Changes in memory and attention during and after occupational rehabilitation: A longitudinal study.

BACKGROUND: There is need for more knowledge about the relationship between work and cognitive functioning in sick-listed individuals. OBJECTIVE: This study investigated whether the degree of work participation is relevant for recovery of cognitive functioning in sick-listed individuals. METHODS: 177 occupational rehabilitation participants and 70 controls participated in a non-randomised, longitudinal study. Participants completed computerised cognitive tests targeting sustained attention and working memory at start and end of rehabilitation and 3 and 12 months after rehabilitation. The change score performance in attention and memory between start and end, start and 3 months and 12 months was compared in individuals on sick leave 100-75%, 74-40% and 39-0% (three sick leave groups) of the time in the year after rehabilitation, and a control group not being on sick leave. Fixed effect analysis of covariance adjusting for education and work ability was used. RESULTS: The sick leave group 100-75% had significantly lower score on work ability compared to the other groups at baseline. The main findings indicated that the sick leave group 39-0% improved significantly more in sustained attention compared to the sick leave group 100-75% between start and end of rehabilitation and from start of rehabilitation to 3 and 12 months after. CONCLUSION: The degree of work participation seems relevant to recovery of the cognitive function sustained attention in sick-listed individuals. These findings encourage work rehabilitation clinicians, work consultants and employers to develop RTW plans which take into account that graded employment influence cognitive functioning.

Work Ability in the Year after Rehabilitation-Results from the RehabNytte Cohort.

BACKGROUND: There is limited knowledge regarding the impact of rehabilitation on work ability. The aim of this study was to explore factors associated with work ability 12 months following a multidisciplinary rehabilitation program in a cohort with different diagnoses. METHODS: Of 9108 potentially eligible participants for the RehabNytte research project, 3731 were eligible for the present study, and 2649 participants (mean age 48.6 years, 71% female) consented to contribute with work-related data, and were included. Self-perceived work ability was assessed by the Work Ability Score (WAS) (0-10, 10 = best), during the follow-up period using paired t-tests and logistic regression to examine associations between demographic and disease-related factors and work ability at 12-month follow-up. RESULTS: The mean baseline WAS for the total cohort was 3.53 (SD 2.97), and increased significantly to 4.59 (SD 3.31) at 12-month follow-up. High work ability (WAS ≥ 8) at 12 months was associated with high self-perceived health at the baseline (OR 3.83, 95% CI 2.45, 5.96), while low work ability was associated with a higher number of comorbidities (OR 0.26, 95% CI 0.11, 0.61), medium pain intensity (OR 0.56, 95% CI 0.38, 0.83) and being married or cohabiting (OR 0.61, 95% CI 0.43, 0.88). There were no significant differences in work ability between participants receiving occupational and standard rehabilitation. CONCLUSIONS: Work ability increased significantly over the follow-up period. High work ability at 12-month follow-up was associated with high self-perceived health at baseline, while being married or cohabiting, having higher number of comorbidities, and experiencing medium baseline pain intensity was associated with lower work ability. Rehabilitation interventions targeting these factors may potentially enhance work ability, leading to a positive impact on work participation among people in need of rehabilitation.

Can cognitive inflexibility reduce symptoms of anxiety and depression? Promoting the structural nested mean model in psychotherapy research.

OBJECTIVE: To estimate the causal effect of executive functioning on the remission of depression and anxiety symptoms in an observational dataset from a vocational rehabilitation program. It is also an aim to promote a method from the causal inference literature and to illustrate its value in this setting. METHOD: With longitudinal (four-time points over 13 months) data from four independent sites, we compiled a dataset with 390 participants. At each time point, participants were tested on executive function and self-reported symptoms of anxiety and depression. We used g-estimation to evaluate whether objectively tested cognitive flexibility affected depressive/anxious symptoms and tested for moderation. Multiple imputations were used to handle missing data. RESULTS: The g-estimation showed a strong causal effect of cognitive inflexibility reducing depression and anxiety and modified by education level. In a counterfactual framework, a hypothetical intervention that could lower cognitive flexibility seemed to cause improvement in mental distress at the subsequent time-point (negative sign) for low education. The less flexibility, the larger improvement. For high education, the same but weaker effect was found, with a change in sign, negative during the intervention and positive during follow-up. DISCUSSION: An unexpected and strong effect was found from cognitive inflexibility on symptom improvement. This study demonstrates how to estimate causal psychological effects with standard software in an observational dataset with substantial missing and shows the value of such methods.

