Attention-deficit/hyperactivity disorder in childhood is associated with cognitive test profiles in the geriatric population but not with mild cognitive impairment or Alzheimer's disease.

The frequency of ADHD in the aging population and its relationship to late-life cognitive decline has not been studied previously. To address this gap in our understanding, the Wender-Utah ADHD Rating scale (WURS) was administered to 310 geriatric subjects with cognitive status ranging from normal cognition to mild cognitive impairment to overt dementia. The frequency of WURS-positive ADHD in this sample was 4.4%. WURS scores were not related to cognitive diagnoses, but did show nonlinear associations with tasks requiring sustained attention. The frequency of ADHD appears stable across generations and does not appear to be associated with MCI or dementia diagnoses. The association of attentional processing deficits and WURS scores in geriatric subjects could suggest that such traits remain stable throughout life. Caution should be considered when interpreting cognitive test profiles in the aging population that exhibit signs and symptoms of ADHD, as attentional deficits may not necessarily imply the existence of an underlying neurodegenerative disease state.

Short-term neuropsychological outcome following Gamma Knife radiosurgery for arteriovenous malformations: a preliminary report.

This study investigated the effect of Gamma Knife radiosurgery for the treatment of arteriovenous malformations (AVMs) on neuropsychological functioning. We examined neuropsychological performance in 10 patients before and after radiosurgical treatment with the Leksell cobalt-60 Gamma Knife unit. The patients included 7 right-handed women and 3 right-handed men. Three patients had left hemisphere AVMs, 4 had right hemisphere AVMs, and 3 had midline AVMs. Each patient was given neuropsychological testing within 1 week before Gamma Knife radiosurgery. Testing was repeated an average of 11.4 months after treatment. There were no statistically significant differences between pre- and postradiosurgical neuropsychological test scores on any measure. Pretreatment AVM diameter as measured on magnetic resonance scans ranged from 1.6 to 6.5 cm. After treatment, 2 AVMs disappeared, 4 decreased slightly in size, and 4 remained unchanged. We conclude that Gamma Knife radiotherapy in this sample of patients was neither detrimental nor beneficial to neuropsychological functioning.

NEO PI-R profiles of adults with attention deficit disorder.

The personality functioning of adults diagnosed with attention deficit disorder (ADD) without comorbid psychiatric illness was examined. NEO PI-R profiles in a group of 25 adults referred for ADD evaluation meeting criteria for this diagnosis without any history of other psychiatric disturbance were compared to profiles from a control group of 23 nonpsychotic adult outpatients being treated with psychotherapy. All participants completed self-report measures of ADD symptoms as well as the NEO PI-R (Form S). The ADD adult group obtained significantly higher scores in the Neuroticism domain and significantly lower scores in the Conscientiousness domain than the outpatient comparison group. The NEO PI-R appears useful to the understanding of ADD in adulthood.

Consumer satisfaction with telemedicine child psychiatry consultation in rural Kentucky.

Forty-three rural Kentucky families who obtained child psychiatry consultation during the initial eight months of the University of Kentucky's telemedicine program completed questionnaires assessing their satisfaction with telemedicine. Respondents were 46 parents and nine children. All respondents reported that they were very satisfied with the consultation; all of the children and 98 percent of the parents reported that they were as satisfied with the telemedicine consultation as with an in-person visit. Few respondents reported nervousness about using the equipment. These results suggest that child psychiatry consultation via telemedicine provides high levels of satisfaction for both children and adults.

Estimating pattern similarity for correlation matrices from differing neuropsychiatric populations.

The present example illustrates a method for assessing pattern similarity for correlation matrices from populations known to differ in clinically important respects. The data underlying previously published confirmatory factor analyses of neuropsychological traits are presented in two methods for assessing whether the matrices are similar enough to justify their aggregation into a single composite matrix. The significance of this procedure for research in applied neuropsychology is commented upon in terms of the benefits to model diagnostics.

Trait analyses of the Luria-Nebraska Intellectual Processes, Motor Functions, and Memory Scales.

Trait analyses of the Luria-Nebraska's Intellectual Processes, Motor Functions, and Memory Scales were performed using multitrait-multimethod procedures and confirmatory factor analysis. Three measures each of intellectual, motor, and memory functions were administered to 161 neuropsychiatric patients. Intellectual scales (viz., Luria-Nebraska and WAIS-R) were found to have convincing discriminant properties, but motor and memory measures demonstrated visibly less such robustness. Confirmatory factor analyses supported a three-factor model of the 9 x 9 matrix, in which each of the three Luria-Nebraska scales serves as a marker for the factors. Issues related to the neuropsychological constructs, test construction, and construct validity of measurement procedures employed in clinical neuropsychology are discussed.

The intellectual functioning of eating disorder patients.

This study investigated the intellectual functioning of a large group of eating disorder patients to examine two previously reported findings: (1) this population exhibits above-average general intellectual skills; and (2) a specific pattern of strength in verbal abilities. Standard intellectual testing of 100 consecutive inpatient females with eating disorder diagnoses was performed. Results indicate intellectual performance conforming to a normal distribution with no specific pattern of strengths or weaknesses.

An update on selected organic mental syndromes.

The authors review recent literature on four medical conditions that constitute important examples of organic mental disorders: AIDS dementia complex, cocaine abuse, cerebrovascular accident, and traumatic brain injury. These disorders are of particular interest because they are frequently the result of high-risk behaviors and the patients are often young adults. Progress in classification and diagnosis, along with greater understanding of pathophysiological mechanisms, has facilitated therapies to ameliorate some symptoms. More specific classification of organic mental disorders should facilitate the examination of biological factors believed responsible for functional psychiatric disturbances.

Cognitive mental status examinations.

The authors review several brief mental status examinations which are currently used to assess geriatric patients. The strengths and weaknesses of these measures are discussed in light of standard test construction procedures, including validity of the mental status examination and correlation with standard psychological tests. Additional data are presented for several mental status examinations used to evaluate general neurologic patients and patients with Alzheimer's disease.

The relationship between neuropsychological impairment in alcoholics and treatment outcome at one year.

One hundred and thirty-two (132) patients with a diagnosis of alcohol dependence who participated in an inpatient treatment program were assessed on select neuropsychological measures and followed for a one year period. Neuropsychological, personality, and demographic variables did not predict outcome defined as abstinence at one year follow-up. Relapsed patients displayed slightly better initial neuropsychological functioning compared to abstainers, although this effect was not significant when these measures were controlled for age and education. These findings and the clinical implications of neuropsychological assessment in alcoholic populations is discussed.

WAIS-R factor and performance on the Luria-Nebraska's Intelligence, Memory, and Motor Scales: a canonical model of relationships.

The pattern and level of performance on the WAIS-R and the Luria-Nebraska's Intelligence, Memory, and Motor Scales were examined for 93 neurologically impaired adults. Maximum likelihood factor analyses of the WAIS-R indicated the presence of strongly correlated (.72) Verbal Comprehension and Perceptual Organization dimensions. Comparisons of these factors to those of the standardization group revealed an acceptable level of similarity (.94) for Verbal Comprehension, but not for Perceptual Organization (.53). Canonical correlations between WAIS-R factor scores and the three Luria-Nebraska scaled scores accounted for 82% of the total variance. Each set of procedures evidently is indexing the same theoretical constructs. Implications of these findings for our understanding of the measurement models that underlie clinical neuropsychology are discussed.