Transition from mild cognitive impairment to normal cognition: Determining the predictors of reversion with multi-state Markov models.

INTRODUCTION: The theoretical framework of the Alzheimer's disease continuum considers transition between stages in a unidirectional manner. Here we examine the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) and explore a set of potential variables associated with this phenomenon. METHODS: A total of 985 Spanish community-dwelling individuals aged 70 years and over at baseline were monitored for 5 years. During this time, 173 MCI and 36 dementia cases were identified. Multi-state Markov models were performed to characterize transitions between states through the dementia continuum. RESULTS: The rate of reversion from MCI to NC was 11%. There were significant non-modifiable (age, socioeconomic status, or apolipoprotein E) and modifiable factors (cognitive training or absence of affective symptoms) associated with reversion. DISCUSSION: Overall, our results highlight that the likelihood of progression from MCI to dementia is very similar to that of reversion from MCI to NC.

Memory for future actions: the effect of prospective memory on an explicit and implicit memory task.

INTRODUCTION: In the field of retrospective memory, an explicit and implicit memory are known to exist. This study analyses the effect of the prospective memory on a recognition task and a lexical decision task. METHOD: In experiment 1 (n = 78, of which 39 belonged to the experimental group and 39 belonged to the control group), a recognition task was followed by an intentional task, as well as an incidental free recall task. In experiment 2 (n = 74, of which 37 belonged to the experimental group and 37 belonged to the control group), repetition priming was studied during a lexical decision task, followed by an intentional task. The data were analysed using a mixed ANOVA. RESULTS: Experiment 1 showed active monitoring of the prospective memory task accompanied by a recollective search process during the recognition task. The group which carried out the prospective task also showed better scores in the incidental free recall task. Experiment 2 showed active monitoring and repetition priming during the lexical decision task. CONCLUSION: While the prospective memory affects the performance in both concurrent tasks, it does not affect the recollective search process or repetition priming.

Papel de la reserva cognitiva en la recuperación cognitiva de pacientes que han sufrido una adicción grave a sustancias / The role of the cognitive reserve in the cognitive recovery of patients who have suffered a severe addiction to substances

Introducción: La reserva cognitiva resulta ser una variable de pronóstico en la recuperación cognitiva tras un daño cerebral. Pocos estudios han abordado su papel en el estado cognitivo tras un período sostenido de adicción a sustancias. Objetivo: Analizar el papel modulador de la reserva cognitiva sobre la relación entre el tiempo de abstinencia y el estado cognitivo de los pacientes con adicción grave a sustancias. Pacientes y métodos: Se valora a un total de 26 pacientes en recuperación tras una adicción grave a sustancias con un protocolo de evaluación neuropsicológica y cuestionarios de reserva cognitiva. Se emplea el análisis factorial exploratorio para conformar las variables y el análisis de regresión lineal para ver las relaciones predictivas. Resultados: Se obtienen tres factores de funcionamiento cognitivo: integridad de procesamiento, control inhibitorio y memoria verbal, así como un factor global de reserva. En los modelos de regresión, sólo se encuentran relaciones predictivas en un modelo de relación directa entre la abstinencia y la memoria verbal, y en un modelo de relación independiente entre la reserva cognitiva y el tiempo de abstinencia con la memoria verbal, pero no en la relación de modulación, ni en otras relaciones en el resto de los factores. Conclusión: Se debate el papel de la reserva cognitiva como mediadora en el estado cognitivo en los pacientes en período de abstinencia tras una adicción grave a sustancias: muestra una relación con la memoria, pero no una modulación del papel del tiempo de abstinencia sobre ese estado cognitivo

Introduction: Cognitive reserve has been shown to be a prognostic variable in cognitive recovery after brain damage. Few studies have addressed its role in the cognitive status after a sustained period of substance addiction. Aim: To analyse the modulating role of cognitive reserve in the relation between withdrawal time and the cognitive status of patients with severe substance addiction. Patients and methods: A total of 26 patients recovering from severe substance addiction were assessed using a neuropsychological assessment protocol and cognitive reserve questionnaires. Exploratory factor analysis is used to define the variables and linear regression analysis is employed to view the predictive relations. Results: Three cognitive functioning factors are obtained: processing integrity, inhibitory control and verbal memory, as well as an overall reserve factor. In the regression models, predictive relations are found only in a model of a direct relation between withdrawal and verbal memory, and in a model of an independent relation between cognitive reserve and withdrawal time and verbal memory, but not in the modulation relationship or in other relations in the rest of the factors. Conclusion: The article discusses the role of the cognitive reserve as a mediator in the cognitive status of patients in a period of withdrawal after a serious addiction to substances. A relationship with memory is shown, but no modulation of the role of withdrawal time on that cognitive status is detected

