Search results

The purpose of this paper is to determine the nature of the academic skills deficits in male offenders and their relation to neurocognitive deficits.

In total, 72 Finnish male prisoners were tested with regard to reading, spelling, and mathematical abilities.

Low academic skills, especially reading, were related to poor neurocognitive performance in verbal memory, visual memory, attention, and motor dexterity. The results showed a high number (29-36 percent) of reading and spelling disorders. In all, 15 percent of those with medium to severe problems in academic skills had marked difficulties in mathematics. In total, 88 percent of the participants with at least one problem area in literacy skills had neurocognitive deficits. In the present study, the pervasive neurocognitive deficits, occurring comorbidly with reading and spelling difficulties, seem to refer to a fundamental set of deficits which are only minimally explained by IQ, educational background or training.

Reading and spelling difficulties could be seen as functional illiteracy which, combined with a broad spectrum of neuropsychological function deficits, pose a challenging task for rehabilitation. Only after proper identification of deficits has been achieved is it possible to set goals and select the appropriate means for rehabilitation. One obvious limitation is the moderate number of subjects (n=72).

It may not be enough just to train reading or develop literacy activities among prisoners; focussing intervention on comprehensive neurocognitive deficits is also necessary.

Correlates and comorbidity between academic difficulties and neurocognitive deficits among offenders, especially in arithmetic difficulties, have been less studied.

Cognitive dysfunctions are a common clinical feature of schizophrenia and represent important indicators of outcome among patients who are affected. Therefore, a randomized, controlled, monocentric, single-blind trial was carried out to compare two different rehabilitation strategies adopted for the restoration and recovery of cognitive functioning of residential patients with schizophrenia. A sample of 110 residential patients were selected and, during the experimental period, a group of 55 patients was treated with sets of domain-specific exercises (SRT+CRT), whereas an equal control group was treated with sets of non-domain-specific exercises (SRT+PBO) belonging to the Cogpack® software. The effects on the scores (between T0 and T1) of the variables treatment and time and of the interaction time X treatment were analyzed: for the total BACS, the main effect of the between-factors variable treatment is statistically significant (F=201.562 P=0.000), as well as the effect of the within-factors variable “time” (F=496.68 P=0.000).The interaction of these two factors is also statistically significant (F=299.594 P=0.000). The addition of cognitive remediation therapy (CRT) to a standard treatment of metacognitive training (MCT) resulted in a significant improvement in global neurocognitive functioning and has reported positive effects with regard to the strengthening of verbal and working memory, selective and sustained attention at T1. A relevant result is the statistically significance of “time X treatment” for all the tests administered: we can assume that the domain-specific cognitive training amplifies the effects of SRT, as the primary and secondary goals of the present study were achieved.

This article is based on a study that was commissioned by the Youth Justice Board for England and Wales. We report on the learning profiles and education needs of a cohort of young offenders who were recruited for the study. The research was a national cross‐sectional survey of 301 young offenders who were resident in custodial settings or attending youth offending teams in the community. The young people were assessed using the WASI and the WORD measures to obtain psychometric information (IQ scores and reading/reading comprehension ages). One in five (20%) young people met the ICD‐10 criteria for mental retardation (IQ<70), while problems with reading (52%) and reading comprehension (61%) were common. Verbal IQ scores were found to be significantly lower than performance IQ scores, particularly in male offenders. It is clear from these results that a large proportion of juvenile offenders have a learning disability, as characterised by an IQ<70 and significantly low reading and reading comprehension ages. The underlying aetiology of this association is less clear and may be a consequence of both an increased prevalence of neurocognitive deficits and the impact of poor schooling. There is some evidence that developmental pathways may be different for boys compared with girls.

