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Evidence indicates that pediatric chronic health conditions (CHCs) often impair executive functioning (EF) and impaired EF undermines pediatric CHC management. This bidirectional relationship likely occurs due to biobehavioural and social-structural factors that serve to maintain this feedback loop. Specifically, biobehavioural research suggests that inflammation may sustain a feedback loop that links together increased CHC severity, challenges with EF, and lower engagement in health promoting behaviours. Experiencing social and environmental inequity also maintains pressure on this feedback loop as experiencing inequities is associated with greater inflammation, increased CHC severity, as well as challenges with EF and engagement in health promoting behaviours. Amidst this growing body of research, a model of biobehavioural and social-structural factors that centres inflammation and EF is warranted to better identify individual and structural targets to ameliorate the effects of CHCs on children, families, and society at large. This paper proposes this model, reviews relevant literature, and delineates actionable research and clinical implications. [ABSTRACT FROM AUTHOR]

Objective: Executive Functioning (EF) is a construct that is considered central to cognitive development and has recently garnered attention for its potential role in social functioning. This study investigated the relationship between EF and social skill using both multiple regression and relative weights analyses. Participants: A sample of undergraduate college students in the U.S. (N = 257; Nfemale = 145; Mage = 19.51) participated for course credit. Methods: Participants completed an online survey. Data were analyzed using multiple regression and relative weights analysis to better understand the unique contribution of EF skills to specific social skills. Results: For some dimensions of EF, ability positively correlated with adaptive social outcome, whereas for some other dimensions, lower ability correlated with positive social outcomes. Conclusions: EF may play a role in the general social functioning of college students, though the relationship appears complex and domain-specific. Statement of relevance: Social interaction is one of the most important things that humans do on a day-to-day basis, impacting both mental and physical wellness. College is a particularly important period where social interaction becomes increasingly important as well as complex. While there is no currently agreed upon cognitive basis of social interaction, the executive function (EF) system is believed to play a central role. The current study provides further evidence of the role of the EF system across different social skills in addition to highlighting the complexity of these relationships. [ABSTRACT FROM AUTHOR]

Executive functioning (EF) is of major interest in the study of cognitive factors involved in obesity. Among EF, shifting is related to behavioral flexibility, and inhibition to the ability to refrain from impulsive behavior. A deficit in those two EF could predict individual difficulties to maintain a healthy lifestyle. Weak evidence of deficits in shifting and inhibition in individuals of higher Body Mass Index (BMI) have been observed. The objective was to clarify the relationship between inhibition and shifting regarding weight status group differences in healthy adults. Two neuropsychological tests from the Test of Attentional Performance (TAP) battery were used to measure EF performance of three groups of men and women: normal-weight (NW, n = 38), overweight (OW, n = 40) and obesity (OB, n = 37). The results show that individuals with higher BMI have lower inhibition capacities and that classically used weight status categories might not capture cognitive variability. No differences in shifting were observed concerning weight status nor BMI. This paper provides new insights on cognitive factors in obesity by presenting data from healthy individuals with overweight and obesity. The results support that assessing inhibition capacities might be of interest in a clinical setting for patients with difficulties to lose weight. [ABSTRACT FROM AUTHOR]

The traditional linear skill and drill approach prominent in secondary physical education programs may be leaving some students behind. Critics have argued that this approach fails to meet students' basic psychological needs, while separating the requisite skills from the game itself. Nonlinear pedagogy is an alternative model to teaching motor skills where the student is placed at the center of the learning environment. By promoting the design principles of nonlinear pedagogy in soccer, teachers can foster learning that leads to a shift toward hot executive functioning skills (i.e., self-management skills in emotional situations) and autonomous motivation. [ABSTRACT FROM AUTHOR]

Although an increasing number of children are born with prenatal methadone or buprenorphine exposure, little is still known about the potential long-term effects of these opioids. The aim of this study was to investigate executive function (EF) in children of women in opioid maintenance therapy (OMT). A total of 66 children (aged 48–57 months) participated in the study, 35 of which had histories of prenatal methadone or buprenorphine exposure. EF was measured using a battery of neuropsychological tests and the Behavior Rating Inventory of Executive Function—Preschool Version (BRIEF-P). Results showed that children of women in OMT perform lower on tasks of short-term memory and inhibition compared to nonexposed children, which was mainly associated with lower maternal education and employment rate. The OMT group scored significantly lower on all EF tasks compared to the nonexposed group, although scores fell within the average range on all measures. The development of these children should be monitored to assess for the possible problem behaviors and to promote optimal outcomes. [ABSTRACT FROM AUTHOR]

The impact of deafness on a child's rated executive functioning behaviors and performance capabilities on neurological, cognitive, and achievement domains were examined in a sample of 22 deaf students (ages 5 to 18). The parent and teacher ratings on the Behavior Rating Inventory of Executive Function (BRIEF) showed significant positive correlations (p < .01) on six of the eight clinical scales. There were significant correlations between the BRIEF reports and the students' scores on the Wisconsin Card Sorting Test, the (Children's) Color Trails Test, and the Woodcock-Johnson: Writing Fluency subtest. The Wisconsin Card Sorting Test: Total Errors scale and the Writing Fluency subtest accounted for 70% variance of the parent BRIEF Global Executive Composite and 65% of the variance for the teacher report on this same composite scale. Students with genetic deafness were rated with significantly less challenges with executive functioning (p < .05) on BRIEF scales and performed significantly better on select student measures than students with other causes of deafness. [ABSTRACT FROM PUBLISHER]

We analyzed the effects of bilingualism and age on executive function. We examined these variables along a continuum, as opposed to dichotomizing them. We investigated the impact that bilingualism and age have on two measures of executive control (Stroop and Flanker). The mouse-tracking paradigm allowed us to examine the continuous dynamics of the responses as participants completed each trial. First, we found that the Stroop effect was reduced with younger age and higher levels of bilingualism; however, no Bilingualism by Age interaction emerged. Second, after controlling for baseline, the Flanker effect was not influenced by bilingualism or age. These results support the notion that bilingualism is one way of enhancing some aspects of executive function - specifically those related to the Stroop task - across the adult life span. In sum, different levels of bilingualism, and different ages, result in varying degrees of executive function as measured by the Stroop task. [ABSTRACT FROM AUTHOR]

