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Proceedings of the National Academy of... Oct 2023Human cognition is underpinned by structured internal representations that encode relationships between entities in the world (cognitive maps). Clinical features of...
Human cognition is underpinned by structured internal representations that encode relationships between entities in the world (cognitive maps). Clinical features of schizophrenia-from thought disorder to delusions-are proposed to reflect disorganization in such conceptual representations. Schizophrenia is also linked to abnormalities in neural processes that support cognitive map representations, including hippocampal replay and high-frequency ripple oscillations. Here, we report a computational assay of semantically guided conceptual sampling and exploit this to test a hypothesis that people with schizophrenia (PScz) exhibit abnormalities in semantically guided cognition that relate to hippocampal replay and ripples. Fifty-two participants [26 PScz (13 unmedicated) and 26 age-, gender-, and intelligence quotient (IQ)-matched nonclinical controls] completed a category- and letter-verbal fluency task, followed by a magnetoencephalography (MEG) scan involving a separate sequence-learning task. We used a pretrained word embedding model of semantic similarity, coupled to a computational model of word selection, to quantify the degree to which each participant's verbal behavior was guided by semantic similarity. Using MEG, we indexed neural replay and ripple power in a post-task rest session. Across all participants, word selection was strongly influenced by semantic similarity. The strength of this influence showed sensitivity to task demands (category > letter fluency) and predicted performance. In line with our hypothesis, the influence of semantic similarity on behavior was reduced in schizophrenia relative to controls, predicted negative psychotic symptoms, and correlated with an MEG signature of hippocampal ripple power (but not replay). The findings bridge a gap between phenomenological and neurocomputational accounts of schizophrenia.
Topics: Humans; Schizophrenia; Semantics; Psychotic Disorders; Verbal Behavior; Learning
PubMed: 37816054
DOI: 10.1073/pnas.2305290120 -
Molecular Autism Apr 2023Autistic girls are underdiagnosed compared to autistic boys, even when they experience similar clinical impact. Research suggests that girls present with distinct...
BACKGROUND
Autistic girls are underdiagnosed compared to autistic boys, even when they experience similar clinical impact. Research suggests that girls present with distinct symptom profiles across a variety of domains, such as language, which may contribute to their underdiagnosis. In this study, we examine sex differences in the temporal dynamics of natural conversations between naïve adult confederates and school-aged children with or without autism, with the goal of improving our understanding of conversational behavior in autistic girls and ultimately improving identification.
METHODS
Forty-five school-aged children with autism (29 boys and 16 girls) and 47 non-autistic/neurotypical (NT) children (23 boys and 24 girls) engaged in a 5-min "get-to-know-you" conversation with a young adult confederate that was unaware of children's diagnostic status. Groups were matched on IQ estimates. Recordings were time-aligned and orthographically transcribed by trained annotators. Several speech and pause measures were calculated. Groups were compared using analysis of covariance models, controlling for age.
RESULTS
Autistic girls used significantly more words than autistic boys, and produced longer speech segments than all other groups. Autistic boys spoke more slowly than NT children, whereas autistic girls did not differ from NT children in total word counts or speaking rate. Autistic boys interrupted confederates' speech less often and produced longer between-turn pauses (i.e., responded more slowly when it was their turn) compared to other children. Within-turn pause duration did not differ by group.
LIMITATIONS
Our sample included verbally fluent children and adolescents aged 6-15 years, so our study results may not replicate in samples of younger children, adults, and individuals who are not verbally fluent. The results of this relatively small study, while compelling, should be interpreted with caution and replicated in a larger sample.
CONCLUSION
This study investigated the temporal dynamics of everyday conversations and demonstrated that autistic girls and boys have distinct natural language profiles. Specifying differences in verbal communication lays the groundwork for the development of sensitive screening and diagnostic tools to more accurately identify autistic girls, and could inform future personalized interventions that improve short- and long-term social communication outcomes for all autistic children.
Topics: Adolescent; Humans; Child; Male; Female; Autistic Disorder; Sex Characteristics; Communication; Language; Speech
PubMed: 37024960
DOI: 10.1186/s13229-023-00545-6 -
International Journal of Psychiatry in... Jun 2021To investigate the neuropsychological features of depressed patients reporting high level of psychological pain.
OBJECTIVE
To investigate the neuropsychological features of depressed patients reporting high level of psychological pain.
METHODS
Sixty-two inpatients were included and divided into two groups according to the level of psychological pain assessed by a Likert scale. Cognitive abilities were assessed using the Trail Making Test, the Stroop test, and Verbal Fluency Test (semantic and phonemic verbal fluency). Univariate and multivariate analyses were performed to determine neuropsychological factors associated with a high level of psychological pain.