Automatic detection of the mental foramen for estimating mandibular cortical width in dental panoramic radiographs: the seventh survey of the Tromsø Study (Tromsø7) in 2015-2016.

OBJECTIVE: To apply deep learning to a data set of dental panoramic radiographs to detect the mental foramen for automatic assessment of the mandibular cortical width. METHODS: Data from the seventh survey of the Tromsø Study (Tromsø7) were used. The data set contained 5197 randomly chosen dental panoramic radiographs. Four pretrained object detectors were tested. We randomly chose 80% of the data for training and 20% for testing. Models were trained using GeForce RTX 2080 Ti with 11 GB GPU memory (NVIDIA Corporation, Santa Clara, CA, USA). Python programming language version 3.7 was used for analysis. RESULTS: The EfficientDet-D0 model showed the highest average precision of 0.30. When the threshold to regard a prediction as correct (intersection over union) was set to 0.5, the average precision was 0.79. The RetinaNet model achieved the lowest average precision of 0.23, and the precision was 0.64 when the intersection over union was set to 0.5. The procedure to estimate mandibular cortical width showed acceptable results. Of 100 random images, the algorithm produced an output 93 times, 20 of which were not visually satisfactory. CONCLUSIONS: EfficientDet-D0 effectively detected the mental foramen. Methods for estimating bone quality are important in radiology and require further development.

Developing and Implementing ICF-Based Tools for Occupational Rehabilitation Supporting the Communication and Return to Work Process Between Sickness Absentees, Clinical Team and Jobcentre Contacts.

Background: The ICF model is applied as a conceptual framework in occupational rehabilitation in Norway. Objective: To systematically apply the ICF model in rehabilitation this study had the following aims: (1) apply an ICF subset by merging an ICF core set and an ICF set to assess functioning in rehabilitation patients related to work; (2) develop a patient-reported ICF questionnaire and a clinician-friendly ICF report complementing the clinician-rated ICF subset and (3) evaluate whether ICF-based tools (subset, questionnaire, report) support the communication between a clinical team, patient and jobcentre contacts during return to work (RTW) follow up. Methods: Forty-one patients completing four weeks rehabilitation were recruited. The patients were referred from general practitioners and jobcentres. The ICF subset was a combination of the EUMASS core set for disability evaluation and suggested ICF categories by experts in vocational rehabilitation from Iceland. A clinical rehabilitation team interviewed the patients using the ICF subset and problems were quantified on a generic qualifier scale for body functions, activities and participation and environmental factors. The research team and clinical team developed an ICF questionnaire, by cross-culturally adapting the Work Rehabilitation Questionnaire to Norwegian. The same teams also developed an ICF report. The rehabilitation clinic forwarded the report and questionnaire to the patients' jobcentre contact, which was responsible for the RTW follow up. To evaluate the benefits of ICF-based tools, the clinical team, user representative and jobcentre contacts together participated in four workshops. They were asked the degree to which and in what way the tools supported the communication between them. Results: The ICF subset captured RTW challenges but was found to be time consuming. The jobcentres experienced the ICF report and questionnaire beneficial in the follow up as it strengthened their RTW decision-making basis and communication with the rehabilitation clinic and the patients about follow-up interventions. Conclusion: The development and implementation of ICF-based tools for clinical practice was a preliminary success in supporting the communication between three stakeholders during RTW follow up. Future applications of ICF-based tools ought to integrate personal factors to capture both facilitators and barriers related to functioning and work, thus, getting closer to a holistic assessment.

Comparison of Two Multidisciplinary Occupational Rehabilitation Programs Based on Multimodal Cognitive Behavior Therapy on Self-Rated Health and Work Ability.