Homebound older adults are prone to depression, which is linked to systemic inflammation that promotes executive function decline. A companion animal may reduce the negative biobehavioral processes asso- ciated with depression, inflammation, and reduced executive function in homebound older adults. The primary aim of this study was to examine dif- ferences between homebound older adult pet owners and non-pet owners in depression, salivary C-reactive protein (CRP), and executive function. The secondary aim was to determine if the level of attachment to pets was as- sociated with depression, salivary CRP, and executive function. The study was cross-sectional and investigated homebound older adult pet owners and non-pet owners (n= 88) using psychometrically reliable and valid instru- ments (Geriatric Depression Scale Short Form and CLOX 1). Salivary CRP was assessed with immunoassay. Level of attachment to pets was measured using a Likert scale (0–10). Mean age for the total sample was 75 years (SD= 9). Forty-eight (55%) participants owned pets (56% dogs, 25% cats, 4% other pets, 15% both cats and dogs). Pet owners reported a high level of attachment to pets (Median = 10). Pet owners had significantly higher ex- ecutive function than non-pet owners (t= –2.07;p= 0.04) but there were no significant differences in executive function between cat owners and dog owners (t= 1.53;p= 0.14). Pet owners and non-pet owners were similar in depression (t= –1.80,p= 0.08) and salivary CRP levels (t= 0.27,p= 0.79). Level of attachment to pets was significantly and positively correlated with executive function (r= 0.30;p= 0.04) but was not significantly correlated with depression (r= 0.04,p= 0.77) or salivary CRP (r= –0.04,p= 0.80). Compared with non-pet owners, pet owners had better executive function but similar depression and salivary CRP levels. Reasons for these findings are unclear. Significant positive correlation be- tween pet attachment and executive function suggests further investigation in this area. Future studies with larger samples and a longitudinal design are needed to investigate the biobehavioral changes over time in relation to pet ownership, level of attachment to pets, and executive func- tion in homebound older adults. [ABSTRACT FROM PUBLISHER]

To determine whether habitual physical activity status specifically influences executive function change in Alzheimer’s disease (AD) over 1 year. In this longitudinal cohort study, 45 participants with AD were recruited and provided follow-up data approximately 1 year later. Executive function measures (map search task, digit symbol substitution task, controlled oral word association task, verbal fluency task) and habitual physical activity measures (Physical Activity Scale for the Elderly (PASE) and handgrip strength) were taken at baseline and follow-up. Individual composites were subsequently created. Additional demographic, lifestyle, and neuropsychiatric measures were also taken. In a structural equation model (χ2(26) = 9.84,p = .998, comparative fit index = 1.00, root mean square error of approximation = .00), a significant association was found between habitual physical activity and executive function change (β = .27,p = .04). In a cross-lagged panel analysis, a significant path was found between the PASE score and executive change (β = .22,p = .01). As higher habitual physical activity levels were associated with reduced executive function change, the promotion of low-intensity habitual physical activities in individuals with a diagnosis of AD may be warranted. Further research is needed, however, to explore the impact of habitual physical activity on the trajectory of change across cognitive domains, and how this relates to the progression of the underlying pathology associated with this disease. [ABSTRACT FROM PUBLISHER]

Returning to work is an important goal after stroke, not only as a recovery indicator but also for facilitating independent living and improved social identity. The aim of this study was to explore the lived experiences of vocational rehabilitation and the return to work pathway after stroke. Qualitative data were collected through semi-structured interviews with purposively selected participants who had participated in a vocational rehabilitation trial. All participants were employed at the time of their stroke and were community-living. Interviews were undertaken by occupational therapists and were transcribed verbatim before data were thematically analysed using a framework approach. Sixteen participants were interviewed, seven received specialist vocational rehabilitation and nine received usual clinical rehabilitation. Three major themes were identified which highlighted the importance of tailored vocational rehabilitation to address the challenges that arise when returning to the workplace. Stroke survivors perceived the most beneficial components of the specialist vocational rehabilitation intervention to be employer liaison support, fatigue management, and support for cognition and executive processing skills. Vocational rehabilitation was perceived to provide an opportunity to influence working after stroke, although areas of unmet need were highlighted. Findings provide direction for the development of future stroke-specific vocational rehabilitation programs. Psychosocial (emotional) and cognitive (memory and planning) changes along with post-stroke fatigue were perceived to be the greatest barriers faced on returning to work and should be key areas for intervention within a vocational rehabilitation program. Vocational rehabilitation interventions should be tailored to each participant, incorporating elements perceived to be important to stroke survivors, including workplace liaison, employer communication and psychological support. Workplaces may benefit from access to information about the range of physical, cognitive and language deficits associated with stroke, and the potential impact these may have on work skills. [ABSTRACT FROM AUTHOR]

The Modified Six Elements Test (MSET) is used to examine executive deficits—more specifically, planning deficits. This study investigates the reliability of an adapted version of the MSET and proposes a novel scoring method. Two parallel versions of the adapted MSET were administered in 60 healthy participants in a counterbalanced order. Test–retest and parallel-form reliability were examined using intraclass correlation coefficients, Bland-Altman analyses, standard errors of measurement, and smallest real differences, representing clinically relevant changes over time. Moreover, the ecological validity of the adapted MSET was evaluated using the Executive Function Index, a self-rating questionnaire measuring everyday executive performance. No systematic differences between the test occasions were present, and the adapted MSET including the proposed scoring method was capable of detecting real clinical changes. Intraclass correlations for the test–retest and parallel-form reliability were modest, and the variability between the test scores was high. The nonsignificant correlations with the Executive Function Index did not confirm the previously established ecological validity of the MSET. We show that both parallel versions of the test are clinically equivalent and can be used to measure executive function over the course of time without task-specific learning effects. [ABSTRACT FROM PUBLISHER]

