Planning abilities in alcoholics, process and reactive schizophrenics, and normals.

This study investigated planning abilities in alcoholics, process and reactive schizophrenics, and normals. Significant differences among the groups were found on all three planning tasks. Normals and alcoholics showed significantly greater planning ability on the picture arrangement task than the process schizophrenics. On the maze task, normals attained significantly higher scores than the process schizophrenics. On a task in which subjects predicted future effects from a present-day trend, alcoholics showed significantly greater planning ability than normals and process schizophrenics. Reactive schizophrenics did not differ significantly from any of the other groups on any task. The greater planning ability of the alcoholics in comparison with the normals on one of the tasks may be due to sampling and situational differences. The results suggest that deficits in planning abilities are temporary for alcoholics.

Cognitive sequelae of tardive dyskinesia.

Severity and location of tardive dyskinesia (TD) symptoms and diagnosis were related to neurocognitive dysfunction as measured by the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale using schizophrenic and affective patients. Diagnosis, severity, and location of TD symptoms were related to cognitive dysfunction. Total symptom severity correlated significantly negatively with 10 of 14 WAIS scores and with four of seven Wechsler Memory scores in the total group with combined schizophrenic and affective patients. The magnitude of the relationships between TD symptom severity and cognitive deficit was strongly affected by the location of the symptoms and the diagnosis of the patient. In the total group, severity of facial TD symptoms correlated significantly negatively with 11 of 14 WAIS scores and with all eight memory scores. TD symptoms in the extremities correlated significantly negatively with only two WAIS and two memory scores, whereas truncal TD symptoms did not correlate significantly negatively with any WAIS or memory scores. Patients diagnosed as schizophrenic showed significant negative correlations of total TD symptom severity with 12 of 14 WAIS scores and with seven of eight Wechsler Memory Scale scores. Patients diagnosed as having affective disorder showed only one significant correlation between total TD symptom severity and WAIS or memory scores. Length of institutionalization has been found to be related to TD symptoms in schizophrenic but not affective patients. In the present study, institutionalization was negatively correlated with severity of facial TD symptoms but not with severity of TD symptoms of the trunk or extremities.(ABSTRACT TRUNCATED AT 250 WORDS)

Risk factors for tardive dyskinesia according to primary psychiatric diagnosis.

The role of different variables in the development of tardive dyskinesia was examined among patients in two different diagnostic categories. Age and length of hospitalization were associated with development of tardive dyskinesia in the schizophrenic subjects while parkinsonism and alcoholism were related to tardive dyskinesia in the affective disorder patients. Schizophrenic subjects constituted the largest absolute number of tardive dyskinesia patients, but in relative terms they represented the patient population least likely to develop tardive dyskinesia in comparison to affective disorder and organic mental disorder subjects. The clinical implications of these findings are discussed.

Ego identity status, identification, and decision-making style in late adolescents.

Measures of identification with same-sex parent and decision-making style were administered to 30 male and 30 female late adolescents who had been classified by Marcia's (1964) criteria as either identity achieved, foreclosed, moratorium, or diffused. As predicted, male and female foreclosed subjects were more impulsive than were those in the other statuses, and male moratorium subjects were more reflective than others. However, female moratoriums were impulsive, and male and female diffused were reflective, findings which contradict theoretical expectation. Similarly, data on identification were mixed; female achieved subjects scored (as predicted) with higher identification than female moratorium or diffused subjects, while diffused males were highly identified with their fathers. One reason offered for the conflicting results is that identity formation is, as some have suggested, a different process for women than it is for men. Therefore, study of both genders with the same measures and hypotheses is not recommended.

Future time perspective in alcoholics, process and reactive schizophrenics, and normals.

