Julie A. Suhr

Controllability of Stressful Events and Satisfaction With Spouse Support Behaviors

Among married couples, the effect of the controllability of stressful events was tested as a predictor of the type of social support communications provided and preferred. Sixty married individuals disclosed stressful events to their spouse. Controllability of the stress was rated by observers. The Social Support Behavior Code was used to assess the frequency with which each of five types of social support was provided by the spouse. Action-promoting support (information) was provided most frequently when the stressed person had high control over the event. Of the five types of support communications assessed, only information was evaluated differently in high- and low-controllable situations. Both controllability by the support recipient and controllability by his or her spouse were relevant to support evaluations. Results provide limited support for the optimal matching model proposed by Cutrona and Russell (Cutrona, 1990; Cutrona & Russell, 1990).

Construct Validity of the Iowa Gambling Task

The Iowa Gambling Task (IGT) was created to assess real-world decision making in a laboratory setting and has been applied to various clinical populations (i.e., substance abuse, schizophrenia, pathological gamblers) outside those with orbitofrontal cortex damage, for whom it was originally developed. The current review provides a critical examination of lesion, functional neuroimaging, developmental, and clinical studies in order to examine the construct validity of the IGT. The preponderance of evidence provides support for the use of the IGT to detect decision making deficits in clinical populations, in the context of a more comprehensive evaluation. The review includes a discussion of three critical issues affecting the validity of the IGT, as it has recently become available as a clinical instrument: the lack of a concise definition as to what aspect of decision making the IGT measures, the lack of data regarding reliability of the IGT, and the influence of personality and state mood on IGT performance.

Neuropsychological impairment in fibromyalgia: relation to depression, fatigue, and pain.

OBJECTIVE The present study assessed the relationship of depression, pain, and fatigue to subjective cognitive complaints and objective impairment in patients with fibromyalgia (FM), patients with other chronic pain disorders, and healthy controls. METHOD Neuropsychological assessment was conducted on 28 FM patients, 27 chronic pain patients, and 21 healthy controls. Five FM patients and five chronic pain patients were excluded due to poor effort on cognitive tasks. Assessment included measures of depression, pain, fatigue, subjective cognitive complaints, memory, executive functioning, intellect, attention, and psychomotor speed. Analysis of covariance was used to assess group differences in cognitive complaints and cognitive test performance, after controlling for depression, pain, and fatigue. Hierarchical regression was used to assess whether objective test performance was related to subjective cognitive complaints, after controlling for depression, pain, and fatigue. RESULTS FM patients had more memory complaints and reported more fatigue, pain, and depression than other groups. Groups were not different in cognitive performance, after controlling for fatigue, pain, and depression; depression was related to memory performance and fatigue was related to psychomotor speed. Neuropsychological test results did not add significantly to the variance accounted for in subjective cognitive complaints, after accounting for depression, pain, and fatigue. CONCLUSION Psychological factors, particularly effort, depression, and fatigue, are important in understanding both subjective cognitive complaints and objective cognitive impairment in FM and other chronic pain disorders.

“Diagnosis Threat”: The Effect of Negative Expectations on Cognitive Performance in Head Injury

The present study examined the effect of negative expectations on neuropsychological test performance. It was hypothesized that having attention called to a history of prior head injury and the potential effects of head injury on cognition would result in diminished neuropsychological test performance relative to individuals with a similar head injury history but who did not have their attention called to their head injury history (‘diagnosis threat’). Of 36 participants with a history of mild head injury, 17 were randomly assigned to diagnosis threat and 19 to neutral test directions. The diagnosis threat group performed significantly worse on tests measuring general intellect and memory, but were not different from the neutral group in basic attention or psychomotor speed. The diagnosis threat group rated themselves as putting forth less effort on the neuropsychological battery, and self-rated effort correlated with test performance in that group. Overall, results serve as a reminder that neuropsychological tests are measures of behavior, and thus can be influenced by nonneurological factors.

Handbook of Imagination and Mental Simulation

Over the past thirty years, and particularly within the last ten years, researchers in the areas of social psychology, cognitive psychology, clinical psychology, and neuroscience have been examining fascinating questions regarding the nature of imagination and mental simulation - the imagination and generation of alternative realities. Some of these researchers have focused on the specific processes that occur in the brain when an individual is mentally simulating an action or forming a mental image, whereas others have focused on the consequences of mental simulation processes for affect, cognition, motivation, and behavior.This handbook provides a novel and stimulating integration of work on imagination and mental simulation from a variety of perspectives. It is the first broad-based volume to integrate specific sub-areas such as mental imagery, imagination, thought flow, narrative transportation, fantasizing, and counterfactual thinking, which have, until now, been treated by researchers as disparate and orthogonal lines of inquiry. As such, the volume enlightens psychologists to the notion that a wide-range of mental simulation phenomena may actually share a commonality of underlying processes.

