Sarah Crawford

The effects of anterior lesions on performance on a story comprehension test: left anterior impairment on a theory of mind-type task.

Participants with unilateral anterior or posterior lesions were compared to a healthy group on a theory of mind-type task that involved explaining the words or actions of story characters in a series of brief vignettes. Participants also carried out a set of non-social neuropsychological tests. Those with left anterior brain lesions (n=6) showed impairment relative to those with right anterior (n=13), left (n=4) and right (n=8) posterior lesions and healthy participants (n=60) in story comprehension, and their errors commonly involved failure to make non-literal interpretations. The left anterior lesion participants also showed impairment on some measures of executive function. The implications of the findings for our understanding of impairments in story comprehension after brain injury are discussed in terms of models of executive function and theory of mind.

Real-life-type problem-solving in Asperger's syndrome

This study compared adolescents with Aspergers syndrome with typically developing adolescents on a novel problem-solving task that presented videotaped scenarios in real-life-type social contexts. The Aspergers group was impaired in several aspects of problem-solving, including recounting the pertinent facts, generating possible high-quality problem solutions, and selecting optimal and preferred solutions. This groups solutions differed most from those of the typically developing group in social appropriateness. The contributions of social experience, social understanding, and executive skills to performance on the novel problem-solving task are discussed.

Problem-solving in real-life-type situations: the effects of anterior and posterior lesions on performance.

Clinical studies have described patients who show marked impairments in everyday life, including planning, problem-solving and decision-making. Several factors potentially contribute to such impairments, including difficulties in generating possible problem solutions, and difficulties in selecting an appropriate solution. The present study describes the performance of participants with unilateral anterior or posterior lesions compared to healthy controls in ability to solve real-life-type problems. These covered a range of everyday interpersonal situations, and were presented both in video and story format. Participants also carried out a set of more abstract neuropsychological tests. Those with brain lesions showed impairment relative to controls in both everyday problem-solving and on more abstract tests involving executive function and memory. The anterior group was impaired on more aspects of everyday problem-solving than the posterior group, showing reduced fluency in generating possible solutions, and also impairment in selecting appropriate problem solutions. The implications of the findings for our understanding of impairments in everyday life problem-solving after brain injury are discussed.

Mentalising and social problem-solving after brain injury

This study examined the performance of adults with an acquired brain injury (ABI) on social cognition tasks assessing mentalistic interpretation and social problem-solving. These tasks were based on an earlier version described by Channon and Crawford (1999). Twenty participants with an ABI (10 resulting from a traumatic brain injury, 10 from a cerebrovascular accident), were found to be impaired relative to 20 matched control participants in interpreting scenarios involving either actions or sarcastic remarks on the Mentalistic Interpretation Task. When problem-solving ability was examined, the participants with an ABI were poorer at solving social problems on the Social Problem Resolution Task, and generated fewer responses on the Social Problem Fluency Task. They also had greater difficulty in detecting the awkward elements of the social situations, and in selecting appropriate solutions from a range of alternatives. These tasks provide a potential clinical tool for pinpointing an individuals strengths and weaknesses in everyday social communication and problem-solving, which can serve as the basis for designing individualised rehabilitation programmes.

Real-life-type problem solving in Tourette syndrome.

ObjectiveThe main objective of the study was to examine social problem solving in real-life–type situations in Tourette syndrome (TS). BackgroundStudies of cognitive functioning in TS have usually focused on nonsocial, abstract tasks, with mixed findings as to whether there is evidence of impairment in executive functions in those without comorbid disorders. The current study focuses primarily on social functioning, using a problem-solving task known to be sensitive to frontal lobe lesions. MethodsTS participants without comorbid diagnoses were compared with matched healthy control participants on a problem-solving task, using a range of interpersonal problem scenarios presented on video. A set of more abstract executive tests was also included. ResultsParticipants with TS were found to perform below a matched control group on the problem-solving task both in generating a range of potential problem solutions, and in selecting appropriate final solutions. They also performed more poorly on aspects of executive function. ConclusionsThis study provides evidence of difficulties in both social and nonsocial aspects of functioning in TS. The implications of the findings for our understanding of TS and problem solving are discussed.

Tourette's syndrome (TS): inhibitory performance in adults with uncomplicated TS.

Tourettes syndrome (TS) is a neurodevelopmental disorder linked with frontostriatal dysfunction. Previous work has shown some evidence of mild performance deficits on a range of different tasks that involve inhibitory processes. The present study evaluated this in adult participants with uncomplicated TS. Interference control was measured using the Stroop and flanker tasks and a Stroop-flanker task that combined the inhibitory demands of both. Motor inhibition was measured using a letter continuous performance test (CPT) task and word CPT tasks that manipulated the inhibitory demands using compatible and incompatible words. The TS group was found to be slower than the control group on most measures, but showed differential slowing under conditions with enhanced inhibitory demands on the combined Stroop-flanker and the incompatible CPT tasks. The findings suggest that TS-alone is linked to mild impairments in aspects of inhibitory function, and that these can be detected by relatively powerful inhibitory manipulations. A range of different types of inhibitory tasks may be sensitive to TS-alone, and this may depend on both the type of inhibition and the strength of the inhibitory manipulation.

