The impact of contextual information on the emotion recognition of children with an intellectual disability.

BACKGROUND: Research suggests that having relevant contextual information can help increase the accuracy of emotion recognition in typically developing (TD) individuals and adults with an intellectual disability. The impact of context on the emotion recognition of children with intellectual disability is unknown. METHOD: Emotion recognition tasks, which varied in terms of contextual information, were completed by 102 children (45 with and 57 without intellectual disability). RESULTS: There was a significant effect of age and group, with older and TD children performing better on average. There were significant group by condition interactions, whereby children with intellectual disability were more accurate at identifying emotions depicted by line drawings compared with photos with contextual information that was not directly related to the emotion being depicted. The opposite was found for TD children. CONCLUSIONS: These results have implications for socio-emotional interventions, such as universal school programmes.

Recognition of facial expressions of emotion by adults with intellectual disability: Is there evidence for the emotion specificity hypothesis?

This study aimed to evaluate the emotion recognition abilities of adults (n=23) with an intellectual disability (ID) compared with a control group of children (n=23) without ID matched for estimated cognitive ability. The study examined the impact of: task paradigm, stimulus type and preferred processing style (global/local) on accuracy. We found that, after controlling for estimated cognitive ability, the control group performed significantly better than the individuals with ID. This provides some support for the emotion specificity hypothesis. Having a more local processing style did not significantly mediate the relation between having ID and emotion recognition, but did significantly predict emotion recognition ability after controlling for group. This suggests that processing style is related to emotion recognition independently of having ID. The availability of contextual information improved emotion recognition for people with ID when compared with line drawing stimuli, and identifying a target emotion from a choice of two was relatively easier for individuals with ID, compared with the other task paradigms. The results of the study are considered in the context of current theories of emotion recognition deficits in individuals with ID.

The ability of adults with an intellectual disability to recognise facial expressions of emotion in comparison with typically developing individuals: A systematic review.

This review systematically examined the literature on the ability of adults with an intellectual disability (ID) to recognise facial expressions of emotion. Studies were included that: recruited only adult participants with ID; that did not specifically recruit participants with co-morbid diagnoses of syndrome(s) related to ID; and that directly compared the performance of adults with ID with a group of people without ID. Nine papers met the eligibility criteria for review and were assessed against pre-defined quality rating criteria and the findings synthesised. The majority of included studies were assessed as being of acceptable overall methodological quality. All of the studies reported a relative impairment in emotion recognition for participants with ID on at least some of the tasks administered, with a large effect size being found for most of the significant results. The review suggests that adults with ID are relatively impaired in recognising facial expressions of emotion, when compared with either adults or children without ID. Methodological variation between studies limits the extent to which any interpretations can be made as to the cause of impaired emotion recognition in adults with ID.

Cognitive functioning in newly presenting patients with supratentorial intracranial tumors: is there a role for inspection time?

Quantifying the extent of cognitive dysfunction in patients with intracranial tumors is important to monitor treatment effects and assess patients' needs. Inspection time, a measure of the efficiency of visual information processing, was evaluated, and its usefulness in patients with intracranial tumors was compared with that of other widely used cognitive tests. Newly presenting inpatients with supratentorial intracranial tumors (n = 118) underwent preoperative assessment using inspection time and a number of other measures of cognitive function, mood, and functional status. The brain tumor cohort was compared with patients admitted for elective spinal surgery (n = 85) and a healthy control group (n = 80). Analysis of covariance was used to compare the performance of the 3 groups. The brain tumor cohort had significantly lower inspection time scores than the spinal surgery group (P = .005) and the healthy volunteer control group (P < .001). The effect size was moderate. There was a large effect size of participant group for the Rey Auditory Verbal Learning Test, Digit Symbol-Coding, and Verbal Fluency (P = .002). The performance of patients with brain tumors was significantly worse than that of both of the control groups. Inspection time was well-tolerated by patients with intracranial tumors. However, inspection time is neither as easy to perform nor as sensitive as some other measures of cognitive function. Although its lack of any motor speed or coordination requirements, conceptual simplicity, repeatability, and relative lack of learning effect make inspection time a potentially useful tool in clinical neuro-oncology, practical considerations will limit its use.

