Sustained attention deficit in bipolar disorder

BackgroundRecovery in bipolar disorder is central to its definition but is rarely complete. Previous work has suggested that neuropsychological impairment persists during the euthymic state but has been confounded partly by mild affective symptoms in remitted patients.AimsTo characterise neuropsychological functioning in the euthymic phase of bipolar disorder with an emphasis on tasks of executive functioning.MethodThirty euthymic patients with bipolar disorder were compared with thirty healthy controls on neuropsychological tasks differentially sensitive to damage within prefrontal cortex.ResultsBipolar I patients were impaired on tasks of attentional set shifting, verbal memory and sustained attention. Only sustained attention deficit survived controlling for mild affective symptoms. This deficit was related to progression of illness, but was none the less present in a subgroup of patients near illness onset.ConclusionsSustained attention deficit may represent a neuropsychological vulnerability marker for bipolar disorder, providing a focus for further understanding of the phenotype and analysis of the neuronal networks involved.

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Neuropsychological Deficits in the Prodromal Phase and Course of an Early-Onset Schizophrenia

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000286 ◽

2014 ◽

Vol 42 (3) ◽

pp. 167-176 ◽

Cited By ~ 3

Author(s):

Vanessa Puetz ◽

Thomas Günther ◽

Berrak Kahraman-Lanzerath ◽

Beate Herpertz-Dahlmann ◽

Kerstin Konrad

Keyword(s):

Verbal Memory ◽

Early Onset ◽

Neuropsychological Functioning ◽

Neuropsychological Testing ◽

Clinical Situation ◽

Adolescent Male ◽

Antipsychotic Treatment ◽

Early Onset Schizophrenia ◽

Prodromal Phase ◽

Illness Onset

Objectives: Although clear advances have been achieved in the study of early-onset schizophrenia (EOS), little is known to date about premorbid and prodromal neuropsychological functioning in EOS. Method: Here, we report on a case of an adolescent male with EOS who underwent neuropsychological testing before and after illness onset. Results: Marked cognitive deficits in the domains of attention, set-shifting, and verbal memory were present both pre-onset and during the course of schizophrenia, though only deficits in verbal memory persisted after illness-onset and antipsychotic treatment. Conclusion: The findings of this case study suggest that impairments in the verbal memory domain are particularly prominent symptoms of cognitive impairment in prodromal EOS and persist in the course of the disorder, which further demonstrates the difficult clinical situation of adequate schooling opportunities for adolescent patients with EOS.

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Neuroprogression in children and adolescents with bipolar disorder

Neuroprogression in Psychiatry ◽

10.1093/med/9780198787143.003.0011 ◽

2019 ◽

pp. 175-190

Author(s):

Francisco Romo-Nava ◽

Jenni E. Farrow ◽

Luis Rodrigo Patino ◽

Fabiano G. Nery ◽

Caleb M. Adler ◽

...

Keyword(s):

Bipolar Disorder ◽

Children And Adolescents ◽

Clinical Staging ◽

Current Evidence ◽

Cross Sectional ◽

Illness Onset ◽

Affective Symptoms ◽

Pharmacological Studies ◽

Under Construction ◽

And Control

The concept of neuroprogression in children and adolescents with bipolar disorder is still under construction and remains controversial. It encompasses the notion of a temporal progression of illness with regard to its neurobiology, phenomenology, treatment response, and associated functional impairment. In this chapter, we review current evidence surrounding this concept. There is a definite clinical progression from an asymptomatic risk status, the appearance of the prodromal affective symptoms, and, finally, to the onset of illness. Some, but not all, neuroimaging, neuropsychological, and pharmacological studies support the notion of functional and structural brain differences between high-risk individuals and control subjects. Furthermore, current evidence of neuroprogression after illness onset is frail. Most relevant studies are cross-sectional, with few longitudinal exceptions. We will discuss neuroprogression, its use in the context of clinical staging, and other controversial areas regarding this concept in youth with bipolar disorder.

