Differential executive functioning in the topology of Spirit possession or dissociative disorders: an explorative cultural study

Background In Oman, anecdotal and impressionistic observation have helped parse and categorize various manifestations of spirit possession into two broad and distinct categories: intermittent dissociative phenomenon and transitory dissociative phenomenon. The primary aim of the present study was to compare the performance of participants on neuropsychological tests among different grades of possession. Other correlates were also sought. Methods Assessment criteria for the two groups included measures examining executive functioning: controlled oral word association test Verbal Fluency, Wisconsin Card Sorting Test (Perseverative error and the number of categories achieved), Trail Making Test and the Tower of London Test (number of correctly solved problems). Sociodemographic variables and the history of trauma were also sought. Result Among 84 participants, one third of them presented the intermittent possession type and two thirds, the transitory possession type. Their mean age was 34.17 ± 11.82 and 56% of them were female. Nearly 35% of them endorsed a history of a traumatic experience. Both the multivariate models showed statistical significance (F (5, 78) = 5.57, p < 0.001, R2 = 0.22), F (5, 78) = 11.38, p < 0.001, R2 = 0.39) with an independent predictor of intermittent dissociative phenomenon (β = − 3.408, p < 0.001), (β = 63.88, p < 0.001) for Verbal Fluency and Trail Making Test, respectively. The history of the traumatic event was also statistically significant with the results of the Trail Making Test (β = − 26.01, p < 0.041. Furthermore, the subtype of Pathogenic Possession turned out to be an independent predictor across all models: Wisconsin Card Sorting Test perseverative error, Wisconsin card sorting test categories achieved and the number of problems solved in the Tower of London Test (OR = 3.70, 95% C.I. 2.97–4.61; p < 0.001), (OR = 0.57, 95% C.I.0.39–0.84; p = 0.004) and (OR = 0.80, 95% C.I. 0.65–0.99; p < 0.037) respectively. Conclusions This study suggests that typology of spirit possession found in Oman tends to differ on indices of executive function. Those with ‘diagnosis’ of intermittent possession showed impairment in many indices of executive functioning. Despite its wide prevalence, spirit possession has not been examined in terms of its neuropsychological functioning. We believe that this study will be instrumental in laying the groundwork for a more robust methodology.

Study investigating executive function in schizophrenia patients and their unaffected siblings

Background: Schizophrenia (SCZ) is a serious genetic mental illness. Most research indicates that executive impairment has a certain genetic predisposition. The shared neuropathological characteristics of patients with schizophrenia and their siblings might reveal intermediate phenotypes in behavior that could be used to further characterize the illness. Methods: Our study involved 32 schizophrenia patients, 32 unaffected siblings,and 33 healthy controls. The three groups underwent a computerized version of the Wisconsin Card Sorting Test (WCST) and a battery of cognitive neuropsychological assessments. These tests evaluated executive function and several cognitive domains. Results: In this study, the WCST results demonstrate that the total correct (TC), total error (TE), perseverative response (PR) and perseverative error (PE) scores in the SZ group were significantly lower than those in the HC group (TC (p=0.011), TE (p<0.001), PR (p=0.007) and PE (p=0.002)), and compared to the unaffected siblings, we found significant differences in TE (p=0.003). Moreover, significant differences were observed between the unaffected siblings and healthy controls as follows: TC (p=0.034), TE (p=0.008), PR (p=0.016) and PE (p=0.013). Conclusion: The schizophrenia patients and their siblings performed worse in the WCST test than the healthy controls. This result supports the claim that the development of functional impairment is not unique to schizophrenia patients and that unaffected siblings may have a certain level of abnormal brain function.Neurological abnormalities lead to abnormal functioning in siblings and patients,suggesting that genetics plays a considerable role in such results.

Exploratory noise governs both flexibility and spontaneous errors and is regulated by cocaine

SUMMARYIn many cognitive processes, lapses (spontaneous errors) are attributed to nuisance processes like sensorimotor noise or disengagement. However, some lapses could also be caused by exploratory noise: behavioral randomness that facilitates learning in changing environments. If so, strategic processes would need only up-regulate (rather than generate) exploration to adapt to a changing environment. This view predicts that lapse rates should be correlated with flexibility because they share a common cause. We report that when macaques performed a set-shifting task, lapse rates were negatively correlated with perseverative error frequency. Furthermore, chronic exposure to cocaine, which impairs cognitive flexibility, increased perseverative errors, but, surprisingly, improved overall performance by reducing lapse rates. We reconcile these results with a model in which cocaine decreased exploration by deepening attractor basins corresponding to rules. These results support the idea that exploratory noise contributes to lapses, meaning that it affects rule-based decision-making even when it has no strategic value.

Analysis of performance on a modified Wisconsin Card Sorting Test for the military

Purpose Current Army doctrine stresses a need for military leaders to have the capability to make flexible and adaptive decisions based on a future unknown environment, location and enemy. To assess a military decision maker’s ability in this context, this paper aims to modify the Wisconsin Card Sorting Test which assesses cognitive flexibility, into a military relevant map task. Thirty-four military officers from all service branches completed the map task. Design/methodology/approach The purpose of this study was to modify a current psychological task that measures cognitive flexibility into a military relevant task that includes the challenge of overcoming experiential bias, and understand underlying causes of individual variability in the decision-making and cognitive flexibility behavior of active duty military officers on this task. Findings Results indicated that non-perseverative errors were a strong predictor of cognitive flexibility performance on the map task. Decomposition of non-perseverative error into efficient errors and random errors revealed that participants who did not complete the map task changed their sorting strategy too soon within a series, resulting in a high quantity of random errors. Originality/value This study serves as the first step in customizing cognitive psychological tests for a military purpose and understanding why some military participants show poor cognitive flexibility.