Preoperative quality of life in patients with degenerative spinal disorders: many are worse than patients with brain tumours and cancer.

BACKGROUND: This study compared prospectively the quality of life (QoL), function and mood of patients about to undergo surgery for either an intracranial supratentorial tumour or a spinal degenerative condition. The QoL scores were also compared to that of cohorts with a range of extracranial cancers. MATERIAL AND METHODS: The study took place in a Scottish NHS Neurosurgical Unit. Patients were assessed on the day prior to surgery for their QoL (European Organisation for Research and Treatment of Cancer (EORTC)-QLQ C30), mood status (Hospital Anxiety and Depression Score), Performance status (Karnosky Score, timed 10-m walk) and disability (Barthel Disability Index). All tests were performed by a single trained psychologist. RESULTS: Between 2007 and 2009, 101 patients with intracranial tumours, 75 age- and gender-matched patients with degenerative spinal disorders and 80 healthy adults were evaluated. There was no difference in the mood or disability scores between the two patient cohorts, but mood was significantly worse than a matched healthy cohort. The spinal cohort had significantly worse scores on the Karnovsky Scale, timed 10-m walk and for Global Health than those of the brain tumour cohort. They also had worse mean scores on all five functional scales, as well as six of the nine symptom/single-item scales, of the EORTC QLQ C30. SUMMARY: Patients with degenerative spinal disorders awaiting surgery on the NHS have significantly impaired QoL in multiple domains as well as other functional and mood disorders. Not only are their scores worse than a brain tumour cohort but they are also worse than many cancer cohorts described in the literature using the EORTC QLQ C30. These findings suggest that preoperative care, assessment and management of NHS patients with degenerative spinal disorders could be improved and that the EORTC QLQ C30 may be a useful tool for audit purposes in this cohort.

Recruitment difficulties in brain tumour patients cause participation bias: findings from a neuropsychological study of adult inpatients with supratentorial intracranial tumours.

PURPOSE: Patients who participate in questionnaire surveys, clinical studies and clinical trials can be different from patients who do not participate. The occurrence and direction of this response, participation or ascertainment bias is unpredictable, and can harm the external validity of medical research. METHODS: We compared the characteristics of patients with intracranial tumours who participated in a psychological study of inspection time with the characteristics of patients who did not participate for a number of reasons. RESULTS: Of 178 newly diagnosed adults with intracranial tumours, 136 (76%) were eligible, of whom 76 (56%) participated and 34 (25%) declined. There were no significant differences in terms of age and sex of the patients who participated and those who declined. When the participation group was combined with those who were ineligible and those who declined, the majority of patients in the combined cohort (n = 152) had a WHO grade III or IV glioma (high-grade glioma) (48.0%), and only 13.2% had a WHO grade I or II glioma (low-grade glioma). However, only 38.2% of those who participated had a WHO grade III or IV glioma, and 23.7% had a WHO grade I or II glioma. Comparisons of the participation vs. ineligible and declined groups revealed there was a significant difference (p = 0.002) between the ratio of high-grade to low-grade gliomas in the total and recruited cohorts. Comparisons of only the participation vs. declined groups approached significance (p = 0.051). WHO grade III and IV glioma patients were under-represented, and WHO grade I or II glioma patients were over-represented in the study group. CONCLUSIONS: Noninterventional, non-therapeutic applied neuropsychological studies in neuro-oncology are susceptible to bias since the spectrum of neuropathologies in recruited patients can be significantly different from that of the total cohort. These data could help anticipate recruitment rates for applied neuropsychological studies in clinical neuro-oncology and may help anticipate likely selection biases amongst those who participate.