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Auditory Attentional Set-Shifting and Inhibition in Children Who Stutter

Journal of Speech Language and Hearing Research ◽

10.1044/2017_jslhr-s-16-0096 ◽

2017 ◽

Vol 60 (11) ◽

pp. 3159-3170 ◽

Cited By ~ 13

Author(s):

Kurt Eggers ◽

Eira Jansson-Verkasalo

Keyword(s):

Group Differences ◽

Set Shifting ◽

Attentional Set ◽

Parental Questionnaire ◽

Attentional Set Shifting ◽

Neuropsychological Tasks ◽

And Gender ◽

Accuracy Rates ◽

Error Percentage ◽

Set Shifting Task

Purpose The purpose of this study was to investigate whether previously reported parental questionnaire-based differences in attentional shifting and inhibitory control (AS and IC; Eggers, De Nil, & Van den Bergh, 2010) would be supported by direct measurement of AS and IC using a computer task. Method Participants were 16 Finnish children who stutter (CWS; mean age = 7.06 years) and 16 Finnish children who do not stutter (mean age = 7.05 years). Participants were matched on age (±8 months) and gender. AS and IC were assessed by the auditory set-shifting task of the Amsterdam Neuropsychological Tasks (De Sonneville, 2009). Results No group differences were found for the speed of auditory AS or IC. However, CWS, as a group, scored significantly lower on the accuracy (error percentage) of auditory AS. In addition, CWS, compared with the children who do not stutter, showed a higher increase in error percentages under AS and IC conditions. Conclusions The findings on error percentages partly corroborate earlier questionnaire-based findings showing difficulties in CWS on AS and IC. Moreover, it also seems to imply that CWS are less able to slow down their responses to achieve higher accuracy rates.

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Longitudinal Study of Sustained Attention in Outpatients with Bipolar Disorder

Journal of the International Neuropsychological Society ◽

10.1017/s1355617713001422 ◽

2014 ◽

Vol 20 (2) ◽

pp. 230-237 ◽

Cited By ~ 6

Author(s):

Alexandrea L. Harmell ◽

Brent T. Mausbach ◽

Raeanne C. Moore ◽

Colin A. Depp ◽

Dilip V. Jeste ◽

...

Keyword(s):

Bipolar Disorder ◽

Depressive Symptoms ◽

Sustained Attention ◽

Rating Scales ◽

Performance Test ◽

Psychosocial Interventions ◽

Near Miss ◽

False Alarms ◽

Attentional Capacity ◽

Affective Symptoms

AbstractIndividuals with bipolar disorder (BD) may exhibit attentional deficits, however, the extent of impairment and long-term fluctuations in performance in attention are relatively unknown. We investigated the relationship between sustained attention and affective symptoms over time among BD patients. We also examined whether global differences in attentional capacity differed among BDversusnormal comparison (NC) subjects. Participants included 106 outpatients with BD and 66 NC subjects who were administered symptom rating scales and a measure of sustained attention (Continuous Performance Test- Identical Pairs). Measures were repeated 6, 12, and 26 weeks post-baseline. Compared to NC subjects, participants with BD showed impairment in sustained attention across time. Within patient increases in manic symptoms were associated with increased false alarms; both manic and depressive symptoms were associated with worse discrimination. Neither manic nor depressive symptoms were related to hit rates. Our results indicate that the ability to inhibit a response to near miss stimuli (i.e., those that are close to but not identical to the target) is globally impaired among BD patients relative to NC subjects, as well as state-dependent, covarying with affective symptoms. Psychosocial interventions requiring high levels of attentional capacity may need to be adapted according to patients’ current symptomatology. (JINS, 2014,20, 1–8)

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Exploring the link between character, personality disorder, and neuropsychological function

European Psychiatry ◽

10.1016/j.eurpsy.2003.03.008 ◽

2003 ◽

Vol 18 (7) ◽

pp. 334-344 ◽

Cited By ~ 25

Author(s):

Å.H Bergvall ◽

T Nilsson ◽

S Hansen

Keyword(s):