Síntomas prefrontales en la vida diaria: normalización y estandarización del inventario de síntomas prefrontales abreviado en población española / Prefrontal symptoms in daily life: normalization and standardization of the Prefrontal Symptoms Inventory in the Spanish population

Introducción. El inventario de síntomas prefrontales abreviado (ISP-20) es un cuestionario que investiga síntomas de mal funcionamiento prefrontal en la vida diaria. Ha mostrado buenas propiedades psicométricas y se ha aplicado en población general y muestras clínicas de España y otros países de habla hispana. Objetivo. Normalizar y estandarizar el ISP-20 en una muestra amplia de sujetos de todas las edades en población española. Sujetos y métodos. Se administró el ISP-20 a 4.704 sujetos: una muestra de 2.474 sujetos de población general española, mayores de edad, y otra de 2.230 menores de edad escolarizados (15-17 años), representativa de la población de Madrid. Resultados. Se observó el efecto de interacción del sexo, la edad y el nivel educativo sobre las puntuaciones, aunque el nivel de estudios presenta un efecto bajo. Los adolescentes, como era de esperar por encontrarse en pleno proceso madurativo, obtuvieron mayores puntuaciones en todas las subescalas y el cuestionario en su conjunto. Las mujeres puntuaron significativamente más en síntomas de mal control emocional, y los varones lo hicieron más en síntomas de mal control de la conducta social. Se configuraron tablas diferenciadas por sexo y para menores y mayores de edad. Conclusión. Los datos presentados permiten interpretar las puntuaciones obtenidas en el ISP-20 en población española, incluyendo los menores de edad y los adultos

Introduction. The short Prefrontal Symptoms Inventory (PSI-20) is a questionnaire that investigates symptoms of prefrontal malfunctioning in daily life. It has been shown to have good psychometric properties and has been applied in the general population and clinical samples from Spain and other Spanish-speaking countries. Aims. To normalise and standardise the PSI-20 in a broad sample of subjects of all ages in a Spanish population. Subjects and methods. The PSI-20 was administered to 4704 subjects: in one sample made up of 2474 subjects from the Spanish general population, over 18 years of age, and in another consisting of 2230 school-age subjects (15-17 years old), representative of the population of Madrid. Results. The effect of the interaction of sex, age and level of education on the scores was observed, although the effect of level of education was low. As expected, the adolescents, still undergoing their process of maturation, obtained higher scores on all the subscales and the questionnaire as a whole. Females scored significantly higher on symptoms of poor emotional control, and males achieved higher scores on symptoms of poor control over social behaviour. Tables were developed differentiated by sex and for those above and below 18 years of age. Conclusion. The data presented allow us to interpret the scores obtained in the PSI-20 in the Spanish population, including subjects under 18 and adults

Loewenstein Occupational Therapy Cognitive Assessment to Evaluate People with Addictions.

BACKGROUND: The LOTCA (Loewenstein Occupational Therapy Cognitive Assessment) battery is a cognitive screening test which is widely used in occupational health. However, no work has been found that explores its use in addiction treatment. OBJECTIVES OF STUDY: To explore the convergent validity of LOTCA with neuropsychological tests that assess related cerebral functional areas. METHODS: The LOTCA, along with a battery of neuropsychological tests, was administered to a sample of 48 subjects who start a treatment by substance or gambling addictions. FINDINGS: A correlational pattern was observed of a considerable magnitude between the effects of the LOTCA scales and those of some neuropsychological tests, but not with others. There is barely any convergence in measures with memory and executive function tests. RELEVANCE TO CLINICAL PRACTICE: There is a lack of research applying test of occupational assessment to populations of patients treated by addictive behaviors. The LOTCA seems to be a reliable and valid test for preliminary screening of function in certain cognitive areas, easy, and quick to use (around 30 minutes). However, it must be supplemented with other tests for a full and ecological assessment of patients. LIMITATIONS: An incident, small-size sample. RECOMMENDATIONS FOR FURTHER RESEARCH: New studies are needed to explore the applicability, diagnostic validity, and whole psychometric quality of the test in addiction-related treatment.

