact on Performance Scale was accounted for by mediation analysis and analyses of covariance, group differences were reduced to a medium effect size. A total of 30% of patients showed impairments of at least one standard deviation below the mean. Conclusions This study confirms that neurocognitive impairment in depression is likely overestimated; future studies should consider fair test-taking conditions. We advise researchers to report percentages of patients showing performance deficits rather than relying solely on overall group differences. This prevents fostering the impression that the majority of patients exert deficits, when in fact deficits are only true for a subgroup.

The Stereotype Threat Effect

2018 ◽  
Vol 29 (4) ◽  
pp. 249-258 ◽  
Author(s):  
Steffen Moritz ◽  
Insa Happach ◽  
Karla Spirandelli ◽  
Tania M. Lincoln ◽  
Fabrice Berna
Keyword(s):  
Stereotype Threat ◽  
Self Report ◽  
Neuropsychological Performance ◽  
Neurocognitive Deficits ◽  
Online Study ◽  
Memory And Attention ◽  
Threat Effect ◽  
Efficacy Expectations ◽  
Study Participants ◽  
The Impact

Abstract. Neurocognitive deficits in patients with mental disorders are partially due to secondary influences. “Stereotype threat” denotes the phenomenon that performance is compromised when a participant is confronted with a devaluing stereotype. The present study examined the impact of stereotype threat on neuropsychological performance in schizophrenia. Seventy-seven participants with a self-reported diagnosis of schizophrenia were randomly assigned to either an experimental condition involving stereotype threat activation or a control condition in an online study. Participants completed memory and attention tests as well as questionnaires on motivation, self-efficacy expectations, cognitive complaints, and self-stigmatization. Contrary to our prediction, the two groups showed no significant differences regarding neuropsychological performance and self-report measures. Limitations, such as a possibly too weak threat cue, are discussed and recommendations for future studies are outlined.

scholarly journals A-146 A Comparison of Neuropsychological Assessment Results and Self-Reported Cognitive Deficits in Traumatic Brain Injury Patients with Variable Neurocognitive Impairment Severity

2020 ◽  
Vol 35 (6) ◽  
pp. 940-940
Author(s):  
Coddaire K ◽  
Peyton L ◽  
Powell J ◽  
Virden T
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functioning ◽  
Neuropsychological Assessment ◽  
Cognitive Deficits ◽  
Neurocognitive Impairment ◽  
Self Report ◽  
Neurocognitive Deficits ◽  
Cognitive Domains ◽  
The Relationship

Abstract Objective This study aimed to determine the relationship between symptom self-report accuracy and objective cognitive functioning in multiple cognitive domains for varying neurocognitive impairment (NCI) subsequent to Traumatic Brain Injury (TBI). Specifically, the discrepancy between self-report and objective findings among participants with mild, moderate, and severe NCI was examined within the cognitive domains of Attention, Executive Functioning, Learning/Memory, and Speech/Language. Method The sample included archival data consisting of neuropsychological scores and self-reported Ruff Neurobehavioral Inventory (RNBI) results of 135 adult TBI patients with mild, moderate, or severe NCI who received neuropsychological assessment at a private practice. Patients were grouped based on level of impairment using Halstead Impairment Index criteria. Results No main effect was found for Attention. Patients with severe NCI had greater discrepancies in Executive Functioning (p = 0.015), Learning/Memory (p = 0.015), and Speech/Language (p < 0.001) function, when compared to those with mild NCI. Additionally, patients with severe NCI demonstrated greater discrepancies in Speech/Language (p < 0.001) function when compared to those with moderate NCI. Conclusion These findings indicate as severity of neurocognitive impairment increases for TBI patients, self-reported cognitive symptomatology—specifically executive functioning, learning/memory, and speech/language—will become less accurate. Clinically, these findings suggest that when working with patients who have severe neurocognitive deficits subsequent to TBI, it is important to consider objective testing as self-reporting may not be accurate. Understanding patient’s genuine deficits will foster patient awareness and acceptance of TBI-related cognitive deficits with increased investment in treatment and improved neurorehabilitation outcomes.

