Arousability, Personality, and Decision-Making Ability in Dissociative Disorder.

BACKGROUND: There is a gap in understanding the pathogenesis of dissociative conversion disorder (DCD), despite the disorder having a strong historical root. The role of personality and neurocognitive factors are now highlighted; however, inconsistencies are reported. This study explores the personality disposition, arousability, and decision-making ability of patients with DCD, in reference to a healthy control group (HCG). METHODS: In this cross-sectional study, the sample comprised ten adult psychiatric patients with DCD. Ten participants of the HCG were matched according to age, gender, education, economic status, domicile, religious background, and handedness. The study assessed personality disposition with Temperament and Character Inventory, arousability with reaction time task, and decision-making ability with the Iowa Gambling Task (IGT PEBL version). RESULTS: The DCD group differed significantly on personality disposition related to both temperament and character. There was also evidence of easy arousability and frustration along with deficit in executive function related to decision-making ability. CONCLUSION: This study highlights the presence of both temperamental and characterological factors associated with DCD. Moreover, this study identifies the role of cognitive arousability and decision-making or feedback utilization ability in the psychopathology of DCD.

Development of a Battery to Assess Perceptual-Motor, Cognition, Language, and Scholastic Skills among Bengali Children with Neuro Developmental Disorders.

BACKGROUND: School failure or poor academic performance is often found in neurodevelopmental disorders (NDD); however, there is a dearth of a comprehensive assessment tool to evaluate various underlying deficits, including perceptual-motor, cognitive, language, and scholastic skills of those who have NDD. The study aimed to develop a test to fill-up this gap. MATERIALS AND METHODS: The study followed three phases: the construction of an assessment battery in both Bengali and English languages, separately, incorporating tasks on perceptual-motor, cognitive, language, and scholastic skills; doing a pilot study, and finally, standardization. Standardization was done on 91 normal children (NC) aged 4.5 to 9.5 years, from four districts of West Bengal. The test was applied to 57 children with poor school performance across various NDD, including specific learning disorder, autism spectrum disorder, attention deficit/hyperactivity disorder, and communication disorder. Binet Kamat Test (BKT) of intelligence, National Institute of Mental Health and Neuro-Sciences (NIMHANS) Index for specific learning disability (SLD), Childhood Autism Rating Scale (CARS), Conner's Abbreviated Rating Scale- Parent Report, Linguistic Profile Test, and Test of Pragmatic Language were used as screening tools to identify children with various NDD. The psychometric properties of the tool were assessed. RESULTS: The factor analysis suggested four-factor solution named scholastic-cognitive-motor, attention, auditory-verbal, and perceptual skill. The internal consistency of the test was found to be higher (Cronbach's α >0.70 for most tests), indicating high reliability. Discriminant validity revealed significant score differences between NC and children with NDD (P <.01), suggesting that the new tool can differentiate children with NDD from healthy NC. CONCLUSION: The results favor the new tool as a psychometrically strong tool to assess the scholastic backwardness of children with NDD. It may be further used to create specific profiles for different categories of NDD.

Quantitative analysis of Euclidean distance to complement qualitative analysis of facial expression during deception.

BACKGROUND: Accurate evaluation of an individuals' veracity is a fundamental aspect of social functioning that allows individuals to act in adaptive ways. The domain of deception detection ability is still young, and many components in this field are yet to be touched which demands more research in this field. AIMS: The present study aims at deciphering the structural composition of face during felt, posed, and deceived emotions in facial expression unique to Indian culture, using Facial Action Coding System (FACS). Quantitative analysis of Euclidean distance has been done to complement qualitative FACS analysis. METHODS: In this study, thirty female, young adults with age range of 23-27 years were chosen randomly for portraying their (felt, posed, and deceived) facial expression. All facial expressions were captured through instruction, and videos were converted into static images. The static images were coded on the basis of FACS to decipher the felt, posed, and deceived expressions. Quantitative analysis of the data has been done using MATLAB to meet the objectives of the study and to complement the qualitative analysis. RESULTS: Felt and posed emotions differ in terms of intensity of the expression and subjective experience. Posed emotional and deceived expressions differ in intent. Facial asymmetry is an important indicator for detecting deception.

Instinctual impulses in obsessive compulsive disorder: A neuropsychological and psychoanalytic interface.