Working Memory ◽

Personality Disorder ◽

Visual Working Memory ◽

Spatial Working Memory ◽

Neuropsychological Functioning ◽

Neuropsychological Test ◽

Set Shifting ◽

Attentional Set ◽

Attentional Set Shifting ◽

Personality Disordered

AbstractPersonality deviations and deficits in cognitive executive function are common among forensic populations. The present study on incarcerated offenders explored whether there are links between the two domains. Personality was assessed using the Temperament and Character Inventory (TCI). Neuropsychological performance, including visual working memory, attentional set-shifting and planning, were tested with the Cambridge Neuropsychological Test Automated Battery (CANTAB). Subjects with personality disorders scored high on harm avoidance, and low on self-directedness and cooperativeness. Personality disordered offenders did not differ from the comparison groups (offenders without personality disorder, and non-criminal controls) with regard to CANTAB measures of visual working memory (delayed matching to sample, spatial working memory) and planning (Stockings of Cambridge), but they made a larger number of errors on the attentional set-shifting task. Dimensional analysis of the personality and neuropsychological variables revealed significant associations between self-directedness and cooperativeness on the one hand, and attentional set-shifting on the other. Intellectually disabled, non-criminal individuals (marginal mental retardation) who performed poorly on attentional set-shifting also scored low on self-directedness and cooperativeness. The results indicate that poor development of certain personality traits may be associated with deficits in neuropsychological functioning.

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Effects of methylphenidate on attentional set-shifting in a genetic model of attention-deficit/hyperactivity disorder

Behavioral and Brain Functions ◽

10.1186/1744-9081-8-10 ◽

2012 ◽

Vol 8 (1) ◽

pp. 10 ◽

Cited By ~ 29

Author(s):

Ai-hua Cao ◽

Lin Yu ◽

Yu-wei Wang ◽

Jun-mei Wang ◽

Le-jin Yang ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Genetic Model ◽

Set Shifting ◽

Attentional Set ◽

Hyperactivity Disorder ◽

Attentional Set Shifting

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Sustained attention deficit in bipolar disorder is not a working memory impairment in disguise

Neuropsychologia ◽

10.1016/s0028-3932(02)00019-2 ◽

2002 ◽

Vol 40 (9) ◽

pp. 1586-1590 ◽

Cited By ~ 77

Author(s):

Catherine J Harmer ◽

Luke Clark ◽

Louise Grayson ◽

Guy M Goodwin

Keyword(s):

Bipolar Disorder ◽

Working Memory ◽

Sustained Attention ◽

Attention Deficit ◽

Memory Impairment

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A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models

Psychological Medicine ◽

10.1017/s0033291713002547 ◽

2013 ◽

Vol 44 (9) ◽

pp. 1989-2001 ◽

Cited By ~ 94

Author(s):

D. R. Coghill ◽

S. Seth ◽

K. Matthews

Keyword(s):

Decision Making ◽

Attention Deficit Hyperactivity Disorder ◽

Working Memory ◽

Attention Deficit ◽

Neuropsychological Functioning ◽

Response Variability ◽

Delay Aversion ◽

Hyperactivity Disorder ◽

Neuropsychological Tasks ◽

Almost All

BackgroundAlthough attention deficit hyperactivity disorder (ADHD) has been associated with a broad range of deficits across various neuropsychological domains, most studies have assessed only a narrow range of neuropsychological functions. Direct cross-domain comparisons are rare, with almost all studies restricted to less than four domains. Therefore, the relationships between these various domains remain undefined. In addition, almost all studies included previously medicated participants, limiting the conclusions that can be drawn. We present the first study to compare a large cohort of medication-naive boys with ADHD with healthy controls on a broad battery of neuropsychological tasks, assessing six key domains of neuropsychological functioning.MethodThe neuropsychological functioning of 83 medication-naive boys with well-characterized ADHD (mean age 8.9 years) was compared with that of 66 typically developing (TYP) boys (mean age 9.0 years) on a broad battery of validated neuropsychological tasks.ResultsData reduction using complementary factor analysis (CFA) confirmed six distinct neuropsychological domains: working memory, inhibition, delay aversion, decision making, timing and response variability. Boys with ADHD performed less well across all six domains although, for each domain, only a minority of boys with ADHD had a deficit [effect size (% with deficit) ADHD versus TYP: working memory 0.95 (30.1), inhibition 0.61 (22.9), delay aversion 0.82 (36.1), decision making 0.55 (20.5), timing 0.71 (31.3), response variability 0.37 (18.1)].ConclusionsThe clinical syndrome of ADHD is neuropsychologically heterogeneous. These data highlight the complexity of the relationships between the different neuropsychological profiles associated with ADHD and the clinical symptoms and functional impairment.

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