Utilidad clínica y propiedades psicométricas del inventario de síntomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas / Clinical utility and psychometric properties of Prefrontal Symptoms Inventory (PSI) in acquired brain injury and degenerative dementias

Introducción. Las alteraciones cognitivas, emocionales y comportamentales secundarias al daño cerebral adquirido y las demencias degenerativas pueden valorarse cuantitativa y cualitativamente mediante la administración de autoinformes que interroguen –a pacientes e informadores fiables– sobre las dificultades de los pacientes en la vida cotidiana. Sujetos y métodos. Se administró el inventario de síntomas prefrontales (ISP) y el cuestionario de fallos de memoria en la vida cotidiana modificado (MFE-30) a 174 participantes emparejados: 87 pacientes con daño cerebral o demencias degenerativas y sus 87 informadores fiables. Se exploró, junto con la bondad psicométrica de las pruebas, la utilidad clínica de la aplicación de estos cuestionarios a pacientes e informadores para obtener un índice de discrepancia de las puntuaciones como medida de la anosognosia. Resultados. Los resultados muestran cómo aplicar el ISP-20 (20 ítems) o el ISP (46 ítems), sean o no administrados conjuntamente con el MFE-30 (30 ítems), resulta un procedimiento muy útil para la valoración de la sintomatología en los individuos con daño cerebral adquirido o demencias degenerativas, al proporcionar una gran cantidad de información sobre las dificultades de los pacientes en la vida cotidiana. Conclusiones. Se recomienda, junto con la obligada evaluación neuropsicológica, la cumplimentación de cuestionarios o inventarios de síntomas como los propuestos, dado que presentan ventajas desde el punto de vista clínico, además de resultar eficaces, efectivos y eficientes en términos económicos (AU)

Introduction. The cognitive, emotional and behavioural alterations secondary to acquired brain injury and degenerative dementias can be quantitatively and quantitatively appraised by administering self-reports that ask both patients and reliable informants about the difficulties patients have in their everyday life. Subjects and methods. The Prefrontal Symptoms Inventory (PSI) and the Modified Memory Failures in Everyday Life Questionnaire (MFE-30) were administered to 174 paired participants: 87 patients with brain damage or degenerative dementias and their 87 reliable informants. In addition to the psychometric goodness of the tests, the study also explored the clinical usefulness of applying these questionnaires to patients and their informants in order to obtain a rate of discrepancy in the scores as a measure of anosognosia. Results. The results show how applying the PSI-20 (20 items) or the PSI (46 items), whether administered together with the MFE-30 (30 items) or not, is a very useful procedure for assessing the symptoms in individuals with acquired brain injury or degenerative dementias, since it yields a great deal of information about patients’ difficulties in their daily life. Conclusions. We recommend that, in addition to the compulsory neuropsychological assessment, questionnaires or inventories of symptoms like those proposed here should be carried out, due to the fact that they offer a number of advantages from the clinical point of view, as well as being efficacious and effective in economic terms (AU)

[Clinical utility and psychometric properties of Prefrontal Symptoms Inventory (PSI) in acquired brain injury and degenerative dementias]. / Utilidad clínica y propiedades psicométricas del inventario de síntomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.

INTRODUCTION: The cognitive, emotional and behavioural alterations secondary to acquired brain injury and degenerative dementias can be quantitatively and quantitatively appraised by administering self-reports that ask both patients and reliable informants about the difficulties patients have in their everyday life. SUBJECTS AND METHODS: The Prefrontal Symptoms Inventory (PSI) and the Modified Memory Failures in Everyday Life Questionnaire (MFE-30) were administered to 174 paired participants: 87 patients with brain damage or degenerative dementias and their 87 reliable informants. In addition to the psychometric goodness of the tests, the study also explored the clinical usefulness of applying these questionnaires to patients and their informants in order to obtain a rate of discrepancy in the scores as a measure of anosognosia. RESULTS: The results show how applying the PSI-20 (20 items) or the PSI (46 items), whether administered together with the MFE-30 (30 items) or not, is a very useful procedure for assessing the symptoms in individuals with acquired brain injury or degenerative dementias, since it yields a great deal of information about patients' difficulties in their daily life. CONCLUSIONS: We recommend that, in addition to the compulsory neuropsychological assessment, questionnaires or inventories of symptoms like those proposed here should be carried out, due to the fact that they offer a number of advantages from the clinical point of view, as well as being efficacious and effective in economic terms.