Objective: Musculoskeletal pain and common mental disorders constitute the largest proportion of people who are on sick leave. This study investigated the efficacy of two multidisciplinary occupational rehabilitation programs on self-rated health and work-related outcomes. The interventions were identical in content but differed in length. It was hypothesized that a longer inpatient program would yield greater improvements than a shorter outpatient program. Methods: Patients were sick-listed workers referred to occupational rehabilitation by the Norwegian Labor and Welfare Administration. A non-randomized 2 Condition (20 days, n = 64 versus 12 days, n = 62) × 4 repeated measures (start, end, 3 months, 12 months) between-subject design was used. Both programs were based on multimodal cognitive behavior therapy with a return-to-work focus. Health-related questionnaires were the Subjective Health Complaints inventory, Hospital Anxiety and Depression Scale, and SF-36 Bodily Pain. Work-related questionnaires were the Work Ability Index, the Fear-Avoidance Beliefs Questionnaire, Return To Work Self-Efficacy, and Return To Work expectations. Intervention effects were estimated using linear mixed models and Cohen's d. Results: The results revealed that both groups improved on the selected outcomes. Within-group contrasts and effect sizes showed that the inpatient group showed larger effect sizes at the end of rehabilitation and 12 months post-intervention for work-related outcomes than the outpatient group. Conclusion: Both programs were efficacious in improving health- and work-related outcomes during and after rehabilitation, but the inpatient group generally displayed stronger and more rapid improvements and was more stable at one-year postintervention.

eHealth interventions to facilitate work participation: a scoping review.

OBJECTIVE: The objective of this scoping review was to identify studies combining the concepts of eHealth and work participation for sick-listed employees across diagnostic groups in health care and workplace contexts. INTRODUCTION: There is an increased demand for better health care services and technologies, and eHealth is proposed as a useful tool to improve efficiency and reduce costs. eHealth functions at the intersection of medical informatics, public health, and business, and may be a promising solution for managing the process of return to work among employees on sick leave. Assessment of work outcomes is essential in evaluating the effectiveness of health services, and there is a need to map the research literature on existing eHealth interventions to facilitate work participation. INCLUSION CRITERIA: This scoping review considered studies combining two core concepts: eHealth and work participation. It considered studies on eHealth interventions for employees (18 to 65 years of age) on sick leave due to any type of diagnosis or disability, conducted by any stakeholder in workplace or health care contexts and in any country. Empirical data from both quantitative and qualitative studies were included. METHODS: Published and unpublished studies from January 1, 2008, to August 21, 2020, written in English were included in this review. The search was conducted in MEDLINE, Scopus, Embase, PsycINFO, WHO clinical registry, and ClinicalTrials.gov. A three-step search strategy was followed. Data extraction was performed by two independent reviewers and undertaken using an extraction tool developed specifically for the scoping review objectives. RESULTS: This review identified 15 studies eligible for inclusion. Four studies delivered the eHealth intervention by telephone, while 10 interventions were web-based. Of the web-based interventions, five had a blended approach, such as website and email support, or website and social media platforms. One study used an app-based intervention. Only eight studies targeted employees sick-listed due to common sick leave diagnoses, such as common mental disorders and musculoskeletal disorders. The workplace context was the target of the eHealth intervention in seven studies, although the intervention was still delivered by health personnel such as therapists or occupational physicians. Collaboration on individual cases between the health professional, employer, and employee to facilitate work participation seemed to be rare. Four studies reported both a theoretical and an empirical base for the intervention used. CONCLUSIONS: This review demonstrated that the use of eHealth interventions to facilitate work participation is limited, and there is a need for future studies on the use of eHealth technology for this purpose. Developing eHealth interventions specifically for populations at risk of long-term sick leave, and encouraging collaboration between all relevant stakeholders, may help improve work participation.

Sustained Attention and Working Memory Predict the Number of Days on Health-Related Benefits in the Year Following Occupational Rehabilitation.

