Sten Levander

Aggressive and Non-Aggressive schizophrenics: Symptom profile and neuropsychological differences

Abstract Thirteen aggressive schizophrenic patients (AS) from a maximum security psychiatric unit were compared to 13 non-aggressive schizophrenic patients (NAS) and to 13 healthy controls (HC), using case history data, ratings of psychopathy, schizophrenic symptoms, and neuropsychological tests. The AS had spent more time in prison than the NAS, had more crime and substance abuse among 1st degree relatives, had earlier problem onset, and scored significantly higher on psychopathy. There were no significant differences in schizophrenic symptoms between the two patient groups. The NAS group performed more poorly than the other two groups on most of the neuropsychological tests. However, on some frontal lobe sensitive tasks, the AS group was most impaired. The data suggest that the AS do not have a “double dose” of neuropsychological impairment, but rather the reverse. However, they do display a specific pattern of neuropsychological dysfunction that is consistent with frontal lobe dysfunction.

COGNITIVE SEX DIFFERENCES: SPEED AND PROBLEM-SOLVING STRATEGIES ON COMPUTERIZED NEUROPSYCHOLOGICAL TASKS

Skill, strategy, and laterality measures obtained through computerized neuropsychological tasks, a reaction time (RT) test, and a visuospatial problem-solving test, the Perceptual Maze Test, were analyzed in relation to sex and handedness of 56 high-school students. Boys were significantly faster than girls on most RT subtasks (including a response-inhibition task) and made more two-choice RT response errors for right-sided stimuli, which may be interpreted as resulting from a less cautious strategy. In maze performance, boys were superior to girls. An analysis of separate phases of the maze-solution process suggested that boys preferentially used an impulsive-global strategy. Girls, using a more reflective-sequential task-solving strategy, were significantly slower, without hitting more targets. Compared to all other groups, left-handed girls (strongly left-handed) had lower performance on maze tasks with no target information, particularly in left-sided solution pathways. Results were interpreted as reflecting differences in hemispheric competence and activation patterns between the sexes. Signs of a less differentiated lateralization and slight dysfunction of visuospatial skills in the left-handed girls were discussed.

Individual Rather Than Situational Characteristics Predict Violence in a Maximum Security Hospital

Assaults on staff in a maximum security psychiatric hospital were analyzed over a 6.5-year period. During that time, 94 patients were admitted to the unit. Fifty-two (55%) of the patients engaged in assaultive behavior, generating 1,945 incident reports. A small number of patients was responsible for a large share of the incidents. Serious incidents were rare. Incidents were evenly distributed throughout the day, week, and year. Patients who attacked less often caused more serious harm, showed a decrease in assaults over time, and the preceding events suggested that the violence was functional. For assaultive patients, it was difficult to identify a preceding event, the preceding events that were identified seemed more unreasonable, and the frequency of assault was constant over time. Assaultive patients were more often women, had more positive and borderline symptoms, were younger, and scored lower on psychopathy and depressive symptoms.

Evaluation of cognitive impairment using a computerized neuropsychological test battery

The psychometric tests currently used in psychopharmacology were developed many years ago. Computerization of such tests offers better possibilities of standardization and use in efficient repeated measures designs. The Automated Psychological Test (APT) system runs on any Apple II micro, and comprises a set of eleven basic procedures which are particularly suitable for psychopharmacological research. In addition to general purpose procedures for collecting questionnaire and analogue ratings data, API includes a maze test, reaction time modules, finger tapping tests, a test of rate of perspective reversals, a digit span test, a trailmaking test, a lexicon decision test of verbal skills, a symbol digit test which also taps short-term associative memory, and a classical vigilance test, the continuous clock test. The tests have been applied in a series of studies. The cognitive impairment profile of 18 schizophrenic patients was analysed, and related to clinical data and morphological deviance. A group of se...

