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Case-Based Differential Diagnostic Mental Health Evaluation for Adults
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
Neurocognitive disorders (NCDs) are unique among DSM-5 categories in that there are NCD syndromes (e.g., major, mild), as well as NCDs due to underlying disease entities (e.g., NCD due to Alzheimer's disease [AD]) (APA, 2013). Sadock et al. (2019) classify major NCDs into one of three conditions: (1) delirium, (2) dementia, and (3) other cognitive disorders. However, the DSM-5 no longer uses the term “dementia” as a diagnosis, but instead uses NCD with etiological subtypes (e.g., AD, frontotemporal lobar degeneration, Lewy body disease, and vascular disease). All criteria for NCDs are based upon defined cognitive domains.
Cognitive Science: Integrative Theory of Cognition, Cognitivism and Computationalism
Published in Harald Maurer, Cognitive Science, 2021
Neurocognition is about explaining how these activities are realized in the brain, or rather, in the nervous system. Since the processes occurring there are very complex, they can not be described in detail. But one can form models of these processes that provide very plausible explanations for many phenomena. They are all based on artificial neural networks (ANN). The subject area of neurocognition should therefore be the investigation of the realization of cognitive processes of the brain with the help of suitable forms of ANN" (Dilger 2003/2004). In other words, the term neurocognition refers to the analysis of the internal self-organizing principles of the cognition of an information-processing system3 from the perspective of the more recent scientific empirical and theoretical results of (1) neuroinformatics and computational neuroscience, (2) cognitive neuroscience, (3) neurophilosophy, (4) cognitive neuropsychology and neurolinguistics, based on the mathematical theory of (nonlinear) dynamical complex systems.4 Accordingly, those theoretical models of the cognitive neuroarchitectures5 are taken into consideration which try to consider and replicate the newer neuroscientific, empirical evidence to a high degree. In other words, those neuroarchitectures have a high degree of neurobiological plausibility in the context of the cognitive neurosciences.
Late Effects of Treatment for Childhood Brain and Spinal Tumors
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Ralph Salloum, Katherine Baum, Melissa Gerstle, Helen Spoudeas, Susan R. Rose
Importantly, some of the same risk factors for poor neurocognitive outcomes also predict poor psychological health/adjustment and adaptive dysfunction, in part because neurocognitive problems can reflect or exacerbate associated mood, behavioral, social, or adaptive issues. Survivors of CNS tumors are at increased risk for internalizing behavior problems191 that present as somatization and anxiety (including separation anxiety). Depressive symptoms include low mood, social withdrawal, and reduced peer interactions, but can also manifest as daytime sleepiness.192 These cognitive and emotional difficulties negatively affect school attendance, academic performance, and social relationships,193 making early psychotherapy and psychiatric services critical. The complex interaction among medical, cognitive, and mood-related problems greatly affects an individual’s day-to-day functioning. Relative to controls, pediatric cancer survivors are more likely to require special education, are less likely to graduate from high school or college or to marry,194 and report greater overall distress and decreased QoL.192 In addition, CNS tumor survivors are significantly less likely to live independently as adults than survivors of other childhood cancers195 and are at elevated risk of being unemployed.196
Reliability and Factor Structure of the Saint Louis University Mental Status (SLUMS) Examination
Published in Clinical Gerontologist, 2023
Emily T. Noyes, Saudia Major, Addie M. Wilson, Elizabeth B. Campbell, Lauren N. Ratcliffe, Robert J. Spencer
We examined archived records for 108 Veterans receiving HBPC services at a Midwestern VA medical center. Veterans are referred to HBPC after poor progress toward designated health care goals in their primary care clinic. These Veterans are medically complex with multiple comorbidities, and experience significant psychosocial burdens. Their multitude of impairments often render them either homebound or with limited ability to access spaces in their communities. As part of routine clinical care, Veterans enrolled in these services completed yearly cognitive screening. Veterans were excluded if they did not complete the full SLUMS. Thus, seven Veterans with visual and/or motor impairments that truncated their SLUMS were excluded. The final sample consisted of 101 Veterans (Mage = 76.44 [SD = 9.88], Meducation= 13.07 [SD = 2.26]), who were mostly male (94.1%) and White (85.2%). Twenty-eight Veterans (Mage= 74.86 [SD = 11.08], Meducation= 13.54 [SD = 2.89]) completed the SLUMS approximately one year later. There were no differences between age, education, or SLUMS scores at Time 1 for participants who completed a second SLUMS and those who did not. All participants had medical illnesses that necessitated home-based care. Based on record review, 45.5% participants had neurocognitive disorders, and 62.4% had a mental health diagnosis. Neurocognitive and mental health diagnoses were established clinically and are only used descriptively in this study to characterize the sample.
