The relationship between the Neuro-Quality of Life Depression and Anxiety Measures and the Personality Assessment Inventory in persons with epilepsy.

BACKGROUND: To investigate the associations between the Neuro-Quality of Life (NQOL) Depression and Anxiety measures with an objective emotional inventory (Personality Assessment Inventory; PAI), and demonstrate the clinical utility of the NQOL as screening measures for depression and anxiety in persons with epilepsy (PWE). METHODS: PWE (N=72) were concurrently administered the NQOL Depression and Anxiety measures and the PAI. Pearson product moment correlations were used to determine the relationships between the NQOL measures and the respective PAI scales (i.e., depression, anxiety). One-way ANOVAs were conducted comparing NQOL scores between patients with elevated levels of depression and anxiety (T-score≥65 on the PAI) to profiles that were within normal limits. Using sensitivity and specificity analyses, optimal cut-scores on the NQOL measures were determined. RESULTS: Participants were primarily Caucasian (89%), female (60%), and ~35 years old. The NQOL Depression measure was significantly correlated with the PAI Depression total score (r=.747; p<0.001) and its subscales (p's<0.001). Similarly, the NQOL Anxiety measure was significantly correlated with the PAI Anxiety total score (r=.750; p<0.001) and its subscales (p's<0.001). Compared to profiles that were within normal limits, individuals with elevated depressive symptoms on the PAI had significantly higher NQOL Depression scores (F(1,71)=48.2, p<0.001, d=1.6). Similarly, those who endorsed elevated anxiety on the PAI had significantly higher NQOL Anxiety scores (F(1,71)=32.2, p<0.001, d=1.5). Cut-off scores of 19 on the NQOL Depression and 24 on the NQOL Anxiety measures adequately detected depression (sensitivity=0.67; specificity=0.93; PPV=0.91; NPV=0.74) and anxiety symptoms (sensitivity=0.77; specificity=0.82; PPV=0.81; NPV=0.78) in PWE. CONCLUSIONS: The NQOL Depression and Anxiety measures evidenced strong associations with the PAI Depression and Anxiety scales and may be effective in detecting depressive and anxiety symptoms in PWE using the provided cut-scores.

Referring Providers' Preferences and Satisfaction with Neuropsychological Services.

OBJECTIVE: This study aims to expand upon previous research by characterizing the attitudes/preferences of referring providers who utilize neuropsychological services. METHOD: A 31-question survey link, along with a description of the rationale, was disseminated across several professional listservs and email lists, and data was collected over a 6-month period from individuals who refer for neuropsychological services (N = 81). Survey questions included referring provider preferences (e.g., ideal time frame for receiving the neuropsychological report, preferred length/format of the report, sections of the report they read and consider essential, comfort level with recommendations, and open responses regarding other general preferences) as well as narrative details about useful aspects of neuropsychological services versus areas of desired change. RESULTS: The represented referring providers included epileptologists (18), neurologists (12), psychologists (11), other various physician specialties (10), social workers (9), non-physician medical providers (9), psychiatrists (8), and legal services (4). Most referring providers prefer shorter reports (2-4 pages), in bullet-point/table format for ease of readability, and receipt of the completed report within 2 weeks. Approximately half of the respondents reported reading the entire neuropsychological report, with the background, developmental/medical, and educational histories being the least frequently read sections. Nearly all respondents indicated they are satisfied with neuropsychological services overall and agree that the referral question is satisfactorily answered, the findings are communicated clearly, and the diagnostic impressions are logical. Referring providers appreciate most recommendations by neuropsychologists, with the exception of those regarding laboratory work, medications, and other medical procedures. The most useful aspects of neuropsychological services included the thoroughness and integration of the evaluation/report, along with the impressions, diagnoses, and recommendations. Recommendations for future practice included shorter reports, increased availability of neuropsychological services, and more concise impressions and recommendations. Generally speaking, few differences in preferences and satisfaction were noted across provider specialties, patient populations, or practice settings. CONCLUSION: These findings are generally consistent with prior literature that referring providers are satisfied with neuropsychological services overall. The current findings also expand upon the previous research, specifically, that referring providers prefer reports to include bullet-point/table format due to ease of reading and do not read some sections of the report, most likely due to already having an adequate understanding of their patients' background. Illuminating aspects of neuropsychological services perceived to be the most and least useful by consumers of these services provides valuable information to practitioners, particularly in the context of rapidly changing institutional and healthcare demands.

Conscious attention, meditation, and bilateral information transfer.

Recent findings indicate that conscious attention is related to large-scale information integration of various brain regions, including both hemispheres, that enables integration of parallel distributed modalities of processed information. There is also evidence that the level of information transference related to integration or splitting among brain regions, and between hemispheres, establishes a certain level of efficiency of the information processing. The level of information transference also may have modulatory influences on attentional capacity that are closely linked to the emotional arousal and autonomic response related to a stimulus. These findings suggest a hypothesis that changes in conscious attention, specifically during meditation could be reflected in the autonomic activity as the left-right information transference calculated from bilateral electrodermal activity (EDA). With the aim to compare conscious attention during meditation with other attentional states (resting state, Stroop task, and memory task), we performed bilateral EDA measurement in 7 healthy persons during resting state, Stroop task, neurofeedback memory test, and meditation. The results indicate that the information transference (ie, transinformation) is able to distinguish those attentional states, and that the highest level of the transinformation has been found during attentional processing related to meditation, indicating higher level of connectivity between left and right sides. Calculations other than pointwise transinformation (PTI) performed on EDA records, such as mean skin conductance level or laterality index, were not able to distinguish attentional states. The results suggest that PTI may present an interesting method useful for the assessment of information flow, related to neural functioning, that in the case of meditation may reflect typical integrative changes in the autonomic nervous system related to brain functions and focused attentional processing.