Impaired Ss Research Articles

Asthma in Cincinnati's Elderly Study: Significant Impact of Asthma on Psychosocial Function

S U N D A Y 567 Asthma in Cincinnati's Elderly Study: Significant Impact of Asthma on Psychosocial Function A. M. Smith, E. T. Stanforth, M. Villareal, D. J. Swikert, D. I. Bernstein; University of Cincinnati Medical Center, Cincinnati, OH, Cincinnati VA Medical Center, Cincinnati, OH, St. Elizabeth Medical Center, Edgewood, KY. RATIONALE: Asthma in older adults is underdiagnosed and undertreated, resulting in suboptimal asthma control and potential psychosocial effects. The objective of this study is to evaluate factors affecting psychosocial functioning in older asthmatics. METHODS: Asthmatic and non-asthmatic patients >_60 years old (n577) were recruited from the general population. A medical history, physical exam, skin prick testing, and spirometry were performed. Psychosocial function (daily activity, social characteristics, and mental health symptoms [MHS]) was assessed through the standardized OARS questionnaire and analyzed using chi-square, t-test, and logistic regression. RESULTS: Mean age was 68.767.2 years; 59 (77%) were female. Mean percent predicted FEV1 at baselinewas lower in asthmatics (73.7621.6%) than controls (90.0619.1%) (p50.0008). The univariate analysis showed the asthma group had worse daily functioning, decreased activity levels, and impaired social support [SS] (p < 0.05). After adjusting for gender, race, and comorbidities, physical impairment (Adjusted Odds Ratio [aOR]: 9.7; 95% CI: 3.1-30.8; p50.0001) and impaired SS (aOR: 5.1; 95% CI: 1.5-17.2; p50.0001) were independently related to asthma. No significant differences were found in social interactions/resources or reported MHS. While impaired activity was associated with decreased pulmonary function (p50.004), impaired SS was not (p50.5). Those with impaired SS reported significantly increased desire for psychological counseling (p50.02). CONCLUSIONS: Older adults with asthma have significantly impaired psychosocial functioning, specifically daily activity levels and social support, independent of MHS and social interactions/resources. Treating asthma can improve pulmonary function and potentially reduce physical impairment, but improving levels of social support may require social service or psychological interventions.

An evaluation of a behavioural treatment approach to hearing impairment

Twenty-four elderly hearing impaired Ss participated in an experimental treatment study and received either behavioural group treatment or served as untreated controls. The treatment package included applied relaxation, video self-modelling, exposure, information and various coping skills. Assessments (pre-post) were conducted using a structured video-interview measuring coping behaviour. In order to evoke behavioural compensation small acoustic provocations were included in the interview. The edited videos were then rated blindly by two trained observers. Pre-post assessments also included daily registered hearing problems on visual analogue scales and a questionnaire. Finally, a one month follow-up blind telephone interview was conducted. Results showed significant beneficial effects in favour of the treatment package and support the implementation of a behavioural approach in audiological rehabilitation research.

AVLT memory scores as a function of age among general medical, neurologic and alcoholic patients.

Analyzed data from the administration of the Rey AVLT to 232 general hospital patients according to age and type of diagnosis and influences of these variables on learning, recall and recognition. Aging has a different effect on these three test scores, depending on the classification of the patient. Non-organically impaired Ss had difficulties with recognition the older they were; Ss with ABS showed learning deficits; in CBS (alcoholic) Ss, aging was associated with poor recall performance, but not significantly. Younger, higher educated and more intelligent Ss have better recognition, whereas better learning is associated with only education as a factor. Analysis of these results was made in the context of storage system theory with further implications.

Randomness and the “streaking” phenomenon: Attentional anomalies in performance on the Whitaker Index of Schizophrenic Thinking (WIST)

Examined in detail the performance of 36 hospitalized male schizophrenics on the Whitaker Index of Schizophrenic Thinking (WIST). Results indicated two interesting phenomena. First, the performance of patients with the highest level of cognitive deficit approached a random level of responding with respect to both the type of error made and the propensity to improve after an error. Second, a subgroup of these highly impaired Ss, identified as "streakers," displayed periods of virtually error-free responding, interspersed with periods of extremely impaired performance. The streaking phenomenon, as well as the tendency toward randomness, was discussed in terms of attentional anomalies.

Recognition of overlapping patterns and focal hemisphere damage

204 Ss entered this research, subdivided in controls ( N = 44) and hemisphere damaged patients ( N = 160). A meaningful and a meaningless patterns version of the Poppelreuter-Ghent Test were employed and the answers were worked out in the frame of the Signal Detectability Theory. No hemispheric asymmetry in the recognition performance turned out, patients with visual field defects being the only impaired Ss. Response criterion differences were completely lacking.

Wechsler memory scale indices of brain pathology.

The present study reported on preliminary findings of two experimental forms of Wechsler Memory Scale subtest analyses that show promise as screening procedures for neurologically impaired Ss. Both methods discriminated the organic Ss for controls with 70% accuracy. Both methods compare "hold" subtest scores to "don't hold" subtest scores by the use of a regression equation, a procedure that attempts to compensate for the lack of standard scores. The reasons why the regression equation that uses digits score as a hold criterion is regarded as potentially the more useful were discussed.

