Annual Review of Psychology

Volume 55: Pages 1-22, 2004


Walter Mischel

Department of Psychology, Columbia University, New York, New York 10027; email: wm@psych.columbia.edu

            Abstract To build a science of the person, the most basic question was, and remains, how can one identify and understand the psychological invariance that distinctively characterizes an individual and that underlies the variations in the thoughts, feelings, and actions that occur across contexts and over time? This question proved particularly difficult because of the discrepancies that soon emerged between the expressions of consistency that were expected and those that were found. The resulting dilemma became known as the classic "personality paradox": How can we reconcile our intuitionsand theoriesabout the invariance and stability of personality with the equally compelling empirical evidence for the variability of the person's behavior across diverse situations? Which is right: the intuitions or the research findings? In this chapter I review and discuss some of the advances made to answer this question since it was posed. These findings have allowed a resolution of the paradox, and provide the outlines for a conception of the underlying structure and dynamics of personality that seems to better account for the data.





Annual Review of Psychology

Volume 55: Pages 87-124, 2004

UNDERSTANDING OTHER MINDS: Linking Developmental Psychology and Functional Neuroimaging

R. Saxe, S. Carey, and N. Kanwisher

Department of Brain and Cognitive Sciences, MIT, Cambridge, Massachusetts 02139; email: saxe@mit.edu, scarey@wjh.harvard.edu, ngk@mit.edu

            Abstract Evidence from developmental psychology suggests that understanding other minds constitutes a special domain of cognition with at least two components: an early-developing system for reasoning about goals, perceptions, and emotions, and a later-developing system for representing the contents of beliefs. Neuroimaging reinforces and elaborates upon this view by providing evidence that (a) domain-specific brain regions exist for representing belief contents, (b) these regions are apparently distinct from other regions engaged in reasoning about goals and actions (suggesting that the two developmental stages reflect the emergence of two distinct systems, rather than the elaboration of a single system), and (c) these regions are distinct from brain regions engaged in inhibitory control and in syntactic processing. The clear neural distinction between these processes is evidence that belief attribution is not dependent on either inhibitory control or syntax, but is subserved by a specialized neural system for theory of mind.




Annual Review of Psychology

Volume 55: Pages 333-363, 2004


Lisa A. Serbin and Jennifer Karp

Center for Research in Human Development, Department of Psychology, Concordia University, Montreal, Quebec, Canada, H4B 1R6; email: lserbin@vax2.concordia.ca, karpie7@hotmail.com

            Abstract The recurrence of social, behavioral, and health problems in successive generations of families is a prevalent theme in both the scientific and popular literatures. This review discusses recent conceptual models and findings from longitudinal studies concerning the intergenerational transfer of psychosocial risk, including intergenerational continuity, and the processes whereby a generation of parents may place their offspring at elevated risk for social, behavioral, and health problems. Key findings include the mediational effects of parenting and environmental factors in the transfer of risk. In both girls and boys, childhood aggression and antisocial behavior appear to predict long-term trajectories that place offspring at risk. Sequelae of childhood aggression that may threaten the well-being of offspring include school failure, adolescent risk-taking behavior, early and single parenthood, and family poverty. These childhood and adolescent behavioral styles also predict harsh, aggressive, neglectful, and unstimulating parenting behavior toward offspring. Buffering factors within at-risk families include maternal educational attainment and constructive parenting practices (e.g., emotional warmth, consistent disciplinary practices, and cognitive scaffolding). These findings highlight the potential application and relevance of intergenerational studies for social, educational, and health policy.






Annual Review of Psychology

Volume 55: Pages 591-621, 2004

SOCIAL INFLUENCE: Compliance and Conformity

Robert B. Cialdini and Noah J. Goldstein

Department of Psychology, Arizona State University, Tempe, Arizona 85287-1104; email: Robert.Cialdini@asu.edu, Noah.Goldstein@asu.edu

             Abstract This review covers recent developments in the social influence literature, focusing primarily on compliance and conformity research published between 1997 and 2002. The principles and processes underlying a target's susceptibility to outside influences are considered in light of three goals fundamental to rewarding human functioning. Specifically, targets are motivated to form accurate perceptions of reality and react accordingly, to develop and preserve meaningful social relationships, and to maintain a favorable self-concept. Consistent with the current movement in compliance and conformity research, this review emphasizes the ways in which these goals interact with external forces to engender social influence processes that are subtle, indirect, and outside of awareness.



Annual Review of Psychology

Volume 55: Pages 745-774, 2004

COPING: Pitfalls and Promise

Susan Folkman and Judith Tedlie Moskowitz

Osher Center for Integrative Medicine, University of California, San Francisco, California 94143-1726; email: folkman@ocim.ucsf.edu, moskj@ocim.ucsf.edu

            Abstract Coping, defined as the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful, has been a focus of research in the social sciences for more than three decades. The dramatic proliferation of coping research has spawned healthy debate and criticism and offered insight into the question of why some individuals fare better than others do when encountering stress in their lives. We briefly review the history of contemporary coping research with adults. We discuss three primary challenges for coping researchers (measurement, nomenclature, and effectiveness), and highlight recent developments in coping theory and research that hold promise for the field, including previously unaddressed aspects of coping, new measurement approaches, and focus on positive affective outcomes.