Although first rank symptoms focus on positive symptoms of psychosis they are shared by a number of psychiatric conditions. The difficulty in differentiating bipolar disorder from schizophrenia with affective features has led to a third category of patients often loosely labeled as schizoaffective. Research in schizophrenia has attempted to render the presence or absence of negative symptoms and their relation to etiology and prognosis more explicit. A dichotomous population is a recurring theme in experimental paradigms. Thus, schizophrenia is defined as process or reactive, deficit or non-deficit and by the presence or absence of affective symptoms. Laboratory tests confirm the clinical impression showing conflicting responses to dexamethasone suppression and clearly defined differences in autonomic responsiveness, but their patho-physiological significance eludes mainstream theory. Added to this is the difficulty in agreeing to what exactly constitutes useful clinical features differentiating, for example, negative symptoms of a true deficit syndrome from features of depression. Two recent papers proposed that the general and specific cognitive features of schizophrenia and major depression result from a monoamine-cholinergic imbalance, the former due to a relative muscarinic receptor hypofunction and the latter, in contrast, to a muscarinic hypersensitivity exacerbated by monoamine depletion. Further development of these ideas will provide pharmacological principles for what is currently an incomplete and largely, descriptive nosology of psychosis. It will propose a dimensional view of affective and negative symptoms based on relative muscarinic integrity and is supported by several exciting intracellular signaling and gene expression studies. Bipolar disorder manifests both muscarinic and dopaminergic hypersensitivity. The greater the imbalance between these two receptor signaling systems, the more the clinical picture will resemble schizophrenia with bizarre, incongruent delusions and increasingly disorganized thought. The capacity for affective expression, by definition a non-deficit syndrome, will remain contingent on the degree of preservation of muscarinic signaling, which itself may be unstable and vary between trait and state examinations. At the extreme end of muscarinic impairment, a deficit schizophrenia subpopulation is proposed with a primary and fixed muscarinic receptor hypofunction.

The genomic profile of bipolar disorder and schizophrenia overlap and both have a common dopaminergic intracellular signaling which is hypersensitive to various stressors. It is proposed that the concomitant muscarinic receptor upregulation differentiates the syndromes, being marked in bipolar disorder and rather less so in schizophrenia. From a behavioral point of view non-deficit syndromes and bipolar disorder appear most proximate and could be reclassified as a spectrum of affective psychosis or schizoaffective disorders. Because of a profound malfunction of the muscarinic receptor, the deficit subgroup cannot express a comparable stress response. None -theless, a convergent principle of psychotic features across psychiatric disorders is a relative monoaminergic-muscarinic imbalance in signal transduction.

Impairments in social cognitions in schizophrenia are increasingly reported in the last decade but only a few studies have come from Asia. The objective of the study was to evaluated emotion perception, theory of mind and social knowledge in people with schizophrenia compared to healthy controls. Participants were 36 clinically stable outpatients with schizophrenia and 36 normal controls with comparable age and level of education. We administered general neurocognition test (the Addenbrooke's Cognitive Examination), emotion perception (the Faces Test), theory of mind (the Eyes Test) and social knowledge (the Situational Features Recognition Test; SFRT). Schizophrenia patients displayed obvious impairment in all three social cognition domains i.e. the Faces Test [13.7 (2.9) vs 15.7 (1.9), P=0.001], the Eyes Test [18.9 (4.4) vs 23.5 (4.4), P<0.001] and SFRT [0.85 (0.09) vs 0.9 (0.05), P=0.002]. The performances on three social cognition tests did not correlate with positive symptoms. Only the Faces Test seemed to be related to negative symptoms. The results demonstrated that there are deficits of social cognitions in schizophrenia even in a clinically stable population.

The aims of this paper are to: briefly review the long‐term or late effects of cancer diagnosis and treatment on children and youth; examine the implications of these effects on the educational needs of the child or youth; explore the implications of childhood cancer survivorship on the school, particularly for female students. Over the last 25 years, treatments for childhood cancers have increased survival rates by 45 per cent, to nearly 77 per cent. It is estimated that one in 900 people aged 15‐44 years in the USA is a childhood cancer survivor; 80 per cent of children diagnosed with cancer in 1990 will survive into adulthood.

A comprehensive literature review of studies relevant to female childhood cancer survivorship and education over the past ten years was conducted, having been collected through searches of MEDLINE, CINAHL, PSYCINFO, and EMBASE.

Long‐term and late effects of cancer have been observed in neurocognition, cardiopulmonary symptoms, second cancers, reproductive organs, and hearing loss. Other health effects, such as impaired growth, osteopenia, hepatitis C infection, oral and dental malformations, and behavioral risk factors such as fatigue, obesity, and smoking have also been reported among childhood cancer survivors. These longer‐term treatment sequelae, particularly on neurological systems, have implications for changed student educational needs, including the provision of specialized instruction, classroom adaptations, as well as ancillary health services.