Future time perspective was investigated in alcoholics, process and reactive schizophrenics, and hospitalized medical patients. The four groups, of 24 subjects each, were compared on measures of future extension, coherence, density, and directionality based on Kastenbaum's model of future time perspective. Process and reactive schizophrenics differed only in future coherence, with reactives significantly more coherent. Both alcoholics and normals showed significantly greater future extension (on one of two extension measures) than both groups of schizophrenics. Future coherence for alcoholics and normals was significantly greater than for process schizophrenics but not greater than for reactives. Alcoholics had significantly greater future density than schizophrenics and normals. Alcoholics showed significantly greater future coherence than normals. The greater future density and coherence for alcoholics than normals appeared to be due to sampling and situational differences. These results suggested that future time perspective deficits are temporary for alcoholics and that long-range treatment goals can be appropriate for them.

Vulnerability to tardive dyskinesia.

Of 99 consecutive male patients studied at the North Chicago VA Tardive Dyskinesia Program, 58 had tardive dyskinesia and 41 did not. Factors that were significantly related, singly and in combinations, to tardive dyskinesia were 1) diagnosis of affective disorder with alcoholism and/or drug-induced parkinsonism, and 2) diagnosis of schizophrenia with advanced age (over 50) and/or prolonged hospitalization (over 14 years). A diagnosis of schizophrenia in patients under age 50 with short hospitalizations was not significantly associated with the presence of tardive dyskinesia.

A word-ordering test to differentiate between aphasia and schizophrenia.

The capacity of a word-ordering task to differentiate aphasic and schizophrenic patients was assessed. Cards containing words from 10 types of sentences were given to the patients. Each sentence was presented individually with the words in jumbled order and patients were asked to reorder them to produce a gramatically correct sentence. Process and reactive schizophrenics were differentiated from aphasic patients using the dual criteria of more than three incorrect sentences or an average of more than 90 sec per sentence as indicative of aphasia. These criteria were initially tested on a group of aphasics matched with the schizophrenics on age and education and cross-validated using a second more representative sample (unmatched) of aphasics. Both comparisons showed no errors of classification. Further analyses indicated no need for separate norms or classification criteria related to the sex, age, or educational level of the patients.

Wechsler performance IQ greater than Verbal IQ index in a forensic sample: a reconsideration.

Explored the relationships of the Performance IQ (PIQ) greater than Verbal IQ (VIQ) to type of crime, ethnicity, and reading disability in a corrections sample of 70 adult males incarcerated on felony charges. The PIQ greater than VIQ sign was not related to Full Scale IQ or to violent vs. nonviolent crime, per se. The PIQ greater than VIQ sign showed a trend toward association with Ethnicity (black vs. white) and was related significantly to reading disability, with the reading disabled inmates more likely to show the sign, and to type of crime, with perpetrators of sex crimes most likely (87%) to show the sign and those incarcerated for murder or attempted murder least likely (33%) to show it. The difference in the proportion of inmates who showed the sign in these two classes of violent crimes (murder and sex crimes) was significant, and further analysis showed that with murder excluded, PIQ greater than VIQ occurred significantly more frequently in those accused of violent crimes than for nonviolent crimes. The latter findings suggested that differences between studies in the relationship of PIQ greater than VIQ and violence may be the result of differences in the proportion of murderers in the violent samples. Additional analyses indicated that the significant relationships between PIQ greater than VIQ and both type of crime and reading disability were most likely independent of ethnicity and each other.

Neuropsychological patterns in uremia.

Administered the Halstead-Reitan Battery (HRB) of neuropsychological tests to 24 patients with advanced renal failure, 24 patients with neurological disorders, and 24 patients with medical and/or non-psychotic psychiatric conditions in order to assess the effects of uremic encephalopathy on human neuropsychological functioning. The groups did not differ significantly in age, education, verbal intelligence, or level of affective disturbance. Results indicated that the uremic and neurological groups were equal in overall level of neuropsychological impairment and that both were significantly more impaired than the medical-psychiatric group. However, the uremic group showed a pattern of deficits that was qualitatively different from both the neurological and medical-psychiatric groups. Results were discussed with reference to selective cortical dysfunctions in uremia and contrasted with earlier studies that did not consider differential sparing of abilities in renal patients.