The efficacy studies of neurocognitive training have focused on the components of the programmes and general methodological questions, not presenting a rationale for the individualization of the intervention, even though this is an essential factor for efficacy. The main objective of this manuscript is to propose a framework for the individual planning of neurocognitive training sessions based on the results of neuropsychological assessment. The proposed framework is coined Branched Programmed Neurocognitive Training (BPNT). BPNT is based on the programmed learning approach and inspired on the Luria's neurocognitive model. The main premises of this framework are the interdependence and hierarchical organization of the cognitive functions, and the individualization of neurocognitive training with multiple patient-tailored paths. The BPNT framework provides guidelines for planning an individualized neurocognitive training in four stages. The potential advantages of this proposal are discussed at various levels, including the role of reward in neurocognitive training and the potential effects of the model on the maintenance and generalization of intervention results. The BPNT framework can be used as an algorithm for the development and adaptation of paper and pencil programmes, as well as computerized rehabilitation platforms. Studies are in place to examine the feasibility of this framework. Individualized neurocognitive training guided by neuropsychological assessment is most likely to be effective. Branched Programmed Neurocognitive Training (BPNT) model provides guidelines to organize the neurocognitive training based on the results of neuropsychological assessment. BPNT is based on the programmed learning model and the Luria neurocognitive model, addresses the role of reward in neurocognitive training and considers the fundamental principle of Errorless Learning. BPNT can be used as an algorithm for the development and adaptation of paper and pencil programmes and computerized rehabilitation platforms. [ABSTRACT FROM AUTHOR]

Objective:Planning is an important executive function (EF) skill that is fundamental to the capacity to achieve everyday goals that require a series of intermediate steps. This study examined the effect of preterm birth on planning skills in early and middle childhood using Tower problems that made different cognitive workload demands.Method:We administered a novel touchscreen Tower of Hanoi task (Monkey Tree Task; MTT) in three age cohorts (3, 6, and 9 years) to 485 children born between 2000 and 2010 (105 extremely low birth weight [ELBW], 248 late preterm [LP], and 132 term-born [Term]).Results:Children born with ELBW completed significantly fewer Tower problems with higher cognitive demands than children born at Term or LP. Likewise, Term- and LP-born children completed more Tower problems than children born with ELBW. In the youngest cohort, Term-born children solved Tower problems more efficiently than either preterm group, and LP-born children solved problems more efficiently than those born with ELBW. However, there were no group differences in efficiency in the older age cohorts. Significant correlations between our MTT measures and performance on other EF tasks were found.Conclusions:The MTT captured significant performance differences in planning skills between children born term vs. preterm. This study provides important information on the impact that cognitive workload, as a function of Tower problem complexity, has on planning skills in preterm children. This study adds to a growing body of research that distinguishes LP birth as having subtle, but distinguishable, adverse neuropsychological outcomes at earlier ages. [ABSTRACT FROM AUTHOR]

The current study examined how specific neurological systems contribute to the expression of multiple personality dimensions. We used individuals with traumatic brain injuries to examine the contribution of the dorsolateral prefrontal cortex (DLPFC)—a region important for executive function and attention—to the expression of neuroticism and conscientiousness factors and facets. Results from Voxel-Based Lesion-Symptom Mapping analyses revealed that focal damage to the left DLPFC (Brodmann’s area 9) was associated with high neuroticism and low conscientious factor and facet scores (anxiety and self-discipline, respectively). Compared with lesioned and normal controls, veterans with damage in left DLPFC also reported higher neuroticism and lower conscientiousness facet scores, slower reaction times on the California Computerized Assessment Package assessment, and lower scores on the Delis–Kaplan executive function battery. Findings suggest that while neuroticism and conscientiousness remain psychometrically independent personality dimensions, their component facets may rely on a common neurocognitive infrastructure and executive function resources in general. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine executive functions in team sport athletes with and without a history of concussion. Executive functions comprise many cognitive processes including, working memory, attention and multi-tasking. Past research has shown that concussions cause difficulties in vestibular-visual and vestibular-auditory dual-tasking, however, visual-auditory tasks have been examined rarely. Twenty-nine intercollegiate varsity ice hockey athletes (age = 19.13, SD = 1.56; 15 females) performed an experimental dual-task paradigm that required simultaneously processing visual and auditory information. A brief interview, event description and self-report questionnaires were used to assign participants to each group (concussion, no-concussion). Eighteen athletes had a history of concussion and 11 had no concussion history. The two tests involved visuospatial working memory (i.e., Corsi block test) and auditory tone discrimination. Participants completed both tasks individually, then simultaneously. Two outcome variables were measured, Corsi block memory span and auditory tone discrimination accuracy. No differences were shown when each task was performed alone; however, athletes with a history of concussion had a significantly worse performance on the tone discrimination task in the dual-task condition. In conclusion, long-term deficits in executive functions were associated with a prior history of concussion when cognitive resources were stressed. Evaluations of executive functions and divided attention appear to be helpful in discriminating participants with and without a history concussion. [ABSTRACT FROM PUBLISHER]

Executive function refers to a variety of behaviors and abilities related to planning and strategy use, as well as to the maintenance of attention and behavior in the pursuit of some goal. Many instruments have been designed for the purpose of assessing executive function, and the tower tasks represent a specific group of measures commonly used in the assessment of this construct. This review and meta-analysis examines the theoretical and psychometric basis for the use of the various tower tasks in neuropsychological assessment of adults. Neuroimaging and electrophysiological evidence are consistent with theoretical hypotheses of frontal involvement (e.g., planning and strategy use) in tower task performance. Further, adults with various disorders of presumed neurological basis demonstrate impaired performance on tower tasks. Implications for the use of tower tasks in practice and research are discussed. [ABSTRACT FROM AUTHOR]

Executive function (EF) deficit is a hallmark of Fetal Alcohol Spectrum Disorders (FASD), but the vast majority of available evidence comes from school-age children and adolescents. Very little is known about EF during the critical developmental period prior to 6 years of age in FASD. We evaluated EF in 39 children with FASD (3.0–5.5 years) and a comparison group of 50 age-matched, nonexposed controls. Measures included the EF Scale for Early Childhood and a Delay of Gratification task. Compared to age-matched controls, preschool children with FASD had impairments on the EF Scale and showed more impulsivity on the Delay of Gratification task. To confirm the EF Scale finding, FASD group performance was compared to a separate normative dataset (N = 1,400). Those with FASD performed below normal (M = –0.57,SD = 0.92). Within the FASD group, IQ was correlated with the EF Scale (partialr = .60,p = .001) and Delay of Gratification (partialr = .58,p = .005). EF Scale performance did not differ significantly across levels of FASD severity (fetal alcohol syndrome [FAS], partial FAS, or alcohol-related neurobehavioral disorder [ARND]). However, compared to normative data, those with FAS had the largest deficits (M = –0.91SDfrom the mean,SE = 0.23), followed by partial FAS (M = –0.66SDfrom the mean,SE = 0.26), then ARND (M = –0.36SDfrom the mean,SE = 0.20). These novel data show that EF deficits manifest well before the age of 6 years in children with FASD, that they occur across the spectrum, and that EF may be most impaired in children with more severe forms of FASD and/or lower IQs. [ABSTRACT FROM AUTHOR]

