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Brain Sciences
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Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term...
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Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neuropharmacology and Neuropathology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 22516

Special Issue Editor

Dr. Mei-Chi Hsu

E-Mail Website
Guest Editor
Department of Nursing, I-Shou University, Kaohsiung, Taiwan
Interests: cognitive and behavioral research; interventions in mental health and psychiatry; metabolic syndrome; management of cognitive and behavioral problems; clinical trial
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Management of neurocognitive impairments and behavioral disturbances in clinical practice and long-term care is quite challenging. Behavioral disturbances, such as verbal or physical aggression/violence, agitation, and excessive wandering, often leads to institutionalization of the client. Violence is repetitive in nature and leads to emotional distress; violence occurring beyond control in a particular situation translates into client per se, victim of violence, and health professional’s possible endangerment. Furthermore, there are complex interactions between cognitive deficits, clinical symptoms, and behavioral disturbances. The brain functions may underlie and manifest cognitive deficits and behavioral difficulties. The ability to maximize the potential of plasticity in clients may depend on the good design of effective intervention and/or therapeutic approaches, which are thought to be an essential component that contributes significantly to the ability to improve cognitive reserve and behavioral patterns. However, certain cognitive and behavioral outcomes appear to have received insufficient attention in both primary care setting and long-term care facilities.

The aim of the current Special Issue is to exploit different aspects of the cognitive impairments and behavioral disturbances in clinical practice, long-term care and workplace. The Special Issue is also aimed at bringing together studies on those clinically rich accounts of innovative assessment and therapeutic procedures that are clearly capable of providing insights into the comprehension, evaluation, and/or treatment of a specific cognitive or behavioral problem or the inclusion of several such problems or deficits. Accordingly, topics are selected to address current challenges facing health professionals, mental health, behavioral science, and allied fields, both in terms of assessment, process, the content of intervention or treatment, and work-related violence in the health care environment. Papers concerning all aspects of cognitive impairments and behavioral disturbances are also welcome, e.g., epidemiologic studies; nurse–client cohorts; biological, neurobiological, physiological, cellular, genetic, and interventional studies, reviews and opinions, that enhance understanding of the brain, cognition, and behavior.

I look forward to receiving your contributions.

Dr. Mei-Chi Hsu
Guest Editor

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Keywords

  • neurocognition/cognition
  • behavior
  • aggression/violence
  • impulsivity/anger
  • emotion
  • coping
  • self-efficacy
  • risk factors
  • brain
  • quality of life
  • workplace

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Published Papers (8 papers)