Purpose The objective of this study was to investigate the association between cognitive and emotional functioning and the number of days on health-related benefits such as sick leave, work assessment allowance and disability pension. We investigated whether cognitive and emotional functioning at the start of rehabilitation and the change from the start to the end of rehabilitation predicted the number of days on health-related benefits in the year after occupational rehabilitation. Methods A sample of 317 individuals (age 19-67 years), mainly diagnosed with a musculoskeletal or mental and behavioural ICD-10 disorder, participated. The sample was stratified depending on the benefit status in the year before rehabilitation. Those receiving health-related benefits for the full year comprised the work assessment allowance and disability pension (WAA) group and those receiving benefits for less than a year comprised the sick leave (SL) group. The participants were administered cognitive and emotional computerised tests and work and health questionnaires at the beginning and end of rehabilitation. The cumulative number of days on health-related benefits during 12 months after rehabilitation was the primary outcome variable and age, gender, educational level, subjective health complaints, anxiety, and depression were controlled for in multiple regression analyses. Results The WAA group (n = 179) was significantly impaired at baseline compared to the SL group (n = 135) in focused attention and executive function, and they also scored worse on work and health related variables. Higher baseline scores and change scores from the start to the end of rehabilitation, for sustained attention, were associated with fewer number of health-related benefit days in the WAA group, while higher baseline scores for working memory were associated with fewer number of health-related benefit days in the SL group. Conclusions New knowledge about attention and memory and return to work in individuals with different benefit status may pave the way for more targeted programme interventions. Rehabilitation programmes could benefit from designing interventions that respectively improve sustain attention and working memory related to working life in individuals on sick leave or work assessment allowance and disability pension.

Jung and the spirit: a review of Jung's discussions of the phenomenon of spirit.

Le phénomène de l'esprit est un sujet abordé fréquemment par Jung au fil de ses écrits bien que l'esprit ne soit pas toujours considéré comme central à la pratique de la psychologie analytique. Cet article souligne l'importance de l'esprit dans la psychologie analytique en présentant une étude des discussions de Jung sur le sujet. Dans les discussions de Jung, l'esprit n'est pas traité comme un concept abstrait mais comme un phénomène empirique: pour Jung, l'esprit est une réalité psychologique pouvant être décrite et dont on peut sentir les effets. L'esprit est décrit à la fois comme un archétype et comme un élément de tous les archétypes. L'esprit est en lien avec le principe même de la vie et est une condition préalable pour le développement et la transformation personnels et culturels. Cet article documente comment la compréhension de Jung de l'esprit s'est développée sur une longue période et en lien avec différents sujets: la psychanalyse de Freud, le Livre Rouge, les contes de fées, le Christianisme, le Zarathoustra de Nietzsche, l'Allemagne dans les années 30, l'alchimie, et le travail créatif. L'article se conclut par une discussion sur la pertinence de l'esprit dans la pratique clinique.

El fenómeno del espíritu es un tópico discutido frecuentemente por Jung a través de sus escritos, aunque no siempre se lo considere central a la práctica de la psicología analítica. El presente artículo señala la importancia del espíritu en la psicología analítica, a través de una reseña de los debates de Jung acerca del espíritu. En los debates de Jung, el espíritu no es tratado como un fenómeno abstracto, sino como fenómeno empírico: para Jung, el espíritu es una realidad psicológica que puede ser descripta y cuyos efectos pueden ser experimentados. El espíritu es descripto como ambos, un arquetipo y como componente de todos los arquetipos. El espíritu se relaciona al principio de vida y es un prerrequisito para el desarrollo y la transformación, tanto personal, como cultural. El artículo documenta como la comprensión de Jung respecto del espíritu fue desarrollándose a través del tiempo y en relación a diversos tópicos: el psicoanálisis de Freud, el Libro Rojo, los cuentos de hadas, el Cristianismo, el Zarathustra de Nietzsche, Alemania en 1930, la alquimia y el trabajo creativo. El trabajo concluye con una discusión sobre la relevancia del espíritu en la práctica clínica.

Occupational Rehabilitation Is Associated With Improvements in Cognitive Functioning.

