Mild Traumatic Brain Injury and Postconcussive Symptom Endorsement: A Parallel Comparison Between Two Nonclinical Cohorts.

INTRODUCTION: The prevalence of mild traumatic brain injury (mTBI) is commonly estimated based on indirect metrics such as emergency department visits and self-reporting tools. The study of postconcussive symptoms faces similar challenges because of their unspecific character and indistinct causality. In this article, we compare two nonclinical, epidemiological studies that addressed these two elements and were performed within a relatively narrow period in the state of Colorado. MATERIALS AND METHODS: De-identified datasets were obtained from a random digit-dialed survey study conducted by the Craig Hospital and a study surveying soldiers returning from deployment by Defense and Veteran Traumatic Brain Injury Center. Information pertinent to participants' demographics, a history of mTBI, and symptom endorsement was extracted and homogenized in order to establish a parallel comparison between the populations of the two studies. RESULTS: From the 1,558 (Warrior Strong, 679; Craig Hospital, 879) records selected for analysis, 43% reported a history of at least one mTBI. The prevalence was significantly higher among individuals from the Defense and Veteran Traumatic Brain Injury Center study independent of gender or race. Repetitive injuries were reported by 15% of the total combined cohort and were more prevalent among males. Symptom endorsement was significantly higher in individuals with a positive history of mTBI, but over 80% of those with a negative history of mTBI endorsed at least one of the symptoms interrogated. Significant differences were observed between the military and the civilian populations in terms of the types and frequencies of the symptoms endorsed. CONCLUSIONS: The prevalence of mTBI and associated symptoms identified in the two study populations is higher than that of previously reported. This suggests that not all individuals sustaining concussion seek medical care and highlights the limitations of using clinical reports to assess such estimates. The lack of appropriate mechanisms to determine symptom presence and causality remains a challenge. However, the differences observed in symptom reporting between cohorts raise questions about the nature of the symptoms, the impact on the quality of life for different individuals, and the effects on military health and force readiness.

Utility of the SLUMS as a cognitive screening tool among a nonveteran sample of older adults.

OBJECTIVES: To investigate the concurrent validity of the Saint Louis University Mental Status examination (SLUMS) by comparing the ability of the Mini-Mental State Examination (MMSE) and the SLUMS to predict performance on standard neuropsychological measures of memory and executive functioning. DESIGN: Cross-sectional. SETTING: University-based research clinic. PARTICIPANTS: Community-dwelling adults (N = 170) age 60 years and older (Mage = 73.08; SD = 8.18). MEASUREMENTS: The Trail Making Test (TMT), Rey Auditory Verbal Learning Test, Wisconsin Card Sorting Test (WCST), MMSE, and SLUMS. RESULTS: The distributional properties of the SLUMS and the MMSE were directly compared. The SLUMS showed statistically a smaller mean, lower rank scores, and less skewness than the MMSE. Comparisons of the correlations of the screening tests with the neuropsychological measures indicated that the SLUMS demonstrated stronger relationships with the TMT compared with the MMSE. Multiple regression analyses were conducted to determine the ability of the SLUMS and the MMSE to predict scores on common neuropsychological tests after controlling for demographic variables. Results demonstrated that the SLUMS significantly predicted performance across all measures over the MMSE and demographic variables, with the exception of the WCST's perseverative errors. However, the MMSE does not add to the prediction of neuropsychological functioning over the SLUMS. CONCLUSION: Although the SLUMS and the MMSE are strongly correlated, the SLUMS significantly adds to the prediction of neuropsychological measures beyond the MMSE scores. Our findings suggest that the SLUMS may be an appropriate measure to use as a screening tool among older adults and may have fewer ceiling effects than the MMSE.

Subjective organization, verbal learning, and forgetting across the life span: from 5 to 89.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Previous tests of the relationship between subjective organization during encoding, aging, and recall have produced inconsistent findings. The present study investigates subjective organization and the acquisition and recall of verbal material across the life span (from 5 to 89 years of age) using two measures, the intertrial repetition paired frequency (PF) measure and the unidirectional subjective organization (SO) measure. METHODS: Participants (N = 2656) were administered a version of the Rey Auditory Verbal Learning Test, including a delayed recall trial. Analyses of variance (ANOVAs) were performed to examine the relationship between age and subjective organization and between age and recall. Mediation and growth curve analyses were performed to further examine the relationship between age, verbal acquisition, and subjective organization. RESULTS: Subjective organization was not predictive of verbal forgetting. Deficits in verbal acquisition and subjective organization were detected among children and elderly adults. Mediational analyses showed that age affected the number of words recalled as well as subjective organization, and that subjective organization affected the number of words recalled in children, young adults and elderly. Latent growth curve modeling suggests that increases in subjective organization over time are related to increases in recall over time for each age group. CONCLUSION: Subjective organization is predictive of recall, and both subjective organization and recall are lowest among children and elderly individuals. Age has direct effects on recall but this effect is partially mediated by subjective organization. Brain imaging studies showing increased prefrontal cortex activation during encoding of remembered words bolster our findings that age affects the relationship between verbal learning and organization of material during encoding.

Age effects on emotion recognition in facial displays: from 20 to 89 years of age.

