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- Frölander, Hans-Erik, 1966-
(författare)
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Deafblindness : Theory-of-mind, cognitive functioning and social network in Alström syndrome
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis addresses young adults with Alström syndrome (AS). AS causes acquired deafblindness, a severe, progressive, combined auditory and visual impairment affecting daily life and self-reliance to a degree that full participation depends on help from others and society. AS is an autosomal, recessively inherited single-gene disorder that affects the ALMS1 gene. AS has a multi-systemic pathology including a high incidence of additional multiple endocrine abnormalities, cardiomyopathy, pulmonary fibrosis, restrictive lung disease and progressive hepatic and renal failure leading to reduced life expectancy. The focus in the present thesis is on the development of Theory-of-mind (ToM) and on how ToM relates to the development of certain cognitive skills and the characteristics of the individual social network. ToM refers to the ability to understand the thoughts and feelings of others.The results reveal that individuals with AS displayed a significantly higher degree of heterogeneity in the performance of ToM tasks, and some individuals with AS performed on an equal level with nondisabled individuals. ToM performance was predicted by verbal ability and executive functioning (EF), whereas working memory capacity (WM) proved to be an indirect predictor. Later onset of visual loss further characterized AS individuals with better ToM. The sizes of the social networks of individuals with AS were smaller relative to those of nondisabled individuals, and many of the acquaintances were professionals working with individuals with AS. The number of friends correlated with ToM performance.Methods to improve verbal ability and EF, and interventions to enhance social participation in childhood of individuals with AS might prove to be fruitful. In addition assistive technology to establish and maintain friendships in adulthood is required.
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| 2. |
- Aaro Jonsson, Catherine
(författare)
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Long-term cognitive outcome of childhood traumatic brain injury
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is limited knowledge of cognitive outcome extending beyond 5 years after childhood traumatic brain injury, CTBI. The main objectives of this thesis were to investigate cognitive outcome at 6-14 years after CTBI, and to evaluate if advancements in the neurosurgical care, starting 1992, did influence long-term outcome and early epidemiology. An additional aim was to study the relationship between early brain injury parameters and early functional outcome. Study 1 evaluated cognitive progress during 14 years after CTBI, over three neuropsychological assessments in 8 patients with serious CTBI. Study 2 used patient records to investigate early epidemiology, received rehabilitation and medical follow up in two clinical cohorts, n=82 and n=46, treated neurosurgically for CTBI before and after 1992. An exploratory cluster analysis was applied to analyse the relation between early brain injury severity parameters and early functional outcome. In Study 3, participants in the two cohorts, n=18 and n=23, treated neurosurgically for CTBI before and after 1992, were subject to an extensive neuropsychological assessment, 13 and 6 years after injury, respectively. Assessment results of the two cohorts were compared with each other and with controls. Data were analysed with multivariate analyses of variance. Results and discussion. There were significant long-term cognitive deficits of similar magnitude and character in the two cohorts with CTBI, treated before and after the advancements in neurosurgical care. At 6-14 years after injury, long-term deficits in verbal intellectual and executive functions were found, and were discussed in terms of their late maturation and a decreased executive control over verbal memory-functions after CTBI. Visuospatial functions had a slightly better long-term recovery. The amount of rehabilitation received was equally low in both cohorts. The length of time spent in intensive care and the duration of care in the respirator may have a stronger relationship to early outcome than does a single measure of level of consciousness at admission. Main conclusions are that cognitive deficits are apparent at long-term follow up, 6-13 years after neurosurgically treated CTBI, even after advancements in the neurosurgical care in Sweden. Measures of verbal IQ, verbal memory and executive functions were especially low while visuospatial intellectual functions appear to have a better long-term recovery.
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| 3. |
- Berlin, Lisa, 1973-
(författare)
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The Role of Inhibitory Control and Executive Functioning in Hyperactivity/ADHD
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis examined inhibition, executive functioning and their possible relation to childhood problems of hyperactivity and inattention, in its clinical form referred to as Attention Deficit Hyper-activity Disorder (ADHD). Concurrent as well as longitudinal relations were of interest, and both clinical and non-clinical samples were studied. Study I demonstrated concurrent relations between executive inhibition and both hyperactivity and conduct problems in preschool. However, the relation between inhibition and conduct problems could be attributed to the large overlap between hyperactivity and conduct problems.In Study II, linear relations were found between executive inhibition and hyperactivity, whereas inhibition to the unfamiliar was related to hyperactivity, social initiative, as well as social anxiety. Non-linear analyses showed that children with high levels of both types of inhibition were at risk for developing low social initiative and social anxiety, whereas children with low levels of inhibition were at risk for developing hyperactivity, but at the same time protected from social anxiety. In Study III, executive inhibition was longitudinally related to ADHD symptoms in both school and at home for boys, but only in the school context for girls. Executive inhibition was also related to more general executive functioning deficits, and concurrent relations were found between executive functioning and ADHD symptoms, although in both cases only for boys. Inhibition and executive functioning made independent contributions to the understanding of ADHD symptoms for boys, and together explained about half the variance in inattention problems. In Study IV, group differences were found between ADHD children and controls for both inhibition and various other executive function measures. These measures also discriminated well between groups. The best model, which included measures tapping inhibition, working memory and emotion regulation, classified 86% of the children correctly. In summary, the results of the present thesis were mostly supportive of Barkley’s hybrid model of ADHD, although it should be noted that the question of whether inhibition should be regarded as primary to other executive functions requires further investigation.
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