Clinical Relevance of Specific Cognitive Complaints in Determining Mild Cognitive Impairment from Cognitively Normal States in a Study of Healthy Elderly Controls.

Introduction: Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI) by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ). Materials and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI). The EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis (EFA) and Item Response Theory (IRT) were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI. Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely Forgetfulness of Immediate Information (FII), Executive Functions (EF) and Prospective Memory (PM) proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10). Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to use the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.

Inventario de síntomas prefrontales (ISP): validez ecológica y convergencia con medidas neuropsicológicas / Prefrontal Symptoms Inventory (PSI): ecological validity and convergence with neuropsychological measures

Introducción. El inventario de síntomas prefrontales (ISP) es un cuestionario autoinformado creado en España que interroga sobre alteraciones cognitivas, emocionales y comportamentales en las actividades de la vida diaria y que resulta aplicable tanto en población general como en múltiples poblaciones clínicas. Existe una versión abreviada de 20 ítems (ISP-20) con excelentes propiedades psicométricas para el cribado. Objetivo. Estudiar la validez convergente y divergente del ISP e ISP-20, analizando cómo sus escalas reflejan las consecuencias cotidianas de déficits reales hallados en evaluación neuropsicológica mediante pruebas de ejecución. Pacientes y métodos. Se estudiaron 52 personas con adicción a sustancias en tratamiento (31 varones y 21 mujeres) a las que se administró el ISP junto con una batería de exploración neuropsicológica abreviada centrada en describir procesos atencionales, mnémicos y ejecutivos. Resultados. Ambas versiones del ISP presentan óptimas propiedades psicométricas (0,78 > alfa > 0,94 para la versión completa de 46 ítems y 0,7 > alfa > 0,89 para la versión abreviada de 20 ítems). Los resultados confirman las hipótesis sobre su validez: la escala de problemas en la ejecución se relaciona con la capacidad para resolver tests que presumiblemente valoran funciones ejecutivas de origen prefrontal (validez convergente), mientras que las escalas de problemas en el control emocional y problemas en la conducta social no se relacionan con dichas capacidades cognitivas (validez discriminante). Conclusiones. El ISP es una prueba clínicamente útil, psicométricamente válida y aplicable en múltiples poblaciones clínicas (AU)

Introduction. The Prefrontal Symptoms Inventory (PSI) is a self-reported questionnaire, created in Spain, which asks about cognitive, emotional and behavioural alterations in activities of daily living and which can be applied in both the general population and in multiple clinical populations. There is a shorter 20-item version (PSI-20) with excellent psychomotor properties for screening. Aim. To study the convergent and divergent validity of the PSI and PSI-20, by analysing how their scales reflect the day-today consequences of real deficits found in neurological assessment performed by means of performance tests. Patients and methods. A sample of 52 persons undergoing treatment for substance addiction (31 males and 21 females) were administered the PSI together with an abbreviated neuropsychological examination battery focused on describing attentional, mnemonic and executive processes. Results. Both versions of the PSI present optimal psychometric properties (0.78 > alpha > 0.94 for the complete 46-item version and 0.7 > alpha > 0.89 for the abbreviated 20-item version). The results confirm the hypotheses regarding their validity: the performance problems scale is related with the capacity to resolve tests that supposedly rate the executive functions of a prefrontal origin (convergent validity), whereas the scales of problems in emotional control and problems with social behaviour are not related with those cognitive capabilities (discriminant validity). Conclusions. The PSI is a test that is clinically useful, psychometrically valid and applicable in multiple clinical populations (AU)

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

Sintomatología prefrontal en la vida diaria: evaluación de cribado mediante el inventario de síntomas prefrontales abreviado (ISP-20) / Prefrontal clinical symptoms in daily living: screening assessment by means of the short Prefrontal Symptoms Inventory (PSI-20)