Subjective executive functioning (EF) measures provide valuable information about real-world difficulties, although it is unclear what variables actually associate with subjective EF scores. We investigated subjective EF in 245 nondemented, community-dwelling older adults (aged 70 and above) from the Einstein Aging Study. Partial correlational analyses controlling for age were performed between the nine Behavior Rating Inventory of Executive Function—Adult version (BRIEF-A) clinical scales and objective EF tests, self-reported mood and personality, and informant-reported activities of daily living. The significance level was set atp < .006 for all analyses (two-tailed). Most notably, higher worry/oversensitivity, physiological anxiety, and fear of aging were significantly associated with increased EF difficulties on all nine BRIEF-A scales. Additionally, increased EF difficulties on five or more BRIEF-A scales were significantly associated with lower conscientiousness, higher neuroticism, and higher depressive symptom scores. The only objective neuropsychological test that significantly correlated with increased EF difficulties (on four BRIEF-A scales) was a measure of practical judgment. Overall, results indicate that interpretation of subjective EF scores must account for self-report of mood and personality. Moreover, the BRIEF-A only minimally taps objective EF as measured by performance-based measures. We discuss the theoretical and practical implications of these findings. [ABSTRACT FROM PUBLISHER]

The article provides information about the Delis-Kaplan Executive Function System (D-KEFS). It provides a co-normed assortment of existing measures, or newly modified established tests, which crosses modalities and covers a wide age range. The D-KEFS includes 9 stand-alone tests. It should be noted that the D-KEFS manual provides no new validation data for these assignments and implicitly relies on past validation studies of the independent tests to assign executive function (EF) characteristics. The fractionation of EF into subdomains has become routine, with certain capacities such as inhibition, working memory, mental shifting, and cognitive flexibility receiving special and deserved attention.

Investigates the Iowa Gambling Task (IGT) in relation to fluid intelligence and two conventional executive function tasks. Intercorrelations among executive function tasks; Comparison of different measures of the IGT between adults and children; Conclusion that the IGT may serve as a complementary tool to the executive functions test battery.

Objectives: The aim of this study was to investigate physical decline over 1-year in a cohort of older people across the cognitive spectrum. Methods: Physical function was assessed using the Physiological Profile Assessment (PPA) in 593 participants (cognitively normal [CN]: n = 342, mild cognitive impairment [MCI]: n = 77, dementia: n = 174) at baseline and in 490 participants available for reassessment 1-year later. Neuropsychological performance and physical activity (PA) were assessed at baseline. Results: Median baseline PPA scores for CN, MCI and dementia groups were 0.41 (IQR = −0.09–1.02), 0.66 (IQR = −0.06–1.15) and 2.37 (IQR = 0.93–3.78) respectively. All baseline neuropsychological domains and PA were significantly associated with baseline PPA. There were significant interaction terms (Time × Cognitive Group, Global Cognition, Processing Speed, Executive Function and PA) in the models investigating PPA decline. In multivariate analysis the Time × Executive Function and PA interaction terms were significant, indicating that participants with poorer baseline executive function and reduced PA demonstrated greater physical decline when compared to individuals with better executive function and PA respectively. Discussion: Having MCI or dementia is associated with greater physical decline compared to CN older people. Physical inactivity and executive dysfunction were associated with physical decline in this sample, which included participants with MCI and dementia. Both factors influencing physical decline are potentially amenable to interventions e.g. exercise. [ABSTRACT FROM AUTHOR]

Executive functions (EF) allow persons to adapt to situations arising in daily life and can be affected following acquired brain injury (ABI). Measuring the impact of EF impairments on the accomplishment of activities of daily living (ADL) requires specific assessment tools, but choosing the right tool may be difficult.Purpose: To conduct a scoping review on how assessments of ADL address EF and EF impairments in persons with ABI.Method: A scoping review of literature (peer-reviewed and grey literature) published until August 2014 was conducted. Using a systematic procedure, literature was selected, results were charted, and tools were analysed with respect to their goals, underlying models, psychometric properties and applicability. The analysis also included how tools considered components of EF according to Lezak's model.Results: 12 tools, developed either to assess EF in ADL, independence in ADL considering EF or ADL capacities, were identified and analysed according to multiple criteria.Conclusions: This review provides important information about existing tools to assist in tool selection and clinical decision-making related to ABI and EF. [ABSTRACT FROM AUTHOR]

Children born very preterm (VP, ≤ 32 weeks) exhibit poor performance on tasks of executive functioning. However, it is largely unknown whether this reflects the cumulative impact of non-executive deficits or a separable impairment in executive-level abilities. A dual-task paradigm was used in the current study to differentiate the executive processes involved in performing two simple attention tasks simultaneously. The executive-level contribution to performance was indexed by the within-subject cost incurred to single-task performance under dual-task conditions, termeddual-task cost. The participants included 77 VP children (mean age: 7.17 years) and 74 peer controls (mean age: 7.16 years) who completed Sky Search (selective attention), Score (sustained attention) and Sky Search DT (divided attention) from the Test of Everyday Attention for Children. The divided-attention task requires the simultaneous performance of the selective- and sustained-attention tasks. The VP group exhibited poorer performance on the selective- and divided-attention tasks, and showed a strong trend toward poorer performance on the sustained-attention task. However, there were no significant group differences in dual-task cost. These results suggest a cumulative impact of vulnerable lower-level cognitive processes on dual-tasking or divided attention in VP children, and fail to support the hypothesis that VP children show a separable impairment in executive-level abilities. [ABSTRACT FROM PUBLISHER]

