Gordon Teichner

The relationship of neuropsychological impairment to conduct disorder in adolescence: A conceptual review

This review is an attempt to expand the understanding of the neuropsychological mechanisms that may influence the expression of violent or aggressive behavior in adolescents. Although a relative large literature of adult studies examining the relation of neuropsychological impairment and aggression exists, the research literature investigating this relationship in adolescents is much smaller. With a few exceptions, the delinquent literature suffers from methodological problems, including biased sampling methods, small numbers of subjects, failing to objectively diagnose conduct disorder, incorrect use of specific statistical procedures, and lacking of appropriate control groups. In general, a mixed pattern of neuropsychological deficits are displayed across studies, depending on the sampling method, methodological design, statistics employed, control groups, and assessment tools that were utilized. Verbal deficits have been frequently displayed across the literature, while evidence for executive dysfunction varies, depending on the specific construct being evaluated (e.g., attention, cognitive flexibility, concept formation, planning abilities) and the specific population. Relatively inconsistent findings have been observed for visuospatial, sensory, and motor deficits. This article provides a critical review of this literature and discusses the varying impact that any neurological insult will have, depending on premorbid personality and cognitive functioning, location of the lesion, age at which the injury occurred, childs pre- and postinjury environment, and ability of the brain to adapt to acquired deficits as the result of the insult. On the basis of this review and neuropsychological theory, four subgroups within this population are proposed (i.e., adolescents with subcortical injuries, dominant hemisphere temporal-parietal injuries, nondominant hemisphere temporal-parietal injuries, and injuries to the prefrontal regions), which may better explain the neuropsychological and behavioral outcomes exhibited by this heterogeneous population. Recommendations for future research are offered.

Evaluation of an instructional program for improving medication compliance for chronically mentally ill outpatients.

Outpatient medication adherence is a major problem, especially for patients repeatedly hospitalized for psychiatric disorders. This study included 39 such patients who were receiving case management services from a community mental health center. Patients were matched and randomly assigned to receive in a single session either (1) information regarding medication and its benefits, (2) guidelines for assuring adherence which encompassed all phases related to pill-taking including filling prescriptions, use of a pill container, transportation, self-reminders, doctors appointments and so forth, or (3) the same guidelines as (2) above but given in the presence of a family member who was enlisted in support. The results showed that adherence increased to about 94% after the guidelines were given for both the individual and family guideline procedure, whereas adherence remained unchanged at 73% after the medication information procedure. These results suggest a practical means for assuring a high level of medication adherence for patients with psychiatric disorders.

Adolescents and their parents: a critical review of measures to assess their satisfaction with one another.

The importance of assessing the parent-adolescent relationship has been stressed in the literature. However, an integration of studies that have been conducted to assess satisfaction in the parent-adolescent relationship is warranted, including evaluation of measures to assess their satisfaction with one another. Therefore, the purpose of this paper is to provide a critical examination of the clinical utility and psychometric properties of such measures. Suggestions for future research are also provided.

Identification of neuropsychological subtypes in a sample of delinquent adolescents

Although research has long recognized a relationship between neurological dysfunction and delinquency, the nature of this relationship is unclear. Based on the theory that there may be clusters of delinquents with different types of neurological dysfunction which contribute to the delinquency in different ways, the present research attempted to identify these subtypes using neuropsychological testing. Seventy-seven such adolescents were administered the full Luria-Nebraska Neuropsychological Battery-III (LNNB-III) and a battery of assessments measuring behavioral functioning and substance use. A Hierarchical Cluster Analysis yielded four identifiable neuropsychological clusters: Verbal/Left-Hemispheric Deficits, Subcortical-Frontal Deficits, Mild-Verbal Deficits, and Normals. The distinctiveness of these subtypes was confirmed by univariate analyses. Results further indicated that the number of LNNB scales that were in the abnormal range differed per subtype, with each subtype differing significantly from one another. These neuropsychological subtypes were found to be associated with specific psychological and behavioral problems.