INTRODUCTION: Occupational rehabilitation may be offered to workers on long-term sick leave who often report problems with cognitive functioning, anxiety, depression, pain, and reduced work ability. The empirical knowledge is sparce on how occupational rehabilitation may influence cognitive and emotional functioning and patients have not previously been subjected to comprehensive objective testing. The main aim of this study was to assess possible changes in cognitive and emotional functioning such as memory, attention, executive function, and emotion recognition among patients in occupational rehabilitation. METHODS: A large sample of 280 sick-listed workers referred to inpatient and outpatient occupational rehabilitation was recruited. The rehabilitation programs had a mean duration of 28 days and comprised physical activity, cognitive behavior treatment components and collaboration with the workplace. A pre-post design was applied to investigate possible changes in cognitive and emotional functioning (primary outcomes) and work and health measures (secondary outcomes), comparing the rehabilitation group with a control group of 70 healthy workers. Individuals in the control group were tested at random time points with an approximately 28 day interval between pre- and post-test, thus coinciding with the duration of rehabilitation. Repeated measures analysis of variance was used for the main analyses. RESULTS: Compared to the control group, the rehabilitation group had greater gains from pre- to post-test in focused and sustained attention, as well as greater improvements in work ability and reduction in subjective health complaints (SHC), helplessness, pain, pain related to work, anxiety, and depression. In the rehabilitation group, exploratory correlational analysis indicated that improvements in focused and sustained attention were associated with improvements in return-to-work self-efficacy, work ability as well as a reduction in SHC. CONCLUSION: The sick-listed workers improved in focused and sustained attention and work and health measures after participating in occupational rehabilitation. This study is one of the first to systematically investigate changes in cognitive and emotional functioning during occupational rehabilitation. Clinical practice should benefit from increased knowledge about all cognitive functions and should be specifically aware of the improvements in focused and sustained attention, while memory, executive function and emotion recognition remained unchanged. The results can be used as a motivation to tailor specific interventions to gain further improvements in all cognitive and emotional functions.

Inhibition of Type III CRISPR-Cas Immunity by an Archaeal Virus-Encoded Anti-CRISPR Protein.

Bacteria and archaea possess a striking diversity of CRISPR-Cas systems divided into six types, posing a significant barrier to viral infection. As part of the virus-host arms race, viruses encode protein inhibitors of type I, II, and V CRISPR-Cas systems, but whether there are natural inhibitors of the other, mechanistically distinct CRISPR-Cas types is unknown. Here, we present the discovery of a type III CRISPR-Cas inhibitor, AcrIIIB1, encoded by the Sulfolobus virus SIRV2. AcrIIIB1 exclusively inhibits CRISPR-Cas subtype III-B immunity mediated by the RNase activity of the accessory protein Csx1. AcrIIIB1 does not appear to bind Csx1 but, rather, interacts with two distinct subtype III-B effector complexes-Cmr-α and Cmr-γ-which, in response to protospacer transcript binding, are known to synthesize cyclic oligoadenylates (cOAs) that activate the Csx1 "collateral" RNase. Taken together, we infer that AcrIIIB1 inhibits type III-B CRISPR-Cas immunity by interfering with a Csx1 RNase-related process.

eHealth interventions to facilitate work participation: a scoping review protocol.

REVIEW QUESTION: The objective of this scoping review is to identify and synthesize existing literature on the different types of eHealth interventions used in workplaces and healthcare settings to facilitate work participation. The following questions will be examined: For which user groups, in which settings and by which stakeholders are eHealth interventions provided? Are eHealth interventions that are aimed at work participation theory-driven or based on empirical evidence?

pmartR: Quality Control and Statistics for Mass Spectrometry-Based Biological Data.

Prior to statistical analysis of mass spectrometry (MS) data, quality control (QC) of the identified biomolecule peak intensities is imperative for reducing process-based sources of variation and extreme biological outliers. Without this step, statistical results can be biased. Additionally, liquid chromatography-MS proteomics data present inherent challenges due to large amounts of missing data that require special consideration during statistical analysis. While a number of R packages exist to address these challenges individually, there is no single R package that addresses all of them. We present pmartR, an open-source R package, for QC (filtering and normalization), exploratory data analysis (EDA), visualization, and statistical analysis robust to missing data. Example analysis using proteomics data from a mouse study comparing smoke exposure to control demonstrates the core functionality of the package and highlights the capabilities for handling missing data. In particular, using a combined quantitative and qualitative statistical test, 19 proteins whose statistical significance would have been missed by a quantitative test alone were identified. The pmartR package provides a single software tool for QC, EDA, and statistical comparisons of MS data that is robust to missing data and includes numerous visualization capabilities.

Cross-cultural adaptation of the Work Role Functioning Questionnaire 2.0 to Norwegian and Danish.