Annual Review of Psychology

Volume 55: Pages 803-832, 2004


Michael H. Birnbaum

Department of Psychology, California State University, Fullerton, California 92834-6846; email: mbirnbaum@fullerton.edu

            Abstract Advantages and disadvantages of Web and lab research are reviewed. Via the World Wide Web, one can efficiently recruit large, heterogeneous samples quickly, recruit specialized samples (people with rare characteristics), and standardize procedures, making studies easy to replicate. Alternative programming techniques (procedures for data collection) are compared, including client-side as opposed to server-side programming. Web studies have methodological problems; for example, higher rates of drop out and of repeated participation. Web studies must be thoroughly analyzed and tested before launching on-line. Many studies compared data obtained in Web versus lab. These two methods usually reach the same conclusions; however, there are significant differences between college students tested in the lab and people recruited and tested via the Internet. Reasons that Web researchers are enthusiastic about the potential of the new methods are discussed.




Annual Review of Psychology

Volume 55: Pages 573-590, 2004


John A. Bargh and Katelyn Y. A. McKenna

New York University, New York, New York 10003; email: john.bargh@nyu.edu, kym1@nyu.edu

            Abstract The Internet is the latest in a series of technological breakthroughs in interpersonal communication, following the telegraph, telephone, radio, and television. It combines innovative features of its predecessors, such as bridging great distances and reaching a mass audience. However, the Internet has novel features as well, most critically the relative anonymity afforded to users and the provision of group venues in which to meet others with similar interests and values. We place the Internet in its historical context, and then examine the effects of Internet use on the user's psychological well-being, the formation and maintenance of personal relationships, group memberships and social identity, the workplace, and community involvement. The evidence suggests that while these effects are largely dependent on the particular goals that users bring to the interactionsuch as self-expression, affiliation, or competitionthey also interact in important ways with the unique qualities of the Internet communication situation.





Annu Rev Psychol. 2004;55:23-50

On building a bridge between brain and behavior.

Schall JD.

Center for Integrative & Cognitive Neuroscience, Vanderbilt Vision Research Center, Department of Psychology, Vanderbilt University, Nashville, Tennessee 37203; email: jeffrey.d.schall@vanderbilt.edu

            Cognitive neuroscience is motivated by the precept that a discoverable correspondence exists between mental states and brain states. This precept seems to be supported by remarkable observations and conclusions derived from event-related potentials and functional imaging with humans and neurophysiology with behaving monkeys. This review evaluates specific conceptual and technical limits of claims of correspondence between neural events, overt behavior, and hypothesized covert processes examined using data on the neural control of saccadic eye movements.



Cerebral reserve



J Neuropsychiatry Clin Neurosci 15:333-339, August 2003

The Influence of COGNITIVE RESERVE Reserve on Memory Following Electroconvulsive Therapy

Susan A. Legendre, Ph.D., Robert A. Stern, Ph.D., David A. Solomon, M.D., Martin J. Furman, M.D. and Kristin E. Smith, B.A.

Address correspondence to Dr. Robert A. Stern, Neuropsychology Program, Rhode Island Hospital, 110 Lockwood Street, Suite 430, Providence, RI 02903

           Cognitive reserve (CR) theory proposes that certain genetic and nonacquired variables, such as larger head size and greater neuronal density, and some life experiences, such as higher educational and occupational attainment, provide a buffer against brain dysfunction in the face of acquired central nervous system (CNS) dysfunction. This study examined CR in the pseudoexperimental paradigm of electroconvulsive therapy (ECT). Subjects included fifty (N = 50) depressed patients treated with bilateral ECT. Subjects were placed in high (n = 27) or low (n = 23) CR groups based on years of education and occupational attainment. At baseline, no significant differences were observed between the groups in the amount of information forgotten on a verbal memory measure (Randt stories) after a 30-minute delay. Following three ECT treatments, however, the high CR group forgot significantly less information after a 30-minute delay, as compared to the low CR group (p < 0.01). These data provide further support for CR theory and suggest that CR may be an underlying factor in differential memory loss in ECT.



Appl Neuropsychol. 2003;10(3):153-62.

Premorbid intellectual functioning, education, and brain size in traumatic brain injury: an investigation of the cognitive reserve hypothesis.

Kesler SR, Adams HF, Blasey CM, Bigler ED.