The Relationship of Neuropsychological Functioning to Measures of Substance use in an Adolescent Drug Abusing Sample

The purpose of this research was to investigate the relationship between recent and long term substance use on adolescents neuropsychological functioning. Subjects were 77 adolescents who were referred for outpatient treatment for drug and conduct problems. Subjects were administered the Luria-Nebraska Neuropsychological Battery-III, structured interviews to assess substance use, and urine tests. Subjects were divided into neuropsychologically impaired and nonimpaired groups. Results indicated no significant group differences for: self-reports of lifetime use of alcohol, cannabis, and hard drugs; self or collateral reports of recent (past 30 days) use of alcohol, cannabis, and hard drugs; or urinalysis detection of alcohol, cannabis, and hard drugs. Correlations between these dependent measures of substance use and neuropsychological functioning were also nonsignificant (all ps >. 05). Although neuropsychological impairment was observed for some subjects in this sample, it was unrelated to their cannabis, hard drug, or alcohol use. These results are consistent with those found in the adult literature, given the relatively short period of time that these youth have used such substances. However, given the severity of their absolute levels of substance usage, they may be at greater risk for developing future neuropsychological problems, related directly to the ingestion of alcohol and illicit drugs, and to their secondary effects (e.g., head traumas, malnutrition).

Internal consistency and discriminant validity of the Luria Nebraska Neuropsychological Battery-III.

This research presents data pertaining to the development of the recently revised Luria Nebraska Neuropsychological Battery-III. The final version of this test battery consists of 31 clinical scales yielding 35 scores. The battery was given to 109 non brain-injured controls and 119 brain-injured subjects. High internal consistency was demonstrated for each clinical scale. Results further indicated that the test battery was very effective at discriminating between normal and brain-injured subjects, as significant between-group differences on 33 of 35 scores were observed. Significant between-group differences were also observed on 25 of the 35 scores when age and education were covaried out of the analyses; those scales not displaying significant between-group differences generally measured very basic over-learned skills.

Prediction of WAIS-R indices based on performance on the Luria Nebraska Neuropsychological Battery-III

The purpose of this research was to examine the clinical utility of the Luria-Nebraska Neuropsychological Battery - Third Edition (LNNB-III) in estimating intellectual functioning as measured by the WAIS-R. Ninety-one subjects were administered the WAIS-R and the LNNB-III. Multiple regression were calculated to examine the ability of the LNNB-III clinical scales to predict FSIQ, VIQ, and PIQ indices. The LNNB-III General Intelligence Scale (GI) predicted FSIQ within 10 points 79% of the time, and within 15 points 97% of the time. Similarly, GI predicted VIQ and PIQ indices with 67% accuracy within 10 points and with 91% and 87% accuracy, respectively, within 15 points. A combination of LNNB clinical scales fared no better than GI alone when predicting the FSIQ index. However, a combination of LNNB-III scales predicted VIQ with 80% accuracy within 10 points and with 94% accuracy within 15 points. In contrast, a combination of LNNB-III clinical scales predicted the PIQ index 76% of the time within 10 points and 90% of the time within 15 points. GI appears to be a good alternative when an estimate of intellectual functioning is desired given its less than 10 minute administration time. When greater specificity regarding VIQ and PIQ estimates are desired, a combination of specific LNNB-III scales appear preferable.

Concurrent validity and analysis of learning curves on the memory scales of the Luria-Nebraska Neuropsychological Battery-Third Edition.

The purpose of this investigation was to evaluate the concurrent validity of the Luria-Nebraska Neuropsychological Battery Third Edition (LNNB-III) memory scales with the WSM-R (study 1), as well as to investigate performance differences between brain-injured and nonbrain injured subjects on the LNNB-III memory indices, first trial learning, and learning curves of each scale (study 2). Study 1 had 90 subjects (46 males and 44 females). Study 2 had 228 subjects (109 normals and 119 brain-injured). Significant correlations were found between the LNNB-III memory scales and the WSM-R index scores. Findings also revealed poorer overall performance and initial learning of brain-injured subjects across all LNNB-III memory scales. Brain-injured subjects also demonstrated significantly reduced learning curves across repeated trials on two of the three scales. The clinical implications of these findings are discussed.