Introducción. La estimación de síntomas cotidianos de disfunción frontal se considera imprescindible para aportar validez ecológica a las evaluaciones neuropsicológicas. Los cuestionarios disponibles se construyeron para estimar problemas ejecutivos en la vida diaria en poblaciones con daño neurológico. Se requieren instrumentos enfocados a medir estos comportamientos en la población general o en poblaciones clínicas con fallos leves o moderados. Objetivo. Estudiar la validez factorial y encontrar indicios de validez concurrente de la versión abreviada del inventario de síntomas prefrontales. Sujetos y métodos. Se obtuvieron tres muestras: la primera, a través de Internet (n = 504); la segunda, en población no clínica mediante lápiz y papel (n = 1.257), y la tercera, de pacientes en tratamiento por adicción a sustancias (n = 602). Se utilizó un método de análisis factorial sin restricciones sobre la primera muestra y los resultados se sometieron a análisis factorial confirmatorio sobre las otras dos muestras. Resultados. La estructura de tres factores encontrada se confirmó con excelentes indicadores de ajuste en las otras dos muestras. Se hallaron indicios de validez concurrente con pruebas de calidad de vida y salud mental. Conclusiones. Se propone un cuestionario breve para la detección de fallos de origen prefrontal en la vida diaria, que mejora las cualidades psicométricas de tests similares, pero orientados a patologías neurológicas graves. La estabilidad estructural de la prueba garantiza la utilidad en la población general, para la detección precoz del deterioro cognitivo, y en poblaciones clínicas con deterioro leve o moderado. Se proponen baremos para la interpretación de resultados (AU)

Introduction. Estimation of daily symptoms of frontal dysfunction is considered to be essential in order to endow neuropsychological assessments with ecological validity. The questionnaires available today were constructed to estimate executive problems in daily life in populations with neurological damage. There is a need for instruments focused on measuring these behaviours in the general population or in clinical populations with mild or moderate impairment. Aim. To examine the factorial validity and to find evidence of concurrent validity of the short version of the Prefrontal Symptoms Inventory. Subjects and methods. Three samples were obtained: the first, from the Internet (n = 504); the second, in a non-clinical population by means of paper and pencil (n = 1,257); and the third, from patients being treated for substance addiction (n = 602). A factorial analysis without restraints was used on the first sample and the results were submitted to confirmatory factorial analysis on the other two samples. Results. The three-factor structure that was found was confirmed with excellent indicators of fit in the other two samples. Evidence of concurrent validity was found with quality of life and mental health tests. Conclusions. We propose a short questionnaire for detecting failures of a prefrontal origin in daily living, which improves on the psychometric qualities of similar tests, but is oriented towards severe neurological pathologies. The structural stability of the test ensures it can be used in the general population, for the early detection of cognitive impairment, and in clinical populations with mild or moderate deterioration. A set of criteria are proposed for use in interpreting the results (AU)

[Prefrontal clinical symptoms in daily living: screening assessment by means of the short Prefrontal Symptoms Inventory (PSI-20)]. / Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).

INTRODUCTION: Estimation of daily symptoms of frontal dysfunction is considered to be essential in order to endow neuro-psychological assessments with ecological validity. The questionnaires available today were constructed to estimate executive problems in daily life in populations with neurological damage. There is a need for instruments focused on measuring these behaviours in the general population or in clinical populations with mild or moderate impairment. AIM: To examine the factorial validity and to find evidence of concurrent validity of the short version of the Prefrontal Symptoms Inventory. SUBJECTS AND METHODS: Three samples were obtained: the first, from the Internet (n = 504); the second, in a non-clinical population by means of paper and pencil (n = 1,257); and the third, from patients being treated for substance addiction (n = 602). A factorial analysis without restraints was used on the first sample and the results were submitted to confirmatory factorial analysis on the other two samples. RESULTS: The three-factor structure that was found was confirmed with excellent indicators of fit in the other two samples. Evidence of concurrent validity was found with quality of life and mental health tests. CONCLUSIONS: We propose a short questionnaire for detecting failures of a prefrontal origin in daily living, which improves on the psychometric qualities of similar tests, but is oriented towards severe neurological pathologies. The structural stability of the test ensures it can be used in the general population, for the early detection of cognitive impairment, and in clinical populations with mild or moderate deterioration. A set of criteria are proposed for use in interpreting the results.

