The Clinical neuropsychologist
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Sufficient sleep is essential for optimum cognitive and psychological functioning. Diminished sleep quality is associated with depression and anxiety, but the extent to which poor sleep quality uniquely impacts attention and executive functions independent of the effects of the common underlying features of depression and anxiety requires further exploration. Here 67 healthy young adults were given the Minnesota Multiphasic Personality Inventory, second edition (MMPI-2), the Pittsburgh Sleep Quality Index (PSQI), and tests of attention and executive functions. ⋯ In addition, PSQI component scores indexing poor sleep quality, duration, and medication use were associated with diminished attention and executive functions, even after controlling for emotional reactivity or demoralization (rs = 0.21-0.27). These results add to the concurrent validity of the PSQI, and provide further evidence for subtle cognitive decrements related to insufficient sleep even in healthy young adults. Future extension of these findings is necessary with larger samples and clinical comparison groups, and using objective indices of sleep dysfunction such as polysomnography.
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Pain-related fear is related to self-reported avoidance of physical activities that might induce pain (kinesiophobia), as well as diminished physical performance in non-headache chronic pain. A related concept, "cogniphobia," has been proposed by others, which suggests that individuals high in headache-related fear will avoid cognitive tasks (by putting forth less effort) in an attempt to minimize the risk of bringing on or exacerbating existing headache symptoms. ⋯ Latent variable analysis of the cogniphobia measure revealed a component focused on fear of headache pain and avoidance of behaviors that would induce pain, which was related to sustained attention performance, performance on a symptom validity measure, and pressure pain threshold on the head, consistent with existing kinesiophobia research in non-headache pain. Results have implications for neuropsychological assessment in headache; pain-related fear may be related to diminished effort on neuropsychological tasks.
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This article reviews current issues in the following areas of pediatric sports-related concussion: incidence of concussion, potential long-term effects, return to play, and the emergence of legislation regarding concussion education and management programs. Incidence of concussion is presented in context of emergency room visits, as well as under-reporting of concussions. ⋯ Specific discussions of effects include: decreased cognition and increased symptom reporting following multiple concussions, and recent diagnoses of chronic traumatic encephalopathy in non-professional and youth athletes. Recent legislative and advocacy efforts are reviewed, including mandated programs in specific states.
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Patients with a reported history of mild traumatic brain injury (mild TBI) due to blast (n = 298) or non-blast (n = 92) mechanisms were asked to complete the Neurobehavioral Symptom Inventory (NSI) and the Post-traumatic Stress Disorder Checklist (PCL). Mechanism of injury did not account for a significant amount of variance in post-concussion symptom reporting overall, nor did severity of mild TBI (i.e., brief loss of consciousness versus only an alteration of consciousness). ⋯ When examining specific symptoms, the only symptom that significantly varied between groups was hearing difficulty (with the blast-injured group reporting more severe difficulty with hearing). Findings suggest that greater symptom reporting is most strongly related to emotional distress.
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Maple Syrup Urine Disease (MSUD) is a metabolic disease with associated enzyme deficiency and an inability to break down amino acids. Neurotoxic levels can occur resulting in neurological sequelae. Information regarding cognitive functions has suggested greater verbal than visuospatial abilities. ⋯ Consistent with existing literature, a profile of stronger verbal reasoning and memory skills compared with visual-perceptual and nonverbal memory was revealed. Additional weaknesses were demonstrated with attention, emerging executive functions, and fine motor control. The results suggest that while previously described nonverbal reasoning and visuospatial impairments are present, there is likely a more complex pattern of neuropsychological impairments in children with MSUD, especially those with poor metabolic control.