BACKGROUND: A healthy and productive working life has attracted attention owing to future employment and demographic challenges. OBJECTIVE: The aim was to translate and adapt the Work Role Functioning Questionnaire (WRFQ) 2.0 to Norwegian and Danish. METHODS: The WRFQ is a self-administered tool developed to identify health-related work limitations. Standardised cross-cultural adaptation procedures were followed in both countries' translation processes. Direct translation, synthesis, back translation and consolidation were carried out successfully. RESULTS: A pre-test among 78 employees who had returned to work after sickness absence found idiomatic issues requiring reformulation in the instructions, four items in the Norwegian version, and three items in the Danish version, respectively. In the final versions, seven items were adjusted in each country. Psychometric properties were analysed for the Norwegian sample (n = 40) and preliminary Cronbach's alpha coefficients were satisfactory. A final consensus process was performed to achieve similar titles and introductions. CONCLUSIONS: The WRFQ 2.0 cross-cultural adaptation to Norwegian and Danish was performed and consensus was obtained. Future validation studies will examine validity, reliability, responsiveness and differential item response. The WRFQ can be used to elucidate both individual and work environmental factors leading to a more holistic approach in work rehabilitation.

Cross-cultural adaptation and validation of the Danish version of the 19-item return-to-work self-efficacy (RTWSE-19) questionnaire.

OBJECTIVES: The aim of this study was to perform a cross-cultural adaptation of the return-to-work self-efficacy (RTWSE-19) scale into Danish and test the reliability, validity and responsiveness of the final version. METHODS: The adaptation process followed standard guidelines and the pretest was performed on 40 sickness absence beneficiaries. Tests of reliability, validity and responsiveness of the final version was performed on 782 participants of whom 440 (56%) responded. For the sub- and global scales, internal consistency was evaluated by Cronbach's alpha and reproducibility using paired t-test and intraclass correlation coefficient (ICC), respectively Responsiveness was evaluated by paired t-test and the association between RTWSE-19 and job status at ten weeks was tested in a logistic regression model, adjusted for gender, age and baseline job status. RESULTS: The face validity and reliability of the Danish version of the RTWSE-19 questionnaire were satisfactory. The internal consistency (alpha) for the three subscales ranged from 0.93 to 0.97. A test-retest showed no difference as well as high ICC between scale scores at baseline and one week later. The content validity of the final version was confirmed. High baseline RTWSE-19 level was associated with being at work after ten weeks odds ratio (OR) 3.24, 95% confidence interval (95% CI) 1.48-7.07. CONCLUSIONS: The RTWSE-19 cross-cultural translation to Danish was performed satisfactorily. A modified final version was produced, and the test of the instrument's reliability and validity showed that the psychometric properties of the questionnaire were partly confirmed. The instrument may be useful in rehabilitation practice to guide further assessment, goal setting and RTW decision-making.

Jung in education: a review of historical and contemporary contributions from analytical psychology to the field of education.

The available literature on the influence of Jungian thought on the theory and practice of education leaves the impression that although the work of Carl Jung and analytical psychology have much to offer the field of education, the Jungian influence has so far been slight. While this has certainly been true, the last decade or so has nevertheless witnessed an increased scholarly interest in exploring how analytical psychology may inform and inspire the field of education. As an explanation for this burgeoning interest in Jung, several of the contemporary contributors mention that analytical psychology has the potential of functioning as a counterbalance to the tendencies in Western societies to focus on measurable learning targets and increasingly standardized measures of teaching and assessment. It seems pertinent then to gain an overview of how analytical psychology has so far inspired the field of education and how it may fruitfully continue do so in the future. To this end this paper is structured chronologically, starting with the different phases of Jung's own engagement with the field of education and ending with later post-Jungian applications of his concepts and ideas to education.

Changes in cognitive functioning in sick-listed participants in occupational rehabilitation: A feasibility study.