TITLE: Sintomatologia prefrontal en la vida diaria: evaluacion de cribado mediante el inventario de sintomas prefrontales abreviado (ISP-20).Introduccion. La estimacion de sintomas cotidianos de disfuncion frontal se considera imprescindible para aportar validez ecologica a las evaluaciones neuropsicologicas. Los cuestionarios disponibles se construyeron para estimar problemas ejecutivos en la vida diaria en poblaciones con daño neurologico. Se requieren instrumentos enfocados a medir estos comportamientos en la poblacion general o en poblaciones clinicas con fallos leves o moderados. Objetivo. Estudiar la validez factorial y encontrar indicios de validez concurrente de la version abreviada del inventario de sintomas prefrontales. Sujetos y metodos. Se obtuvieron tres muestras: la primera, a traves de Internet (n = 504); la segunda, en poblacion no clinica mediante lapiz y papel (n = 1.257), y la tercera, de pacientes en tratamiento por adiccion a sustancias (n = 602). Se utilizo un metodo de analisis factorial sin restricciones sobre la primera muestra y los resultados se sometieron a analisis factorial confirmatorio sobre las otras dos muestras. Resultados. La estructura de tres factores encontrada se confirmo con excelentes indicadores de ajuste en las otras dos muestras. Se hallaron indicios de validez concurrente con pruebas de calidad de vida y salud mental. Conclusiones. Se propone un cuestionario breve para la deteccion de fallos de origen prefrontal en la vida diaria, que mejora las cualidades psicometricas de tests similares, pero orientados a patologias neurologicas graves. La estabilidad estructural de la prueba garantiza la utilidad en la poblacion general, para la deteccion precoz del deterioro cognitivo, y en poblaciones clinicas con deterioro leve o moderado. Se proponen baremos para la interpretacion de resultados.

Personalidad y cerebro: un encuentro inevitable / No disponible

La personalidad es un constructo que, hasta los últimos años, no había suscitado demasiado interés entre los neuropsicólogos. Sin embargo, durante la década pasada han proliferado los estudios interesados en buscar correlatos cerebrales, estructurales y funcionales de rasgos de personalidad propuestos por las distintas teorías, especialmente el modelo de los cinco grandes factores de personalidad. Se ha ido acumulando evidencia sobre el hecho de que los cinco rasgos se relacionan con localizaciones cerebrales concretas pudiendo, actualmente, trazar un mapa cerebral asociado a cada rasgo. Estudios más recientes relacionan a estos rasgos con la red cerebral por defecto, donde residiría el compendio de reglas implícitas de gestión (personalidad), que se iría formando durante la vida mediante mecanismos de "plasticidad dependiente de la experiencia". Estas propuestas suponen el umbral de un cambio de paradigma que puede llevar el estudio de los "trastornos mentales" al territorio de las alteraciones en la conectividad cerebral

Personality is a construct that, until recent years, had not aroused much interest among neurologists and neuropsychologists. However, during the past decade it have proliferated interest in studies pursuing brain structural and functional correlates of personality traits proposed by different theories, especially the Big Five model of personality. These studies have accumulated evidence about the five traits related to specific brain locations, allowing, at the present time, drawing a brain map associated with each trait. More recent studies relate these features with the brain default mode network, where he reside the compendium of implicit rules of management which we call personality. This will go forming along the life through mechanisms of "experience-dependent plasticity". These proposals represent the threshold of a paradigm shift which may lead the study of "mental disorders" to the territory of the alterations in brain connectivity, which is an immediate challenge for neuroscience

Dysexecutive Questionnaire (DEX): Unrestricted structural analysis in large clinical and non-clinical samples.

The factorial structure of the Dysexecutive Questionnaire (DEX) is an unresolved issue in scientific literature. One-to-five-factor solutions have been found in several studies by applying different research methods. Only a few of these studies used appropriate analysis procedures to suit a Likert scale-type of answer or investigated large enough samples to ensure the stability of factorial solutions. The present study examines a sample of 2151 subjects, 1482 from the general population and 669 from a clinical population. An unrestricted factorial analysis was carried out on both samples. The results unequivocally point to a single-factor solution in both samples. This means that only one latent variable is displayed in the DEX, which accounts for symptoms of oversight malfunction in activities of daily living. It is concluded that the diversity of results previously obtained in other studies may be due to using research methods that depict Likert-type scales on a continuum when they are actually ordinal categorical measures. In conclusion, the DEX should be considered a screening test that reports symptoms of prefrontal malfunction, although it is unable to specify what areas or functions have been affected, as previous studies have claimed.