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14 pages, 880 KiB  
Article
Resilience and Strategic Emotional Intelligence as Mediators between the Disconnection and Rejection Domain and Negative Parenting among Female Intimate Partner Violence Victims
by Klaudia Sójta, Małgorzata Juraś-Darowny, Aleksandra Margulska, Wioletta Jóźwiak-Majchrzak, Anna Grażka and Dominik Strzelecki
Brain Sci. 2023, 13(9), 1290; https://doi.org/10.3390/brainsci13091290 - 6 Sep 2023
Viewed by 1187
Abstract
(1) Background: The exposure of children to intimate partner violence (IPV) is associated with a wide range of negative effects on children’s development, where as parenting practice is considered to be one of the key factors mediating and mitigating this. Studies have found [...] Read more.
(1) Background: The exposure of children to intimate partner violence (IPV) is associated with a wide range of negative effects on children’s development, where as parenting practice is considered to be one of the key factors mediating and mitigating this. Studies have found mixed results regarding the impact of female IPV victimization on maternal parenting practice; however, the most frequently tested hypothesis suggests that the cumulative stress of the IPV experience may emotionally deregulate the mother, contributing to an increased risk of neglected and abusive parenting practices. Little is still known about the factors determining the observed differences in maternal parenting practices among IPV victims. Thus, in our study, we use mediation models to provide preliminary results exploring the role of resilience and strategic emotional intelligence in the relationship between women’s disconnection and rejection (D/R) schema domain and maternal parenting practice among IPV victims. (2) Methods: A total of 48 female survivors of IPV and 48 age-matched women with no prior experience of IPV completed a set of tests examining parenting practices, the D/R domain, resilience and emotional intelligence. (3) Results: IPV victimization was associated with significantly higher rates of negative parenting practices. The D/R domain was found to be a significant predictor of parental autonomy attitude and level of parental competence, and these relationships were fully mediated by resilience with strategic emotional intelligence and resilience, respectively. (4) Conclusions: The results shed light on the under-researched relationship between early maladaptive schemas and parenting behavior in the context of IPV. The implications for clinical practice and further research can be drawn based on the study findings. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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16 pages, 1606 KiB  
Article
Neurocognitive Artificial Neural Network Models Are Superior to Linear Models at Accounting for Dimensional Psychopathology
by Darren Haywood, Frank D. Baughman, Barbara A. Mullan and Karen R. Heslop
Brain Sci. 2022, 12(8), 1060; https://doi.org/10.3390/brainsci12081060 - 10 Aug 2022
Cited by 9 | Viewed by 2424
Abstract
In recent years, there has been debate about the optimal conceptualisation of psychopathology. Structural models of psychopathology have been developed to counter issues, including comorbidity and poor diagnostic stability prevalent within the traditional nosological approach. Regardless of the conceptualisation of psychological dysfunction, deficits [...] Read more.
In recent years, there has been debate about the optimal conceptualisation of psychopathology. Structural models of psychopathology have been developed to counter issues, including comorbidity and poor diagnostic stability prevalent within the traditional nosological approach. Regardless of the conceptualisation of psychological dysfunction, deficits in neurocognitive abilities have been claimed to be an aetiological feature of psychopathology. Explorations of the association between neurocognition and psychopathology have typically taken a linear approach, overlooking the potential interactive dynamics of neurocognitive abilities. Previously, we proposed a multidimensional hypothesis, where within-person interactions between neurocognitive domains are fundamental to understanding the role of neurocognition within psychopathology. In this study, we used previously collected psychopathology data for 400 participants on psychopathological symptoms, substance use, and performance on eight neurocognitive tasks and compared the predictive accuracy of linear models to artificial neural network models. The artificial neural network models were significantly more accurate than the traditional linear models at predicting actual (a) lower-level and (b) high-level dimensional psychopathology. These results provide support for the multidimensional hypothesis: that the study of non-linear interactions and compensatory neurocognitive profiles are integral to understanding the functional associations between neurocognition and of psychopathology. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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9 pages, 605 KiB  
Article
Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study
by Emily Bellartz, Milena Pertz, Johannes Jungilligens, Ilka Kleffner, Jörg Wellmer, Uwe Schlegel, Patrizia Thoma and Stoyan Popkirov
Brain Sci. 2022, 12(6), 694; https://doi.org/10.3390/brainsci12060694 - 27 May 2022
Viewed by 2707
Abstract
Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care [...] Read more.
Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88–1, p < 0.001). Using an optimal cut-off of ≥2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance ‘A’ Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: r = 0.64, p < 0.001; B: r = 0.75, p < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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21 pages, 883 KiB  
Article
What Accounts for the Factors of Psychopathology? An Investigation of the Neurocognitive Correlates of Internalising, Externalising, and the p-Factor
by Darren Haywood, Frank D. Baughman, Barbara A. Mullan and Karen R. Heslop
Brain Sci. 2022, 12(4), 421; https://doi.org/10.3390/brainsci12040421 - 22 Mar 2022
Cited by 16 | Viewed by 2997
Abstract
Neurocognitive deficits have been consistently associated with a wide range of psychopathology and are proposed to not only be a consequence of the development of psychopathology but also directly involved in its aetiology. However, there is no clear understanding of what neurocognitive processes [...] Read more.
Neurocognitive deficits have been consistently associated with a wide range of psychopathology and are proposed to not only be a consequence of the development of psychopathology but also directly involved in its aetiology. However, there is no clear understanding of what neurocognitive processes are particularly important to mental health. In this paper, we explored the association between neurocognitive abilities and the factors derived from structural models of psychopathology. Four hundred participants from a representative community sample completed measures of symptomology and substance use, as well as 8 neurocognitive tasks. We found a correlated-factors model, with internalising and externalising as the higher-order factors, and a single-factor model with only the p-factor, to be good fits for the data. Tasks that measured the speed of processing were significantly associated with internalising, externalising, and the p-factor, and accounted for significant amounts of unique variance in the factors after accounting for the common variance of the other tasks. Tasks that measured working memory, shifting, and inhibition were not significantly associated with psychopathology factors. Our findings suggest that neurocognitive abilities may not be differentially associated with psychopathology factors, but that speed of processing is a common correlate of the factors. We emphasise the importance of examining neurocognitive abilities and psychopathology on the individual level. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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16 pages, 2195 KiB  