A-53 The Relationship between Age and TMT-A Performance in Patients with Heart Failure

2021 ◽  
Vol 36 (6) ◽  
pp. 1095-1095
Author(s):  
Nicholas S Lackey ◽  
Natasha Nemanim ◽  
Alexander O Hauson ◽  
Eric J Connors ◽  
Anna Pollard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Effect Size ◽  
Significant Proportion ◽  
Effect Sizes ◽  
Medium Effect ◽  
Future Research ◽  
Medium Effect Size ◽  
Meta Regression ◽  
The Impact ◽  
The Relationship

Abstract Objective A previous meta-analysis utilized the Trail Making Test A (TMT-A) to measure the impact of heart failure (HF) on attention. A near medium effect size with moderate heterogeneity was observed, the HF group performed worse than healthy controls (HC). This study explores if the age of the HF group moderates differences in the performance of individuals with HF versus HC on TMT-A. Data Selection Two researchers searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with HF (New York Heart Association severity II or higher), (b) comparison to a HC group, (c) standardized neuropsychological/cognitive testing, and (d) adequate data to calculate effect sizes. Exclusion criteria were: (a) participants had other types of major organ failure, (b) the article was not in English, or (c) there was a risk of sample overlap with another included study. A total of six articles were included in this sub-study (Total HF n = 602 and HC n = 342). The unrestricted maximum likelihood computational model was used for the meta-regression. Data Synthesis Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 6, g = 0.636, p < 0.001, I2 = 56.85%). The meta-regression was statistically significant (slope = −0.0515, p = 0.0016, Qmodel = 9.86, df = 1, p = 0.0016). Conclusions Individuals with HF performed worse on the TMT-A than HC. Age accounted for a significant proportion of the observed heterogeneity in the meta-regression. Future research should examine the relationship of age on cognition in individuals with HF.

scholarly journals Do animated triangles reveal a marked difficulty among autistic people with reading minds?

Autism ◽  
2021 ◽  
pp. 136236132198915
Author(s):  
Alexander C Wilson
Keyword(s):  
Effect Size ◽  
Meta Analysis ◽  
General Information ◽  
Medium Effect ◽  
Group Differences ◽  
Social Challenges ◽  
Autistic People ◽  
The Social ◽  
Small Effect Size ◽  
The Difference

This meta-analysis tested whether autistic people show a marked, isolated difficulty with mentalising when assessed using the Frith -Happé Animations, an advanced test of mentalising (or ‘theory of mind’). Effect sizes were aggregated in multivariate meta-analysis from 33 papers reporting data for over 3000 autistic and non-autistic people. Relative to non-autistic individuals, autistic people underperformed, with a small effect size on the non-mentalising control conditions and a medium effect size on the mentalising condition. This indicates that studies have reliably found mentalising to be an area of challenge for autistic people, although the group differences were not large. It remains to be seen how important mentalising difficulties are in accounting for the social difficulties diagnostic of autism. As autistic people underperformed on the control conditions as well as the mentalising condition, it is likely that group differences on the test are partly due to domain-general information processing differences. Finally, there was evidence of publication bias, suggesting that true effects on the Frith -Happé Animations may be somewhat smaller than reported in the literature. Lay abstract Autistic people are thought to have difficulty with mentalising (our drive to track and understand the minds of other people). Mentalising is often measured by the Frith -Happé Animations task, where individuals need to interpret the interactions of abstract shapes. This review article collated results from over 3000 people to assess how autistic people performed on the task. Analysis showed that autistic people tended to underperform compared to non-autistic people on the task, although the scale of the difference was moderate rather than large. Also, autistic people showed some difficulty with the non-mentalising as well as mentalising aspects of the task. These results raise questions about the scale and specificity of mentalising difficulties in autism. It also remains unclear how well mentalising difficulties account for the social challenges diagnostic of autism.

Improvement of the Upper Extremity at the Subacute Stage Poststroke: Does Hand Dominance Play a Role?