TITLE: Utilidad clinica y propiedades psicometricas del inventario de sintomas prefrontales (ISP) en el daño cerebral adquirido y las demencias degenerativas.Introduccion. Las alteraciones cognitivas, emocionales y comportamentales secundarias al daño cerebral adquirido y las demencias degenerativas pueden valorarse cuantitativa y cualitativamente mediante la administracion de autoinformes que interroguen ­a pacientes e informadores fiables­ sobre las dificultades de los pacientes en la vida cotidiana. Sujetos y metodos. Se administro el inventario de sintomas prefrontales (ISP) y el cuestionario de fallos de memoria en la vida cotidiana modificado (MFE-30) a 174 participantes emparejados: 87 pacientes con daño cerebral o demencias degenerativas y sus 87 informadores fiables. Se exploro, junto con la bondad psicometrica de las pruebas, la utilidad clinica de la aplicacion de estos cuestionarios a pacientes e informadores para obtener un indice de discrepancia de las puntuaciones como medida de la anosognosia. Resultados. Los resultados muestran como aplicar el ISP-20 (20 items) o el ISP (46 items), sean o no administrados conjuntamente con el MFE-30 (30 items), resulta un procedimiento muy util para la valoracion de la sintomatologia en los individuos con daño cerebral adquirido o demencias degenerativas, al proporcionar una gran cantidad de informacion sobre las dificultades de los pacientes en la vida cotidiana. Conclusiones. Se recomienda, junto con la obligada evaluacion neuropsicologica, la cumplimentacion de cuestionarios o inventarios de sintomas como los propuestos, dado que presentan ventajas desde el punto de vista clinico, ademas de resultar eficaces, efectivos y eficientes en terminos economicos.

La "Escala de estrés percibido": estudio psicométrico sin restricciones en población no clínica y adictos a sustancias en tratamiento / The Perceived Stress Scale: an unrestricted approach to its psychometric properties in non-clinical population and treated substance-addicts

La "Escala de estrés percibido" (EEP) es uno de los autoinformes más utilizados en la actualidad para estimar el grado en que las personas sienten que controlan las circunstancias de la vida o se ven desbordadas por ellas. Se realizó un análisis factorial exploratorio sin restricciones sobre una muestra de participantes de población general (n= 1023) y un análisis confirmatorio en una muestra clínica de personas con adicción a drogas en tratamiento (n= 542). De las tres versiones de la EEP (14, 10 y 4 ítems), la de 10 ítems es la que presenta mejores propiedades psicométricas en ambas muestras. Los sujetos clínicos mostraron mayores niveles de estrés percibido, asociados con estrategias de afrontamiento pasivas (evitación) y con más sintomatología comportamental de origen prefrontal en la vida cotidiana. La EEP-10 presenta suficientes garantías psicométricas para su utilización tanto en población general como aplicada a muestras clínicas, permitiendo estimar una variable crucial en el estudio de aspectos relacionados con el estrés, como la disfunción prefrontal y las estrategias que se utilizan ante dificultades de la vida

The Perceived Stress Scale (PSS) is currently one of the most used selfreports to estimate the extent to which people feel that they control the challenges of life or are overwhelmed by them. An unrestricted exploratory factor analysis over a sample of participants from the general population (n= 1023) and a confirmatory analysis in a clinical sample of drug addicts in treatment (n= 542) were performed. From the three versions (14, 10 and 4 items), the results suggest that the 10-item version is the one has better psychometric fit indicators in both samples. Addicted people showed higher levels of perceived stress in all age groups, which was associated with passive coping strategies (avoidance) and higher levels of prefrontal behavioral symptoms in everyday life. In conclusion, the 10-item version of the PSS presents enough psychometric properties for its use in estimating the perceived stress, applied both to general population and clinical samples. Its use allows to estimate a crucial variable in the study of stress-related conditions such as prefrontal dysfunction and strategies that the people used to cope with the difficulties of life