“Theory of mind” (ToM) refers to the ability to predict others’ thoughts, intentions, beliefs, and feelings. Evidence from neuropsychology and functional imaging indicates that ToM is a domain-specific or modular architecture; however, research in development psychology has suggested that ToM is the full development of the executive functions in individuals. Therefore, the relationship between ToM and the executive functions needs to be clarified. Since the frontal lobe plays a critical role in the abilities of ToM and the executive functions, patients with frontal lobe damage were recruited for the present study. Assessments of ToM and the executive functions were performed on 23 patients with frontal lobe damage and 20 healthy controls. When controlling for the executive functions, significant differences between the patient and normal groups were found in the affective component of ToM, but not in the cognitive component. The present study suggests that in various social situations, executing ToM abilities requires logical reasoning processes provided by the executive functions. However, the reasoning processes of affective ToM are independent of executive functions. [ABSTRACT FROM PUBLISHER]

Background/aims: The issue of whether sex offenders have cognitive deficits remains controversial. The objective of this study was to compare the neuropsychological function of older adult first time sex-offenders (FTSO), who had not previously been charged with a sexual offence prior to the age of 50, to historical long-term sex offenders (HSO) and non-sex offenders (NSO). The hypotheses were (a) that FTSO would demonstrate greater deficits in executive function, decision-making, and memory compared to non-sex offenders; and (b) the HSOs would present similar neuropsychological deficits to non-sex offenders.Method: A battery of neuropsychological measures was administered to 100 participants comprising 32 FTSOs, 36 HSOs, and 32 NSOs.Results: Both FTSOs and HSOs showed significant impairment on tests of executive function (including verbal fluency, trail-making, and the Hayling test of response inhibition) as well as on tests of verbal and verbal memory compared to NSOs; however, there was no difference between the two sex offender groups.Conclusions: Older adult sex offenders, overall, demonstrated poorer neuropsychological performance than older adult non-sex offenders did, although there was no difference between older first-time and historical offenders. Cognitive deficits may increase the risk of sexual offending due to impaired capacity in self-regulation, planning, judgment, and inhibition. A proportion of older adult sex offenders may be harboring acquired frontal lobe pathology. [ABSTRACT FROM AUTHOR]

Background: Promising models for cognitive rehabilitation in alcohol treatment rest on a more nuanced understanding of the associated impairments in the multifaceted domains of executive functioning (EF) and impulsivity.Objectives: This meta-analysis examined the effects of alcohol on the individual subcomponents of EF and impulsivity in recently detoxified participants, including 1) Inhibition & Self-Regulation, 2) Flexibility & Set Shifting, 3) Planning & Problem Solving, 4) Reasoning & Abstraction, and 5) Verbal Fluency. Impulsivity was further examined through an analysis of motor, cognitive, and decisional subcategories.Method: Investigators searched, coded, and calculated effect sizes of impairments demonstrated in a broad range of neuropsychological tests for EF. A total of 77 studies were selected covering 48 years of research with a sample size of 5140.Results: Findings ranged from a Hedges' g effect size of 0.803 for Inhibition to a Hedges' g of 0.359 for Verbal Fluency. Results also varied for the individual subcategories of Inhibition, including a large effect size for decisional impulsivity (g = 0.817) and cognitive impulsivity (0.860), and a moderate effect size for motor impulsivity (g = 0.529). The Hayling Test, Wisconsin Card Sorting Test, and Iowa Gambling Task were the measures most sensitive for alcohol effects.Conclusion: Planning, problem solving, and inhibitory abilities are significantly affected by alcohol abuse, with decisional and cognitive forms of impulsivity most impacted. Cognitive remediation targeting these deficits might increase the related functions that mediate the ability to moderate or abstain from alcohol, and so lead to improved treatment results. [ABSTRACT FROM AUTHOR]

Objectives: The projected increase in the population of older adults in the United States entails a pressing need to examine risk and protective factors associated with cognitive function. This study aims to examine the association between neighborhood social cohesion and cognitive function among older Chinese adults in the United States. Method: Using the first epidemiological survey of older Chinese Americans and applying ordinary least squares and quantile regressions, this study examines the association between neighborhood social cohesion and various domains of cognitive function. Results: Results show that neighborhood social cohesion is independently associated with most domains of cognitive function (i.e. global cognition score, and its components such as the Chinese Mini-Mental State Examination and executive function and episodic memory measures). Conclusion: This study represents one of a few initial efforts that examined the association between neighborhood social cohesion and cognitive function for Chinese older adults in the United States. Our findings suggest that socially cohesive neighborhoods can provide enriched environments where active lifestyles can be encouraged, and cognitive skills and abilities can be stimulated, practiced, and preserved for older adults. [ABSTRACT FROM AUTHOR]

The Dysexecutive Questionnaire (DEX) is a tool for measuring everyday problems experienced with the dysexecutive syndrome. This study investigated the psychometric properties of a revised version of the measure (DEX-R), a comprehensive tool, grounded in current theoretical conceptualisations of frontal lobe function and dysexecutive problems. The aim was to improve measurement of dysexecutive problems following acquired brain injury (ABI). Responses to the DEX-R were collected from 136 men and women who had experienced an ABI (the majority of whom had experienced a stroke or subarachnoid haemorrhage) and where possible, one of their carers or family members (n = 71), who acted as an informant. Rasch analysis techniques were employed to explore the psychometric properties of four newly developed, theoretically distinct subscales based on Stuss model of frontal lobe function and to evaluate the comparative validity and reliability of self and informant ratings of these four subscales. The newly developed subscales were well targeted to the range of dysexecutive problems reported by the current sample and each displayed a good level of internal validity. Both self- and independent-ratings were found to be performing reliably as outcome measures for at least a group-level. This new version of the tool could help guide selection of interventions for different types of dysexecutive problems and provide accurate measurement in neurorehabilitation services. [ABSTRACT FROM PUBLISHER]

An increasing number of studies demonstrate that individuals with a history of suicidality exhibit impaired executive functioning abilities. The current study examines whether these differences are linked to suicidal thoughts or suicidal acts—a crucial distinction given that most people who think about suicide will not act on their thoughts. A large online sample of U.S. participants with a history of suicide ideation (n = 197), suicide attempts (n = 166), and no suicidality (n = 180) completed self-report measures assessing executive functioning, suicide ideation and attempts; in addition, depression, self-efficacy, and history of drug abuse and brain injury were assessed as potential covariates. Individuals with recent suicide attempts reported significantly worse executive functioning than ideators. This difference was not accounted for by depression, self-efficacy, history of drug abuse or brain injury. Self-reported executive functioning may represent an important short-term risk factor for suicide attempts. [ABSTRACT FROM PUBLISHER]