Stanford Psychiatry Neuroimaging Laboratory, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA, USA. erin_bigler@byu.edu

            Cognitive reserve theories have been postulated in an attempt to explain individual differences in functional outcome following cerebral insult or disease. These theories suggest that higher education and psychometric intelligence may preserve functional capacity regardless of injury or disease severity. This study investigated cognitive reserve in 25 participants with traumatic brain injury (TBI) using high-resolution magnetic resonance imaging (MRI) analyses. We examined the relationships between total intracranial volume (TICV), ventricle-tobrain ratio (VBR), education level, and standardized testing obtained prior to injury with post-injury cognitive outcome. Participants with lower post-injury IQ scores had significantly lower TICV values, irrespective of injury severity, and experienced significantly greater change in IQ from pre- to post-injury. TICV and education correctly predicted participants' post-injury IQ category ( Y 90 or < 90). However, premorbid standardized testing (PST) scores did not predict cognitive outcome. The results of this study suggest that larger premorbid brain volume and higher education level may decrease vulnerability to cognitive deficits following TBI, consistent with the notion of a cognitive reserve.



Archives of Clinical Neuropsychology

18 (2003) 643–

Preliminary examination of cognitive reserve theory in closed head injury

Michael T. Ropacki a,*, Jeffrey W. Elias b

            This investigation was designed to provide preliminary support for cognitive reserve theory in closed head injury (CHI), and demonstrate the effectiveness of using the Oklahoma premorbid intelligence estimate (OPIE) in research and clinical activities. Out of a possible 124 consecutive referrals, 26 patients (N = 26) who underwent neuropsychological assessment following brain injury met study inclusion/ exclusion criteria. Participants were included if they had exited post-traumatic amnesia (PTA), demonstrated uncompromised upper extremity use, displayed adequate verbal communication, and were judged capable of completing a full neuropsychological evaluation. Participants were divided into a closed head injury— premorbid history (CHI-) or closed head injury— premorbid history (CHI+) group based upon premorbid variables (e.g., history of alcoholism). Groups did not differ in terms of demographic variables or premorbid IQ. Despite having less severe head injuries, the CHI+ group had a greater pre– difference for PIQ, and a significantly larger VIQ/PIQ discrepancy than the CHI- group. In conclusion, these findings suggest that the CHI+ group had diminished cognitive reserve secondary to the aggregate effects of premorbid insult, which resulted in greater cognitive decline following an additional stressor (i.e., CHI) than what might otherwise be expected from the head injury alone.







Volume 19, Issue 3 , July 2003, Pages 1215-1227

Cognitive reserve modulates functional brain responses during memory tasks: a PET study in healthy young and elderly subjects

Nikolaos Scarmeas, Eric Zarahn, Karen E. Anderson, John Hilton, Joseph Flynn, Ronald L. Van Heertum, Harold A. Sackeim and Yaakov Stern

            Cognitive reserve (CR) is the ability of an individual to cope with advancing brain pathology so that he remains free of symptomatology. Epidemiological evidence and in vivo neurometabolic data suggest that CR may be mediated through education or IQ. The goal of this study was to investigate CR-mediated differential brain activation in 17 healthy young adults and 19 healthy elders. Using nonquantitative H215O PET scanning, we assessed relative regional cerebral blood flow while subjects performed a serial recognition memory task under two conditions: nonmemory control (NMC), in which one shape was presented in each study trial; and titrated demand (TD), in which study list length was adjusted so that each subject recognized shapes at approximately 75% accuracy. A factor score that summarized years of education and scores on two IQ indices was used as an index of CR. Voxel-wise, multiple regression analyses were performed with TD minus NMC difference PET counts as the dependent variable and the CR variable as the independent variable of interest. We identified brain regions where regression slopes were different from zero in each separate group, and also those where regression slopes differed between the two age groups. The slopes were significantly more positive in the young in the right inferior temporal gyrus, right postcentral gyrus, and cingulate, while the elderly had a significantly more positive slope in left cuneus. Brain regions where systematic relationships between CR and brain activation differ as a function of aging are loci where compensation for aging has occurred. They may mediate differential ability to cope with brain changes in aging.






J Head Trauma Rehabil. 2003 Mar-Apr;18(2):148-63.

Demographic, medical, and psychiatric factors in work and marital status after mild head injury.

Vanderploeg RD, Curtiss G, Duchnick JJ, Luis CA.

The James A. Haley Veterans Affairs Medical Center, Defense and Veterans Head Injury Program, Psychology Service 116B, Tampa, FL 33612, USA. Rodney.Vanderploeg@med.va.gov

            OBJECTIVE: To explore factors associated with long-term outcomes of work and marital status in individuals who had experienced a mild head injury (MHI), as well as those who had not. DESIGN: Population-based study using logistical regression analyses to investigate the impact of preinjury characteristics on work and marital status. PARTICIPANTS: Two groups of Vietnam-era Army veterans: 626 who had experienced a MHI an average of 8 years before examination, and 3,896 who had not. MAIN OUTCOME MEASURES: Demographic characteristics, concurrent medical conditions, early life psychiatric problems, loss of consciousness (LOC), and interactions among these variables were used to predict current work and marital status. RESULTS: Multiple variables were associated with work and marital status in the sample with MHI, accounting for approximately 23% and 17% of the variance in these two outcome variables, respectively. In contrast, the same factors accounted for significantly less variance in outcome in the sample without a head injury-13.3% and 9.4% for work and marital status, respectively. CONCLUSIONS: These findings suggest a more potent role for and increased vulnerability to the influence of demographic, medical, and psychiatric factors on outcomes after a MHI. That is, MHI itself moderates the influence of preinjury characteristics on work and marital status. In addition, in those who had a MHI, moderator relationships were found between education and LOC for both work and marital status. Similarly, complex moderator relationships among race, region of residence, and LOC were found for both work and marital status outcomes.