Caracterización neuropsicológica de las quejas de memoria en la población general: relación con la sintomatología prefrontal y el estrés percibido / Neuropsychological characterization of memory complaints in the general population: relationship to prefrontal symptoms and perceived stress

En los últimos años se ha relacionado la presencia de quejas cognitivas en los adultos jóvenes con perfiles atencionales y ejecutivos deficitarios, aunque no patognomónicos, que parecen justificar la aparición de los errores cotidianos. El presente estudio pretende analizar si la aparición de dichas quejas y su magnitud están relacionadas con un perfil neuropsicológico levemente inatento y disejecutivo. Por otro lado, se estudia si dichas quejas están también relacionadas con incrementos del estrés percibido, en la medida en que dichos incrementos pudieran funcionar como desencadenantes de las quejas. Para ello, se administró una batería de exploración neuropsicológica junto con el Cuestionario de Fallos de Memoria de la Vida Cotidiana, el Cuestionario Disejecutivo y la Escala de Estrés Percibido a una muestra de 99 individuos de población no clínica. Los resultados sugieren que los individuos de la población general que presentan quejas cognitivas presentan, por un lado, un menor rendimiento atencional, amnésico y ejecutivo y, por otro, una mayor sintomatología de tipo prefrontal. Se sugiere que este perfil cognitivo les hace más propensos a que los incrementos en el estrés percibido incrementen también dichos déficits, que son percibidos como alteraciones amnésicas sin que en sentido estricto lo sean

In recent years, the presence of cognitive complaints in young adults has been related with attentional and executive deficit profiles, although not pathognomonic, which seem to justify the occurrence of everyday errors. This study aims to analyze whether the occurrence of such complaints and their magnitude are associated with a slightly dysexecutive and inattentive neuropsychological profile. On the other hand, we study whether these complaints are also related to increases in perceived stress, so that such increases could function as triggers of complaints. A neuropsychological battery and Memory Failures Everyday, Dysexecutive Questionnaire and Perceived Stress Scale were administered to a sample of 99 nonclinical participants. The results suggest that individuals in the general population who have cognitive complaints show, first, lower attentional, mnemonic and executive ratings and, second, increased prefrontal-type symptoms. It is suggested that this cognitive profile makes them more prone to increase these deficits due to increases in perceived stress, which are perceived as memory impairment without strictly being it

[Prefrontal symptoms and personality disorders in substance abusers]. / Sintomatologia prefrontal y trastornos de la personalidad en adictos a sustancias.

INTRODUCTION: Neuroimaging findings associate personality traits and their disorders with an altered functioning of certain areas of the brain, especially in the frontal lobe. There is a need for instruments that can be applied in clinical practice to explore these relations based on their behavioural manifestations. PATIENTS AND METHODS: The sample was composed of 371 subjects with substance abuse/dependence. The Prefrontal Symptoms Inventory (PSI) and the Millon Clinical Multiaxial Inventory II (MCMI-II) were administered and diagnostic interviews were carried out to determine the existence of disorders affecting axis II (personality disorders). RESULTS: Criteria satisfying a diagnosis of some personality disorder were present in 43.9% of the sample. The results show a broad correlational pattern between the prefrontal symptoms scales and those of personality disorders. The variance in up to eight of the 13 scales of the MCMI-II is predicted in over 20%, based on the combination of scales from the PSI. The personality disorders diagnosed by means of a clinical interview present differential prefrontal symptomatological profiles that were consistent with what was expected. CONCLUSIONS: The results support the hypothesis of a relationship between the diagnosis of personality disorders and frontal malfunctioning, thus suggesting new lines for studying and approaching them in clinical practice. Such new paths could involve the use of cognitive rehabilitation to improve day-to-day functioning and modify the neurological substrates underlying personality disorders.