This study examined the clinical utility of the Multiple Errands Test (MET) from the perspective of clinicians. Employing a qualitative descriptive design, in-depth semi-structured interviews were conducted with eight occupational therapists. Participants had an average of 12 years clinical experience and their experience using the MET varied. Interviews were transcribed and analysed using framework analysis. Three dominant themes emerged from the data. Theme 1 was that clinicians value the MET because it reflects real-life functioning. Clinicians perceived the MET to be a unique assessment collecting data on functional performance, and sensitive to higher level cognitive deficits. Theme 2 was that the MET could be used flexibly depending on one's rehabilitation goals. Clinicians employed the MET as an assessment to inform the direction of treatment and as a component of their intervention. Theme 3 was that the MET is a challenging assessment requiring buy in and commitment from therapists. This study is the first to report clinicians’ perspectives of the clinical utility of the MET. It reinforces the importance of ecologically valid tests, and augments existing research evaluating psychometric properties of the MET by describing how the MET has been employed in rehabilitation settings to improve health outcomes for adults with neurological conditions. [ABSTRACT FROM PUBLISHER]

Previous literature has explained older individuals’ disadvantageous decision-making under ambiguity in the Iowa Gambling Task (IGT) by reduced emotional warning signals preceding decisions. We argue that age-related reductions in IGT performance may also be explained by reductions in certain cognitive abilities (reasoning, executive functions). In 210 participants (18–86 years), we found that the age-related variance on IGT performance occurred only in the last 60 trials. The effect was mediated by cognitive abilities and their relation with decision-making performance under risk with explicit rules (Game of Dice Task). Thus, reductions in cognitive functions in older age may be associated with both a reduced ability to gain explicit insight into the rules of the ambiguous decision situation and with failure to choose the less risky options consequently after the rules have been understood explicitly. Previous literature may have underestimated the relevance of cognitive functions for age-related decline in decision-making performance under ambiguity. [ABSTRACT FROM AUTHOR]

Real-world contexts differ in the clarity of expectations for desired responses, as do assessment procedures, ranging along a continuum from maximal conditions that provide well-defined expectations to typical conditions that provide ill-defined expectations. Executive functions guide effective social interactions, but relations between them have not been studied with measures that are matched in the clarity of response expectations. In predicting teacher-rated social competence (SC) from kindergarteners' performance on tasks of executive functions (EFs), we found better model–data fit indexes when both measures were similar in the clarity of response expectations for the child. The maximal EF measure, the Developmental Neuropsychological Assessment, presents well-defined response expectations, and the typical EF measure, 5 scales from the Thematic Apperception Test (TAT), presents ill-defined response expectations (i.e., Abstraction, Perceptual Integration, Cognitive-Experiential Integration, and Associative Thinking). To assess SC under maximal and typical conditions, we used 2 teacher-rated questionnaires, with items, respectively, that emphasize well-defined and ill-defined expectations: the Behavior Rating Inventory: Behavioral Regulation Index and the Social Skills Improvement System: Social Competence Scale. Findings suggest that matching clarity of expectations improves generalization across measures and highlight the usefulness of the TAT to measure EF. [ABSTRACT FROM PUBLISHER]

Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study. Seventy-five patients suffering from various neurological diseases (Alzheimer’s disease (AD), Parkinson’s disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity–distractibility–impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes. [ABSTRACT FROM PUBLISHER]

The present short review discusses reasons for the mixed results on the possible enhancement of cognition, especially executive function, in bilingualism. We define three major problem areas that hamper many studies in this field: the use of research designs that are weak for the task at hand, the lack of a detailed theory on how bilingual experience would modify cognition, and the employment of measures of bilingual behaviour and executive function that are troublesome. Potential remedies for these problem areas are discussed, and the emerging research approach where specific aspects of individual bilingual experience are examined and related to specific aspects of executive performance is highlighted. [ABSTRACT FROM AUTHOR]

Background: The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) is a measure of cognitive-communication and executive functions involving everyday tasks. Scores are predictive of employment status; however, the measure’s construct validity is unclear. Objective: The study’s objective was to assess the linear association of FAVRES test performance with performance on a number of neuropsychological measures in a sample of individuals with neurocognitive deficits. Methods: Twenty-two adults completed the FAVRES, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Delis-Kaplan Executive Function System (D-KEFS), Color-Word Interference (CWI), Tower and Trail Making (TM). Results: FAVRES Total Accuracy score significantly correlated with CWI Inhibition (r = −0.43) and Tower (r = 0.60). Total Rationale significantly correlated with CWI Inhibition (r = −0.49), TM Number-Letter Switching (r = −0.48) and Tower (r = 0.55). Total Reasoning significantly correlated with CWI Inhibition (r = −0.71), Inhibition Switching (r = −0.50), TM Number-Letter Switching (r = −0.67) and Tower (r = 0.69) but also correlated with a number of measures involving other elements of cognition. Conclusion: Results provide evidence of convergent validity for the FAVRES as a measure of executive functions. Accuracy and Rationale scores also appear to have good discriminant validity. [ABSTRACT FROM PUBLISHER]

Objectives: To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients.Method: We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function.Results: All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL.Conclusions: Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated. [ABSTRACT FROM AUTHOR]

Objective:The current investigation examined the relationship between cognitive impairment and sense of self in Alzheimer's disease (AD). Method:Forty-nine participants with dementia associated with AD were recruited through memory clinics in Victoria, Australia. The 26 participants of the healthy control sample were recruited from a retirement village. Self was measured via theReflectiveSelf-Function Scale– a theory of mind indicator that provides personal and social self-reflection scores. Cognitive assessment included measures of new learning, executive function, and speed of information processing. Results:A reduction in sense of self in mild AD was demonstrated in both personal and social domains, as compared to healthy adults of a similar age. With a focus on specific cognitive impairment relationships, new learning was found to predict personal self-reflection, whereas speed of information processing predicted social self-reflection capacity. Conclusion:Findings suggest that deficits in new learning ability contribute to a reduced ability of people with early AD to understand their mental world and interpret thoughts, feelings, and beliefs about themselves. This impaired capacity to self-reflect will be intrusive in daily activities that require monitoring of current self-performance. Furthermore, with reduced speed of information processing found to impact on ability to reflect on social relations, individuals with AD are placed at risk of reduced ability to understand their social world, including communicating and interacting with others. Notwithstanding the overall group findings, individual variability was evident which reinforces the need for person-centred care in dementia. [ABSTRACT FROM AUTHOR]

