ABSTRACT
Resumen El perfil cognitivo de los pacientes con anorexia nerviosa se caracteriza por dificultades en la flexibilidad mental y en la coherencia central. El objetivo de este trabajo fue analizar si los familiares de primer grado no afectados de los pacientes presentan estas dificultades cognitivas, que podrían representar rasgos endofenotípicos de la enfermedad. Fueron estudiadas 34 mujeres: 17 familiares de primer grado (madres y hermanas) de pacientes con anorexia nerviosa y 17 controles sanos agrupados por edad y escolaridad. Se consideraron el índice de masa corporal, la ansiedad, la depresión, los síntomas obsesivo-compulsivos y los relacionados con los trastornos alimentarios. Se evaluó la coherencia central, mediante la copia de la Figura Compleja de Rey, y la flexibilidad mental, mediante el test de Stroop, el test de los trazos B y el test de fluencia fonológica. Los familiares de pacientes con anorexia nerviosa presentaron un menor rendimiento en las medidas de coherencia central (p < .05) y en fluencia fonológica (p < .05) que los controles sanos. Se observó una correlación entre el test de Stroop y los síntomas de depresión y trastornos alimentarios (p < .05). Los familiares de primer grado no afectados de pacientes con anorexia nerviosa presentaron dificultades en la coherencia central y, en menor grado, en la flexibilidad mental. Los resultados en los familiares indican que este perfil podría ser mediado genéticamente, constituyendo un rasgo característico de la anorexia nerviosa y, por ende, un posible candidato a endofenotipo neuropsicológico de esta enfermedad.
Abstract The cognitive profile of patients with anorexia nervosa is characterized by difficulties in central coherence and mental flexibility. Central coherence is defined by the ability to integrate incoming information in its own context, and weakness in central coherence is characterized by poor overall processing and superior detail processing. Mental flexibility is defined by the ability to change the course of a thought or action according to the demands of the environment. Alterations in this cognitive domain generate rigid and inflexible behavior. An open question in the literature is whether these cognitive characteristics are a transient state derived from the disease or whether they are stable traits associated with anorexia nervosa and endophenotypical features of this disease. The concept of endophenotype refers to the internal phenotype that is not clinically appreciable but can be observed indirectly through deficits that arise in the performance of certain neuropsychological tests. In recent years the search for endophenotypes has been renewed in the field of psychiatry as they would constitute an important route for the understanding of the biological and genetic bases of mental illnesses, constituting markers that allow a diagnosis before the onset of clinical symptomatology. For a cognitive marker to be considered an endophenotype it must meet a series of characteristics such as being measurable, inherited, found in patients with and without active disease and in first-degree relatives not affected by the disease. The aim of the present study was to assess whether difficulties in central coherence and mental flexibility are shared by unaffected first-degree relatives of patients with anorexia nervosa and thus constitute an endophenotypical feature of this disease. This is a cross-sectional, descriptive-comparative study in which 34 women participated: 17 unaffected first-degree relatives of patients with anorexia nervosa (mothers and sisters) and 17 healthy controls matched by age and education. For the study of central coherence the copy of Rey's Complex Figure was used and to assess set-shifting the Stroop test, the Trail Making Test B and the Phonological Fluency test were used. Demographic and clinical aspects such as age, educational level, body mass index, anxiety, depression, obsessive-compulsive and eating disorder related symptoms were also evaluated. First-degree relatives of patients with anorexia nervosa showed lower performance on measures of central coherence (p < .05) and phonological fluency (p < .05) than healthy controls. A correlation was observed between the Stroop test and depression and eating disorders symptoms (p < .05). The results of this study show that unaffected first-degree relatives of patients with anorexia nervosa presented alterations in central coherence and, to a lesser degree, in mental flexibility. These results, in addition to previous research in which difficulties persisted even after recovery, indicate that these alterations could be genetically mediated, constituting a characteristic trait of anorexia nervosa and therefore a possible candidate for neuropsychological endophenotype of this disease. Regarding practical implications of the study, the findings reinforce the importance of cognitive remediation treatments not only for patients with anorexia nervosa but also emphasize that they could be useful for unaffected family members. Taking into account that family intervention is a widely used tool in the psychological treatment of anorexia, improving the perception of the patient and his relatives about cognitive biases, could contribute to raising awareness of the disease, something that patients with anorexia nervosa do not usually have, and generate a positive impact on the response to treatment as a whole.