2020 ◽  
Vol 34 (11) ◽  
pp. 1030-1037
Author(s):  
Samar Hmaied Assadi ◽  
Revital Feige Gross-Nevo ◽  
Israel Dudkiewicz ◽  
Haim Barel ◽  
Debbie Rand
Keyword(s):  
Upper Extremity ◽  
Effect Size ◽  
Functional Ability ◽  
Group Differences ◽  
Hand Dominance ◽  
Subacute Stroke ◽  
Percent Improvement ◽  
Improvement Effect ◽  
T1 And T2 ◽  
The Impact

Background The impact of hand dominance on the expected (motor and functional ability and daily use) improvement of the affected upper extremity (UE) in subacute stroke has not yet been investigated. Objectives To compare between the affected dominant and affected nondominant UE (1) on rehabilitation admission (T1) for motor and sensory abilities, functional ability, and daily use and (2) 6 weeks poststroke onset (T2) and the UE recovery between T1 and T2 regarding percent change, improvement effect size, and percent of participants achieving minimal clinical important difference (MCID). Methods Multicenter longitudinal study. Results Thirty-eight participants with affected dominant and 51 participants with affected nondominant UE were recruited. On T1 and T2, between-group differences were not seen for all UE variables. Significant improvement in the motor and functional ability, daily use, and perceived recovery between T1 and T2 were seen for the affected dominant ( z = −3.01 to −4.13, P < .01) and nondominant UEs ( z = −4.59 to −5.32, P < .01). Effect size improvement values were moderate and large in the affected dominant and nondominant UE (respectively). In addition, 14% to 40% of the participants in both UEs achieved MCID. Conclusions Significant and similar clinical meaningfulness in UE improvement can be expected during subacute rehabilitation; however, improvement magnitude and percent improvement is different for the UE domains of the affected dominant and the affected nondominant UEs. These findings highlight the distinct roles of the dominant and nondominant hands during bimanual daily activities, which can guide clinicians during stroke rehabilitation.

The effectiveness of the loci method as a mnemonic device: Meta-analysis

2021 ◽  
pp. 174702182199345
Author(s):  
Conal Twomey ◽  
Meike Kroneisen
Keyword(s):  
Academic Success ◽  
Effect Size ◽  
Random Sequence ◽  
Meta Analysis ◽  
Allocation Concealment ◽  
Medium Effect ◽  
Mnemonic Device ◽  
Random Sequence Generation ◽  
Randomised Controlled ◽  
The Impact

The “loci method” is a popular mnemonic device that involves visualising and recalling items at specific points along a familiar route. The loci method has been used for thousands of years, and by many successful memory athletes; yet there have been relatively few educational and clinical applications, possibly owing to empirical uncertainty. The current meta-analysis of 13 randomised controlled trials (RCTs) mostly based in university settings demonstrated the effectiveness of the loci method as a mnemonic device, with a medium effect size ( g = 0.65, 95% confidence interval [CI] = [0.45, 0.85]; I2 = 45.5%). The effect size remained at similar levels in further analyses adjusting for publication bias, the impact of removing each study, setting, control conditions, outliers, and number of loci method sessions. High risk of experimental bias was indicated, however, as the vast majority of studies did not report procedures to minimise biases relating to random sequence generation and allocation concealment. Overall, this meta-analysis of predominantly university-based RCTs has provided good initial support for the loci method as a mnemonic device and this may encourage future investigations and applications, particularly in educational settings, where it has the potential to improve recall of information relevant to academic success.

scholarly journals The Impact of a Training Device on Perception and Performance by Novice Users of an Autoinjector

2019 ◽  
Vol 8 (1) ◽  
pp. 192-196
Author(s):  
Jenna Garafalo ◽  
Huiyang Li ◽  
Michael Lau
Keyword(s):  
Self Report ◽  
Subjective Data ◽  
Impact Performance ◽  
Training Materials ◽  
Novice Users ◽  
And Performance ◽  
Device Use ◽  
Instructions For Use ◽  
Study Participants ◽  
The Impact

