Behavioral Assessment Of Dysexecutive Syndrome Research Articles

Occupational Therapy Practice in Predriving Assessment Post Stroke in the Irish Context: Findings From a Nominal Group Technique Meeting

Purpose: Practice in the area of predriving assessment for people with stroke varies, and research findings are not always easily transferred into the clinical setting, particularly when such assessment is not conducted within a dedicated driver assessment programme. This article explores the clinical predriving assessment practices and recommendations of a group of Irish occupational therapists for people with stroke. Method: A consensus meeting of occupational therapists was facilitated using a nominal group technique (NGT) to identify specific components of cognition, perception, and executive function that may influence fitness to return to driving and should be assessed prior to referral for on-road evaluation. Standardised assessments for use in predriving assessment were recommended. Results: Thirteen occupational therapists participated in the NGT meeting. Strongest consensus emerged for the inclusion of cognitive components of attention and speed of processing; perceptual components of spatial awareness, depth perception, and visual inattention; and executive components of planning, problem solving, judgment, and self-awareness. Consensus emerged for the use of the following standardised tests: Behavioural Assessment of Dysexecutive Syndrome (BADS), Test of Everyday Attention (TEA), Brain Injury Visual Assessment Battery for Adults (biVABA), Rivermead Perceptual Assessment Battery (RPAB), and Motor Free Visual Perceptual Test (MVPT). Conclusion: Tests were recommended that gave an indication of the patient’s underlying component skills in the area of cognition, perception, and executive functions considered important for driving. Further research is needed in this area to develop clinical practice guidelines for occupational therapists for the assessment of fitness to return to driving after stroke.

Occupational Therapy Practice in Predriving Assessment Post Stroke in the Irish Context: Findings From a Nominal Group Technique Meeting

Purpose: Practice in the area of predriving assessment for people with stroke varies, and research findings are not always easily transferred into the clinical setting, particularly when such assessment is not conducted within a dedicated driver assessment programme. This article explores the clinical predriving assessment practices and recommendations of a group of Irish occupational therapists for people with stroke. Method: A consensus meeting of occupational therapists was facilitated using a nominal group technique (NGT) to identify specific components of cognition, perception, and executive function that may influence fitness to return to driving and should be assessed prior to referral for on-road evaluation. Standardised assessments for use in predriving assessment were recommended. Results: Thirteen occupational therapists participated in the NGT meeting. Strongest consensus emerged for the inclusion of cognitive components of attention and speed of processing; perceptual components of spatial awareness, depth perception, and visual inattention; and executive components of planning, problem solving, judgment, and self-awareness. Consensus emerged for the use of the following standardised tests: Behavioural Assessment of Dysexecutive Syndrome (BADS), Test of Everyday Attention (TEA), Brain Injury Visual Assessment Battery for Adults (biVABA), Rivermead Perceptual Assessment Battery (RPAB), and Motor Free Visual Perceptual Test (MVPT). Conclusion: Tests were recommended that gave an indication of the patient’s underlying component skills in the area of cognition, perception, and executive functions considered important for driving. Further research is needed in this area to develop clinical practice guidelines for occupational therapists for the assessment of fitness to return to driving after stroke.

Using virtual reality to evaluate executive functioning among persons with schizophrenia: A validity study

Persons with Schizophrenia experience difficulties with Executive Functioning (EF) that affect independence and participation in activities. Specifically, EF impacts performance in Instrumental Activities of Daily Living (IADL) that require flexible thinking and accommodation to complex environments. However, less is known how schizophrenia affects EF and individuals' performance in activities. IADL performance can be tested using a virtual reality (VR) environment that simulates real life activities. The purpose of this study was: 1) to examine the feasibility and validity of the Virtual Action Planning-Supermarket (VAP-S) to assess EF in persons with schizophrenia as compared to a standardized EF measure (the Behavioral Assessment of Dysexecutive Syndrome, BADS); 2) to compare performance of persons with schizophrenia and healthy controls in the VAP-S; 3) to assess the ability of the VAP-S to differentiate between different levels of EF within schizophrenia; 4) to explore the relationships between negative and positive symptoms and performance on the tests. Thirty persons with schizophrenia were matched with 30 healthy controls. Significant differences in performance between research and control groups were detected on the VAP-S and BADS, with the research group performing worse. Large variations in number of purchases within the VAP-S by the research group point to level of task completion thus secondary analysis was conducted. There was a significant negative correlation between level of the negative signs and overall performance on the BADS and on most measures of the VAP-S. Results of this study support the use the VAP-S to assess EF among persons with Schizophrenia.