Theory of Mind and Executive Functioning in Alcohol Dependence Syndrome

Title: Theory of mind and executive functioning in alcohol dependence syndrome. Objectives: The objective of study to examine the relationship of the Theory of Mind (TOM) deficit and Executive Functioning difficulties of the Alcohol Dependence Syndrome (ADS). Methods: Forty-five patients of ADS age range between 18 to 35 years participated in the study. All patients selected for study were inpatients of de-addiction ward of the Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS), Ranchi. All participants were tested on measures of TOM tasks and Wisconsin Card Sorting Test (WCST). Results: The result findings suggest that the First Order Deception Tasks (FODT) of TOM was significantly correlated with the WCST’s no. of error, percentage of error, non-perseverative error and First Order Deception Tasks (FODT) of Memory with all variables of WCST. Second Order Deception Tasks (FODT) of TOM was significantly correlated with the WCST’s percentage of error, non-perseverative error and conceptual level responses. Attribution of Intention Tasks (AIT) of TOM was significantly correlated with the all variables of the WCST. Conclusions: The ADS patients having difficulty in TOM tasks and this difficulty may be related to underlying deficit in executive functioning.

Humour experience in schizophrenia: relationship with executive dysfunction and psychosocial impairment

BackgroundThe ability to appreciate humour is essential to successful human interactions. In this study, we hypothesized that individuals with schizophrenia would have diminished ability to recognize and appreciate humour. The relationship between humour experience and clinical symptoms, cognitive and social functioning was examined.MethodThirty patients with a DSM-IV diagnosis of schizophrenia were compared with 30 age-, gender-, IQ- and ethnicity-matched healthy controls. Humour recognition was measured by identification of humorous moments in four silent slapstick comedy film clips and calculated as d-prime (d′) according to signal detection theory. Humour appreciation was measured by self-report mood state and funniness ratings. Patients were assessed for clinical symptoms, theory of mind ability, executive function [using the Wisconsin Card Sorting Test (WCST)] and social functioning [using the Life Skills Profile (LSP)].ResultsPatient and control groups did not differ in the funniness ratings they attributed to the video clips. Patients with schizophrenia had a lower d′ (humour) compared to the controls, after controlling for (1) the performance of a baseline recognition task with a non-humorous video clip and (2) severity of depressive symptoms. In patients, d′ (humour) had significant negative correlation with delusion and depression scores, the perseverative error score of the WCST and the total scores of the LSP.ConclusionsCompared with controls, patients with schizophrenia were less sensitive at detecting humour but similarly able to appreciate humour. The degree of humour recognition difficulty may be associated with the extent of executive dysfunction and thus contribute to the psychosocial impairment in patients with schizophrenia.

Perseveration in Healthy Subjects: An Impressive Classroom Demonstration for Educational Purposes

Perseveration, that is, the inappropriate maintenance of an activity, is not exclusively observed in patients with brain pathology. We present a brief calculation task that requires healthy subjects to add eight numbers sequentially. While the first seven steps of the addition involve the repeated application of a particular rule, this rule does not apply for the last step. However, a high percentage of subjects (approximately 70%) will commit a perseverative error at this last step and hence obtain an incorrect final result. This simple task is a highly informative illustration of the principle of perseverative behavior. When applied in a classroom setting, it is an impressive demonstration of the ease with which perseveration can be evoked in healthy persons.

Alcoholism, Korsakoff’s Syndrome and the Frontal Lobes

A subset of the diffuse cerebral changes and psychometric deficits found in chronic alcoholics is similar to that seen in the frontal lobe syndrome. Certain features of alcoholic Korsakoff's syndrome (AKS) also point to cortical involvement, and this may have a basis in alcohol neurotoxicity. Twenty-five patients with AKS and 24 non-Korsakoff alcoholic controls were compared using an automated CT brain scan program. In addition to evidence of their diencephalic lesions (wide third ventricles), AKS patients revealed widespread cerebral damage with greater Sylvian and interhemispheric fissure (IHF) size than alcoholics. Korsakoffs were also inferior to alcoholics in performance on a category sorting test, in which non-perseverative error scores correlated significantly with IHF size. The principle of distinguishing between selective memory decline and global intellectual decline (GID) was applied to 38 patients with AKS. Indices were developed for each type of deficit and much variation found in their distributions. The degree of GID correlated significantly with IHF size, showing similar trends with other cortical measures. These results suggest a cortical substrate for the degree of GID and a frontal substrate for category sorting deficits; with a probable basis in alcohol neurotoxicity rather than thiamine deficiency, which is not known to impair cortical structure. A new model is proposed of the pathophysiology of alcoholic brain damage and AKS which includes recent work on neurotransmitter sources and thalamo-frontal connections.

Further Studies of Nonverbal Learning and Aphasia

This research study follows a previous paper on the performance of adult aphasics tested with a modified form of the Wisconsin Card Sorting Task. It investigates the effects of varying the order of presentation of the three sorting concepts or problems on the overall task-learning rate, the percentage of error responses and the percentage of perseverative error. It is found that varying the order of the concepts does not effect the task difficulty, as measured by these indices. Statistical and interpretative analyses of the data also investigate the nature of performance improvement patterns. It is found that any significant improvement is due to the elimination of nonperseverative errors, while the proportion of perseverative responses remains fairly constant. The aphasics' inability to generalize problem solution methods and possible techniques for reducing perseveration, in addition to an evaluation of this task as an aphasia research instrument, are discussed.