ABSTRACT
Objective: Evidence suggests that early-onset obsessive-compulsive disorder (OCD) is an etiologically distinct subtype of OCD. The objective of the present work was to search for neurocognitive endophenotypes of early-onset OCD based on assessments of attention, memory, and executive function in patients with the disorder and their unaffected siblings. Methods: We compared the performance of 40 adult patients with early-onset OCD, 40 of their unaffected siblings, and 40 unrelated healthy controls on a neuropsychological battery designed for this study. We searched for associations among test performance, demographic variables (age, sex and years of education) and clinical symptoms of early-onset OCD. Results: Patients performed significantly worse than healthy controls on the Tower of Hanoi, and the Stroop and Wisconsin tests, indicating impairments in planning, mental flexibility and inhibitory control. The performance of the unaffected first-degree siblings of patients with early-onset OCD on the Stroop and Wisconsin tests also differed from that of healthy controls. Symptom severity in early-onset OCD was strongly correlated with performance on the Tower of Hanoi. Conclusions: Our findings support the existence of specific executive function deficits in patients with early-onset OCD. Relatives presented an intermediate phenotype between patients and controls, suggesting that executive functions such as mental flexibility and response inhibition may be considered candidate endophenotypes of early-onset OCD. .
Subject(s)
Adult , Female , Humans , Male , Young Adult , Cognition Disorders/genetics , Cognition Disorders/psychology , Endophenotypes , Obsessive-Compulsive Disorder/genetics , Obsessive-Compulsive Disorder/psychology , Case-Control Studies , Educational Status , Executive Function , Family Health , Neuropsychological TestsABSTRACT
El VIH provoca alteraciones de la flexibilidad mental, cuyo carácter devastador aumenta cuanto más temprano el individuo haya sido contagiado. Por ello, en este artículo de investigación científica, se analiza comparativamente la ejecución en tests de flexibilidad mental de 30 sujetos positivos al VIH y 30 sujetos normales, con edades de 12 a 14 años. Como pruebas de flexibilidad mental se utilizaron el Trail Making Test y el Test de Series Gráficas Alternantes. Para el análisis de datos, se utilizaron pruebas de estadística descriptiva y la prueba T de Student. Los resultados muestran que en ambos test, los sujetos seropositivos rinden sobre lo patológico, en tanto los sanos rinden normal, al margen de la variabilidad interindividual.
Taking into consideration that Human Immunodefiency Virus (VIH) affect mental flexibility as earlier an individual have been infected with the virus, this research article aims to analyze and compare mental flexibility in 30 individuals with Human Immunodeficiency Virus (VIH) aged between 12 and 14 and 30 individuasl without virus. Trail Making Test and Graphical Alternant Series Test were applied and in order to analyze the data descriptive statistic tests were used. Re-sults showed seropositive individual perform normal compared with those ones with VIH within individual variability.
ABSTRACT
Objetivo: Os objetivos destes trabalhos foram realizar um estudo de normatização para o teste de Stroop numa amostra brasileira, tradicionalmente aceita como medida de atenção seletiva e flexibilidade mental, usando como referência a versão Victoria do teste, bem como analisar diferenças no desempenho de estudantes de escolas das redes pública e particular, e também investigar diferenças quanto ao sexo, além de observar se aumento de idade e anos de escolaridade favorecem um melhor desempenho no teste. Métodos: Cento e trinta e dois estudantes de duas escolas (uma particular e outra pública), na faixa etária de 12 a 14 anos, alunos da 6ª à 8ª série do ensino fundamental, participaram da pesquisa após levantamento do rendimento escolar e entrevista inicial. Resultados: A análise estatística dos resultados revelou que os alunos da escola pública tiveram um desempenho significativamente pior em relação aos da particular. Quanto à variável sexo, os resultados não foram significativos e, em relação à idade, o resultado não foi consistente, revelando que essa variável perde a significância quando analisada à luz das seis medidas dependentes do experimento. Conclusões: Os resultados sugerem a influência das diferentes condições socioeconômicas, educacionais e culturais a que estão expostos os alunos das duas escolas como uma possível explicação para as diferenças observadas no desempenho no teste.
Objective: This study had two objetctives to perform a normalization of the Stroop test in a Brazilian sample, traditionally accepted as a measure of selective attention and mental flexibility, using as a reference the Victoria test version and to analyze the performance of public and private schools students; investigating differences in regard to sex; to observe if the increase in age and years of education promote a better performance in the above mentioned task. Methods: One hundred thirty two students of two schools (one private and the other public), in the age range from 12 to 14 years, students from 6th to 8th grades of elementary school, participated in the research, after data on school progress was compiled and the initial interview was conducted. Results: The statistical analysis of the results revealed that the students of the public school had a significanty worse performance in relation to the students of the private school; as to the sex variable, the results were not significant and, as for age, the result was not consistent, revealing that that variable loses significance when analyzed in light of the six dependent measures of the experiment. Conclusions: The results suggest the influence of the different socio-economic, educational and cultural conditions to which the students from the two schools are exposed, as a possible explanation for the differences observed in regard to the test performance.