Steeper aging-related declines in cognitive control processes among adults with bipolar disorders.

BACKGROUND: Little is known about the specificity of executive functioning (EF) decline in older adults with bipolar disorders (OABD), or the impact of bipolar disorders (BD) on the timing and slope of age-related declines in EF processes implicated in both BD etiology and normative aging-cognitive control (CC). This cross-sectional study investigated age-related CC decline in BD. METHODS: Participants were 43 adults with BD (M age = 61.5, SD = 15.8; 86% male) and 45 Controls (M age = 65.2, SD = 12.2; 98% male). Two-way ANOVAs examined the effects of median-age-split and diagnostic groups on cognitive processes with established BD deficits-CC processes (mental flexibility and response inhibition), verbal learning, and verbal fluency. RESULTS: The median-split-age-by-diagnostic-group interaction was significant for mental flexibility; OABD performed significantly worse than younger adults with BD and younger and older Controls. Exploratory multivariate adaptive regression spline characterized non-linear nature of aging-slope changes in mental flexibility for each diagnostic group, yielding an inflection point at older age and steeper subsequent decline in OABD versus Controls. LIMITATIONS: This study is limited by a small sample (particularly for select neuropsychological measures) of mostly Caucasian men and BD diagnoses based on clinical interview and medical records review. CONCLUSIONS: Compared to healthy older adults, OABD showed steeper age-related decline in mental flexibility-select EF processes that depend on the integrity of the CC system. Preliminary evidence links CC integrity to daily functioning in OABD; accelerated aging decline in CC may pose a mechanism for high risk of functional impairment and dementia in OABD.

The relationship between performance-based visual acuity screening, self-reported visual acuity, and neuropsychological performance.

Despite frequent cautions in the literature concerning the importance of visual acuity in neuropsychological testing, there are few published empirical investigations of what constitutes "sufficient" visual acuity, nor are there published guidelines for performance-based visual screening techniques. The current study attempted to validate the utility of a visual acuity screening technique by examining individuals with varying visual ability on neuropsychological measures. Results revealed declines on neuropsychological measures associated with reduced visual acuity, as well as discrepancies between self-reported and measured visual acuity, with neuropsychological performance being more closely related to a performance-based measure of visual acuity than to self-reported visual acuity. Clinical implications are discussed.

Are relations between parental history of alcohol problems and changes in drinking moderated by positive expectancies?

BACKGROUND: Risk factors of alcohol abuse generally have been examined for their additive or direct effects on the development of alcohol-related problems. This study was designed to assess the interaction between two important predictors: parental history of alcohol problems and positive expectancies regarding alcohol consumption. METHODS: The positive expectancies, reported parental alcohol problems, and alcohol use and problems of 169 first-year college students were assessed at their entrance to college, and their alcohol use and problems were assessed again approximately 3 months later. The main effects of positive family history and expectancies as well as their interaction in predicting changes in alcohol use and problems were examined in hierarchical regression analyses. RESULTS: A parental history of alcohol-related problems was related to greater alcohol problems at the two assessment times, and positive expectancies for the effects of alcohol were related to both alcohol problems and alcohol use. The parental history x positive expectancies term significantly added to the prediction of changes in alcohol problems (8% incremental increase in explained variance) even after baseline problems were entered in a prior step in the equation. Follow-up exploration revealed that the interaction was accounted for by high levels of alcohol problems at time 2 being reported by those high in positive expectancies and reporting high parental alcohol problems. The parental history x positive expectancies interaction term also added slightly to the prediction of changes in alcohol use amounts but accounted for a modest 1% incremental variance. CONCLUSIONS: Reported parental history and positive alcohol expectancies interacted to predict increases in alcohol problems over the course of the first semester of college. These results suggest that risk factors for alcohol problems may conjointly interact to confer heightened risk. Such interactive models may further assist in identifying at risk young adults. Limitations such as the reliance on self-report measures and the predominantly female sample are discussed.