Neuropsychological outcome of cognitive training in mild to moderate dementia: A randomized controlled trial
Published in Neuropsychological Rehabilitation, 2021
Eeva-Liisa Kallio, Marja Hietanen, Hannu Kautiainen, Kaisu H. Pitkälä
Treatment modalities specifically designed to target cognitive impairment include general cognitive stimulation, practice-oriented cognitive training (CT), and individualized cognitive rehabilitation. (Clare & Woods, 2004) CT is a feasible, low-cost, and face-valid training method used in various rehabilitation contexts. It refers to a behavioural intervention strategy the objective of which is to remediate deterioration in memory, attention, and other cognitive domains using either restorative or compensatory methods. (Choi & Twamley, 2013; Clare & Woods, 2004; Mowszowski et al., 2010) When the aim is restorative, CT involves guided practice on various tasks reflecting specific cognitive functions. (Clare & Woods, 2004) Training is typically offered using predesigned paper-and-pencil exercises or computerized programmes with various levels of difficulty. Its effects on cognition and functional abilities have been widely studied and reviewed among healthy older adults, (Lampit et al., 2014; Reijnders et al., 2013; Smith et al., 2009; Willis et al., 2006) in minor neurocognitive disorders, (Huckans et al., 2013; Sherman et al., 2017) as well as in major neurocognitive disorders. (Bahar-Fuchs et al., 2019; Kallio et al., 2017b; Leung et al., 2015) The results for people with mild to moderate dementia have been mixed. Recent systematic reviews suggest little or no benefit of CT in dementia, however, the quality of evidence has typically been low. (Bahar-Fuchs et al., 2019; Kallio et al., 2017b)
The Efficacy of Cognitive Videogame Training for ADHD and What FDA Clearance Means for Clinicians
Published in Evidence-Based Practice in Child and Adolescent Mental Health, 2021
Steven W. Evans, Theodore P. Beauchaine, Andrea Chronis-Tuscano, Stephen P. Becker, Anil Chacko, Richard Gallagher, Cynthia M. Hartung, Michael J. Kofler, Brandon K. Schultz, Leanne Tamm, Eric A. Youngstrom
An additional challenge concerns transfer. CT is only useful insofar as it improves both the neurocognitive deficiency targeted and impairment exhibited by children with ADHD (e.g., failure to complete tasks, difficulties maintaining friendships). In other words, clinical success requires that proficiencies gained through CT generalize beyond outcomes closely related to the training condition (near transfer) to meaningful functioning (far transfer). Generalization is challenging because CT places far fewer demands on children than complex environments where effective daily function is required (e.g., school). Following CT, children may improve skills related specifically to the training; however, more complex skill deployment is required when interacting with other people and when organizing one’s time and belongings. In other words, neurocognitive abilities are only one necessary skill for success in real-world contexts. To offer an analogy, strength and endurance are two elements needed to improve performance in sports such as basketball and baseball. One can have exceptional strength and endurance, yet be terrible at basketball (Chacko et al., 2014). Similarly, one may show improved neurocognitive abilities but continue to struggle with school, social, and family functioning. Put more simply, improving neurocognitive functioning may be necessary but insufficient for improvement in daily tasks.