Is Training Working Memory in Children with Learning Disabilities a Viable Solution? A Systematic Review.

Background: Working memory (WM) is one of the most influential cognitive functions in encoding, registering, and retrieving information. It influences the learning process in children. Its role becomes essential, especially in a child with a learning disability (LD). Researchers worldwide are giving much prominence to WM, especially in devising cognitive retraining strategies for better cognitive functioning and academic attainment in these children. This current study aims to explore globally used instruments to measure this construct and review effective WM training models in the cognitive rehabilitation of children with LD. This study used a systematic review, availing the elaborate "Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA)" guidelines. Summary: The databases of Google Scholar, PubMed, and Web of Science were searched thoroughly, and those studies, which met the inclusion criteria, were considered for this review. Out of 770 studies found with keywords, only six met the inclusion criteria and were selected for a detailed analysis. The outcome of the current review provides trustworthy evidence of poor performance, especially in tasks involving verbal and executive WM in children with all types of learning disabilities (LD) and difficulties. The studies reviewed support the hypothesis that WM can improve with training and significantly improve children's academic attainment. Key Message: Further this review recommends that research and efforts must go into devising these cognitive training techniques. Children have high cerebral plasticity; hence, using cognitive training (emphasizing WM training and other cognitive functions) with them would enhance their cognitive functioning and capacity, improving their academic performance.

Evaluation of N-400 Evoked Response Potential in schizophrenia: An endophenotype or a disease marker?

N400 evoked response potentials (ERP) reliably map key semantic deficits in schizophrenia. Assessing them as endophenotypes might help in better understanding of schizophrenia risk and their use as biomarkers. We aimed to study N400 as an endophenotype marker by comparing schizophrenia (SCZ), unaffected first-degree relatives (FDR) and healthy controls (HC) and, by assessing its ability to discriminate these groups. Drug naïve or free SCZ probands (n=30), their unaffected FDRs (n=30) and HC (n=30), underwent a 40-channel ERP recording while performing a custom-made, Hindi- sentence context paradigm task, containing congruent and incongruent conditions. Fifteen centro-parietal (CP) leads, further classified into three regions-midline (CPM), right (CPR) and left (CPL) were selected as electrodes-of-interest for assessing N400. During the incongruent condition, compared to both FDRs and HC, SCZ showed significantly longer N400 latency, at CPM, CPR and CPL, and significantly lesser (more negative) amplitude, at CPM; no significant difference was noted between FDR and HC groups. On discriminant functional analysis, significant N400 predictors could accurately classify 73.3% SCZ from HC and 75% of SCZ from FDR. We conclude that N400 deficits, elicited by the incongruent condition of the sentence task, could be potential biomarkers to define disease state in schizophrenia; they may not be endophenotype markers.

Impaired recollection-based episodic memory as a cognitive endophenotype in schizophrenia.

INTRODUCTION: Patients with schizophrenia show impaired recollection but largely preserved familiarity-based episodic memory. This study was done to clarify the endophenotypic nature of recollection and familiarity-based episodic memory in schizophrenia and the role of emotional valence of memoranda and degree of recall confidence in it. METHOD: Twenty-five patients with schizophrenia, one unaffected sibling of each patient, and twenty-three healthy controls completed two tasks assessing recollection and familiarity-based processes in episodic memory. In the first task, participants were asked to remember positive, negative, and neutral emotional valence words in a remember-know paradigm. In the second task, in addition to recollection and familiarity-based responses, participants were asked to make confidence judgments about their responses. RESULTS: Patients with schizophrenia and their first-degree relatives (FDRs) performed poorly on recollection but not familiarity-based responses, compared to healthy controls; performance of first-degree relatives was in between and significantly different from that of both patients and controls. The differences in recollection and familiarity-based responses across the three groups were not moderated by recall confidence judgments or emotional valence of memoranda. Furthermore, there was no correlation between recollection-based memory impairments and duration or severity of illness or current medication exposure. CONCLUSIONS: Impaired recollection-based memory constitutes a potential cognitive endophenotype in schizophrenia. Furthermore, selective impairment of recollection-based, but sparing of familiarity-based, memory in patients and their FDRs supports the distinct nature of recollection and familiarity-based episodic memories.

Predictors of chronicity in alcohol use disorder: an evoked response potential study.