Halstead-Reitan Test results in chronic hemodialysis.

Neuropsychological functioning of chronic hemodialysis, undialyzed uremic, and medical-psychiatric patients was explored using the Halstead-Reitan Battery. The three groups of 16 patients each did not differ significantly in age, education, verbal intelligence, or degree of affective disturbance. Specific Halstead-Reitan Battery subtest comparisons demonstrated that dialysis patients performed significantly better than uremic patients and were equivalent to medical-psychiatric subjects on tasks of psychomotor problem-solving and spatial ability. Dialysis patients were significantly better than uremic subjects, but impaired relative to the medical-psychiatric patients on a task of flexible thinking. Dialysis patients were impaired relative to medical-psychiatric subjects and equivalent to uremic patients on tasks which required complex analysis, auditory information processing, language capacities, and sensory-perceptual functions.

Intellectual deficit in chronic renal failure. A comparison with neurological and medical-psychiatric patients.

Intellectual functioning of renal failure, neurological, and medical-psychiatric patients was explored using the Wechsler Adult Intelligence Scale. The three groups of 24 patients each did not differ significantly in age or education. The medical-psychiatric group was significantly higher than the renal failure and neurological groups on the Performance IQ and Full Scale IQ. A significant groups X subtests interaction in an analysis of variance with Wechsler Adult Intelligence Scale subtests as the repeated measures variable indicated that the groups differed significantly in pattern of intellectual deficit. Subsequent analysis of deviation scores, which controlled for overall level of performance, indicated significant differences among the groups in relative deficit on the Information, Comprehension, Vocabulary, Block Design, and Object Assembly subtests. The renal failure patients showed much less deficit on the Information, Comprehension, and Vocabulary subtests relative to their own mean than did the other two groups which were similar to each other. However, the renal failure patients showed considerably greater deficit on the Block Design and Object Assembly subtests relative to their own mean than did the neurological and medical-psychiatric patients who again were quite comparable to each other. The pattern of deficits for the renal failure group was different from both neurological and medical-psychiatric patients and their level of deficit was greater than that of the medical-psychiatric patients. Thus, renal failure patients showed quantitative and qualitative differences compared to medical-psychiatric subjects and qualitative differences compared to neurological subjects.

Audiometric configuration in patients being treated for alcoholism.

The auditory acuity of 52 alcoholic subjects showed a consistent bilateral high frequency loss. Presence of this loss was found to be related to drinking time, but independent of age, suggesting a definite relationship between length of heavy drinking time and loss of auditory acuity in the high frequencies.

Interference in word associations in schizophrenia.

Assessed the effect of response interference on the word associations of male and female process and reactive schizophrenics in two studies that used the difference in associative disturbances between high and low interference (low and high commonality stimulus words) as the measure. The reactives showed a significantly greater increase in disturbances in the high interference condition than did process schizophrenics in both studies. These results occurred in process and reactive groups that did not differ in age, IQ, institutionalization, and current level of physiological arousal and symptom severity in Study I. Findings supported predictions from a qualitative differences theory of cognitive deficit in schizophrenia.

Behavioral and physiological effects of examiner sex on process and reactive schizophrenics.

In the physiological (polygraph) data, the sex of the E (ES) interacted with the sex of the patient (PS) or the patient's process-reactive status (PR) in only 1 of 16 analyses. Only in the heart-rate variability data was the ES by PS interaction significant (p less than .001). Sex of the E had an appreciable effect in two of the three measures of associative disturbance. The ES by PS interaction was significant (p less than .025) in the recall measure of instability of though processes, and the same interaction neared significance (p less than .06) in the multiword response measure of associative disturbance. It appears that the sex of the E should be considered in studies that use measures of associative disturbance and perhaps when heart-rate variability measures are used.