RESULTS
The median level of psychological pain was 8/10. High level of psychological pain was associated with poor phonemic verbal fluency performance in men ( = 0.009), but not in women, even after controlling for confounding factors (age, level of depression, anxiety). Groups did not differ on the Trail Making Test, the Stroop test, or the semantic verbal fluency measure.
CONCLUSION
Psychological pain is a specific clinical entity that should be considered to be more significant than just a symptom of depression. High level of psychological pain appears to be associated with a deficit of phonemic verbal fluency in depressed men. This finding could help to target psychotherapeutic treatments and improve screening.Key pointsPatients with high psychological pain do not differ on the Trail Making Test, the Stroop Test or the Sematic Verbal Fluency Measure to patients with low psychological painHigh psychological pain is associated with a deficit in phonemic verbal fluency in depressed menFuture research should aim to clarify gender differences in psychological pain in participants with and without major depressive disorder, as well as explore the complex relationship between cognition and the different forms of pain (psychological, physical and psychosomatic).
Topics: Adult; Cognition; Depression; Depressive Disorder, Major; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Pain; Phonetics; Semantics; Verbal Behavior
PubMed: 33275047
DOI: 10.1080/13651501.2020.1836225 -
Folia Phoniatrica Et Logopaedica :... 2022Fluency and disfluency exist on a continuum of speech production.Typically fluent speakers produce varying numbers of disfluencies; this number increases in stressful or...
BACKGROUND
Fluency and disfluency exist on a continuum of speech production.Typically fluent speakers produce varying numbers of disfluencies; this number increases in stressful or cognitively demanding situations. Prior research indicates that adult second language learners produce more disfluencies in their weaker, second language, however, this has not been explored among heritage bilinguals who developed in both languages during childhood. There is a lack of foundational knowledge regarding disfluencies among typically fluent adult bilinguals; typical fluency patterns are likely influenced by bidirectional relationships between languages. These patterns may be viewed as disfluencies by listeners who generally perceive disfluencies unfavorably.
OBJECTIVES
The current study explores the quantity and types of disfluencies produced by bilinguals.
METHODS
Twenty Spanish-English bilinguals took part in a simulated job interview. Responses were transcribed and the total number and percent of disfluencies were calculated.
RESULTS
The findings indicated that typically fluent Spanish-English bilingual adults produce 6.99 typical (nonstuttered) disfluencies per 100 words and are therefore within the range of normative data on monolingual adults (5.1-10.99 per 100 words). The 2 most common disfluencies were superfluous verbal behaviors and pauses.
CONCLUSIONS
The findings revealed that typically fluent Spanish-English bilingual adult participants produced more fixed postures than previously reported among monolingual English speakers.
Topics: Adult; Humans; Language; Multilingualism; Speech; Speech Production Measurement; Verbal Behavior
PubMed: 34350868
DOI: 10.1159/000518138 -
Journal of the American Geriatrics... Aug 2020American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive...
BACKGROUND
American Indians have excess risk of depression, which can contribute to cerebrovascular and cognitive disability, with effects on memory, processing speed, executive function, and visuospatial ability. However, studies examining depression and cognition in American Indians are limited; this study aims to report associations of depression with general cognition, verbal fluency and memory, and processing speed.
DESIGN
Cohort study.
SETTING
The Cerebrovascular Disease and its Consequences in American Indians study was an ancillary examination of Strong Heart Study participants from 3 U.S. regions.
PARTICIPANTS
All eligible were included in this analysis (N=818).
MEASUREMENTS
Participants completed evaluations for depressive symptomology, cognition, and physical function-including Center for Epidemiologic Studies Depression (CESD), Modified Mini-Mental State Examination (3MSE), Wechsler Adult Intelligence Scale-Fourth Edition coding (WAIS), Controlled Oral Word Association (COWA), California Verbal and Learning Test, Halstead finger tapping, grip strength, and Short Physical Performance Battery (SPPB) tests. Linear mixed models were adjusted for site, age, sex, education, income, marital status, alcohol, smoking, diabetes, hypertension, obesity, cholesterol, stroke, infarct, and hemorrhage.
RESULTS
Symptoms of depression were common, with 20% (N=138) endorsing CES-D scores of 16+. More depressive symptoms were associated with older age, female sex, lower education, lower income, non-married status, not using alcohol, not smoking, hypertension, diabetes, and stroke. In adjusted analyses, processing speed (WAIS: β -0.13, 95%CI -0.25, -0.03), general cognition (3MSE: β -0.10, 95%CI -0.17, -0.03), verbal fluency (COWA: β -0.10, 95%CI -0.19, -0.01), and motor function (SPPB: β -0.05, 95%CI -0.07, -0.03) were significantly associated with more symptoms of depression.
CONCLUSION
These findings maybe informative for health disparities populations, especially those with depressive risk. Clinicians may require particular training in cultural humility. Future studies should validate use of the CES-D scale in this population; longitudinal studies may focus on causal mechanisms and potential secondary prevention, such as social support. J Am Geriatr Soc 68:1739-1747, 2020.