Sintomatología prefrontal y trastornos de la personalidad en adictos a sustancias / Prefrontal symptoms and personality disorders in substance abusers

Introducción. Los hallazgos de neuroimagen asocian los rasgos de la personalidad y sus trastornos al funcionamiento alterado de determinadas localizaciones cerebrales, especialmente en el lóbulo frontal. Se requieren instrumentos aplicables en la clínica que exploren estas relaciones a partir de sus manifestaciones comportamentales. Pacientes y métodos. La muestra estuvo compuesta por 371 sujetos con abuso/dependencia de sustancias. Se administraron el inventario de síntomas prefrontales (ISP) y el inventario clínico multiaxial de Millon-II (MCMI-II), y se realizaron entrevistas diagnósticas para estimar la existencia de trastornos del eje II (trastornos de la personalidad). Resultados. El 43,9% presentó criterios para el diagnóstico de algún trastorno de la personalidad. Los resultados muestran un amplio patrón correlacional entre las escalas de síntomas prefrontales y las de trastornos de la personalidad. La varianza de hasta ocho de las 13 escalas del MCMI-II se predice en más de un 20% a partir de la combinación de escalas del ISP. Los trastornos de la personalidad diagnosticados mediante entrevista clínica presentan perfiles de sintomatología prefrontal diferenciales y congruentes con lo esperado. Conclusiones. Los resultados sostienen la hipótesis de la relación entre el diagnóstico de trastornos de la personalidad y mal funcionamiento frontal, sugiriendo nuevas vías para su estudio y abordaje en la clínica, como el uso de la rehabilitación cognitiva para mejorar el funcionamiento cotidiano y modificar los sustratos neurológicos de los trastornos de la personalidad(AU)

Introduction. Neuroimaging findings associate personality traits and their disorders with an altered functioning of certain areas of the brain, especially in the frontal lobe. There is a need for instruments that can be applied in clinical practice to explore these relations based on their behavioural manifestations. Patients and methods. The sample was composed of 371 subjects with substance abuse/dependence. The Prefrontal Symptoms Inventory (PSI) and the Millon Clinical Multiaxial Inventory II (MCMI-II) were administered and diagnostic interviews were carried out to determine the existence of disorders affecting axis II (personality disorders). Results. Criteria satisfying a diagnosis of some personality disorder were present in 43.9% of the sample. The results show a broad correlational pattern between the prefrontal symptoms scales and those of personality disorders. The variance in up to eight of the 13 scales of the MCMI-II is predicted in over 20%, based on the combination of scales from the PSI. The personality disorders diagnosed by means of a clinical interview present differential prefrontal symptomatological profiles that were consistent with what was expected. Conclusions. The results support the hypothesis of a relationship between the diagnosis of personality disorders and frontal malfunctioning, thus suggesting new lines for studying and approaching them in clinical practice. Such new paths could involve the use of cognitive rehabilitation to improve day-to-day functioning and modify the neurological substrates underlying personality disorders(AU)

Inventario de síntomas prefrontales para la evaluación clínica de las adicciones en la vida diaria: proceso de creación y propiedades psicométricas / Prefrontal Symptoms Inventory for clinical evaluation of addictions in everyday life: development process and psychometric properties

Introducción. La investigación evidencia la presencia de sintomatología prefrontal en los adictos, aunque en su valoraciónse suelen usar cuestionarios creados para el daño cerebral sobrevenido.Objetivo. Elaborar un instrumento específico para la evaluación de dicha sintomatología en sujetos con adicciones. Sujetos y métodos. Se reclutaron 1.624 participantes (445 adictos y 1.179 de población general) a los que se aplicó un inventariode 100 ítems basados en las tres esferas de la actividad humana (cognición, emoción y conducta) en relación con los tres grandes síndromes prefrontales (dorsolateral, ventromedial y orbital). Los análisis preliminares descartaron aquellos que no mostraron suficiente capacidad discriminante, configurando el inventario de síntomas prefrontales (ISP) de 46 ítems. Se administraron el cuestionario disejecutivo (DEX-Sp) y la escala de estrés percibido (EEP) para estudiar su validezconvergente. Resultados. Los datos muestran la estructura trifactorial del cuestionario: problemas en el control ejecutivo (con tressubfactores; problemas motivacionales, de control y atencionales), problemas en la conducta social y problemas en elcontrol emocional. Se analizan las relaciones entre las puntuaciones en el ISP con variables sociodemográficas y del consumo, así como con el DEX-Sp y la EEP. Se proporciona una versión reducida de 20 ítems como cribado. Conclusiones. El ISP relaciona la autoevaluación de las personas (‘sujetocéntrica’) con la formulación teórica a priori (‘cerebrocéntrica’), mostrando unas propiedades psicométricas adecuadas. Se propone su uso a la hora de explorar la sintomatología prefrontal de los adictos, así como en otras poblaciones clínicas o subclínicas con perfiles cognitivos similares (AU)

