Identification of Neuropsychiatric Symptoms in Preclinical and Prodromal Stages in Dementias: Development of a Screening Test for Mild Behavioral Impairment.

BACKGROUND: Neuropsychiatric symptoms (NPS) are a psychopathological dimension of neurodegenerative diseases, consisting of personality changes, behavioral disorders, and alterations in basic functions such as appetite or sleep, among others. The aim of this study was the construction and validation of a screening test to identify these NPS associated with neurodegenerative pathologies in preclinical and prodromal stages, based on the ISTAART criteria for Mild Behavioral Impairment (MBI). METHOD: The sample consisted of 206 subjects over 55 years old (117 cognitively healthy, 89 with Mild Cognitive Impairment). 69% were women, the mean age was 77 years ( SD = 10.58). RESULTS: The new scale consists of 19 items and exhibited a one-dimensional structure. Confidence was excellent (α = .94 and Ω = .97) and there was evidence of convergent validity with the MBI-C test ( r = .88) and the NPI-Q ( r = .82). In addition, the scale demonstrated good sensitivity (.88) and specificity (.80). CONCLUSIONS: The scale allows evaluation of NPS in DCoL. It exhibits good psychometric properties and makes a useful tool in early diagnosis of neurodegenerative pathologies.

Reorganization of Brain Networks as a Substrate of Resilience: An Analysis of Cytochrome c Oxidase Activity in Rats.

The unpredictable chronic mild stress (UCMS) model has been used to induce depressive-like symptoms in animal models, showing adequate predictive validity. Our work aims to evaluate the effects of environmental enrichment (EE) on resilience in this experimental model of depression. We also aim to assess changes in brain connectivity using cytochrome c oxidase histochemistry in cerebral regions related to cognitive-affective processes associated with depressive disorder: dorsal hippocampus, prefrontal cortex, amygdala, accumbens, and habenula nuclei. Five groups of rats were used: UCMS, EE, EE + UCMS (enrichment + stress), BG (basal level of brain activity), and CONT (behavioral tests only). We assessed the hedonic responses elicited by sucrose solution using a consumption test; the anxiety level was evaluated using the elevated zero maze test, and the unconditioned fear responses were assessed by the cat odor test. The behavioral results showed that the UCMS protocol induces elevated anhedonia and anxiety. But these responses are attenuated previous exposure to EE. Regarding brain activity, the UCMS group showed greater activity in the habenula compared to the EE + UCMS group. EE induced a functional reorganization of brain activity. The EE + UCMS and UCMS groups showed different patterns of connections between brain regions. Our results showed that EE favors greater resilience and could reduce vulnerability to disorders such as depression and anxiety, modifying metabolic brain activity.

Psychological Inflexibility, Anxiety and Depression: The Moderating Role of Cognitive Fusion, Experiential Avoidance and Activation.

BACKGROUND: Evidence about how cognitive fusion (CF) and experiential avoidance (EA) interact with emotional distress underlines the importance of analyzing the interrelationships between the different processes of psychological inflexibility in order to improve ways of addressing emotional problems. This study analyzes the moderating effect of CF, EA and activation (A) in relation to four criteria of anxiety and depression. METHOD: A cross-sectional study of a clinical sample of adults was carried out by means of a questionnaire administered before (N = 172) and 6 months after (N = 114) participation in a clinical study. RESULTS: Regression analyses gave results which were consistent in the two evaluations. The EAxCF interaction modulated anxiety symptomatology, whereas A was not a significant predictor. Nevertheless, a reduction in A was the principal modulating condition in the symptomatology of depression; and although CF and EA did act as independent predictors, the EAxCF interaction was not significant. CONCLUSIONS: The presence and intensity of manifestations of emotional distress are explained and modulated by the progressive concurrence of CF, EA and reduction in A. The use of therapeutic approaches which increase activation could be a beneficial strategy with regard to decreasing cognitive fusion and experiential avoidance.

Assessment of the global intelligence and selective cognitive capacities in preterm 8-year-old children.

The aim of this study was to assess various cognitive abilities such as attention, IQ, reasoning, and memory related to academic achievement in 8- and 9-year-old preterm children. A total of 141 children were assessed. The preterm group (=37 weeks) comprised 63 children and was compared to 78 full-term children. Attention was evaluated using the d2 Selective Attention test, and the IQ by the L-M form of the Stanford-Binet Intelligence Scale, establishing a profile of abilities: perception, memory, comprehension, reasoning, and verbal fluency. Significant differences in IQ were found between the preterm and full-term children. Of the cognitive abilities assessed, the only significant differences were found in verbal fluency, with preterm boys showing lower verbal fluency scores than full-term children. In conclusion, all preterm groups have attention ability similar to that of full-term children. However, preterm children obtain lower scores in intelligence measures. In addition, preterm boys have verbal fluency difficulties. Taking into account the increase in preterm births, suitable intervention programs must be planned to attend the difficulties found.

Psychometric properties of the d2 selective attention test in a sample of premature and born-at-term babies.

The psychometric properties of the d2 Selective Attention Test are analyzed in two samples of premature ( n = 63) and born-at-term ( n = 78) children. The reliability coefficients (internal consistency) reached values of around .90. Principal components analysis revealed a three-factor structure, which accounts for 58% of the variance, and thus coincides with the number of factors presented in the manual of the Spanish adaptation of the test but not with their composition. Results suggest that the d2 test has adequate psychometric properties both for the global sample and for each sub-sample.

Estimating the reliability coefficient of tests in presence of missing values.

BACKGROUND: The problem of missing values at the item level is common in studies using educational and psychological tests. The aim of the present work is to explore how the estimation of reliability is affected by missing values. METHOD: Using real data, we simulated missing values in accordance with a "missing at random mechanism". Four factors were manipulated with the aim of checking their effect on the estimation of the reliability of the instrument: missing data mechanism, percentage of missing data in the database, sample size, and procedure employed for the treatment of missing values. RESULTS: The results show that the quality of estimations depends on the interaction of various factors. The general tendency is that the estimations are worse when the sample size is small and the percentage of missing values increases. Listwise is the worst procedure for treatment of the missing data in the simulated conditions. CONCLUSIONS: It is concluded that with a small percentage of missing values one can obtain estimations that are acceptable from a practical point of view with all the procedures employed, except Listwise.