Behavioural assessment of dysexecutive syndrome in Parkinson's disease without dementia: A comparison with other clinical executive tasks

The Behavioural Assessment of the Dysexecutive Syndrome (BADS) is a neuropsychological battery developed with the intent of measuring a wide range of executive impairments. Although the psychometric characteristics of BADS have previously been investigated in distinct neurological disorders, data on its validity in Parkinson's Disease (PD) without dementia are still lacking. The principal aim of the study was to address this issue. Twenty-five non-demented PD patients and 24 demographically-matched controls were administered BADS and other commonly used executive tools. Comparisons between groups indicated that two of the six BADS subtests (Temporal Judgement and Action Program) did not have sufficient sensitivity to executive impairments. However, when we explored group-predictive capabilities among the tests, the BADS total score was the most sensitive, followed by the Tower of London (TOL). We obtained similar results when we disentangled the sensitivity of the six BADS subtests. The BADS Six Elements task was the best group predictor followed by the TOL. Our findings showed that BADS is more sensitive to executive dysfunction than some of the tools commonly used to assess this construct in PD. However, we also demonstrated that, to assess executive impairments in PD without dementia adequately, this battery should be administered in combination with the TOL.

Performance of three racial/ethnic groups on two tests of executive function: Clinical implications for traumatic brain injury (TBI)

The purpose of this study was to determine if race/ethnicity may influence performance of college students on the Behavioral Assessment of Dysexecutive Syndrome (BADS) and the Wisconsin Card Sorting Test (WCST), two different tests of executive function (EF). A total of 149 participants who self-identified as African American (AA), European American (EA), and Latina/o American (LA) constituted the three different racial/ethnic groups. Participants ranged in age range from 18 to 24 years old (SD = 1.29) and none reported histories of disabilities. The BADS was administered to 149 college students and the WCST was administered to 142 of the same participants. No statistically significant differences were found for race/ethnicity or gender on the WCST. Statistically significant differences were found for race/ethnicity on the Profile Scores (raw scores), standard scores (SS) and the Zoo Map subtest of the BADS, but no statistically significant differences were found for gender on these same tasks. While there should be less concern in administering WCST to diverse groups who are English speakers, caution should be taken in administering and interpreting the BADS for individuals from diverse cultural and linguistic backgrounds.

高次脳機能障害者の職場復帰に関連する神経心理学的要因

We conducted neuropsychological tests of patients with higher brain dysfunction to examine the characteristics of barriers to employment. We tested 92 patients with higher brain dysfunction (average age of 36.3 +/- 13.8 years old, ranging between 16 and 63 years old, with an average post-injury period of 35.6 +/- 67.8 months) who were hospitalized at the university hospital between February 2002 and June 2007 for further neuropsychological evaluation, conducting the Wechsler Adult Intelligence Scale-Revised (WAIS-R), Wechsler Memory Scale-Revised (WMS-R), the Rivermead Behavioral Memory Test (RBMT), Frontal Assessment Battery (FAB) and Behavioral Assessment of Dysexecutive Syndrome (BADS). The outcomes after discharge were classified between competitive employment, sheltered employment and non-employment, and the three groups were compared using one-way analysis of variance and the Scheffe test. The WAIS-R subtests were mutually compared based on the standard values of significant differences described in the WAIS-R manual. Verbal performance and full scale Intelligence Quotient (IQ) of WAIS-R were 87.7 +/- 15.6 (mean +/- standard deviation), 78.5 +/- 18.1 and 81.0 +/- 17.2, respectively, and verbal memory, visual memory, general memory, attention/concentration and delayed recall were 74.6 +/- 20.0, 76.6 +/- 21.4, 72.0 +/- 20.4, 89.0 +/- 16.5 and 65.2 +/- 20.8, respectively. The competitive employment group showed significantly higher scores in performance IQ and full IQ on the WAIS-R and verbal memory, visual memory, general memory and delayed recall on the WMS-R and RBMT than the non-employment group. The sheltered employment group showed a significantly higher score in delayed recall than the non-employment group. No difference was observed in the FAB or BADS between the three groups. In the subtests of the WAIS-R, the score for Digit Symbol-Coding was significantly lower than almost all the other subtests. For patients with higher brain dysfunction, IQ (full scale IQ > 53.2) and memory (general memory > 74.1) are important indicators in returning to work under the conditions of competitive employment.