Introduction. Research has provided evidence of the presence of prefrontal symptoms in addicts, although they are usuallyevaluated using questionnaires that were created for acquired brain injury. Aims. To produce a specific instrument for evaluating those symptoms in subjects with addictions. Subjects and methods. For the study, 1624 participants were recruited (445 addicts and 1179 from the general population) and were given a 100-item inventory to complete based on the three spheres of human activity (cognition, emotion andbehaviour) in relation to the three great prefrontal syndromes (dorsolateral, ventromedial and orbital). The preliminaryanalyses ruled out those that did not prove to have sufficient discriminating power, which resulted in the Prefrontal Symptoms Inventory (PSI) consisting of 46 items. The Dysexecutive Questionnaire (DEX-Sp) and the Perceived Stress Scale (PSS) were administered in order to study the convergent validity. Results. The data show the three-factor structure of the questionnaire: problems with executive control (with three subfactors: problems with motivation, control and attention), problems with social behaviour and problems with emotional control. The relationships between the scores on the PSI and sociodemographic and consumption variables, as well as withthe DEX-Sp and the PSS were analysed. A reduced 20-item version is provided for screening. Conclusions. The PSI relates the (‘subject-centred’) self-evaluation of persons with the a priori (‘brain-centred’) theoretical formulation, the results showing adequate psychometric properties. We recommend its use when it comes to exploring the prefrontal symptoms of addicts, as well as other clinical or subclinical populations with similar cognitive profiles (AU)

[Prefrontal Symptoms Inventory for clinical evaluation of addictions in everyday life: development process and psychometric properties]. / Inventario de sintomas prefrontales para la evaluación clinica de las adicciones en la vida diaria: proceso de creación y propiedades psicométricas.

INTRODUCTION: Research has provided evidence of the presence of prefrontal symptoms in addicts, although they are usually evaluated using questionnaires that were created for acquired brain injury. AIMS: To produce a specific instrument for evaluating those symptoms in subjects with addictions. SUBJECTS AND METHODS: For the study, 1624 participants were recruited (445 addicts and 1179 from the general population) and were given a 100-item inventory to complete based on the three spheres of human activity (cognition, emotion and behaviour) in relation to the three great prefrontal syndromes (dorsolateral, ventromedial and orbital). The preliminary analyses ruled out those that did not prove to have sufficient discriminating power, which resulted in the Prefrontal Symptoms Inventory (PSI) consisting of 46 items. The Dysexecutive Questionnaire (DEX-Sp) and the Perceived Stress Scale (PSS) were administered in order to study the convergent validity. RESULTS: The data show the three-factor structure of the questionnaire: problems with executive control (with three sub-factors: problems with motivation, control and attention), problems with social behaviour and problems with emotional control. The relationships between the scores on the PSI and sociodemographic and consumption variables, as well as with the DEX-Sp and the PSS were analysed. A reduced 20-item version is provided for screening. CONCLUSIONS: The PSI relates the ('subject-centred') self-evaluation of persons with the a priori ('brain-centred') theoretical formulation, the results showing adequate psychometric properties. We recommend its use when it comes to exploring the prefrontal symptoms of addicts, as well as other clinical or subclinical populations with similar cognitive profiles.

Validación de un cuestionario de quejas cognitivas para adultos jóvenes: relación entre las quejas subjetivas de memoria, la sintomatología prefrontal y el estrés percibido / Validation of a cognitive complaints questionnaire for young adults: the relation between subjective memory complaints, prefrontal symptoms and perceived stress