Article
Cognitive Behavioral Therapy plus Coping Management for Depression and Anxiety on Improving Sleep Quality and Health for Patients with Breast Cancer
by Hui-Ling Lai, Chun-I Chen, Chu-Yun Lu and Chiung-Yu Huang
Brain Sci. 2021, 11(12), 1614; https://doi.org/10.3390/brainsci11121614 - 8 Dec 2021
Cited by 8 | Viewed by 3801
Abstract
Cancer-related treatments may lead to side effects that undermine a patients’ quality of life (QOL). Although cognitive behavioral therapy plus coping management (CBTM) may appear to improve health-related QOL in cancer patients, limited documentation exists on the effectiveness of psychosocial interventions for patients [...] Read more.
Cancer-related treatments may lead to side effects that undermine a patients’ quality of life (QOL). Although cognitive behavioral therapy plus coping management (CBTM) may appear to improve health-related QOL in cancer patients, limited documentation exists on the effectiveness of psychosocial interventions for patients with breast cancer (BC) during recovery. The purpose of this study was to examine the effectiveness of CBTM for sleep quality, anxiety, depression, and health among patients with BC. An experimental study was conducted to assess the efficacy of a CBTM intervention (experimental group = 36, control group = 34). The experimental group received a 12-week CBTM intervention focused on their identity, challenges, the replacement of dysfunctional beliefs, coping skills, relaxation, and rehabilitation exercises, while the control group received usual care. The follow-up evaluations were performed immediately after the intervention (T1), and at one (T2) and three months (T3). The generalized estimating equation (GEE) model showed significant effects from the CBTM intervention over time. The experimental group showed significant improvement in sleep quality, anxiety and depressive symptoms, and significant increases in their mental and physical QOL from baseline, T1, T2, and T3—except for the mental and physical QOL showing no significant change at T3—while the control group receiving usual care showed no changes over time. The results suggest that CBTM increases sleep quality, reduces anxiety and depressive symptoms, and enhances health-related QOL for participants. CBTM is efficacious and can be provided by nurses to enhance patients’ coping skills and consequently improve their QOL. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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21 pages, 7223 KiB  
Article
Is Instructional Scaffolding a Better Strategy for Teaching Writing to EFL Learners? A Functional MRI Study in Healthy Young Adults
by Hung-Cheng Tai, Chun-Ming Chen, Yuan-Hsiung Tsai, Bih-O Lee and Yulis Setiya Dewi
Brain Sci. 2021, 11(11), 1378; https://doi.org/10.3390/brainsci11111378 - 21 Oct 2021
Cited by 3 | Viewed by 2682
Abstract
To test the scaffolding theory when applied to the teaching and learning of writing English as a foreign language, this cross-sectional study was conducted to collect physiological data. A total of 53 participants were randomly assigned into two groups, and brain activity was [...] Read more.
To test the scaffolding theory when applied to the teaching and learning of writing English as a foreign language, this cross-sectional study was conducted to collect physiological data. A total of 53 participants were randomly assigned into two groups, and brain activity was investigated during a guided-writing task using storytelling pictures. The writing task was further divided into four parts using graded levels of difficulty. The experimental group performed tasks in sequence from easy to difficult, whereas the comparison group performed the tasks at random. Outcomes included handwriting assessments and fMRI measurements. Writing outcome assessments were analyzed using SPSS, and scanned images were analyzed using Statistical Parametric Mapping (SPM) software. The results revealed a positive learning effect associated with scaffolding instruction. The experimental group performed better during the writing tasks, and the fMRI images showed less intense and weaker reactions in the language processing region than were observed in the comparison group. The fMRI results also presented the experimental group with reduced motor and cognitive functions when writing in English. This study provides insight regarding brain activity during writing tasks in humans and may have implications for English-language instruction. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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20 pages, 348 KiB  
Article
Effects of Integrated Violence Intervention on Alexithymia, Cognitive, and Neurocognitive Features of Violence in Schizophrenia: A Randomized Controlled Trial
by Mei-Chi Hsu and Wen-Chen Ouyang
Brain Sci. 2021, 11(7), 837; https://doi.org/10.3390/brainsci11070837 - 24 Jun 2021
Cited by 11 | Viewed by 2907
Abstract
Patients with schizophrenia and repetitive violence express core impairments that encompass multiple domains. To date, there have been few interventions integrating neurocognition, social cognition, alexithymia, and emotion regulation together as an approach to manage repetitive violence. The aim of this open-label randomized controlled [...] Read more.
Patients with schizophrenia and repetitive violence express core impairments that encompass multiple domains. To date, there have been few interventions integrating neurocognition, social cognition, alexithymia, and emotion regulation together as an approach to manage repetitive violence. The aim of this open-label randomized controlled trial was to examine more comprehensively the effectiveness of a novel Integrated Cognitive Based Violence Intervention Program on management of repetitive violence in patients with schizophrenia (vSZ). Sixty recruited patients were aged ≥20 years, diagnosed with schizophrenia for >2 years, had repetitive violent behavior within one year, and were psychiatrically hospitalized. The vSZ patients were randomly allocated to two groups and received either the intervention or treatment as usual. The intervention module, consisting of all defined 11 cognitive and social cognitive domains as well as emotion regulation, which were grouped into four modules. The intervention placed emphasis on the patients’ behavioral problems or intrinsic conflicts in relation to repetitive violence. The results indicate a statistically significant trend toward reducing impulsivity, anger with resentment, physical aggression, suspicion, and hostility (p < 0.05). The intervention significantly alleviated the intensity of cognitive failure, improved the management of alexithymic features and attribution styles and errors, and fostered adequate decision-making styles and emotion regulation capacity (p < 0.05). The intervention, when applied in conjunction with psychiatric standard care, could exert synergistic effects on alexithymia and cognitive, clinical, and neurocognitive features of repetitive violence in schizophrenia. This intervention provided patients a more active role to manage their violent behavior with the involvement of alexithymia. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)

