Basic processes as foundations of cognitive impairment in adult ADHD.

Attention deficit hyperactivity disorder (ADHD) in adulthood is associated with impairment of multiple aspects of cognition which adversely affect the individual's everyday functioning. However, little is known about how these impairments are intertwined. This study explores whether impairments in basic processes (processing speed and distractibility) in adults with ADHD explain impairments in higher order functions, namely executive functions, memory, and complex attention. Furthermore, it is explored whether pharmacological treatment with methylphenidate (MPH) affects basic processes and higher order functions. A between-subjects design compared patients with ADHD without stimulant drug treatment (N = 55) and patients with ADHD treated with MPH (N = 31) with a healthy control group (N = 80). A neuropsychological test battery assessing basic processes and higher order functions was administered. Hierarchical logistic regression analyses were performed to evaluate the contribution of basic processes to impairments in higher order functions. Patients with ADHD not treated with MPH showed impairments in basic processes and higher order functions compared to controls. The impairments in basic processes explained 41-43% of impairments in executive functions, 27-29% in memory, and 56-74% in complex attention. In patients with ADHD treated with MPH, basic processes were not impaired and did not contribute significantly to impairments of higher order functions. Basic processes may constitute part of the foundation of cognitive impairments in adult ADHD. MPH may improve cognitive performance, presumably through improving basic processes. Applying this information could optimize neuropsychological assessments and inform treatment strategies by targeting basic processes.

The Search for the Elusive Basic Processes Underlying Human Intelligence: Historical and Contemporary Perspectives.

This article discusses the issues of the basic processes underlying intelligence, considering both historical and contemporary perspectives. The attempt to elucidate basic processes has had, at best, mixed success. There are some problems with pinpointing the underlying basic processes of intelligence, both in theory and as tested, such as what constitutes a basic process, what constitutes intelligence, and whether the processes, basic or not, are the same across time and space (cultural contexts). Nevertheless, the search for basic processes has elucidated phenomena of intelligence that the field would have been hard-pressed to elucidate in any other way. Intelligence cannot be fully understood through any one conceptual or methodological approach. A comprehensive understanding of intelligence requires the converging operations of a variety of approaches to it.

Validación empírica del modelo de formulación clínica por procesos básicos de Castro y Ángel / Empirical validation of Castro and Angel's CLINICAL formulation model by basic process / Validação empírica do modelo de formulação clínica por processos básicos de Castro e Ángel

Esta investigación tuvo como propósito realizar la validación empírica del modelo de formulación clínica por procesos básicos de Castro y Ángel (1998). Se utilizó un diseño cuasi-experimental transeccional, descriptivo y comparativo de tres grupos. Participaron treinta psicólogos divididos en tres grupos según su nivel de formación académica y experiencia clínica (novato, intermedio, experto), a quienes se les entregó la información de un caso clínico y se les solicitó elaborar la formulación de dicho caso con base en el modelo de Castro y Ángel. El nivel de validez empírica se obtuvo calculando el porcentaje de acuerdo de dichas formulaciones con una formulación de referencia, y utilizando un instrumento especialmente diseñado y validado para tal fin. Igualmente, se aplicaron las pruebas H de Kruskal-Wallis y W de Kendall. Se encontró que el modelo, en general, orientó el desarrollo de las formulaciones sin depender, en la mayoría de aspectos, del nivel de experiencia del clínico, lo cual apunta a su validez empírica; sin embargo, los niveles de acuerdo no fueron altos y las diferencias se presentaron en una de las categorías básicas del modelo. Éste es el primer estudio realizado para la validación del modelo de Castro y Ángel; sus resultados permitirán estructurarlo y a su vez sentarán las bases para su validación en futuras investigaciones.

The aim of this research was to carry out the empirical validation of the clinical formulation model founded on basic processes and proposed by Castro and Angel (1998). A quasi-experimental trans-sectional descriptive and comparative design with three groups was used. Participants were thirty psychologists assigned to the three groups according to their academic background and clinical experience (novice, intermediate an expert). They received written information about a clinical case in order to formulate it using Castro and Angel's model. Validity indexes were obtained by calculating the percentage of agreements between the formulations of the three groups and a reference formulation; a special instrument was designed for this purpose. The statistical tests H of Kruskal-Wallis and W of Kendall were also used. Results showed that, in general, the model oriented the development of the formulations in the majority of aspects regardless the clinician's level of experience. This points out the empirical validity of the model; nevertheless, the levels of agreement were not high and the differences lie in one of the model's basic categories. This is the first study aimed at validating Castro and Angel's model; its results will allow the restructuring of that model and in turn will lay the foundations for validating it in future research projects.

Nesta pesquisa validou-se empiricamente o modelo de formulação clínica por processos básicos de Castro e Ángel (1998). Nós usamos um desenho quase-experimental, transversal, descritivo e comparativo de três grupos. Participaram trinta psicólogos divididos em três grupos de acordo com seu nível de formação acadêmica e experiência clínica (iniciante, intermediário e avançado), que receberam informação de um caso clínico e se lhes pediu desenvolver a formulação de esse caso aplicando o modelo de Castro e Angel. O nível de validade empírica foi calculado como a percentagem de concordância dessas formulações com uma formulação de referência, utilizando um instrumento especialmente desenhado e validado para esse fim. Da mesma forma, foram aplicados os testes H de Kruskal-Wallis H e W de Kendall. O modelo geral norteou o desenvolvimento de formulações sem depender, em muitos aspectos, do nível de experiência clínica, o que aponta para a sua validade empírica; no entanto, os níveis de acordo não foram altos. As diferenças ocorreram em uma das categorias básicas do modelo. Este é o primeiro estudo realizado para validar o modelo de Castro e Angel; os resultados ajudarão a estruturá-lo e fornecerão a base para sua validação em pesquisas futuras.