Temporal Discrimination of Brief Auditory Stimuli by Schizophrenics, Neurologically Impaired, and Normals

36 normal, 36 schizophrenic, and 36 neurologically impaired Ss were compared for their ability to temporally discriminate brief auditory stimuli. The experimental task was the absolute judgment of 3, 5, or 9 stimuli ranging in duration from .10 to 1.90 sec. Univariate and bivariate information analysis showed that normal Ss obtained significantly higher information transmission scores than did either brain-damaged or schizophrenic Ss. The two clinical populations failed to produce the classical information-transmission function of a linear increase up to channel capacity, then virtually no change thereafter. Normal Ss also demonstrated less response stereotypy than did the schizophrenic and neurologically impaired Ss.

Monaural and Binaural Free-Field Speech Reception through Ear-Level Hearing Aids under Noise and Reverberation

Speech reception was studied in a room at reverberation times T = 0.3 and 0.6 sec, to compare binaural and monaural reception through ear-level hearing aids in the presence of a babble of eight voices. Some subjects (Ss) had normal hearing and some had severe sensorineural hearing impairment with bilaterally symmetrical audiograms. The speech and noise sources subtended an arc of 60° on a circle 11 ft in radius centered on the S's head. Binaural gain, the difference in speech to noise ratios for 50% correct speech reception comparing binuaral and monaural results, was 3 dB for normal Ss at both reverberant conditions. The binaural gain for impaired Ss varied from 3 dB to 0; those with previous binaural experience tended to show greater binaural gain. The prolongation of reverberation caused a reduction in reception. In presence of the masking noise, the reduction was about 15% correct response for both normal and impaired Ss. In quiet, normal Ss' reception was not influenced by the prolonged reverberation but the impaired Ss showed about 10% reduction in reception. [Supported by Gallaudet College].

Tactile-visual equivalence of shape and slant in brain-damaged and mongoloid children.

Earlier, we reported on the development in children of the ability to equate stimuli written o p the back with visually presented equivalents (Kennedy & Sheridan, 1972) . Here, we describe the performances of brain-damaged and mongoloid children on the same. two-choice tasks involving discrimination between mirror-image oblique lines oriented 45 to the right vs left or between a triangle vs a circle. The stimulus chosen from a given pair was presented either visually or by tactile drawing on a cloth template placed on the back. Locus of tactile presentations of slant stimuli was varied-either right, left or middle of the back. Tactile and visual stimuli were identical in size, shape, and orientation. Order of presentation of slant and shape tasks was varied haphazardly across children. Matching from sample was always done by selecting one from the visually presented pair, the standard being varied randomly from trial to trial. A guess rate was obtained for each stimulus pair by eliminating presentation of the standard on certain trials. There were three groups of Ss: (1) a group diagnosed as brain-damaged, ranging in age from 12 to 13 yr. (N = 8 ) , ( 2 ) a group oE mongoloids ages 11 to 14 yr. (N = 3 ) , and (3) a group of children ranging from 7 to 13 yr. of age. The brain-damaged and mongoloid children attended a school for trainable children and had IQs, measured by the Stanford-Binet Intelligence Test, ranging from 25 through 50. Performances of normal children were between 92% and 100% correct on all conditions except the guess-rate condition, which yielded 50% correct. Thus, normal children readily match to sample regardless of modality, stimulus type, o r locus on the back. Mongoloids performed essentially at chance levels on all conditions except that requiring visualto-visual matching with triangle vs circle stimuli, for which the mean performance was 97% correct. Thus, they could neither perform cross-modal equivalence testr, nor match to a visual sample when slant was the dimension being discriminated. Except for the abovementioned triangle-circle, visual-to-visual condition and the guess-rate condition, there was no overlap between mongoloid and normal children. There was also no overlap between scores of brain-damaged and normal children, except for visual-to-visual triangle-circle and guess-rate conditions. W i t h the same two exceptions, mean scores were slightly higher in all conditions for brain-damaged than for mongoloid children, though overlap berween the two classes of impaired children was substantial. Whether brain-damaged or mongoloid, impaired children tended to show their worst performance when slant stimuli were presented to the left of the back. In fact, the highest level of performance obtained was by one child (brain-damaged) who reached the 50% level. This indicates that the impaired Ss tended to select the reverse orientation when matching from a slant sample presented to the left back. It is interesting that, despite the high level performances of normal children, this was the worst condition for them as well, half of them falling below the typical 100% correct under this condition.

Response sets on the Rod-and-Frame Test in neurologically impaired Ss.

30 male and 30 female patients with confirmed central nervous system pathology were administered the Rod-and-frame Test (RFT) as part of an extensive neuropsychological evaluation. The RFT data were examined for the presence of response sets. While sex groups did not display as strong a tendency toward response sets as did a college group, they matched a technical engineering group more closely. The tendency to favor the left side of the vertical noted in earlier studies was not observed in the neurologically impaired groups. Instead, they had a strong tendency to err in the direction of the frame. The possible relationship between psychometric intelligence and response sets was discussed as well as some of the possible underlying visual perceptual mechanisms that may contribute to response sets on the RFT.

Stimulus rotation and visual scanning in Ss with copying disability.

Rotation of squares increases copying difficulty for young children and brain-damaged adults. Explanations stress both perceptual and cognitive factors. Records of visual scanning were used as an index of attention to areas of the stimulus field. Perceptual explanations were translated into scanning terms. The degree to which scanning is consistent with expectations inferred from perceptual theories was examined. Scanning of squares, rotated and unrotated, was compared for 7 normals and 7 adults with impaired copying ability. Variables were attention to contour, enclosed form, and ground. Conclusions were that: (a) normals scan rotated and unrotated squares similarly; (b) impaired Ss' scanning of rotated squares is different from normal scanning and from their own scanning of unrotated squares; (c) the differences found do not follow theoretical expectation.