Birth stress handedness and cognitive performance

Information regarding conditions during pregnancy and delivery was obtained by extensive interviews with mothers to left-handed and right-handed students. Using the same criterion as van Strien, Bouma and Bakker (1987) for defining birth stress, the present study did not replicate their findings of higher frequency of reported birth stress in left-handers. The difference in outcome was ascribed to differences in recruitment of subjects, the present sample constituting a majority of left hand writers from a population of 921 students, while the van Strien sample was less well defined. The present study was extended by comparing left-handed and right-handed subjects (separated for sex) with and without birth stress, on verbal and nonverbal abilities, and on eye dominance, early learning difficulties and familial sinistrality. Left eye dominance was more frequent in male left-handers with birth stress. Birth stress alone had negative effects on cognitive performance, different for males and females.

Crime and Violence among Psychiatric Patients in a Maximum Security Psychiatric Hospital

Data on crime and aggression, psychopathology, and early adjustment problems were examined for 94 consecutively admitted patients to a national maximum security psychiatric unit. A majority of the patients had a criminal record. Aggression inside and outside institutional settings was frequent, as were early adjustment problems. Factor analysis suggested five types of crime/aggression patterns: a nonviolent pattern, a pattern involving aggression/violence in an institutional setting, a sexual violence pattern, a homicidal aggressive pattern, and an arson pattern. These patterns evidenced both overlap and distinctiveness in their psychopathology-related correlates. The most frequent significant correlates were the presence of an Axis II diagnosis, psychopathy, alcohol abuse, and drug abuse. Axis I diagnoses and other symptom variables poorly predicted crime/aggression patterns.

Personality, health and job stress among employees in a Norwegian penitentiary and in a maximum security hospital

Abstract Employees at the Br⊘set maximum security hospital and the Tunga penitentiary participated in a study of the psychosocial working environment. The aim of the study was to examine the relation between personality factors and self-reported health status, and the coping strategy that employees had used in a self-chosen stressful situation at work. A total of 122 employees (84%) returned completed questionnaires. Scores were obtained on the Karolinska Scales of Personality (KSP), the Eysenck Personality Questionnaire (EPQ), Ursins Health Inventory (UHI), Coopers Job Stress Questionnaire (CJSQ), the Life Experiences Survey (LES), and the Ways of Coping Check-lists (WOCC). The results show that there is a selective recruitment of employees to the two institutions, based on personality characteristics. Br⊘set employees reported a higher level of job stress with respect to issues of leadership, communication and institutional goals. Employees with higher scores in anxiety also reported significantly more...

Lack of self-monitoring competency in aggressive schizophrenics

Abstract Scores in 2 self-report personality questionnaires for 13 aggressive and 13 non-aggressive schizophrenic patients (AS and NAS) were compared to 13 healthy controls (HC), matched for age, and with similar educational background. The Eysenck Personality Questionnaire (EPQ, with 20 extra impulsiveness items yielding 114 items, 5 scales) and the Karolinska Scales of Personality (135 items, 15 subscales) were given. Premorbidly, the AS group had psychopathic as well as aggressive traits. The AS group perceived themselves as very similar to the HC group, in contrast to the NAS patients who seemed to be more aware of their problems. The most note-worthy finding was that the extremely aggressive and dangerous AS patients did not differ from the non-aggressive groups in terms of ratings of aggressiveness. The findings were interpreted as a lack of self-monitoring competency of the AS group, possibly related to other signs of frontal lobe dysfunction.

Hand preference and sex as determinants of neuropsychological skill, solving strategy and side preference ☆

Abstract The purpose of this study was to analyze cognitive neuropsychological differences in terms of skill, strategy, and side preference between right- and left-handers. Three computerized tests (Reaction Time, Perceptual Maze Test, and Trail Making) and a paper-and-pencil test battery comprising verbal and perceptuomotor tests were given to 48 left-handed males, 54 left-handed females, 49 right-handed males and 53 right-handed females. Only small and scattered differences emerged between right- and left-handers. Left-handers were superior in spelling and in reading comprehension speed as compared to right-handers. Females excelled over males in reading speed (Stroop A) and in spelling, as well as in writing fluency. Males were faster than females in most of the tests, but with lower accuracy. Females showed some side preferences as evidenced from, for example, the relatively shorter reaction time when stimuli were presented on the right side.