Reserva cognitiva en adictos a sustancias en tratamiento: relación con el rendimiento cognitivo y las actividades cotidianas / Cognitive reserve in substance addicts in treatment: relation to cognitive performance and activities of daily living

Introducción. El concepto de reserva cognitiva ha ido ganando interés en la medida en que se ha acumulado evidencia sobre su relación con la resistencia del cerebro a declinar en su funcionamiento ante amenazas o alteraciones neurológicas. Aunque se ha estudiado en un gran número de alteraciones (degenerativas, traumáticas, psicopatológicas), pocos trabajos relacionan la reserva cognitiva con la adicción a sustancias, un proceso multidimensional con clara base neurológica. Objetivo. Explorar la reserva cognitiva de pacientes en tratamiento por adicción a drogas, relacionándolo con su rendimiento cognitivo en pruebas neuropsicológicas y en actividades de la vida diaria. Pacientes y métodos. Muestra de 57 pacientes en tratamiento por adicción a sustancias en un centro específico. Se administraron el cuestionario de reserva cognitiva, la evaluación cognitiva de Montreal y el inventario de síntomas prefrontales, y se recogieron variables relacionadas con la adicción. Resultados. Se encontró una relación positiva entre la reserva cognitiva y el tiempo de abstinencia, y negativa con la gravedad de la adicción. Aparecieron diferencias significativas según la reserva cognitiva en rendimiento neuropsicológico (especialmente en ciertos dominios cognitivos) y en actividades cotidianas. Conclusiones. La reserva cognitiva aparece como una variable relacionada con la adicción y los déficits cognitivos que la acompañan; resulta ser una potencial diana de las actividades rehabilitadoras, vinculada al paradigma de enriquecimiento ambiental, como estrategia para potenciar la resistencia frente al deterioro cognitivo que favorece y mantiene la adicción y para disminuir el potencial reforzador de la conducta de consumo (AU)

Introduction. The concept of cognitive reserve has gradually attracted more interest as a greater body of evidence has been collected on its relationship with the resistance of the brain to decline in its functioning when faced with neurological threats or disorders. Although a large amount of research has been conducted on (degenerative, traumatic, psychopathological) conditions, very few studies relate cognitive reserve with substance addiction, a multidimensional process with a clear neurological base. Aims. To explore the cognitive reserve of patients undergoing treatment for addiction to drugs of abuse by relating it with their cognitive performance in neuropsychological tests and in activities of daily living. Patients and methods. The study involved a sample of 57 patients being treated for substance abuse at a centre set up for this specific purpose. The cognitive reserve questionnaire, the Montreal cognitive assessment and the prefrontal symptoms inventory were administered, and variables related with the addiction were collected. Results. A positive relation was found between the cognitive reserve and the time of abstinence, and a negative one was seen with the severity of the addiction. Significant differences were observed according to the cognitive reserve in neuropsychological performance (especially in certain cognitive domains) and in daily activities. Conclusions. The cognitive reserve appears as a variable related to addiction and the cognitive deficits that accompany it. It is thus a potential target for rehabilitation activities and is linked to the environmental enrichment paradigm, as a strategy for enhancing resistance against the cognitive impairment that favours and maintains the addiction, and for lowering the reinforcing potential of the behaviour of consuming (AU)

[Cognitive reserve in substance addicts in treatment: relation to cognitive performance and activities of daily living]. / Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.

INTRODUCTION: The concept of cognitive reserve has gradually attracted more interest as a greater body of evidence has been collected on its relationship with the resistance of the brain to decline in its functioning when faced with neurological threats or disorders. Although a large amount of research has been conducted on (degenerative, traumatic, psychopathological) conditions, very few studies relate cognitive reserve with substance addiction, a multidimensional process with a clear neurological base. AIMS: To explore the cognitive reserve of patients undergoing treatment for addiction to drugs of abuse by relating it with their cognitive performance in neuropsychological tests and in activities of daily living. PATIENTS AND METHODS: The study involved a sample of 57 patients being treated for substance abuse at a centre set up for this specific purpose. The cognitive reserve questionnaire, the Montreal cognitive assessment and the prefrontal symptoms inventory were administered, and variables related with the addiction were collected. RESULTS: A positive relation was found between the cognitive reserve and the time of abstinence, and a negative one was seen with the severity of the addiction. Significant differences were observed according to the cognitive reserve in neuropsychological performance (especially in certain cognitive domains) and in daily activities. CONCLUSIONS: The cognitive reserve appears as a variable related to addiction and the cognitive deficits that accompany it. It is thus a potential target for rehabilitation activities and is linked to the environmental enrichment paradigm, as a strategy for enhancing resistance against the cognitive impairment that favours and maintains the addiction, and for lowering the reinforcing potential of the behaviour of consuming.