UNLABELLED: BACKGROUND/STUDY CONTEXT: An emotion recognition task that morphs emotional facial expressions from an initial neutral expression to distinct increments of the full emotional expression was administered to 482 individuals, 20 to 89 years of age. METHODS: Participants assessed six basic emotions at 25%, 50%, 75%, and 100% of the full facial expression. RESULTS: Participants in the three oldest age groups (60s, 70s, and 80s) demonstrated decreased performance for the recognition of the fear, anger, and sad emotions. Increased age was associated with increased recognition rates for the disgust expression, whereas no age effect was detected for the happy and surprise expressions. Covariate analyses revealed age effects were reduced by processing speed, but were unaffected by decision-making ability. The effects of age on individual emotions and levels of presentation are discussed. CONCLUSION: These findings suggest that age has the greatest impact on the recognition of the sad emotion and the greatest age effect at the 50% level of presentation across the adult life span.

The recognition of facial expressions: an investigation of the influence of age and cognition.

The present study aimed to investigate changes in facial expression recognition across the lifespan, as well as to determine the influence of fluid intelligence, processing speed, and memory on this ability. Peak performance in the ability to identify facial affect was found to occur in middle-age, with the children and older adults performing the poorest. Specifically, older adults were impaired in their ability to identify fear, sadness, and happiness, but had preserved recognition of anger, disgust, and surprise. Analyses investigating the influence of cognition on emotion recognition demonstrated that cognitive abilities contribute to performance, especially for participants over age 45. However, the cognitive functions did not fully account for the older adults' impairments on expression recognition. Overall, the age-related deficits in facial expression recognition have implications for older adults' use of non-verbal communicative information.

Maternal tendencies in women are associated with estrogen levels and facial femininity.

Previous studies have shown that women with higher maternal tendencies are shorter and have lower testosterone levels than those with lower maternal tendencies. Here we report two studies that investigated the relationships between maternal tendencies and two further measures of physical masculinization/feminization; urinary estrogen metabolite (estrone-3-glucuronide: E1-3G) levels (Study 1) and rated facial femininity (Study 2). In Study 1, nulliparous women reported both their ideal number of children and ideal own age at first child and also provided urine samples. There was a significant positive correlation between measured late-follicular estrogen levels and reported ideal number of children. In Study 2, analyses of facial cues in two independent samples of women showed that the average facial characteristics of women who reported desiring many children were rated as more feminine than those desiring fewer children. Collectively, these results support the proposal that maternal tendencies are related to physical feminization and that this effect may, at least in part, reflect the influence of the hormone estrogen.

Reproductive strategy, sexual development and attraction to facial characteristics.

Sexual reproduction strategies vary both between and within species in the level of investment in offspring. Life-history theories suggest that the rate of sexual maturation is critically linked to reproductive strategy, with high investment being associated with few offspring and delayed maturation. For humans, age of puberty and age of first sex are two developmental milestones that have been associated with reproductive strategies. Stress during early development can retard or accelerate sexual maturation and reproduction. Early age of menarche is associated with absence of younger siblings, absence of a father figure during early life and increased weight. Father absence during early life is also associated with early marriage, pregnancy and divorce. Choice of partner characteristics is critical to successful implementation of sexual strategies. It has been suggested that sexually dimorphic traits (including those evident in the face) signal high-quality immune function and reproductive status. Masculinity in males has also been associated with low investment in mate and offspring. Thus, women's reproductive strategy should be matched to the probability of male investment, hence to male masculinity. Our review leads us to predict associations between the rate of sexual maturation and adult preferences for facial characteristics (enhanced sexual dimorphism and attractiveness). We find for men, engaging in sex at an early age is related to an increased preference for feminized female faces. Similarly, for women, the earlier the age of first sex the greater the preference for masculinity in opposite-sex faces. When we controlled sexual dimorphism in male faces, the speed of sexual development in women was not associated with differences in preference for male facial attractiveness. These developmental influences on partner choice were not mediated by self-rated attractiveness or parental relationships. We conclude that individuals assort in preferences based on the rapidity of their sexual development. Fast developing individuals prefer opposite-sex partners with an increased level of sexually dimorphic facial characteristics.

Concordant preferences for opposite-sex signals? Human pheromones and facial characteristics.

We have investigated whether preferences for masculine and feminine characteristics are correlated across two modalities, olfaction and vision. In study 1, subjects rated the pleasantness of putative male (4,16-androstadien-3-one; 5alpha-androst-16-en-3-one) and female (1,3,5 (10),16-estratetraen-3-ol) pheromones, and chose the most attractive face shape from a masculine-feminine continuum for a long- and a short-term relationship. Study 2 replicated study 1 and further explored the effects of relationship context on pheromone ratings. For long-term relationships, women's preferences for masculine face shapes correlated with ratings of 4,16-androstadien-3-one and men's preferences for feminine face shapes correlated with ratings of 1,3,5(10),16-estratetraen-3-ol. These studies link sex-specific preferences for putative human sex pheromones and sexually dimorphic facial characteristics. Our findings suggest that putative sex pheromones and sexually dimorphic facial characteristics convey common information about the quality of potential mates.

Smelling human sex hormone-like compounds affects face gender judgment of men.

Although strong cross-sensory interactions between visual, tactile and auditory modalities have already been shown, we know little about how chemosensory information affects processing in other sensory modalities. We studied whether smelling gender-specific odorous sex hormone-like steroids: 5-alpha-androgenst-16-en-3-one (androgen) or oestra-1, 3, 5 (10), 16-tetraen-3-ol (estrogen) can bias face gender discrimination. We found that, as a result of inhalation of androgen, men perceive faces to be more masculine as compared to when they are exposed to estrogen. Our results provide evidence for specific cross-sensory effects of the gender-specific chemosensory cues on the categorization of visual face gender.