Evidence regarding biological correlates of sexual offending, which might enhance the understanding, research, and treatment of these offenders, is rather emerging or in the embryonic stage. In this study, our main objective is to identify specific executive functioning (EF) processes that are commonly impaired in sexual offenders, and to further determine whether these differ as a function of offender subtypes. A search is conducted inProQuest,Criminal Justice Abstract,EBSCOhost, andSocial Science Citation Indexelectronic journal databases for studies published spanning the period 1990–2015. Google Scholar and Google search engines were also searched and the reference lists of the retrieved papers were searched for additional papers. A total of 1303 papers were retained for consideration. After removing duplicates, and subjecting the retrieved papers to inclusion and exclusion criteria, 24 papers (19 published and 5 unpublished) were deemed appropriate for the review. While several EF processes have been investigated, the available evidence implicates deficits incognitive flexibilityandinhibition of interferenceas commonly reported among adult male sexual offenders. This finding may be due to the sensitivity of tests ofcognitive flexibility(e.g. the Wisconsin Card Sorting Test) andinhibition of interference(e.g. the Stroop Test) to frontal lobe lesions, and also because these tests are among the most frequently administered EF tests as revealed by this study. Juvenile sexual offenders, however, exhibit no distinct EF profiles. The findings of the study, implications for treatment, and recommendations for future studies are succinctly discussed. [ABSTRACT FROM PUBLISHER]

Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients’ needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients’ goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account. [ABSTRACT FROM PUBLISHER]

This study investigates neuropsychological deficits in recently deployed veterans with mild traumatic brain injury (mTBI). Veterans discharged from 2007 to 2012 were recruited from Veterans Affairs clinics. Independent groups of participants with mTBI (n = 57) and those without TBI (n = 57) were administered the Beck Depression Inventory-II, Combat Exposure Scale, Word Memory Test, and the Self-Awareness of Deficits Interview. Neuropsychological instruments included the Rey-Osterrieth Complex Figure Test, Letter and Category Fluency, Trail-Making Test-Parts A and B, Christiansen H-abbreviated, Soper Neuropsychology Screen, Wechsler Memory Scale subtests Logical Memory I and II, and the Street Completion Test. The mTBI group performed significantly worse on all of the executive and nonexecutive measurements with the exception of Category Fluency, after controlling for age, depression effort, and combat exposure. Depression and combat exposure were greater for the mTBI group. The mTBI group scored poorer on effort, but only the Multiple Choice subtest was significant. The mTBI group had good awareness of their deficits. [ABSTRACT FROM PUBLISHER]

Aim: Self-generation is a learning strategy, demonstrated to improve learning in healthy persons as well as persons with multiple sclerosis (MS). This study examines the relative influence of memory performance and executive functioning on the ability to benefit from self-generated learning in persons with MS. Method: Participants consisted of 70 individuals with MS. A within-groups design was employed examining recall of words that were presented in two learning conditions: (a) a condition in which the to-be-learned information was provided to the participant and (b) a condition in which the to-be-learned information was self-generated by the participant. Participants were divided into 2 groups based on their benefit from self-generation. Participants who benefited from using self-generation strategy were included in the responders group, and participants who did not benefit from using self-generation were included in the nonresponders group. Executive functions were assessed with the D-KEFS (Delis–Kaplan Executive Function System) Sorting Test, and learning and memory were assessed via the Open-Trial Selective Reminding Test and the Brief Visual Spatial Memory Test–Revised. Results: Responders had significantly better executive functions than nonresponders, while no significant differences were noted between the 2 groups on memory abilities. Logistic regression analysis revealed that performance on the executive functioning task significantly predicted benefit from self-generation. Conclusions: Executive functioning is critical for the ability of an individual with MS to benefit from self-generation strategy use. [ABSTRACT FROM AUTHOR]

The Zoo Map Test of the Behavioral Assessment of the Dysexecutive Syndrome battery is often applied to measure planning ability as part of executive function. Successful performance on this test is, however, dependent on various cognitive functions, and deficient Zoo Map performance does therefore not necessarily imply selectively disrupted planning abilities. To address this important issue, we examined whether planning is still the most important predictor of Zoo Map performance in a heterogeneous sample of neurologic and psychiatric outpatients (N = 71). In addition to the Zoo Map Test, the patients completed other neuropsychological tests of planning, inhibition, processing speed, and episodic memory. Planning was the strongest predictor of the total raw score and inappropriate places visited, and no additional contribution of other cognitive scores was found. One exception to this was the total time, which was associated with processing speed. Overall, our findings indicate that the Zoo Map Test is a valid indicator of planning ability in a heterogeneous patient sample. [ABSTRACT FROM PUBLISHER]

Introduction: In recent years, evidence has accumulated to suggest that patients with bipolar disorder show altered processing of emotionally relevant information. However, only a few studies have examined manic patients' eye movements when processing facial expressions. Method: A free viewing task and anti-saccade task were used separately to investigate attentional bias and response inhibition while processing emotional stimuli. Data were drawn from matched samples of manic patients (n = 25) and healthy controls (n = 20). Results: The analyses of eye-movement data revealed that there was a significant difference between manic patients and healthy controls in the total duration of fixations but not in the orientation or duration of the first fixation. However, no significant differences between manic patients and healthy controls in response inhibition were detected. Conclusion: These results demonstrate that compared to healthy controls, manic patients show a deficiency in processing speed. The patients showed no attentional vigilance to happy or sad expressions but did showed avoidance of the sad expression and focused more on the happy expression in later emotion processing. There were no impairments of response inhibition detected in manic patients. Abnormal processing of emotional information and having aberrant inner-experiences of emotion is a feature of bipolar disorders. Processing speed is slow in manic patients versus healthy controls. Manic patients focused lesser on sad expression than healthy controls, which suggesting an avoidance of sad expressions. The findings show that psychotherapies like CBT may be applicable to manic patients. [ABSTRACT FROM AUTHOR]