TITLE: Reserva cognitiva en adictos a sustancias en tratamiento: relacion con el rendimiento cognitivo y las actividades cotidianas.Introduccion. El concepto de reserva cognitiva ha ido ganando interes en la medida en que se ha acumulado evidencia sobre su relacion con la resistencia del cerebro a declinar en su funcionamiento ante amenazas o alteraciones neurologicas. Aunque se ha estudiado en un gran numero de alteraciones (degenerativas, traumaticas, psicopatologicas), pocos trabajos relacionan la reserva cognitiva con la adiccion a sustancias, un proceso multidimensional con clara base neurologica. Objetivo. Explorar la reserva cognitiva de pacientes en tratamiento por adiccion a drogas, relacionandolo con su rendimiento cognitivo en pruebas neuropsicologicas y en actividades de la vida diaria. Pacientes y metodos. Muestra de 57 pacientes en tratamiento por adiccion a sustancias en un centro especifico. Se administraron el cuestionario de reserva cognitiva, la evaluacion cognitiva de Montreal y el inventario de sintomas prefrontales, y se recogieron variables relacionadas con la adiccion. Resultados. Se encontro una relacion positiva entre la reserva cognitiva y el tiempo de abstinencia, y negativa con la gravedad de la adiccion. Aparecieron diferencias significativas segun la reserva cognitiva en rendimiento neuropsicologico (especialmente en ciertos dominios cognitivos) y en actividades cotidianas. Conclusiones. La reserva cognitiva aparece como una variable relacionada con la adiccion y los deficits cognitivos que la acompañan; resulta ser una potencial diana de las actividades rehabilitadoras, vinculada al paradigma de enriquecimiento ambiental, como estrategia para potenciar la resistencia frente al deterioro cognitivo que favorece y mantiene la adiccion y para disminuir el potencial reforzador de la conducta de consumo.

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

Quejas subjetivas de memoria, personalidad y sintomatología prefrontal en adultos jóvenes / Subjective memory complaints, personality and prefrontal symptomatology in young adults

Introducción. El presente trabajo explora dos cuestiones relacionadas con la aparición de quejas subjetivas de memoria en adultos jóvenes: la posibilidad de que dichas quejas sean resultado de déficits atencionales y ejecutivos, y, por otro lado, si determinadas características de la personalidad propician y modulan la expresión clínica de las quejas. Sujetos y métodos. Se administró el Memory Everyday Failures, versión española, el inventario de síntomas prefrontales y el inventario del temperamento y el carácter-revisado a una muestra de 1.132 participantes (900 de población general y 232 en tratamiento por adicción a drogas). Se exploró la correlación entre variables de las quejas de memoria, del funcionamiento prefrontal en la vida diaria y de las dimensiones de la personalidad propuestas por Cloninger. Se estudiaron relaciones de causalidad entre las variables mediante métodos estructurales. Resultados. Se observa una fuerte correlación entre las quejas cognitivas y la sintomatología prefrontal, lo que sugiere que las quejas son, en realidad, resultado de una inadecuada gestión atencional y ejecutiva que propicia los errores cotidianos. Se aprecia también una relación con gran tamaño del efecto entre las quejas cognitivas y la baja autodirección. Esta dimensión de la personalidad presenta una importante capacidad predictiva sobre la aparición y la intensidad de las quejas, bien directamente, bien modulada por otras dimensiones, especialmente la evitación del daño. Conclusiones. Los datos apoyan la idea de que las quejas de memoria son producto de la autopercepción de fallos y errores cotidianos provocados a nivel atencional y ejecutivo –aunque son tenidos por olvidos mnésicos–, y que la expresión clínica de dichas quejas está modulada por un perfil de la personalidad (AU)