Cognitive factors in Postconcussion Syndrome symptom report

Past studies suggest a variety of factors that influence the report of Postconcussion Syndrome (PCS) symptoms, including head injury, depression, pain, and subjective expectation. Participants included 190 undergraduates across 8 groups chosen to examine the relative contribution of these factors, as well as treatment-seeking behavior, in the report of both current and past PCS symptoms. Depressed persons, depressed persons receiving treatment, and headache sufferers receiving treatment reported elevated rates of PCS symptoms when compared to controls. Five of the eight groups reported experiencing more current than past symptoms. Head-injured persons and headache sufferers underestimated premorbid symptom rates relative to the baseline of controls. These findings are consistent with the growing number of studies that suggest non-neurologic factors may be more closely related to PCS symptom report than head injury status and raise further concern regarding use of self-reported PCS symptoms in the diagnosis of head injury.

The relationship of malingering test failure to self-reported symptoms and neuropsychological findings in adults referred for ADHD evaluation

Diagnosis of adult attention-deficit/hyperactivity disorder (ADHD) adults is difficult, as neither symptom report nor neuropsychological findings are specific to ADHD. Few studies address the possibility that noncredible performance influences both symptom report and neuropsychological findings. The present study utilized archival data from young adults referred for concerns about ADHD, divided into three groups: (1) those who failed a measure of noncredible performance (the Word Memory Test; WMT), (2) those who met diagnostic criteria for ADHD, and (3) controls with psychological symptoms but no ADHD. Results showed a 31% failure rate on the WMT. Those who failed the WMT showed clinical levels of self-reported ADHD symptoms and impaired neuropsychological performance. Neither self-report measures nor neuropsychological tests could distinguish ADHD from psychological controls, with the exception of self-reported current hyperactive/impulsive symptoms and Stroop interference. Results underscore the effect of noncredible performance on both self-report and cognitive measures in ADHD.

Memory performance after head injury: contributions of malingering, litigation status, psychological factors, and medication use

Impaired memory test performance can reflect a host of factors, such as head injury/postconcussive syndrome, involvement in litigation, malingering behavior, psychological distress, and medication use. Such factors are important in interpreting memory test performances in patients referred in the context of litigation. We examined memory test performance in mild head-injured patients in litigation, mild to moderate head-injured patients not in litigation, severely head-injured patients not in litigation, depressed patients, and patients with somatization disorders. Findings showed that several memory tests were useful in distinguishing probable malingerers from the other groups. There was a complex interaction among malingering status, psychological status, and medication use in the prediction of memory test results. Although nonneurological factors were related to memory impairment, litigation status alone was not predictive of memory performance. The results emphasize the need to consider nonneurological factors in the interpretation of poor memory performance in patients seen for forensic evaluation.

The Effects of Coaching on the Sensitivity and Specificity of Malingering Measures

This study sought to identify patterns of performance indicative of malingering on the Auditory Verbal Learning Test (AVLT). Participants were randomly assigned to perform normally, simulate head injury, or simulate head injury with warning that there might be attempts to detect malingering. Participants completed an expanded AVLT and a forced-choice task, in addition to several other memory tests. The warned simulators performed worse than normals on the forced-choice task, but better than those simulating head injury without a warning, suggesting that the warned subjects recognized forced choice as a malingering test. A combination of AVLT indices was able to predict group status for both nai;ve and warned malingerers (73.6% for nai;ve malingerers, 84.8% for warned, no false positives). The forced-choice measure detected only 31.6% of the nai;ve malingerers when specificity was maximized, and detected only 6.5% of the warned malingerers, a significant drop in detection rate. Findings suggest that pattern of performance indices are useful in detecting malingering, even when subjects are aware of attempts to detect malingering.

Postconcussive Symptom Report: The Relative Influence of Head Injury and Depression

The present study explored whether any subset of self-reported postconcussion (PCS) symptoms or specific PCS symptom is sensitive and/or specific to head injury in non-self-selected samples of individuals aged 18-21 with head injury and depression (n = 32), head injury without depression (n = 31).. depression without head injury (n = 25), and controls (n = 50). All participants completed a self-report PCS symptom scale based on their current symptoms. Results showed that depression, not head-injury status, largely accounted for elevation in PCS symptom reports, including cognitive symptoms. Thus, report of cognitive PCS symptoms is not specific to head injury, raising concerns about using such items to screen for head injury in the general population.