The study was conducted to understand the effects of having access to different training materials in the interim between training and first use of an injection device for 27 injection-naïve participants. Participants were told they would be giving themselves a real injection of saline in the return session, and were not told that they would use injection pads until after subjective data was gathered during session 2. This deception paradigm was used to increase the external validity of the study. Participants self-trained in one of three conditions based on what they were given to take home: instructions for use, mechanical trainer, and/or a training video. Participants self-trained in session 1, performed a simulated injection in the session 2 two weeks later, and completed three online surveys in the interim. In session 2, a majority of participants were able to achieve minimally acceptable performance to deliver the medication during the simulated use of the autoinjector. Participants who took home a mechanical trainer had fewer use deviations than those who did not have the trainer at home. This difference was only seen in injection specific subtasks; performance on pre- and post-injection subtasks was low across all groups. Intermittent practice with a mechanical trainer was seen to improve performance on subtasks involved in the motor performance of the injection itself but did not impact performance or compliance with other tasks important to the injection. More holistic training solutions may be required to impact other aspects of the injection beyond the injection itself. While performance differed, subjective ratings did not differ, showing an overconfidence bias that may affect a user’s ability to self-report competence in device use.

scholarly journals Correlates and Predictors of PTSD Symptoms Among Healthcare Workers During the COVID-19 Pandemic: Results of the egePan-VOICE Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Susann Steudte-Schmiedgen ◽  
Lisa Stieler ◽  
Yesim Erim ◽  
Eva Morawa ◽  
Franziska Geiser ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Sleep Problems ◽  
Linear Regression Analysis ◽  
Self Report ◽  
Medium Effect ◽  
Generalized Anxiety ◽  
Ptsd Symptoms ◽  
Event Scale ◽  
The Impact ◽  
Ptsd Symptomatology

Background: The COVID-19 pandemic has led to ongoing challenges for healthcare systems across the world. Previous research has provided evidence for an increased prevalence of depression and anxiety as well as post-traumatic stress disorder (PTSD). In Germany, however, only scarce data on correlates and predictors for PTSD symptomatology in the context of the COVID-19 pandemic among healthcare workers (HCW) are available.Methods: This research is part of a large prospective web-based survey (egePan-VOICE study) among HCW in Germany. The current sample (N = 4,724) consisted of physicians (n = 1,575), nurses (n = 1,277), medical technical assistants (MTA, n = 1,662), and psychologists (n = 210). PTSD symptomatology was measured using the abbreviated version of the Impact of Event Scale (IES-6). In addition, sociodemographic, occupational, COVID-19-related, psychological (e.g., depressive symptoms and generalized anxiety), as well as work-related variables were assessed.Results: Our findings revealed significant higher PTSD symptoms with medium effect sizes among HCW reporting an increased self-report burden during the pandemic, increased fear of becoming infected or infecting relatives with the virus, sleep problems, feeling physically or mentally exhausted, as well as increased levels of depressiveness and generalized anxiety. According to multiple linear regression analysis, the most relevant predictors for higher IES-6 scores were increased level of generalized anxiety and depressiveness, increased fear of infecting relatives, as well as medical profession (MTA compared to physicians).Conclusion: Despite the cross-sectional design of our study, the here identified associations with PTSD symptomatology may provide a basis for future preventive interventions.

scholarly journals Vagally mediated heart rate variability in headache patients—a systematic review and meta-analysis

Cephalalgia ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 265-278 ◽  
Author(s):  
Julian Koenig ◽  
DeWayne P Williams ◽  
Andrew H Kemp ◽  
Julian F Thayer
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Effect Size ◽  
Meta Analysis ◽  
Medium Effect ◽  
Future Research ◽  
Vagal Activity ◽  
Headache Disorders ◽  
The Impact