Mentalising and social problem solving in adults with Asperger's syndrome

Introduction It is well established that autistic spectrum disorder is linked to difficulties with mentalising, but the ways in which this affects everyday behaviour is less well understood. This study explored the nature and extent of difficulties in everyday social functioning in adults with Aspergers syndrome (AS), since increased understanding can enhance the development of more effective intervention strategies. Methods Individuals with AS (n=21) were compared with healthy control participants (n=21) on three tests of social cognition: the Mentalistic Interpretation task, which assesses interpretation of sarcasm and actions; the Social Problem Fluency task, which assesses ability to generate problem solutions; and the Social Problem Resolution task, which assesses judgement in selecting problem solutions. Results Comprehension of both sarcastic remarks and actions was impaired in those with AS on the mentalistic interpretation task. Participants with AS showed difficulties in identifying the awkward elements of everyday social scenarios, and they were also impaired in generating problem solutions but not in judging alternative solutions on the social problem fluency and resolution tasks. Conclusions These tasks potentially provide a means of profiling strengths and weaknesses in social processing, which in turn has implications for informing clinical evaluation and training.

Emotional processing and executive functioning in children and adults with Tourette's syndrome

Tourettes syndrome (TS) is predominantly a childhood disorder, with many of those who meet diagnostic criteria in childhood experiencing a remission of symptoms in adulthood. This indicates that the influence of TS on cognitive and emotional processing can best be understood by examining performance in both adults and children with TS. The present study examined emotional processing using a battery of face and prosody tasks with increasing levels of difficulty (same-different emotion discrimination, emotion naming, and emotion naming with conflict for prosody only). Experiment 1 compared the performance of children with TS-alone (n = 16) or TS+ADHD (n = 15) to healthy matched control children (n = 27). Compared to healthy control children, no significant group differences were found for those with TS-alone. Children with TS+ADHD showed subtle impairments on the more difficult emotion processing tasks relative to healthy control children, and differences were more pronounced for anger items (voice emotion naming, p < .05; voice emotion naming with conflict, p < .01). Experiment 2 compared the performance of adults with TS-alone (n = 23) to healthy matched controls (n = 21). No significant group differences were found, other than evidence of subtle impairment in the adults with TS-alone on the most complex task, again particularly for anger items (p < .05). Separate measurement of executive skills detected no evidence of impairment in children or adults with TS and little in the way of correlational evidence linking emotion recognition and executive skills. Implications of the findings for our understanding of emotion processing in TS are discussed.

Psychological needs of patients in low awareness states, their families, and health professionals.

Patients who have emerged from low awareness states may present with psychological needs that can be addressed via adapted formal clinical psychological interventions, or by behavioural techniques. Families of these patients may experience similar psychological reactions to relatives of any patients with severe brain injury, but there are also additional factors that are unique to patients in low awareness states. These sources of psychological distress for relatives are discussed. The needs of clinicians working with these clients are also discussed. It is important that services attending to the needs of clients in low awareness states also have adequate support for both relatives and clinicians.

Comprehension of direct and indirect sarcastic remarks in children and adolescents with Tourette’s syndrome

ABSTRACT Previous research has reported that aspects of social cognition such as nonliteral language comprehension are impaired in adults with Tourette’s syndrome (TS), but little is known about social cognition in children and adolescents with TS. The present study aims to evaluate a measure of sarcasm comprehension suitable for use with children and adolescents (Experiment 1), and to examine sarcasm comprehension in children and adolescents with TS-alone or TS and attention deficit hyperactivity disorder (ADHD; Experiment 2). In Experiment 1, the measure of sarcasm comprehension was found to be sensitive to differences in nonliteral language comprehension for typically-developing children aged 10 to 11 years old compared to children aged 8 to 9 years old; the older group performed significantly better on the comprehension of scenarios ending with either direct or indirect sarcastic remarks, whereas the two age groups did not differ on the comprehension of scenarios ending with sincere remarks. In Experiment 2, both the TS-alone and TS+ADHD groups performed below the level of the control participants on the comprehension of indirect sarcasm items but not on the comprehension of direct sarcasm items and sincere items. Those with TS+ADHD also performed below the level of the control participants on measures of interference control and fluency. The findings are discussed with reference to the possible contribution of executive functioning and mentalizing to the patterns of performance.