INTRODUCTION: Evoked response potentials (ERP) can reliably map key neurocognitive processes which are putatively responsible for chronic alcohol use disorder (AUD). Aim of the present study was to study P300 auditory odd ball and N400 visual semantic incongruity paradigm mapping executive functions rubric as a potential biomarker predicting chronicity in AUDs. Methodology: 60 right handed 18 to 54 years age subjects were divided into chronic "CAD" and non chronic alcohol dependence "NAD" in addition to healthy control "HC" (N = 30). Subjects were assessed by Addiction Severity Index (ASI), P300 auditory odd ball paradigm in midline region and visual N400 semantic incongruity task in centro-parietal region in a cross sectional design. Results: All the three groups differed significantly for P300 and N400 amplitude in all the leads with maximum attenuation seen in CAD. On discriminant function analysis (DFA), P300 Pz and N 400 C2 amplitude values could accurately classified 78.3% subjects. Composite sensitivity and specificity of the two predictor variables differentiating CAD subjects from NAD were 79.31 and 77.41%. receiver operating characteristic curve generated an area under the curve of .758 and .847 i.e., "fair to good" ability to predict CAD from NAD. Conclusion: We conclude that specific ERP paradigm can be used as a state marker to map the cognitive deficits and as a biomarker to detect chronic AUDs.

Multimodal psychotherapy in the management of somatization disorder.

BACKGROUND: Somatization is the presentation of physical symptoms without an objective and identifiable cause, and the condition is among the most common and challenging problems in primary medical care. Several modal of psychotherapy modal is being practiced but effective treatment in rarely delivered. AIM: The aim of this study is to evaluate the efficacy and durability of multimodal psychotherapy in the management of somatization disorder. MATERIALS AND METHODS: This is a hospital-based study using the pre-post design with control group. Thirty outpatient department patients with somatization disorder were selected and divided into two groups, i.e., intervention group and control group using the purposive sampling method. Intervention group was given 12 sessions of management package, i.e., symptoms monitoring form, scheduling of daily activity, sleep hygiene, diaphragmatic breathing, psycho-social intervention, psychodynamic individual psychotherapy, and cognitive restructuring (approximately 3-4 months). Efficacy and durability were measured by the Bradford somatic inventory, general health questionnaire-28 (GHQ-28), defense mechanism inventory (DMI), and Sack's sentence completion test (SSCT). RESULTS: The results reveal that there are significant differences found among intervention group in comparisons to the control group in the context of somatic complaints (BSI), general health functioning (GHQ-28), life conflict (SSCT), and in defense mechanism (DMI). Significant improvement also found between postintervention and follow-up of the intervention group on different study variables. CONCLUSION: The present study findings indicate that multimodal psychotherapy program is effective in the Indian context in the management of somatization disorder.

Application of mindfulness on stress, anxiety, and well-being in an adolescent student: A case study.

BACKGROUND: Stress and anxiety are the major problems students face in their lives and specifically in their academic life, which, in turn, has a significant negative impact on their academic performance. There are different approaches to deal with stress and anxiety, for example, cognitive behavioral therapy and relaxation techniques. OBJECTIVE: The present study was conducted to evaluate the applicability of mindfulness on stress, anxiety, and psychological well-being in an adolescent student. METHODS: In this study, single-case study design was used. The Pediatric Symptoms Checklist, Youth Self-Report, Institute of Personality and Ability Testing Anxiety Scale, and Checklist of Psychological Well-Being were administered on ten adolescent students. After the initial assessment, one participant was selected who was having significant level of stress, anxiety, and poor psychological well-being. Further detailed assessment was done using the Raven Standard Progressive Matrices, Parents' Observation Checklist, Teachers' Observation Checklist, and Students' Self-Observation Checklist. The student underwent 24 sessions of mindfulness training with a frequency of three sessions in a week. After completion of sessions, post assessment was done. He was re-assessed after 3 months. RESULTS: After completion of mindfulness training, improvement was observed in stress, anxiety, well-being, and other variables, and the improvement was maintained till follow-up. CONCLUSION: Mindfulness training has the potential in effectively reducing stress and anxiety and increasing a sense of well-being, but the major barrier is getting fixated with an idea of what's the right way to do mindfulness and feel it.

Impact of neuropsychological rehabilitation on activities of daily living and community reintegration of patients with traumatic brain injury.

OBJECTIVES: The present study was targeted to observe the impact of neuropsychological rehabilitation on activities of daily living (ADL) and community reintegration of patients with traumatic brain injury (TBI). SETTINGS AND PARTICIPANTS: Based on purposive sampling technique, ten patients with TBI falling in the age range of 20-40 years and fulfilling the inclusion and exclusion criteria were chosen from All India Institute of Speech and Hearing, Mysuru, India. DESIGN: A quasi-experimental design, i.e., nonequivalent control group design was chosen for the study. MATERIALS AND METHODS: Patients were assessed on Luria-Nebraska Neuropsychological Battery for Adults, Cognitive Symptoms Checklist, and Community Integration Questionnaire. Patients in experimental group were given neuropsychological rehabilitation for 6 months. Brainwave-R and Talking Pen were used as rehabilitative tools. RESULTS: Patients with TBI have significant neuropsychological deficits observed in memory, visuo-spatial organization, arithmetic, spelling, writing, fine motor coordination, and executive functioning. Neuropsychological deficits have a major impact on ADL and community reintegration. Neuropsychological rehabilitation is effective in rehabilitating neuropsychological deficits, which in turn leads to improvement in ADL and community reintegration. CONCLUSION: Neuropsychological rehabilitation should be one of the major goals in rehabilitation procedures for patients with TBI in order to bring overall improvement in them.