BACKGROUND: Individuals on long-term sick leave attending occupational rehabilitation often complain about impairments in cognitive functions such as memory and attention. Knowledge of cognitive functioning in these individuals is limited. Such knowledge is clinically relevant for improving occupational rehabilitation programmes. OBJECTIVE: The aims of this feasibility study were to assess the methodological design and to investigate changes in memory and attention on participants during occupational rehabilitation. METHODS: Individuals attending occupational rehabilitation (n = 28) and individuals working full time (n = 25) matched for age, gender, and education participated. The two groups were administered cognitive tests targeting memory and attention and self-reported questionnaires at pre-test and post-test. Outcome measures were speed and accuracy of responses on the cognitive tests and self-reported work ability, subjective health complaints, and symptoms of depression and anxiety. RESULTS: In total, 35% of all invited participants agreed to take part and 93% of these also completed the second test. The mean gain scores in the intervention group were significantly higher than in the control group in response latency on simple and choice reaction time and errors in spatial working memory. CONCLUSION: The results of this study indicate that the motivation of participants to complete testing was high. Improvements in memory and attention were evident in rehabilitation participants indicating that rehabilitation may have an effect on cognitive functions.

Cognitive performance in a subclinical obsessive-compulsive sample 1: cognitive functions.

Individuals who are not clinically diagnosed with obsessive-compulsive disorder (OCD) but still display obsessive-compulsive (OC) tendencies may show cognitive impairments. The present study investigated whether there are subgroups within a healthy group showing characteristic cognitive and emotional performance levels similar to those found in OCD patients and whether they differ from OCD subgroups regarding performance levels. Of interest are those cases showing subclinical symptomatology. The results revealed no impairments in the subclinical OC participants on the neuropsychological tasks, while evidence suggests that there exist high and low scores on two standardised clinical instruments (Yale-Brown Obsessive Compulsive Scale and Cognitive Assessment Instrument of Obsessions and Compulsions) in a healthy sample. OC symptoms may diminish the quality of life and prolong sustainable return to work. It may be that occupational rehabilitation programmes are more effective in rectifying subclinical OC tendencies compared to the often complex symptoms of diagnosed OCD patients. The relationship between cognitive style and subclinical OC symptoms is discussed in terms of how materials and information might be processed. Although subclinical OC tendencies would not seem to constitute a diagnosis of OCD, the quality of treatment programmes such as cognitive behavioural therapy can be improved based on the current investigation.

Cognitive deficits of executive functions and decision-making in obsessive-compulsive disorder.

The nature of cognitive deficits in obsessive-compulsive disorder (OCD) is characterized by contradictory findings in terms of specific neuropsychological deficits. Selective impairments have been suggested to involve visuospatial memory, set shifting, decision-making and response inhibition. The aim of this study was to investigate cognitive deficits in decision-making and executive functioning in OCD. It was hypothesized that the OCD patients would be less accurate in their responses compared to the healthy controls in rational decision-making on a version of the Cambridge gambling task (CGT) and on the color-word interference test and on a version of the Tower of Hanoi test (tower test) of executive functioning. Thirteen participants with OCD were compared to a group of healthy controls (n = 13) matched for age, gender, education and verbal IQ. Results revealed significant differences between the OCD group and the healthy control group on quality of decision-making on the CGT and for achievement score on the tower test. On these two tasks the OCD group performed worse than the healthy control group. The symptom-dimension analysis revealed performance differences where safety checking patients were impaired on the tower test compared to contamination patients. Results are discussed in the framework of cognition and emotion processing and findings implicate that OCD models should address, specifically, the interaction between cognition and emotion. Here the emotional disruption hypothesis is forwarded to account for the dysfunctional behaviors in OCD. Further implications regarding methodological and inhibitory factors affecting cognitive information processing are highlighted.

Pointing and the interference effect in obsessive-compulsive disorder (OCD).

The interference effect in obsessive-compulsive disorder (OCD) was investigated in order to analyze cognitive aspects of motor stereotypy in OCD-related compulsions. So far, the domain of cognitive control in compulsive behavior has been under-investigated. Twelve participants (OCD patients and healthy controls) completed a newly created computer-based pointing task as well as standard clinical and psychological background measures. Findings showed that the patients displayed a larger visual interference effect compared to the controls and pointing paths were longer in time as well as distance when a distractor stimulus was present. It is concluded that, for compensation, patients would need to generate excessive amounts of attentional resources not available to overcome motor rigidity on the one side and visual distraction on the other side.