The relationship between cognitive dysfunction and stress sensitivity in schizophrenia

The aim of the current study was to replicate the finding that cognitive impairments are not or inversely associated with sensitivity to stress in a sample of 25 patients diagnosed with psychotic disorder. The results indicated that impairments in performance on the Trailmaking Test and the Stroop Color Word Test were inversely associated with sensitivity to stress in daily life, whereas impairment in a subtest of the Behavioral Assessment of Dysexecutive Syndrome (BADS) was not associated with stress-sensitivity. The data thus show that in some instances cognitive functioning is not, and in other instances is inversely associated with momentary sensitivity to stress. Cognitive impairment and affective reactivity thus appear to be independent or mutually exclusive mechanisms in psychosis, suggesting competing causal pathways.

The ecological validity of executive tests in a severely brain injured sample

It is unclear how well performance on recently developed, specialized executive tests, reflects problems that patients and their relatives complain of in real life. The ecological validity of four specialised tests of executive function: the Hayling and Brixton Tests, and the Zoo Map and Key Search sub-tests from the Behavioural Assessment of Dysexecutive Syndrome (BADS) battery, was assessed against the Dysexecutive Questionnaire from the BADS in a sample of 59 severely brain injured individuals. Results indicated that only the Hayling C was significantly negatively correlated ( r = −.26, P < .05) with the informant version of the Dysexecutive Questionnaire. An index of insight was not correlated with any of the executive tests. It is concluded that these tests have limited ecological validity when used to assess patients following severe head trauma.

Lack of insight in schizophrenia is not a dysexecutive phenomenon

It is unclear how well performance on recently developed, specialized executive tests, reflects problems that patients and their relatives complain of in real life. The ecological validity of four specialised tests of executive function: the Hayling and Brixton Tests, and the Zoo Map and Key Search sub-tests from the Behavioural Assessment of Dysexecutive Syndrome (BADS) battery, was assessed against the Dysexecutive Questionnaire from the BADS in a sample of 59 severely brain injured individuals. Results indicated that only the Hayling C was significantly negatively correlated (r = −.26, P < .05) with the informant version of the Dysexecutive Questionnaire. An index of insight was not correlated with any of the executive tests. It is concluded that these tests have limited ecological validity when used to assess patients following severe head trauma.

The association between negative and dysexecutive syndromes in schizophrenia: a cross-cultural study.

This paper examined the relationship between the ‘negative syndrome’ (NS) and the neuropsychological ‘dysexecutive syndrome’ (DES) in schizophrenia. The study also examined whether any relationship that exists between the NS and the DES holds equally for British and Japanese subjects. We compared 26 Japanese with 17 British schizophrenic patients, divided into ‘mild’ and ‘severe’ NS groups, on the basis of performance on neuropsychological tests, including the ‘Behavioural Assessment of Dysexecutive Syndrome’ (BADS). We found that patients with severe NS showed more everyday executive deficits than those with mild NS. The severity of NS was correlated with executive competence. The association between NS and the BADS performance was closer than that between NS and other conventional executive measures. These findings were not influenced by cultural differences between Japanese and British subjects, and, hence, suggested the existence of culture-neutral neurobehavioural processes.

Group and case study of the dysexecutive syndrome in alcoholism without amnesia

OBJECTIVESTo test the dysexecutive syndrome (DES) hypothesis of chronic alcoholism by the neuropsychological group and case study approaches.METHODSA comprehensive neuropsychological assessment, including the “behavioural assessment of dysexecutive syndrome”, a battery...

Dysexecutive syndrome in schizophrenia: A cross-cultural comparison between Japanese and British patients.

This study tested the hypothesis that the dysexecutive syndrome of schizophrenia is impervious to cultural differences. 18 Japanese and 22 British patients and 14 Japanese and 19 British control subjects were compared on the BADS (Behavioural Assessment of Dysexecutive Syndrome), a comprehensive neuropsychological assessment battery, designed for 'ecological validity', and other measures of frontal executive functions (EFs). Both cultural groups of schizophrenic patients showed equally severe impairment in most executive tests including the BADS (verbal fluency and intelligence were less impaired). Irrespective of cultural origin, similar neuropsychological deficits were found in patients with minimal intellectual deterioration. Our study suggests that socio-cultural background does not affect the dysexecutive profile of schizophrenia very much, and that neuropsychological assessment may possibly provide added clinical information relevant to the management and rehabilitation of schizophrenic patients across different cultures.