Efficacy of Yoga therapy for the management of psychopathology of patients having chronic schizophrenia.

BACKGROUND: There is a large body of literature and scientific data regarding the efficacy of pharmacological and psychosocial interventions for schizophrenia, however, studies on Yoga therapy is scanty. Yoga is a means of balancing and harmonizing the body, mind and emotion, and for enlightening the mind and upliftment of the total personality. AIMS: The present study was conducted to determine the efficacy of Yoga therapy as an adjunctive therapy and to see its effects on psychopathology on the patients suffering from chronic schizophrenia. SETTINGS AND DESIGN: Pre- and post-test design with the control group. MATERIALS AND METHODS: It is a study using purposive sampling technique by which 30 chronic schizophrenic patients were selected and 15 patients were randomly assigned to Yoga therapy along with pharmacotherapy (experimental group), and 15 were assigned pharmacotherapy alone (control group) after the baseline assessment using Positive and Negative Syndrome Scale (PANSS). The Yoga group attended Yoga therapy everyday for about 1½ h including motivational and feedback session. RESULTS: At the end of 1 month postassessment was done, and schizophrenic patients, who received the yogic intervention showed better rating than those in pharmacotherapy alone on PANSS variables. CONCLUSION: Yoga could be a right choice for improving psychopathology resulting in better quality of life along with other pharmacological management and psychosocial interventions.

The efficacy of electroencephalogram neurofeedback training in cognition, anxiety, and depression in alcohol dependence syndrome: A case study.

Electroencephalogram (EEG) neurofeedback's efficacy in reducing the symptoms of patients with alcohol dependence syndrome is well-documented in previous literature. Here, a case is being described who presented with alcohol dependence syndrome was given EEG neurofeedback training. After 10 sessions of EEG neurofeedback training program, a significant reduction was found in the cognitive deficits, anxiety, and depression of the patient. Furthermore, noticeable improvement was found in his memory and neurological functioning. He also showed a significant reduction in his alcohol intake on follow-up.

Efficacy of yoga therapy on subjective well-being and basic living skills of patients having chronic schizophrenia.

BACKGROUND: Scientific studies demonstrate efficacy of yogic treatment methods in stress and anxiety related disorders, psychosomatic disorders and physical illness. Very few studies have been conducted on schizophrenic patients. AIMS: This study was conducted to determine the efficacy of yoga therapy on subjective well-being, basic living skills, self-care, interpersonal, communicational and routine functions of schizophrenic patients. MATERIALS AND METHODS: Thirty chronic schizophrenic hospitalized patients were selected from Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi and were randomly assigned to the experimental group (yoga therapy along with Pharmacotherapy, n=15), and to control group (Pharmacotherapy alone, n=15). Baseline assessment was done using Post Graduate Institute general well-being measure (GWBM), Checklist for basic living skills and Indian disability evaluation and assessment scale (IDEAS). The experimental group attended yoga therapy every day for about 1½ h including motivational and feedback session. After 1 month post-assessment was done for both the groups. STATISTICAL ANALYSIS: Pearson Chi-square test was used for comparing the results. RESULTS: At the end of 1 month experimental group showed better rating in comparison to control group in PGI GWBM, basic living skills and IDEAS. CONCLUSION: Yoga could improve patients' subjective well-being, their daily basic living functioning, personal hygiene, self-care, interpersonal activities and communication, and prompted more involvement in routine work.

Cross-sectional analysis of psychological aspects of adolescent underachievers.

BACKGROUND: Previous research supports that factors commonly associated with underachievement include low academic self-concept, low self-efficacy, low self-motivation, low goal valuation and negative attitude toward school and teachers. PURPOSE: The purpose of this study was to assess the feeling about reading of adolescent underachievers, including emotional difficulties, physical problem (usually eye dysfunction), mechanism of reading, self-concept, and interest in reading. MATERIALS AND METHODS: Forty-eight underachievers were compared with 40 achievers from 6 to 10 standard students on "My feeling about reading" checklist. Hypotheses were tested using t-test and χ(2) (chi-square) test through statistical package for the social sciences. RESULTS: The result suggests that underachievers significantly differ from achievers in all five domains, i.e. emotional difficulties, physical problems (usually eye dysfunction), mechanism of reading, self-concept, and interest in learning. CONCLUSION: Underachievers face different emotional and other psychological difficulties during their academic sessions. They must be taken care of properly within their academic environment.