Topics: Aged; Aged, 80 and over; Cognition; Depression; Executive Function; Female; Humans; Linear Models; Male; Memory; Neuropsychological Tests; Psychomotor Performance; Reaction Time; United States; Verbal Behavior; American Indian or Alaska Native
PubMed: 32250446
DOI: 10.1111/jgs.16434 -
Journal of Clinical and Experimental... Nov 2021This study's purpose is to describe the performance of healthy community dwelling Saudi Arabians on fluency tasks and explore the effects of age, sex and education.
INTRODUCTION
This study's purpose is to describe the performance of healthy community dwelling Saudi Arabians on fluency tasks and explore the effects of age, sex and education.
METHODS
Arabic-speaking Saudi Arabians > 18 were chosen through convenience sampling. Included were healthy community members whose first language is Arabic. Excluded were anyone with a past history of psychiatric or central neurological diseases, or who was taking medications that affect the central nervous system. Information regarding the variables sex, age, and education was collected. Participants were required to name as many words as they could that started with the letters (ع), (ش), and (ق) (letter task), and words that belonged to the categories "countries," "boy names," "girl names," and "four-legged animals" (categorical task). Mean scores were derived for the three letters (ASQ) and four categories (TC). Descriptive statistics, percentile curves, and quantile regressions (0.05, 0.25, 0.5, 0.75, and 0.95) were conducted to determine performance range.
RESULTS
The study included 301 participants, comprising 162 (53.47%) females. The M(SD) for age was 46.74 (16) and for years of education 14 (4.78). The M(SD) for ASQ was 26.26 (10.01), and for TC, 81.56 (20.77). Percentile curves demonstrated an initial increase, followed by a decrease, in performance with increasing age on letter and categorical fluency tasks. Performance scores showed an increase of 1 to 1.5 and 2 to 3.5 words in the letter and categorical tasks, respectively, for each additional year of education across the quantiles (both with p < 0.0001). Males scored higher in the 0.05 and 0.95 quantiles of the letter fluency task only.
CONCLUSION
We demonstrated a range of normative performance from a Saudi Arabian community, with varying age and education levels. The assessment demonstrated the importance of education as a major variable linearly associated with performance, influencing both tasks.
Topics: Animals; Educational Status; Female; Humans; Language; Male; Middle Aged; Neuropsychological Tests; Saudi Arabia; Verbal Behavior
PubMed: 35060441
DOI: 10.1080/13803395.2021.2025344 -
Journal of Neuropsychology Jun 2024Amyotrophic lateral sclerosis (ALS) is a multi-system disorder that commonly affects cognition and behaviour. Verbal fluency impairments are consistently reported in ALS...
Amyotrophic lateral sclerosis (ALS) is a multi-system disorder that commonly affects cognition and behaviour. Verbal fluency impairments are consistently reported in ALS patients, and we aimed to investigate whether this deficit extends beyond the verbal domain. We further aimed to determine whether deficits are underpinned by a primary intrinsic response generation impairment (i.e., a global reduction across tasks), potentially related to apathy, or an inability to maintain responding over time (i.e., a 'drop off' pattern). Twenty-two ALS patients and 21 demographically-matched controls completed verbal and nonverbal fluency tasks (phonemic/semantic word fluency, design fluency, gesture fluency and ideational fluency), requiring the generation of responses over a specified time period. Fluency performance was analysed in terms of the overall number of novel items produced, as well as the number of items produced in the first 'initiation' and the remaining 'maintenance' time periods. ALS patients' overall performance was not globally reduced across tasks. Patients were impaired only on meaningful gesture fluency, which requires the generation of gestures that communicate meaning (e.g., waving). On phonemic fluency, ALS patients showed a 'drop off' pattern of performance, where they had difficulty maintaining responding over time, but this pattern was not evident on the other fluency tasks. Apathy did not appear to be related to fluency performance. The selective meaningful gesture fluency deficit, in the context of preserved meaningless gesture fluency, highlights that the retrieval of action knowledge may be weakened in early ALS.
Topics: Humans; Amyotrophic Lateral Sclerosis; Male; Female; Middle Aged; Aged; Neuropsychological Tests; Gestures; Verbal Behavior; Apathy; Adult; Semantics
PubMed: 37997256
DOI: 10.1111/jnp.12354 -
Nature Neuroscience Nov 2023
Topics: Speech; Speech Perception
PubMed: 37919611
DOI: 10.1038/s41593-023-01492-4 -
International Journal of Language &... 2023Verbal fluency tests (VFT) are highly sensitive to cognitive deficits. Usually, the score on VFT is based on the number of correct words produced, yet it alone gives...