Psychopathology of obsessive compulsive disorder (OCD) that has been characterized by a conflict between the ego and superego on one hand, and aggressive and sexual impulses emerging from the id on the other, and employment of characteristic defenses to combat intense conflicts being connected with ones' biological disposition from the psychoanalytic school of thought now gets empirical foundation from neuroimaging research. The findings disregard the psychological construct, exclusively establishing the neurobiology of the disorder. With the objective to study the impact of sexual and aggressive impulses on the executive functions and processing speed in the patient group, 20 OCD patients (11 males, 9 females) and 20 normal control subjects, matched for all relevant variables including age, sex, educational level and handedness were studied. Sexual impulse and guilt was assessed on the Sex Guilt Rating Scale (SGRS), aggressive impulses were tested using State-Trait Anger Expression Inventory (STAXI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess symptom severity, executive functions were assessed through Wisconsin Card Sorting Test (WCST), and processing speed was assessed by employing the Processing Speed Index (PSI) - from WAIS III. It was found that the OCD group differed significantly from the controls, attaining significantly lower percentiles on Processing Speed Index and for all variables of WCST under consideration, namely, perseverative response, perseverative error, non-perseverative error, conceptual level response and number of categories completed. They reported higher scores on subscales of STAXI, specifically related to trait anger and lower scores on anger expression. On the items of SGRS, the OCD group significantly differed with the controls, expressing greater sexual inhibition. In conclusion, we propose an explanation of psychopathology of OCD, which addresses instinctual impulses, executive functions and neural substrates. Our findings contribute to understanding instinctual impulses from the neuropsychological perspective. The findings have implications for better eclectic understanding of the pathogenesis of OCD.

Identification of neuroanatomical substrates of set-shifting ability: evidence from patients with focal brain lesions.

This work concerns the investigation of executive functions in patients with focal brain lesion. In order to identify the underlying substrates for executive functions, 54 patients with focal cortical (n=30), subcortical (n=13) and cerebellar damage (n=10) (M=9; F=1) in the age range of 24-65 years with a minimum of Class V education have been investigated. The patients were admitted to the Department of Neuromedicine of Bangur Institute of Neurology, Calcutta. Each patient with focal lesion was matched with a healthy normal subject controlling for age and education. The socio-economic background was also taken into consideration. Controls were selected from the families of other patients admitted to the institution and also from individuals who volunteered to act as controls. Here too, rigid criteria have been followed to select the normals. Mini Mental State Examination (MMSE) and General Health Questionnaire (GHQ) were administered to screen out the neurological and psychiatric abnormalities in selection of normal control and Wisconsin Card Sorting Test (WCST) was administered to find out the executive function, in terms of set-shifting ability. Since standard anatomical groupings can obscure more specific brain-behavior relations, group-comparison design does not always allow determination of the effective lesion responsible for a particular deficit (Godefroy et al., 1998). The Classification and Regression Tree (CART) analysis has been used to determine the brain-behavior relationships. The result reveals that the frontal lobes are essential determinants of set-shifting capacity. However, for optimal execution of set-shifting function, the frontal lobes require participation of other cortical, subcortical and cerebellar regions. The result has been discussed in the light of the existing theories and research reports.

Neuropsychological disposition and its impact on the executive functions and cognitive style in patients with obsessive-compulsive disorder.

BACKGROUND: Recent brain imaging and electrophysiological studies have consistently shown dysfunction of the fronto-striatal thalamic pathways in patients with obsessive-compulsive disorder (OCD). AIM: To study the relationship of neuropsychological disposition with the executive functions and cognitive style in patients with OCD. METHODS: Twenty OCD patients (14 males, 6 females) and 20 normal control subjects, matched for all relevant variables including age, sex and education, were studied. Neuropsychological disposition was assessed on the Adult Neuropsychological Questionnaire (ANQ), the executive functions were assessed through Wisconsin Card Sorting Test (WCST), and the cognitive style was assessed by employing the Embedded Figure Test (EFT). RESULTS: Subcortical-cerebellar-spinal domain of ANQ was found to be associated with cognitive style and executive functions. CONCLUSION: The impairment of executive functions and poor activation of specific neurological circuitry in OCD patients affirms the neurobiological basis of the disorder.