Perceived social support and life satisfaction in persons with somatization disorder.

BACKGROUND: Life satisfaction and perceived social support been shown to improve the well-being of a person and also affect the outcome of treatment in somatization disorder. The phenomenon of somatization was explored in relation to the perceived social support and life satisfaction. AIM: This study aimed at investigating perceived social support and life satisfaction in people with somatization disorder. MATERIALS AND METHODS: The study was conducted on persons having somatization disorder attending the outpatient unit of LGB Regional Institute of Mental Health, Tezpur, Assam. Satisfaction with life scale and multidimensional scale of perceived social support were used to assess life satisfaction and perceived social support respectively. RESULTS: Women reported more somatic symptoms than men. Family perceived social support was high in the patient in comparison to significant others' perceived social support and friends' perceived social support. Perceived social support showed that a significant positive correlation was found with life satisfaction. CONCLUSION: Poor social support and low life satisfaction might be a stress response with regard to increased distress severity and psychosocial stressors rather than a cultural response to express psychological problems in somatic terms.

Prevalence of obsessive compulsive symptoms among patients with schizophrenia.

BACKGROUND: Obsessive compulsive symptoms in schizophrenia are well recognized but are a less-researched entity. These symptoms have important implications for management and prognosis. AIM: To find out the prevalence of obsessive compulsive symptoms among patients with schizophrenia. MATERIALS AND METHODS: A total of 90 hospitalized patients with schizophrenia diagnosed according to DCR of ICD-10 criteria were selected for the study. Padua inventory and Yale-Brown Obsessive Compulsive Scale were applied to find out the prevalence and nature of obsessive compulsive symptoms. RESULTS: It was found that 10% of schizophrenic patients had obsessive compulsive symptoms. CONCLUSION: Obsessive compulsive symptoms are prevalent in patients with schizophrenia. The presence of comorbidity should be explored for adequate management.

Parent-child relationship in children of alcoholic and non-alcoholic parents.

AIM: Overall aim of the study was to see parent-child relationship in children of alcoholic and non-alcoholic parents. MATERIALS AND METHODS: The sample consisted of 30 alcoholic and 30 non-alcoholic parents and their children taken from Kanke Block of Ranchi district. The sample was selected on the basis of inclusion and exclusion criteria. Socio-demographic data sheet and Parent Child Relationship Scale (Rao, 1978) were administered to the children. RESULTS: In a child's perception of father in various domains of parent-child relationship, significant difference at P < 0.01 was found in the domain of symbolic punishment, rejecting, objective punishment, demanding, indifferent, symbolic reward in loving and neglecting, and in child's perception of the mother. Significant difference at P < 0.01 was found in the domain of symbolic punishment, rejecting, object punishment, indifferent and in neglecting. CONCLUSION: The result showed that the children of alcoholic parents tended to have more symbolic punishment, rejecting, objective punishment, demanding, indifferent, symbolic reward loving and in neglecting than children of non alcoholic parents.

Activity-based prospective memory in schizophrenia.

The study reports activity-based prospective memory as well as its clinical and neuropsychological correlates in schizophrenia. A total of 42 persons diagnosed with schizophrenia and 42 healthy controls were administered prospective memory, set-shifting, and verbal working memory tasks. The schizophrenia group was additionally administered various psychopathology rating scales. Group differences, with poorer performances of the schizophrenia group, were observed on the measures of prospective memory, working memory, and set shifting. The performance on prospective memory tasks correlated with the performance levels on verbal working memory and set-shifting tasks but not with the clinical measures. This study demonstrated impaired activity-based prospective memory in schizophrenia. The impairment can be due to deficits in various neuropsychological domains.

Event-based prospective memory in schizophrenia.

Although memory deficits have been well documented in schizophrenia, so far, there is dearth of literature about prospective memory (PM), that is memory for future events, in this disorder. The present study investigated event-based PM in schizophrenia. Additionally, the relationship of event-based PM with clinical variables of schizophrenia was also assessed. Task incorporating event-based prospective memory was administered on 42 schizophrenia patients and 42 nonpsychiatric comparison subjects. Patients with schizophrenia were additionally rated on The Scale for the Assessment of Positive Symptoms, The Scale for the Assessment of Negative Symptoms and The Brief Psychiatric Rating Scale. Results showed schizophrenia patients to have poor event-based prospective memory. However, no significant correlation was observed between the clinical variables and PM.