Objective Vagal nerve activity—indexed by heart rate variability (HRV)—has been linked to altered pain processing and inflammation, both of which may underpin headache disorders and lead to cardiovascular disease (CVD). Here we examined the evidence for differences in parasympathetic (vagal) activity indexed by time- and frequency-domain measures of HRV in patients with headache disorders compared to healthy controls (HCs). Methods A systematic review and meta-analysis was conducted on studies investigating group differences in vagally mediated HRV (vmHRV) including time- (root-mean-square of successive R-R-interval differences (RMSSD)) and frequency- (high-frequency HRV) domain measures. Studies eligible for inclusion were identified by a systematic search of the literature, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seven studies reporting a total of 10 comparisons of patients with headache disorders (HF-HRV n = 67, RMSSD n = 122) and HCs (HF-HRV n = 64, RMSSD n = 125) were eligible for inclusion. Random-effects meta-analysis revealed a significant main effect on RMSSD ( Z = 2.03, p = 0.04; Hedges’ g = −0.63; 95% CI (−1.24, –0.02); k = 6) and similar pooled effect size estimates for HF-HRV when breathing was controlled ( g = −0.30; 95% CI (−0.69; 0.10)) but not when breathing was not controlled ( g = 0.02; 95% CI (−0.69; 0.74)). Controlling for breathing had no effect on RMSSD. Conclusion vmHRV is reduced in patients with headache disorders, findings associated with a medium effect size. Suggestions for future research in this area are provided, emphasizing a need to investigate the impact of headache disorders and commonly comorbid conditions—including mental disorders—as well as the investigation of the risk for CVD in migraine in particular. We further emphasize the need for large-scale studies to investigate HRV as a mechanism mediating the association of migraine and CVD.

Persistent effects of playing football and associated (subconcussive) head trauma on brain structure and function: a systematic review of the literature

2016 ◽  
Vol 51 (22) ◽  
pp. 1592-1604 ◽  
Author(s):  
A A Tarnutzer ◽  
D Straumann ◽  
P Brugger ◽  
N Feddermann-Demont
Keyword(s):  
Structure Function ◽  
Brain Structure ◽  
Head Injuries ◽  
Neurocognitive Impairment ◽  
Statistical Testing ◽  
Neurocognitive Deficits ◽  
Neurocognitive Testing ◽  
The Impact ◽  
Selection Of

Aim/objectiveThere is ongoing controversy about persistent neurological deficits in active and former football (soccer) players. We reviewed the literature for associations between football activities (including heading/head injuries) and decline in brain structure/function.DesignSystematic literature review.Data sourcesMEDLINE, Embase, PsycINFO, CINAHL, Cochrane-CRCT, SportDiscus, Cochrane-DSR=4 (accessed 2 August 2016).Eligibility criteria for selecting studiesOriginal studies reporting on football-related persistent effects on brain structure/function. Results from neurocognitive testing, neuroimaging and EEG were compared with controls and/or correlated with heading frequency and/or head injuries. Methodological quality was rated for risk-of-bias, including appropriateness of controls, correction for multiple statistical testing and assessment of heading frequency and head injuries.Results30 studies with 1691 players were included. Those 57% (8/14) of case–control studies reporting persistent neurocognitive impairment had higher odds for inappropriate control of type 1 errors (OR=17.35 (95% CI (10.61 to 28.36)) and for inappropriate selection of controls (OR=1.72 (1.22 to 2.43)) than studies observing no impairment. Studies reporting a correlation between heading frequency and neurocognitive deficits (6/17) had lower quality of heading assessment (OR=14.20 (9.01 to 22.39)) than studies reporting no such correlation. In 7 of 13 studies (54%), the number of head injuries correlated with the degree of neurocognitive impairment. Abnormalities on neuroimaging (6/8 studies) were associated with subclinical neurocognitive deficits in 3 of 4 studies.Summary/conclusionsVarious methodological shortcomings limit the evidence for persistent effects of football play on brain structure/function. Sources of bias include low-quality assessment of heading frequency, inappropriate control for type 1 errors and inappropriate selection of controls. Combining neuroimaging techniques with neurocognitive testing in prospective studies seems most promising to further clarify on the impact of football on the brain.

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