Introducción. Las quejas subjetivas de memoria constituyen uno de los motivos de consulta más frecuentes a los servicios sanitarios, aunque apenas existen instrumentos validados en castellano para valorar su magnitud. Así como los cuestionarios de quejas de memoria habitualmente incluyen ítems referentes a aspectos atencionales y ejecutivos, se formulanhipótesis acerca de su relación con otros procesos dependientes de la integridad de la corteza prefrontal.Objetivo. Se trata de estudiar las propiedades psicométricas de un instrumento basado en el cuestionario de fallos dememoria de la vida cotidiana -Memory Failures Everyday (MFE)-, proporcionando una baremación sobre una amplia muestra de población española. Como objetivo secundario, se pretenden analizar las relaciones existentes entre la aparición de las quejas, la sintomatología de origen prefrontal y el estrés percibido. Sujetos y métodos. Se administran el MFE-30 (una modificación del MFE), el cuestionario disejecutivo y la escala de estrés percibido a una muestra de adultos jóvenes de población general no clínica (n = 900). Resultados. Los análisis muestran que el MFE-30 es un cuestionario unifactorial que valora un único constructo llamado‘quejas cognitivas’. Además, se observa un intenso patrón de correlaciones entre dichas quejas, la sintomatología de origen prefrontal y el estrés percibido.Conclusiones. Los baremos aportados muestran que el MFE-30 es un instrumento útil en la práctica clínica. Los resultados encontrados están en consonancia con estudios anteriores, sugiriendo que existe una estrecha relación entre la aparición de quejas cognitivas, la presencia de sintomatología prefrontal y el estrés percibido (AU)

Introduction. Although subjective memory complaints are one of the most common causes behind visits to health services, there are hardly any validated instruments in Spanish for evaluating their magnitude. Since memory complaintquestionnaires usually include items referring to attentional and executive aspects, it has been hypothesised that they may well be related with other processes that depend on the integrity of the prefrontal cortex. Aim. The purpose of this study was to examine the psychometric properties of an instrument based on the MemoryFailures in Everyday (MFE) questionnaire, thus providing a valuation over a broad sample of the Spanish population. A second aim of the study was to analyse the relations that exist between the appearance of the complaints, the symptoms of a prefrontal origin and perceived stress. Subjects and methods. The MFE-30 (a modified version of the MFE), the dysexecutive questionnaire and the perceived stress scale were dministered to a sample of young adults from a non-clinical general population (n = 900). Results. The analyses show that the MFE-30 is a single-factor questionnaire that evaluates a single construct called‘cognitive complaints’. Moreover, an intense pattern of correlations among these complaints, the symptoms of a prefrontalorigin and perceived stress is observed. Conclusions. The resulting scores show that the MFE-30 is a useful instrument in clinical practice. Findings are in line with those from previous studies, thus suggesting that there is a close relation among the appearance of cognitive complaints, the presence of prefrontal symptoms and perceived stress (AU)

[Validation of a cognitive complaints questionnaire for young adults: the relation between subjective memory complaints, prefrontal symptoms and perceived stress]. / Validación de un cuestionario de quejas cognitivas paraadultos jóvenes: relación entre las quejas subjetivas dememoria, la sintomatología prefrontal y el estrés percibido.

INTRODUCTION: Although subjective memory complaints are one of the most common causes behind visits to health services, there are hardly any validated instruments in Spanish for evaluating their magnitude. Since memory complaint questionnaires usually include items referring to attentional and executive aspects, it has been hypothesised that they may well be related with other processes that depend on the integrity of the prefrontal cortex. AIM: The purpose of this study was to examine the psychometric properties of an instrument based on the Memory Failures in Everyday (MFE) questionnaire, thus providing a valuation over a broad sample of the Spanish population. A second aim of the study was to analyse the relations that exist between the appearance of the complaints, the symptoms of a prefrontal origin and perceived stress. SUBJECTS AND METHODS: The MFE-30 (a modified version of the MFE), the dysexecutive questionnaire and the perceived stress scale were administered to a sample of young adults from a non-clinical general population (n = 900). RESULTS: The analyses show that the MFE-30 is a single-factor questionnaire that evaluates a single construct called 'cognitive complaints'. Moreover, an intense pattern of correlations among these complaints, the symptoms of a prefrontal origin and perceived stress is observed. CONCLUSIONS: The resulting scores show that the MFE-30 is a useful instrument in clinical practice. Findings are in line with those from previous studies, thus suggesting that there is a close relation among the appearance of cognitive complaints, the presence of prefrontal symptoms and perceived stress.

