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Introduction: Stress is a well-known determinant of cognitive performance in both younger and older adults. However, the moderating effect of pathological aging on this relationship remains insufficiently documented. We hypothesize that mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients will report higher perceived stress than control older adults, when asked to complete an effortful cognitive task. We also hypothesize that the deleterious effect of perceived stress on cognitive performance is more evident in MCI and AD patients., Method: The 131 participants consisted of: 25 functional older adults, 35 nonamnestic-MCI patients, 35 amnestic-MCI patients, and 36 AD patients. They were asked to complete the Victoria Stroop test and report their level of perceived stress at four times: before the test (i.e., baseline) and after each part of the test (three, increasingly effortful levels of cognitive requirement)., Results: Overall, perceived stress increased in the most effortful condition-except for AD patients, who reported a decline. A positive main effect of perceived stress on response latency was confirmed. However, this effect became negative in all participants when the model accounted for the difficulty of the task., Discussion: The results suggest that the ability to perceive the stress levels generated by an effortful cognitive task may be altered in AD. They also suggest that the Stroop task may generate a form of perceived stress favoring engagement, and AD patients may not benefit from its positive effects on performance. They put into questions the usual clinical interpretations.

To explore the predictive value of cognitive and coping resources for problem- and emotion-focused coping with age, we collected data from community-dwelling adults between 20 and 90 years old. We hypothesized that age, perceived stress, self-efficacy, working-memory capacity, and mental flexibility were predictors of coping. We collected data using French versions of the Perceived Stress Scale, General Self-Efficacy Scale, and Way of Coping Checklist. Cognitive assessments comprised the WAIS III digit-span subtest and the Trail Making Test parts A and B. In multivariate analyses, neither working-memory nor mental-flexibility deficit predicted problem-focused coping. Age was found to predict only problem-focused coping. Self-efficacy predicted problem-focused coping, and perceived stress predicted emotion-focused coping. Our results confirmed that use of an emotion-focused coping style would not significantly change with age. Problem-focused coping increases with age and depends primarily on participants' confidence in their ability to successfully solve problems (i.e., self-efficacy).

Objectives: To validate the French version of the Scale to Assess Unawareness of Mental Disorder (SUMD) in patients with schizophrenia., Method: One hundred patients with schizophrenic disorders were included. Our statistical analyses evaluated interrater reliability, theoretical validity, and convergent or divergent validity. Finally, an exploratory factor analysis was conducted., Results: The results revealed good psychometric properties for the French version of the SUMD. Both interrater reliability (ICC ranged from 0.68 to 1.00) and internal consistency (Cronbach 0.70) were satisfactory. Criterion validity was confirmed by high correlation values between SUMD scores and scores on the Positive and Negative Syndrome Scale G12 item evaluating insight. Moreover, as hypothesized, there were few associations between SUMD scores and clinical variables. Finally, Principal Component Analyses confirmed the hypothesis of 2 distinct insight dimensions (consciousness and attribution) for both present and past aspects., Conclusions: This French version of the SUMD is a reliable and valid measure of insight in schizophrenia. The clinical relevance of its measure and the development of psychosocial interventions to improve insight into illness in patients with schizophrenia are discussed.

Introduction: This study explores the effect of age on mean-levels of the personality traits defined in Cloninger's personality taxonomy, and investigates the relevance of personality traits for predicting depression levels in adults aged 18 to 94 years., Method: We divided our sample (466 participants) into four age groups (young adult, adult, mature adult and elderly). Personality was measured using the Temperament and Character Inventory, and depression was assessed using the Hospital Anxiety and Depression Scale., Results: Analysis of variance showed mean-level changes for all the personality traits except Self-D. Post hoc analyses revealed a decrease in the level of novelty seeking with age and an increase in the level of self-transcendence for the two oldest age groups. Reward dependence was highest among the youngest participants, whereas harm avoidance was highest for both the youngest and the oldest age groups. Depression correlated positively with harm avoidance and age but negatively with self-transcendence., Discussion: Impulsiveness, curiosity and social dependency decrease with age, whereas spirituality increases. Young and elderly adults are more fearful and socially inhibited. Harm avoidance and self-transcendence are the most relevant personality traits for predicting levels of depression., (Copyright (c) 2008 John Wiley & Sons, Ltd.)

Partial or complete unawareness of deficits in Alzheimer's disease (AD) may result in delaying diagnosis and difficulties for caring. Many theories have been proposed to explain unawareness of neurological or cognitive deficits. Neurological theories use the term of anosognosia to describe unawareness as a consequence of the severity and location of brain lesions. They predict an association between the unawareness of deficits in AD and the severity of dementia or location of the lesions in the right cerebral hemisphere or in the frontal regions. More recent theories have been based on models derived from cognitive neuropsychology. Some models have been designed to explain unawareness of specific deficits such as the memory disorders, others are more extensive based on models of consciousness of the Self. Psychopathological theories postulate that unawareness of deficits is the consequence of a psychological defense mechanism, termed denial. Therefore, unawareness of deficits in AD should be linked to the premorbid personality, abilities to cope with the disease and its consequences more than to the severity and location of brain lesions. The validity of each theory is discussed according to the data from the literature. However, the analysis of the literature is clouded by many methodological difficulties due to the variability of terminology and tools used to assess the unawareness. Moreover, most studies were too narrowly focused on specific points, not taking into account a global model of insight. Nevertheless, some conclusions can be drawn from the available data: 1) the nature of the unawareness of deficits in AD is multidimensional. Terms such anosognosia or denial do not describe single phenomena but correspond to disturbances of various neurological, neuropsychological and psychopathological mechanisms, which can not be explained by a single theory; 2) unawareness should no more be considered as a category but according to a dimensional approach. There is a wide range of levels of unawareness, which can vary from one moment to an other and during the progression of the disease; 3) neurological, neuropsychological and psychopathological mechanisms implicated in unawareness probably coexist in various degrees depending, on one hand, on the disease severity and type of deficits and, on the other hand, on the history and personality of the patient, his(her) familial support, but also on the social perception of the disease. To improve our understanding of the unawareness of deficits in AD, we propose to come back to a detailed clinical description investigating extensively the various aspects of insight.