The Journal of Head Trauma Rehabilitation, March-April 2003 v18 i2 p201(3)

Traumatic brain injury: depression, neurogenesis, and medication management.

Robert B. Perna; Ann Rouselle; Patrick Brennan.

            Recent research suggests that depression and chronic stress may not only interfere with rehabilitation in the obvious ways, but also may cause further cerebral damage or slow the recovery process. Antidepressants not only effectively reduce depression, but may also protect against cell death and promote neurogenesis in that region of the brain linked to memory, a very common long-term deficit in brain injury. Reports of complications have been few, but future research needs to clarify the long term effects of antidepressants, particularly when used with individuals who sustained brain injury.




Mol Pathol. 2003 Jun;56(3):132-6.

Genetic vulnerability following traumatic brain injury: the role of apolipoprotein E.

Nathoo N, Chetty R, van Dellen JR, Barnett GH; nathoon@ccf.org

            Apolipoprotein E (APOE) is thought to be responsible for the transportation of lipids within the brain, maintaining structural integrity of the microtubule within the neurone, and assisting with neural transmission. Possession of the APOE epsilon4 allele has also been shown to influence neuropathological findings in patients who die from traumatic brain injury, including the accumulation of amyloid beta protein. Previous clinical studies reporting varying outcome severities of traumatic brain injury, including cognitive and functional recovery, all support the notion that APOE epsilon4 allele possession is associated with an unfavourable outcome. Evidence from experimental and clinical brain injury studies confirms that APOE plays an important role in the response of the brain to injury.




European Psychiatry

Volume 18, Issue 5 , August 2003, Pages 241-248

Neuropsychological function in obsessive-compulsive disorder: effects of comorbid conditions on task performance

Ayse Aycicegia, Wayne M. Dinn, , b, Catherine L. Harrisb and Husnu Erkmenc

            Background. – Neuropsychological testing reveals a pattern of impairment among patients with obsessive-compulsive disorder (OCD) which implicates the orbitofrontal region. Studies of neuropsychological function in OCD differ regarding performance deficits on classical tests of frontal executive function. In some studies, OCD patients did not demonstrate impaired performance on tests of executive function. However, other researchers have documented performance deficits among OCD patients on measures of executive function. Patients with OCD also exhibit performance deficits on tests of visual/spatial memory and verbal memory. Again, in some studies, OCD patients did not demonstrate impaired performance on tests of memory function. How can we account for the conflicting findings? One possibility is that performance deficits on tests of cognitive function are associated with comorbid conditions. In prior work, we observed that OCD patients who did poorly on executive function tasks obtained high scores on a measure of schizotypal personality. A second possibility is that executive function deficits among patients with OCD are associated with comorbid depressive symptoms. Method. – In the present study, a comprehensive neuropsychological test battery was administered to patients with OCD and matched healthy control subjects. We also administered dimensional measures of schizotypal personality and depression to patients with OCD and controls. We conducted analyses of covariance (ANCOVA), with scores on measures of schizotypal personality and depression used as covariates. Results. – OCD patients demonstrated performance deficits on measures of delayed memory, response inhibition, alternation learning, and obtained significantly higher scores on measures of disinhibition, impulsivity, and temporolimbic symptoms; however, OCD patients did not exhibit impaired performance on tests of executive function and verbal fluency, and did not report a significantly greater number of dysexecutive symptoms, when coexistent depressive and schizotypal symptoms were taken into account.  Conclusion. – Findings are consistent with the contention that dysfunction of an orbitofrontal-limbic network underlies OCD.



The Journal of Head Trauma Rehabilitation, March-April 2003 v18 i2 p128(11)

Moderating factors in return to work and job stability after traumatic brain injury.

Jeffrey S. Kreutzer; Jennifer H. Marwitz; William Walker; Angelle Sander; Mark Sherer; Jennifer Bogner; Robert Fraser; Tamara Bushnik.

            Objective: To examine job stability moderating variables and develop a postinjury work stability prediction model. Design: Multicenter analysis of individuals with traumatic brain injury (TBI) who returned for follow-up at 1, 2, and 3, or 4 years postinjury, were of working age (between 18 and 62 years of age at injury), and were working preinjury. Setting: Six National Institute on Disability and Rehabilitation Research TBI Model System centers for coordinated acute and rehabilitation care. Participants: A total of 186 adults with TBI were included in the study. Main outcome measures: Job stability was categorized as stably employed (employed at all 3 follow-up intervals); unstably employed (employed at one or two of all three follow-up intervals); and unemployed (unemployed at all three follow-up intervals). Results: After injury, 34% were stably employed, 27% were unstably employed, and 39% were unemployed at all three follow-up intervals. Minority group members, people who did not complete high school, and unmarried people were more likely to be unemployed. Driving independence was highly influential and significantly related to employment stability. A discriminant function analysis, which included age, length of unconsciousness and Disability Rating Scale scores at 1 year postinjury, accurately predicted job stability groupings. Conclusion: Data analysis provided evidence that employment stability is predictable with a combination of functional, demographic, and injury severity variables. Identification of people at risk for poor employment outcomes early on can facilitate rehabilitation planning and intervention.



Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 594-613

Genetic Evidence for Cognitive Reserve: Variations in Memory and Related Cognitive Functions

Joseph H. Lee 1

1 G. H. Sergievsky Center, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Epidemiology, School of Public Health, Columbia University, New York, USA

            Variations in cognitive functions across individuals are observed universally, and such observations serve as the basis of cognitive reserve (CR). Broadly, cognitive reserve refers to the inconsistency between neuropathology and clinical severity. The causes of such individual variations are likely to be multi-factorial. In this review, I present studies which suggest that genes are likely to be the contributing causes, and these genes interact with environmental factors to produce even greater variations in cognitive functions. A number of animal and human studies are beginning to reveal the role of genetic contributions to cognitive functions like memory, memory decline, general intelligence, and language. Twin studies suggest that there is a substantial heritable component for memory and related cognitive functions, such as general intelligence and language, but not for others. Thus, heritability estimates vary by cognitive domain. Animal studies and some human studies have identified genes or candidate loci that contribute to memory as well as other related cognitive phenotypes. Yet, our current understanding is limited. It will require interdisciplinary efforts from a number of different fields to better define the neuropsychological phenotype. At the same time, it is necessary to take into account both genetic and environmental factors to understand the complex network underlying CR.



Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 614-624

Lifetime Antecedents of Cognitive Reserve

Marcus Richards 1 and Amanda Sacker 

            We used path analysis on data from the British 1946 birth cohort to model lifetime antecedents of cognitive reserve, represented by the NART at 53 years, and compared this model for verbal memory and psychomotor function at this age, cognitive outcomes that are sensitive to age-associated decline. We showed independent paths from childhood cognition, educational attainment and adult occupation to cognitive reserve, with that from childhood cognition the strongest, and that from adult occupation the weakest. A similar pattern was found for the verbal memory and psychomotor outcomes, although the pathways were weaker than those to the NART. The pattern was also mirrored by the paths from paternal occupation to childhood cognition, educational attainment and adult occupation, with that to childhood cognition the strongest, and that to adult occupation the weakest. The direct influence of paternal occupation on cognitive reserve was negligible, and almost entirely mediated by childhood cognitive ability and educational attainment.



Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 625-633

Cognitive Reserve and Lifestyle

Nikolaos Scarmeas 1 and Yaakov Stern

            The concept of cognitive reserve (CR) suggests that innate intelligence or aspects of life experience like educational or occupational attainments may supply reserve, in the form of a set of skills or repertoires that allows some people to cope with progressing Alzheimer’s disease (AD) pathology better than others. There is epidemiological evidence that lifestyle characterized by engagement in leisure activities of intellectual and social nature is associated with slower cognitive decline in healthy elderly and may reduce the risk of incident dementia. There is also evidence from functional imaging studies that subjects engaging in such leisure activities can clinically tolerate more AD pathology. It is possible that aspects of life experience like engagement in leisure activities may result in functionally more efficient cognitive networks and therefore provide a CR that delays the onset of clinical manifestations of dementia.



Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 634-642

Assessment of Lifetime Participation in Cognitively Stimulating Activities

Robert S. Wilson, Lisa L. Barnes and David A. Bennett

            Cognitively stimulating experience is thought to contribute to cognitive reserve. We constructed a questionnaire consisting of 25 items about frequency of participation in cognitive activities across the life span and administered it to two groups of older persons. The total score on the scale had high internal consistency (coefficient alpha=0.88) and temporal stability over a 4-week re-test interval (r=.79), and it was positively correlated with education. In analyses controlling for age, sex, and education, more frequent cognitive activity was related to better perceptual speed, visuospatial ability, and semantic memory but not to episodic memory or working memory. The results suggest that the scale provides a psychometrically sound measure of frequency of cognitive activity across the life spa





Jurnal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 643-653

Early Life Physical Activity and Cognition at Old Age

Miranda G. Dik, Dorly J.H. Deeg, Marjolein Visser and Cees Jonker

            Physical activity has shown to be inversely associated with cognitive decline in older people. Whether this association is already present in early life has not been investigated previously. The association between early life physical activity and cognition was studied in 1,241 subjects aged 62-85 years, in a prospective population-based study. Physical activity between ages 15 and 25 years was asked retrospectively. The findings suggest a positive association between regular physical activity early in life and level of information processing speed at older age in men, not in women. The association could not be explained by current physical activity or other lifestyle factors. This finding supports the cognitive reserve hypothesis, and might suggest that early life physical activity may delay late-life cognitive deficits.



Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 654-670

Psychosocial Risk Factors of HIV Morbidity and Mortality: Findings from the Multicenter AIDS Cohort Study (MACS)

Roxanna Farinpour 1 , Eric N. Miller 1 , Paul Satz 1 , Ola A. Selnes 2 , Bruce A. Cohen 3 , James T. Becker 4 , Richard L. Skolasky 2 and Barbara R. Visscher 5

            Despite the use of laboratory markers in estimating HIV prognosis, significant variation in the natural history of HIV-1 infection remains unexplained. Recent studies suggest psychosocial risk factors have important prognostic significance in HIV disease. The objective of the present study was to examine the prognostic influence of age, general intellectual functioning, and emotional distress across the spectrum of HIV disease progression. The study sample was drawn from the Multicenter AIDS Cohort Study (MACS), a 13-year, prospective study of HIV-seropositive men recruited from four study centers across the country. The participants were 1,231 HIV-seropositive MACS participants, followed from baseline (median 8/15/87) to the end of the observation period (12/15/98). HIV disease progression was evaluated with respect to three outcome measures: (1) number of years from baseline testing to the first AIDS defining illness (progression to AIDS), (2) years from baseline to HIV-dementia (progression to dementia), and (3) years from baseline to death (survival). The influence of psychosocial risk factors on outcome measures was evaluated using survival analyses. General intellectual functioning, age, and somatic symptoms of depression, were found to be significant predictors of HIV disease progression and survival. Older age at baseline was associated with a more rapid progression to dementia and death. Lower Shipley IQ estimates were associated with a more rapid disease progression (AIDS and dementia) and shortened survival. Somatic symptoms of depression were associated with shortened survival. In addition, age, IQ, and somatic symptoms of depression, had an additive effect with an increase in the number of risk factors associated with accelerated disease progression and shortened time to death. These findings remained consistent, despite controlling for baseline CD4 and HIV medication use. Psychosocial cofactors are important in understanding HIV disease progression. Methods for estimating HIV prognosis may become more reliable if psychosocial factors are considered. Future research will clarify if psychosocial risk factors reflect central nervous system integrity, brain reserve capacity or mediate morbidity and mortality through social economic status, access to health care and other social correlates.




Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 671-679

Head Circumference, Education and Risk of Dementia: Findings from the Nun Study

James A. Mortimer 1 , David A. Snowdon 2 and William R. Markesbery 3

            To examine the prevalence of dementia associated with having a smaller brain, lower education or both of these characteristics, 294 Catholic sisters were assessed annually for dementia. Sixty participants died and their brains were evaluated to determine fulfillment of neuropathological criteria for Alzheimer’s disease (AD). Lower educational attainment and the interaction of smaller head circumference with lower education were associated with the presence of dementia, controlling for age and the presence of one or more apolipoprotein E-?4 alleles. By contrast, neither low educational attainment nor head circumference was significantly associated with fulfillment of neuropathological criteria for AD. Individuals having both low education and small head circumference were four times as likely to be demented as the rest of the sample. The findings suggest that higher education and larger head size, alone or in combination, may reduce the risk of expressing dementia in late life.




Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 680-690

Literacy and Memory Decline Among Ethnically Diverse Elders

Jennifer J. Manly, Pegah Touradji, Ming-Xin Tang  and Yaakov Stern

            Literacy may be a more powerful indicator of brain reserve than years of education. Literacy level may be a proxy for native intellectual capacity or life experience that can compensate for brain damage or provide brain reserve. Alternately, the experience of acquiring literacy skills may in itself change the organization of the brain and increase protection against cognitive decline. However, because people with low levels of literacy obtain poor scores on most cognitive measures, only longitudinal studies can elucidate the role of reading ability in reserve. We determined whether literacy skills could predict cognitive change in a sample of 136 English-speaking African American, Caucasian, and Hispanic elders selected from a longitudinal aging study in New York City. According to a physician’s independent examination, all participants were nondemented throughout the four longitudinal assessments. Literacy level was assessed using the WRAT-3 reading subtest. After accounting for age at baseline and years of education, GEE analyses showed that elders with low levels of literacy had a steeper decline in both immediate and delayed recall of a word list over time as compared to high literacy elders. Our findings suggest that literacy skills are protective against memory decline among nondemented elders.





Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 691-701

Exploring the Neural Basis of Cognitive Reserve

Yaakov Stern 1 , Eric Zarahn 1 , H. John Hilton 1 , Joseph Flynn 1 , Robert DeLaPaz 1 and Brian Rakitin 1

            There is epidemiologic and imaging evidence for the presence of cognitive reserve, but the neurophysiologic substrate of CR has not been established. In order to test the hypothesis that CR is related to aspects of neural processing, we used fMRI to image 19 healthy young adults while they performed a nonverbal recognition test. There were two task conditions. A low demand condition required encoding and recognition of single items and a titrated demand condition required the subject to encode and then recognize a larger list of items, with the study list size for each subject adjusted prior to scanning such that recognition accuracy was 75%. We hypothesized that individual differences in cognitive reserve are related to changes in neural activity as subjects moved from the low to the titrated demand task. To test this, we examined the correlation between subjects’ fMRI activation and NART scores. This analysis was implemented voxel-wise in a whole brain fMRI dataset. During both the study and test phases of the recognition memory task we noted areas where, across subjects, there were significant positive and negative correlations between change in activation from low to titrated demand and the NART score. These correlations support our hypothesis that neural processing differs across individuals as a function of CR. This differential processing may help explain individual differences in capacity, and may underlie reserve against age-related or other pathologic changes




Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 702-720

Cognition and Aging: A Highly Selective Overview of Event-Related Potential (ERP) Data

David Friedman

New York State Psychiatric Institute, Cognitive Electrophysiology Laboratory, New York, USA

            An overview of highly selected cognitive aging investigations of deviance detection, episodic memory and working memory reveals two primary themes: (1) when variability in elderly samples has been assessed, it has proven useful in understanding age-related changes in cognition; and (2) there is a frontal lobe contribution to at least some age-related changes in cognition. However, there are too few ERP age-related investigations of individual differences to determine whether the changes in patterns of ERP responding can be deemed ?compensatory? or ?inefficient.? It is suggested that, to the extent possible, future electrophysiological investigations of cognitive aging (as well as other physiological measurement techniques) include individual difference measures that will enable the determination of the implication of a given neural pattern in the genesis of a given, age-related behavioral outcome pattern.




Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.5, pp. 721-732

Adult Neurogenesis: A Mechanism for Brain Repair?

Yevgenia Kozorovitskiy 1 and Elizabeth Gould

            It is now generally accepted that new neurons are added to the adult mammalian brain. This raises the possibility that naturally occurring neurogenesis may be useful for repairing the damaged adult brain. Indeed, several studies have shown that damage to the adult brain can stimulate reparative neurogenesis. However, the production of new neurons is only one of several steps necessary to restore damaged neural circuits to their original state. Studies carried out on intact animals have identified several conditions that affect the production and survival of new neurons in adult brains. This review considers the evidence for compensatory neurogenesis in the adult mammalian brain with a view toward applying information from the undamaged brain to studies of regeneration.




Psychological Medicine (2003), 33:793-801

Genetic and environmental influences on psychological distress in the population: General Health Questionnaire analyses in UK twins

F. V. RIJSDIJK a1c1, H. SNIEDER a1, J. ORMEL a1, P. SHAM a1, D. P. GOLDBERG a1 and T. D. SPECTOR a1

            Background. The General Health Questionnaire (GHQ) is the most popular screening instrument for detecting psychiatric disorders in community samples. Using longitudinal data of a large sample of UK twin pairs, we explored (i) heritabilities of the four scales and the total score; (ii) the genetic stability over time; and (iii) the existence of differential heritable influences at the high (ill) and low (healthy) tail of the distribution.

Method. At baseline we assessed the GHQ in 627 MZ and 1323 DZ female pairs and at a second occasion (3·5 years later) for a small subsample (90 MZ and 270 DZ pairs). Liability threshold models and raw ordinal maximum likelihood were used to estimate twin correlations and to fit longitudinal genetic models. We estimated extreme group heritabilities of the GHQ distribution by using a model-fitting implementation of the DeFries–Fulker regression method for selected twin data.   Results. Heritabilities for Somatic Symptoms, Anxiety, Social Dysfunction, Depression and total score were 0·37, 0·40, 0·20, 0·42 and 0·44, respectively. The contribution of shared genetic factors to the correlations between time points is substantial for the total score (73%). Group heritabilities of 0·48 and 0·43 were estimated for the top and bottom 10% of the total GHQ score distribution, respectively.  Conclusion. The overall heritability of the GHQ as a measure of psychosocial distress was substantial (44%), with all scales having significant additive genetic influences that persisted across time periods. Extreme group analyses suggest that the genetic control of resilience is as important as the genetic control of vulnerability.




In Press, Corrected Proof , Available online 8 October 2003

Relation of cognitive reserve and task performance to expression of regional covariance networks in an event-related fMRI study of nonverbal memory

Christian Habeck, H. John Hiltona, Eric Zarahna, Joseph Flynna, James Moeller, Yaakov Stern

            Cognitive reserve (CR) has been established as a mechanism that can explain individual differences in the clinical manifestation of neural changes associated with aging or neurodegenerative diseases. CR may represent individual differences in how tasks are processed (i.e., differences in the component processes), or in the underlying neural circuitry (of the component processes). CR may be a function of innate differences or differential life experiences. To investigate to what extent CR can account for individual differences in brain activation and task performance, we used fMRI to image healthy young individuals while performing a nonverbal memory task. We used IQ estimates as a proxy for CR. During both study and test phase of the task, we identified regional covariance patterns whose change in subject expression across two task conditions correlated with performance and CR. Common brain regions in both activation patterns were suggestive of a brain network previously found to underlie overt and covert shifts of spatial attention. After partialing out the influence of task performance variables, this network still showed an association with the CR, i.e., there were reserve-related physiological differences that presumably would persist were there no subject differences in task performance. This suggests that this network may represent a neural correlate of CR.