Neuropsychological research can be advanced through a better understanding of relationships between executive functioning (EF) behavioral competencies and the expression of aggressive behavior. While performance-based EF measures have been widely examined, links between self-report indices and practical real-life outcomes have not yet been established. Executive Functioning Index subscale scores in this sample (N = 579) were linked to trait hostility (Buss-Perry Aggression Questionnaire), aggression in the natural environment (Lifetime Acts of Violence Assessment), and conduct disorder symptoms prior to age 15. Significant associations were found between all of the EFI subscales (Motivational Drive, Organization, Strategic Planning, Impulse Control, and Empathy), trait aggression, and conduct disturbance. Lifetime acts of aggression were predicted by all but Organization scores. Physical injuries inflicted on other(s) were 2 to 4 times more likely to occur among respondents generating low (z < -1) EFI subscale scores. While these EFI relationships were modest in size, they are pervasive in scope. These findings provide support for the potential role of perceived EF deficits in moderating lifetime aggression. [ABSTRACT FROM AUTHOR]

Recent models on decision making under risk conditions have suggested that numerical abilities are important ingredients of advantageous decision-making performance, but empirical evidence is still limited. The results of our first study show that logical reasoning and basic mental calculation capacities predict ratio processing and that ratio processing predicts decision making under risk. In the second study, logical reasoning together with executive functions predicted probability processing (numeracy and probability knowledge), and probability processing predicted decision making under risk. These findings suggest that increasing an individual’s understanding of ratios and probabilities should lead to more advantageous decisions under risk conditions. [ABSTRACT FROM PUBLISHER]

The Frontal Assessment Battery (FAB) is commonly used to evaluate executive functions. Although psychometric properties have been examined in Western studies, data on the FAB in Eastern societies are limited. This study thus aims to examine psychometric properties of the Taiwanese FAB (TFAB). A total of 301 healthy participants were recruited. All participants were evaluated with the TFAB. Thirty participants were retested 3 months after the 1st examination for test–retest reliability. The Verbal Fluency Test was used for criterion-related validity. Although the TFAB had an unacceptable Cronbach’s alpha, its test–retest reliability was good. The criterion validity was also good, while the factor analysis revealed that the TFAB may be represented as a 2-factor or 3-factor structure. The TFAB score was significantly associated with age and education level. This study comprehensively re-examined the psychometric properties of the TFAB for Chinese-speaking people, and it merited more validations for the TFAB with clinical samples in the future. [ABSTRACT FROM PUBLISHER]

Phenylketonuria (PKU) is a hereditary disorder characterized by disrupted phenylalanine metabolism and cognitive impairment. However, the precise nature and developmental trajectory of this cognitive impairment remains unclear. The present study used a verbal fluency task to dissociate executive and verbal processes in children with PKU (n = 23; 7-18 years) and controls (n = 44; 7-19 years). Data were collected at three longitudinal timepoints over a three-year period, and the contributions of age, group, and their interaction to fluency performance were evaluated. Results indicated impairments in executive processes in children with PKU, which were exacerbated by declining metabolic control. [ABSTRACT FROM AUTHOR]

A limited number of longitudinal studies have investigated long-term neuropsychological development in the pediatric stroke population. This study retrospectively examines cognitive outcomes in 41 children with a history of stroke, with reference to age at stroke, laterality, region and mechanism of stroke. In the course of recovery, neuropsychological measures of intellectual functioning and memory were administered at two time points, whilst executive functioning, attention and academic skills were administered at one time point. As predicted, children with stroke performed significantly worse compared to normative expectations on all neuropsychological measures. Up to two thirds of children scored in the borderline impaired and impaired ranges on at least one domain of cognition. Performance on intellectual and memory assessment remained relatively stable over time. Younger age at stroke was found to be associated with poorer intellectual functioning. No effects of laterality of stroke on neuropsychological performance over time were found. Children with subcortical stroke demonstrated a greater improvement in immediate memory over time than children with cortical stroke. These findings reveal that children with stroke display long-term cognitive difficulties that typically remain stable over time. Attention and academic skills are particularly vulnerable to impairment. Further evidence that age at stroke is a significant factor in terms of cognitive outcome is provided, in support of the “early vulnerability” position. [ABSTRACT FROM AUTHOR]

Objective: The objective of this paper was to correlate informant personality change (PC) judgements following moderate-severe traumatic brain injury with quantitative neurobehavioural measures and to contrast the neurobehavioural correlates of informant and participant judgements of PC. Participants: Informant-participant pairs were recruited from a medico-legal clinic passing effort tests (N = 31) and a National Health Service clinic (N = 40). Measures: Participants were assessed on Wechsler tests of general ability, tests of executive functioning (Zoo Map and Fluency) and emotional distress (Beck Depression Inventory-FastScreen, Hospital Anxiety and Depression Scale and State-Trait Anger Expression Inventory-II). Informants' expressed emotion towards participants was assessed with the family questionnaire. Both completed the DEX, the Frontal and Social Behavior Questionnaire and PC ratings. Results: The correlates of participant and informant ratings of participant PC partially overlapped. For example, participant self-reported PC was associated with self-reported dysexecutive symptoms and emotional distress. In contrast, informant report of participant PC was associated with lower perceived emotional recognition and empathy, informant report of dysexecutive symptoms and high informant expressed emotion. Conclusions: It is argued that whilst researchers aim to exhaustively quantify specific neurobehavioural changes and their clusters, partially overlapping subsets of these changes evoke the PC judgements of participants and informants. The clinical implications of this are briefly considered. [ABSTRACT FROM AUTHOR]

The executive functions of the homeless may be contributing to the success or failure of social integration processes. The goal of this study was to analyze the relationship between attachment and executive dysfunction in the homeless, specifically, to analyze the prevalence of adult attachment and executive dysfunction patterns, as well as the predictive power of different types of attachment for executive functioning. Participants were 107 homeless. Descriptive analysis revealed the prevalence of insecure attachment, and a high prevalence of clinically significant executive dysfunction. Regression analysis showed that attachment predicts all the executive functions, although the predictive power of attachment decreased when entering the variable drug addiction. People in a situation of chronic social exclusion are characterized by an insecure attachment style and moderate levels of executive dysfunction. [ABSTRACT FROM AUTHOR]