Based on the ecologic model, a research agenda is proposed for better integrating the increasing numbers of childhood cancer survivors into the educational environment.

Practical interventions for survivors who are experiencing difficulties in school are listed.

To the best of one's knowledge, this is the first comprehensive review on the implications of childhood cancer survivors in schools.

Suicide behaviour rates vary significantly between countries due to a range of cultural, behavioural and health‐related factors. Gender and age‐related factors also appear to be impor tant key determinants of vulnerability to suicide ideation and suicide completion. The homeless population is par ticularly at risk, due to multiple complex issues that relate to social exclusion, alcohol, drug, mental health and nutritional issues. Studying homeless people is problematic due to access, the transitory nature of their contact with statutary services, problems of self‐repor t and recall in people ‐ some of whom have mental health and cognitive issues. There is an increasing interest from practitioners and academic researchers in spiritual factors that appear to modulate the responses of an individual to the internal and external threats that underlie the motivation to end his or her life. Effective approaches to suicide prevention and crisis management require a good understanding of the interplay between this complex set of biological, psychological and social domains. These will be explored in the final section of this review. This paper, therefore, aims to provide a non‐systematic review of the existing literature published in academic journals and relvant ‘grey literature’ and focuses on themes in the literature that will hopefully inform both policy and practice.

Fetal alcohol spectrum disorders (FASD) are a group of developmental disabilities related to prenatal alcohol exposure. FASD is a life-long lasting condition with various neurocognitive impairments and deficits in daily-life functioning. Research also indicates that FASD patients have an increased prevalence for substance use, substance related disorders and other psychiatric disorders. In Germany, data on adult FASD patients and their mental health are rare. The purpose of this paper is to describe substance use and comorbid psychiatric disorders (in addition to FASD) and suicide attempts in adult FASD patients.

The German version of the structured “Mini International Neuropsychiatric Interview (MINI)” was administered to a convenience sample of patients attending a specialized FASD diagnostic service at a German university hospital to assess psychiatric disorders. Current and lifetime substance use were examined using sections from the German version of the “European Addiction Severity Index (EUROP-ASI-R)” interview.

In total, 31 adults with FASD were included. Two patients were diagnosed with a substance related disorder, one for alcohol and one for cannabis. Nearly half of all patients fulfilled the diagnostic criteria for mild mental retardation, a further 16 per cent fulfilled the criteria for another current comorbid psychiatric disorder. In total, 26 per cent reported at least one suicide attempt.

Given that the body of research literature on FASD in adulthood is sparse, even a clinical sample of thirty individuals expands knowledge on mental health and substance use in the adult FASD population. The sample was comprehensively assessed using validated structured interviews on mental health, substance use and FASD.

The existence of neuropsychological deficits associated with antisocial behaviour has received considerable attention. The pilot study investigates the cognitive impairments in a sample 9‐17 years old with suspected or previously diagnosed intellectual disability and/or neurodevelopmental disorders referred to a tier 4 CAMHS service in South East London. This paper aims to present the preliminary findings from the study.

In total, 28 participants between the ages of nine and 16 years, who had been referred to a tier 4 South London Forensic CAMHS, were administered selected subtests to assess intellectual, executive and social functioning using the WISC IV/WAIS IV, NEPSY II and DKEFS. Descriptive and non‐parametric statistics were used to describe the sample and identify neuropsychological deficits.

Consistent with previous research participants FSIQ and VCI were lower than the general population mean and young people identified as being high risk on the SAVRY were more impaired than those assigned to the lower risk group. The results also identified neuropsychological deficits in behavioural inhibition, cognitive flexibility, problem solving and processing fear but spared cognitive inhibition, general social processing and non‐verbal reasoning.

These preliminary findings serve as a platform for better understanding the neuropsychological functioning of the young people referred to the clinic and in the future it is hoped that the data will be used to evaluate cognitive rehabilitation adjuncts to established interventions provided by the service.

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients' pre- and post-treatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.