Evaluación de los síntomas prefrontales: propiedades psicométricas y datos normativos del cuestionario disejecutivo (DEX) en una muestra de población española / Prefrontal symptoms assessment: psychometric properties and normative data of the Dysexecutive

Introducción. El estudio de los déficit derivados de las alteraciones en los circuitos prefrontales se ha desarrollado casi exclusivamente desde una perspectiva categorial, que diferencia el funcionamiento normal del patológico; sin embargo, el funcionamiento de la corteza prefrontal puede contemplarse como una dimensión continua. El cuestionario disejecutivo DEX) se creó con la intención de servir de medida cualitativa de los síntomas del ‘síndrome disejecutivo’ en la vida diaria. Objetivo. Explorar las propiedades psicométricas del DEX autoinformado en una amplia muestra de población no clínica de cara a proporcionar interpretaciones de interés para la clínica. Sujetos y métodos. Se administró la versión española del DEX a 1.013 individuos de población no clínica con residencia en Madrid, Zaragoza, Asturias, Navarra y Sevilla (380 varones y 633 mujeres). Resultados. El estudio factorial paralelo muestra la existencia de dos factores con adecuados índices de consistencia y validez interna: ítems que exploran dificultades en el inicio, mantenimiento y organización de la conducta (desorganización/ apatía) e ítems relacionados con la interrupción de la conducta en situaciones donde ésta es inadecuada (desinhibición/ impulsividad). La distribución por edad se ajusta a los presupuestos evolutivos. Se proponen como puntos de corte: < 10, funcionamiento óptimo; 10-18, funcionamiento subóptimo dentro de la normalidad; 19-28, funcionamiento moderadamente disejecutivo que requiere identificar las posibles causas, y > 28, alteración disejecutiva importante que incluiría patologías de gravedad. Conclusiones. El DEX puede ser un instrumento útil para detectar tanto a sujetos con alteraciones cerebrales evidenciables como a aquéllos con un funcionamiento ejecutivo deficiente sin que conlleve una patología conocida o identificable (AU)

Introduction. Research on the deficits derived from alterations in the prefrontal circuits has been conducted almost exclusively from a categorical perspective, which differentiates normal from pathological functioning. The functioning of the prefrontal cortex, however, can be seen as a continuous dimension. The Dysexecutive Questionnaire (DEX) was created with the intention of being useful as a qualitative measure of the symptoms of ‘dysexecutive syndrome’ in day-today life. Aim. To explore the psychometric properties of the self-reported DEX in a broad sample of the non-clinical population with a view to providing interpretations that can be of use in clinical practice. Subjects and methods. The Spanish version of the DEX was administered to 1013 non-clinical individuals living in Madrid, Saragossa, Asturias, Navarre and Seville (380 males and 633 females). Results. The factorial study conducted in parallel reveals the existence of two factors with adequate consistency and internal validity indices: items that explore difficulties in beginning, maintaining and organising behaviour (disorganisation/apathy) and items related with the interruption of behaviour in situations where it is inappropriate (disinhibition/impulsivity). The distribution according to age matches the developmental premises. The following cut-off points are proposed: < 10, optimal functioning; 10-18, sub-optimal functioning within normality; 19-28, moderately dysexecutive functioning that requires identification of the possible causes, and > 28, important degree of dysexecutive disorder that would include severe pathologies. Conclusions. The DEX may be useful as an instrument for detecting subjects with demonstrable brain disorders and those with deficient executive functioning without the presence of any known or identifiable pathology (AU)

[Prefrontal symptoms assessment: psychometric properties and normative data of the Dysexecutive Questionnaire (DEX) in a sample from the Spanish population]. / Evaluación de los síntomas prefrontales: propiedades psicométricas y datos normativos del cuestionario disejecutivo (DEX) en una muestra de población española.