BACKGROUND
Verbal fluency tests (VFT) are highly sensitive to cognitive deficits. Usually, the score on VFT is based on the number of correct words produced, yet it alone gives little information regarding underlying test performance. The implementation of different strategies (cluster and switching) to perform efficiently during the tasks provide more valuable information. However, normative data for clustering and switching strategies are scarce. Moreover, scoring criteria adapted to Colombian Spanish are missing.
AIMS
(1) To describe the Colombian adaptation of the scoring system guidelines for clustering and switching strategies in VFT; (2) to determine its reliability; and (3) to provide normative data for Colombian children and adolescents aged 6-17 years.
METHODS & PROCEDURES
A total of 691 children and adolescents from Colombia completed phonological (/f/, /a/, /s/, /m/, /r/ and /p/) and semantic (animals and fruits) VFT, and five scores were calculated: total score (TS), number of clusters (NC), cluster size (CS), mean cluster size (MCS) and number of switches (NS). The intraclass correlation coefficient was used for interrater reliability. Hierarchical multiple regressions were conducted to investigate which strategies were associated with VFT TS. Multiple regressions were conducted for each strategy, including as predictors age, age , sex, mean parents' education (MPE), MPE and type of school, to generate normative data.
OUTCOMES & RESULTS
Reliability indexes were excellent. Age was associated with VFT TS, but weakly compared with strategies. For both VFT TS, NS was the strongest variable, followed by CS and NC. Regarding norms, age was the strongest predictor for all measures, while age was relevant for NC (/f/ phoneme) and NS (/m/ phoneme). Participants with higher MPE obtained more NC, and NS, and larger CS in several phonemes and categories. Children and adolescents from private school generated more NC, NS and larger CS in /s/ phoneme.
CONCLUSIONS & IMPLICATIONS
This study provides new scoring guidelines and normative data for clustering and switching strategies for Colombian children and adolescents between 6 and 17 years old. Clinical neuropsychologists should include these measures as part of their everyday practice.
WHAT THIS PAPER ADDS
What is already known on the subject VFT are widely used within the paediatric population due to its sensitivity to brain injury. Its score is based on the number of correct words produced; however, TS alone gives little information regarding underlying test performance. Several normative data for VFT TS in the paediatric population exist, but normative data for clustering and switching strategies are scarce. What this paper adds to existing knowledge The present study is the first to describe the Colombian adaptation of the scoring guidelines for clustering and switching strategies, and provided normative data for these strategies for children and adolescents between 6 and 17 years old. What are the potential or actual clinical implications of this work? Knowing VFT's performance, including strategy development and use in healthy children and adolescents, may be useful for clinical settings. We encourage clinicians to include not only TS, but also a careful analysis of strategies that may be more informative of the underlying cognitive processes failure than TS.
Topics: Animals; Humans; Child; Adolescent; Semantics; Colombia; Reproducibility of Results; Linguistics; Verbal Behavior; Cluster Analysis; Neuropsychological Tests
PubMed: 37140195
DOI: 10.1111/1460-6984.12891 -
Surgery Dec 2021Although 40 years has passed since the Institute of Medicine released its report "To Err Is Human," error counts are still high in healthcare. The understanding and...
BACKGROUND
Although 40 years has passed since the Institute of Medicine released its report "To Err Is Human," error counts are still high in healthcare. The understanding and training of nontechnical skills and teamwork thus remains a pertinent area for improvement. Most evaluation of nontechnical skills of trauma teams takes place in simulation rooms. The aim of this study was to determine if real trauma resuscitation communication could be analyzed using the speech classification system of verbal response modes, otherwise known as the verbal response mode taxonomy and, if so, if there is a predominant approach of verbally delivering messages.
METHODS
Video and audio recordings of 5 trauma team resuscitations were transcribed. Communication was coded using the verbal response mode taxonomy for both form and intent. The rate of mixed-mode communication (unmatched form and intent) and pure-mode communication were calculated and compared between the participants roles. Comparisons were made with simulated material published in other research.
RESULTS
The most frequent mixed-mode communication was acknowledgment in service of confirmation. Question in service of a question was the most used pure-mode communication. Six predominant roles were seen, which matched well with the roles in the simulations.
CONCLUSION
The verbal response mode taxonomy can be used to study communication during real trauma resuscitation, and it was found that pure-mode communication was predominant, meaning that the grammatical form matches the intent. Verbal response mode methodology is time consuming and requires analysts with domain knowledge. Comparisons show some differences between simulations and our material indicating that verbal response modes can be used to evaluate differences in communication.
Topics: Clinical Competence; Humans; Interprofessional Relations; Leadership; Medical Errors; Patient Care Team; Professional Role; Resuscitation; Verbal Behavior; Video Recording; Wounds and Injuries
PubMed: 34217502
DOI: 10.1016/j.surg.2021.05.043