Introduction. This work explores two issues related with the appearance of subjective memory complaints in young adults: on the one hand, the possibility of the complaints being a result of attentional and executive deficits and, on the other, whether certain characteristics of the personality favour and modulate the clinical expression of these complaints. Subjects and methods. The Memory Failures of Everyday questionnaire, Spanish version, the Prefrontal Syndromes Inventory and the Revised Temperament and Character Inventory were administered to a sample of 1132 participants (900 from the general population and 232 on treatment for drug addiction). The correlation among the variables of the memory complaints, of prefrontal functioning in daily life and of the dimensions of personality proposed by Cloninger was explored. The causal relationships among the variables were studied using structural methods. Results. A strong correlation was observed between cognitive complaints and prefrontal symptoms, suggesting that the complaints are, in fact, a result of an inadequate management of the attentional and executive functions that favours daily errors. A relationship with a large effect size is also observed between the cognitive complaints and low self-management. This dimension of the personality offers an important predictive capacity regarding the appearance and the intensity of the complaints, either directly or modulated by other dimensions, especially harm avoidance. Conclusions. The data back the idea that memory complaints are the result of the self-perception of daily faults and errors that are produced at the attentional and executive level –although they are taken as instances of mnemonic oversight– and that the clinical expression of these complaints is modulated by a profile of the personality (AU)

[Subjective memory complaints, personality and prefrontal symptomatology in young adults]. / Quejas subjetivas de memoria, personalidad y sintomatologia prefrontal en adultos jovenes.

INTRODUCTION: This work explores two issues related with the appearance of subjective memory complaints in young adults: on the one hand, the possibility of the complaints being a result of attentional and executive deficits and, on the other, whether certain characteristics of the personality favour and modulate the clinical expression of these complaints. SUBJECTS AND METHODS: The Memory Failures of Everyday questionnaire, Spanish version, the Prefrontal Syndromes Inventory and the Revised Temperament and Character Inventory were administered to a sample of 1132 participants (900 from the general population and 232 on treatment for drug addiction). The correlation among the variables of the memory complaints, of prefrontal functioning in daily life and of the dimensions of personality proposed by Cloninger was explored. The causal relationships among the variables were studied using structural methods. RESULTS: A strong correlation was observed between cognitive complaints and prefrontal symptoms, suggesting that the complaints are, in fact, a result of an inadequate management of the attentional and executive functions that favours daily errors. A relationship with a large effect size is also observed between the cognitive complaints and low self-management. This dimension of the personality offers an important predictive capacity regarding the appearance and the intensity of the complaints, either directly or modulated by other dimensions, especially harm avoidance. CONCLUSIONS: The data back the idea that memory complaints are the result of the self-perception of daily faults and errors that are produced at the attentional and executive level -although they are taken as instances of mnemonic oversight- and that the clinical expression of these complaints is modulated by a profile of the personality.

TITLE: Quejas subjetivas de memoria, personalidad y sintomatologia prefrontal en adultos jovenes.Introduccion. El presente trabajo explora dos cuestiones relacionadas con la aparicion de quejas subjetivas de memoria en adultos jovenes: la posibilidad de que dichas quejas sean resultado de deficits atencionales y ejecutivos, y, por otro lado, si determinadas caracteristicas de la personalidad propician y modulan la expresion clinica de las quejas. Sujetos y metodos. Se administro el Memory Everyday Failures, version española, el inventario de sintomas prefrontales y el inventario del temperamento y el caracter-revisado a una muestra de 1.132 participantes (900 de poblacion general y 232 en tratamiento por adiccion a drogas). Se exploro la correlacion entre variables de las quejas de memoria, del funcionamiento prefrontal en la vida diaria y de las dimensiones de la personalidad propuestas por Cloninger. Se estudiaron relaciones de causalidad entre las variables mediante metodos estructurales. Resultados. Se observa una fuerte correlacion entre las quejas cognitivas y la sintomatologia prefrontal, lo que sugiere que las quejas son, en realidad, resultado de una inadecuada gestion atencional y ejecutiva que propicia los errores cotidianos. Se aprecia tambien una relacion con gran tamaño del efecto entre las quejas cognitivas y la baja autodireccion. Esta dimension de la personalidad presenta una importante capacidad predictiva sobre la aparicion y la intensidad de las quejas, bien directamente, bien modulada por otras dimensiones, especialmente la evitacion del daño. Conclusiones. Los datos apoyan la idea de que las quejas de memoria son producto de la autopercepcion de fallos y errores cotidianos provocados a nivel atencional y ejecutivo ­aunque son tenidos por olvidos mnesicos­, y que la expresion clinica de dichas quejas esta modulada por un perfil de la personalidad.

[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.