INTRODUCTION: Research on the deficits derived from alterations in the prefrontal circuits has been conducted almost exclusively from a categorical perspective, which differentiates normal from pathological functioning. The functioning of the prefrontal cortex, however, can be seen as a continuous dimension. The Dysexecutive Questionnaire (DEX) was created with the intention of being useful as a qualitative measure of the symptoms of 'dysexecutive syndrome' in day-to-day life. AIM. To explore the psychometric properties of the self-reported DEX in a broad sample of the non-clinical population with a view to providing interpretations that can be of use in clinical practice. SUBJECTS AND METHODS: The Spanish version of the DEX was administered to 1013 non-clinical individuals living in Madrid, Saragossa, Asturias, Navarre and Seville (380 males and 633 females). RESULTS: The factorial study conducted in parallel reveals the existence of two factors with adequate consistency and internal validity indices: items that explore difficulties in beginning, maintaining and organising behaviour (disorganisation/apathy) and items related with the interruption of behaviour in situations where it is inappropriate (disinhibition/impulsivity). The distribution according to age matches the developmental premises. The following cut-off points are proposed: < 10, optimal functioning; 10-18, sub-optimal functioning within normality; 19-28, moderately dysexecutive functioning that requires identification of the possible causes, and > 28, important degree of dysexecutive disorder that would include severe pathologies. CONCLUSIONS: The DEX may be useful as an instrument for detecting subjects with demonstrable brain disorders and those with deficient executive functioning without the presence of any known or identifiable pathology.

Estudio neuropsicológico de adultos jóvenes con quejas subjetivas de memoria: implicación de las funciones ejecutivas y otra sintomatología frontal asociada / Physiology and neurobiology of stress and adaptation: central role of the brain

Introducción. Las quejas subjetivas de memoria constituyen uno de los motivos de consulta por los que los adultos jóvenes acuden a los servicios de neurología. En general, se considera que las quejas de memoria aumentan con la edad y que, en los mayores, se asocian con múltiples factores (depresión, otros problemas afectivos, personalidad o calidad de vida autopercibida). También se ha relacionado su aparición con alteraciones de la metamemoria y los lóbulos frontales. Así, ciertos déficit atencionales y ejecutivos podrían explicar la aparición de errores y olvidos cotidianos que son percibidos como alteraciones mnésicas por la población general. Sujetos y métodos. Se administra una batería de exploración neuropsicológica y el cuestionario disejecutivo (DEX-Sp) a dos grupos de adultos jóvenes, uno con quejas subjetivas de memoria suficientes como para acudir a un servicio de neurología (n = 50) y otro sin dichas quejas (n = 67). Resultados. Los datos muestran cómo los individuos con quejas subjetivas tienen un rendimiento mnésico, atencional y ejecutivo inferior al de aquellos que no presentan quejas, aunque ambos grupos se encuentran dentro de la normalidad estadística. También existen diferencias significativas en la cantidad de sintomatología frontal autoinformada mediante el cuestionario aplicado. Conclusiones. Las diferencias encontradas en el rendimiento mnésico pueden explicarse por disfunciones atencionales y ejecutivas no patognomónicas dada la ausencia de un proceso neuropatológico que las justifique. Además, se propone la utilización del DEX-Sp en colaboración con la evaluación neuropsicológica clásica. Se discuten nuevas hipótesis y algunas recomendaciones clínicas para el manejo de estos pacientes en la consulta (AU)

Introduction. Subjective memory complaints are one of the reasons why young adults visit neurology services. Generally speaking, memory complaints are considered to increase with age and, in the elderly, they become associated to a number of factors (depression, other emotional problems, personality or self-perceived quality of life). Their appearance has also been related with disorders affecting meta-memory and the frontal lobes. Thus, certain attentional and executive deficits could account for the appearance of mistakes and lapses in day-to-day life that are perceived as memory disorders by the general population. Subjects and methods. A neuropsychological examination battery and the dysexecutive questionnaire (DEX-Sp) were administered to two groups of young adults, one with subjective memory complaints that were severe enough to require a visit to a neurology service (n = 50) and the other without such complaints (n = 67). Results. Data showed how the individuals with subjective complaints had a lower mnemonic, attentional and executive performance than subjects who did not present any complaints. Both groups, however, are within what can be considered statistically normal values. There were also significant differences in the number of frontal symptoms self-informed by means of the questionnaire that was applied. Conclusions. The differences that were found in mnemonic performance can be explained by non-pathognomonic attentional and executive dysfunctions, given the absence of a neuropathological process to justify them. Furthermore, use of the DEX-Sp in collaboration with classic neuropsychological assessment is proposed. Some new hypotheses and recommendations for the management of these patients in daily clinical practice are also discussed (AU)