Archives of Clinical Neuropsychology

Article in Press, Corrected Proof

Relationship between plasticity, mild cognitive impairment and cognitive decline

M. Dolores Calero,  and Elena Navarro

            A topic of great interest in gerontology research is the prediction of cognitive deterioration which marks the transition from mild cognitive impairment (MCI) to dementia. In this area the term plasticity is a construct of prime importance. Previous studies have demonstrated the existence of plasticity in healthy older persons, and it is thought that this is what discriminates between healthy individuals and those at risk for dementia. The aim of the present study is to demonstrate that plasticity exists in persons with MCI, and that a lack of plasticity may be one of the risk factors related to cognitive decline. An adapted version of the Auditory Verbal Learning Test––the AVLT of Learning Potential––was used to assess plasticity. Participants in the research were 203 older persons whose cognitive status had previously been determined using a cognitive screening test. The results show that plasticity exists in persons with MCI and that its presence is associated with less marked cognitive decline.





Journal of Clinical and Experimental Neuropsychology

2003, Vol.25, No.8, pp. 1090-1101

Social Support Moderates Caregiver Life Satisfaction Following Traumatic Brain Injury

Tanya C. Ergh, Robin A. Hanks, Lisa J. Rapport and Renee D. Coleman

            Social support is an important determinant of adjustment following traumatic brain injury (TBI) sustained by a family member. The present study examined the extent to which social support moderates the influence of characteristics of the person with injury on caregiver subjective well-being. Sixty pairs of individuals who had sustained a moderate to severe TBI and their caregivers (N=120) participated. Years postinjury ranged from 0.3 to 9.9 (M=4.8, SD=2.6). Cognitive, functional, and neurobehavioral functioning of participants with TBI were assessed using neuropsychological tests and rating scales. Caregiver life satisfaction and perceived social support were assessed using self-report questionnaires. Results indicated that time since injury was unrelated to life satisfaction. Neurobehavioral disturbances showed an inverse relation with life satisfaction. Social support emerged as an important moderator of life satisfaction. Only among caregivers with low social support was cognitive dysfunction adversely related to life satisfaction. Similarly, a trend suggested that patient unawareness of deficit was associated with caregiver life dissatisfaction only among caregivers with low social support. In contrast, these characteristics were unrelated to life satisfaction among caregivers with adequate social support.








Journal of Consulting & Clinical Psychology. 2003 Dec Vol 71(6) 973-979

Establishing Specificity in Psychotherapy: A Meta-Analysis of Structural Equivalence of Placebo Controls.

Baskin, Thomas W.; Tierney, Sandy Callen; Minami, Takuya; Wampold, Bruce E.

           Placebo treatments in psychotherapy cannot adequately control for all common factors, which thereby attenuates their effects vis-a-vis active treatments. In this study, the authors used meta-analytic procedures to test one possible factor contributing to the attenuation of effects: structural inequalities between placebo and active treatments. Structural aspects of the placebo included number and duration of sessions, training of therapist, format of therapy, and restriction of topics. Results indicate that comparisons between active treatments and structurally inequivalent placebos produced larger effects than comparisons between active treatments and structurally equivalent placebos: moreover, the latter comparison produced negligible effects, indicating that active treatments were not demonstrably superior to well-designed placebos.




Brain Lesion Volume and Neuropsychological Function Predict Efficacy of Treatment for Depression in Multiple Sclerosis

Mohr, David C.; Epstein, Lucy; Luks, Tracy L.; Goodkin, Donald; Cox, Darcy; Goldberg, Alison; Chin, Cynthia; Nelson, Sarah

Journal of Consulting & Clinical Psychology. 71(6):1017-1024, December 2003.

            This study examined the effects of brain lesions and neuropsychological impairment on the efficacy of treatment for depression in patients with comorbid diagnoses of multiple sclerosis (MS) and major depressive disorder (MDD). Thirty patients meeting criteria for MS and MDD received 1 of 3 16-week treatments for depression and were followed for 6 months following treatment cessation. T2-weighted magnetic resonance imaging and neuropsychological evaluations were also obtained. End-of-treatment Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) results residualized for baseline BDI were related to right temporal periventricular lesion volume (R2 = .32, p = .002) and left temporal grey-white junction lesion volume (R2 = .19, p = .02) but were not statistically related to lesion volume in any other brain region or to neuropsychological function. BDI results at 6-month follow-up, residualized for end-of-treatment BDI, were predicted by total lesion volume (R2 = .22, p = .005), lesion volume in many discrete areas, and neuropsychological functioning (R2 = .29, p = .0009). The effect of total lesion volume on 6-month follow-up BDI results was fully mediated by neuropsychological function.