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10 pages, 279 KiB  
Case Report
Neuropsychiatric Symptoms after Liver Transplantation in a 65-Year-Old Male Patient
by Cesar Bugallo-Carrera, David Facal, Cristina Domínguez-Lenogue, Vanessa Álvarez-Vidal, Manuel Gandoy-Crego and José Caamaño-Ponte
Brain Sci. 2022, 12(12), 1721; https://doi.org/10.3390/brainsci12121721 - 16 Dec 2022
Cited by 3 | Viewed by 2478
Abstract
The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. [...] Read more.
The development of immunosuppressants has been key for the advancement of solid organ transplant surgery. Specifically, cyclosporine, tacrolimus, or everolimus have significantly increased the survival rate of patients by reducing the risk of a rejection of the transplanted organ and limiting graft-versus-host disease. We report the case of a 65-year-old man who, after undergoing a liver transplantation and receiving an immunosuppressive treatment with cyclosporine and everolimus, presented severe obsessive, psychotic, and behavioral symptoms over the past three years, and describe the pharmacological and non-pharmacological interventions implemented against these symptoms. In this case, the immunosuppressants used have been cyclosporine and, preferably, everolimus. On the other hand, potential adverse reactions to the treatment have been observed, including neuropsychiatric symptoms such as tremor, anxiety, dysthymia, psychosis, and behavioral disorders, which make it necessary to use corrective psychoactive drugs such as benzodiazepines, antidepressants, and antipsychotics, combined with non-pharmacological interventions. A transversal approach, from the medical and psychosocial disciplines, facilitates success in managing neuropsychiatric symptoms after soft organ transplants. Full article
(This article belongs to the Special Issue Neurocognitive Impairments and Behavioral Disturbances in Clinical Practice and Long-term Care)
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