W4 T2 P1
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Questions and Answers

According to DSM-5, which cognitive symptom is identified as a diagnostic criterion for a major depressive episode?

  • Increased speed of cognitive processing.
  • Improved memory and recall abilities.
  • A diminished ability to think or concentrate. (correct)
  • Heightened creativity and imagination.

Disturbances in intricate brain circuitry that affect cognition can originate from which of the following levels?

  • Nutritional deficiencies affecting neurotransmitter synthesis.
  • Atmospheric pressure influencing neuronal firing rates.
  • Societal influences on individual thought processes.
  • Dysregulation at any point from gene transcription through network communication. (correct)

Besides self-reporting, which method is used to assess cognitive symptoms of depression?

  • Analysis of handwriting samples.
  • Assessment of personal fashion choices.
  • Evaluation of interpersonal relationship success.
  • Objective neuropsychological tests. (correct)

Which method of cognitive assessment relies on an individual's subjective impression of their cognitive abilities?

<p>Self-report rating scales. (A)</p> Signup and view all the answers

What might cognitive dysfunction in mental illnesses indicate about brain function?

<p>Dysregulation in a complex system, affecting processes like attention and memory. (A)</p> Signup and view all the answers

What aspect of cognitive rating would include behavioral observation?

<p>Clinician ratings. (D)</p> Signup and view all the answers

Where might cognitive impairment originate?

<p>Problems with speed of processing. (B)</p> Signup and view all the answers

What type of organization is King's College London?

<p>An academic institution. (A)</p> Signup and view all the answers

In the Trail-Making Test, Part B, what does a higher score indicate?

<p>Greater impairment and executive dysfunction. (A)</p> Signup and view all the answers

Which cognitive domain is most likely to be impaired in patients with depression based on the information provided?

<p>Delayed recall. (D)</p> Signup and view all the answers

Which type of cognition is more likely to be associated with antidepressant response?

<p>Hot cognition. (A)</p> Signup and view all the answers

Which area of the brain is primarily associated with 'cold cognition'?

<p>Dorsolateral prefrontal cortex. (B)</p> Signup and view all the answers

What is the distinguishing feature of the Trail-Making Test, Part B, compared to Part A?

<p>Requires alternating between numbers and letters. (B)</p> Signup and view all the answers

Which of the following cognitive processes is considered 'cold cognition'?

<p>Solving a logic puzzle. (C)</p> Signup and view all the answers

According to the information, which brain area is associated with processing emotions and is linked to hot cognition?

<p>Amygdala. (B)</p> Signup and view all the answers

If a patient takes longer than three minutes to complete the Trail-Making Test Part B, what might this suggest?

<p>Possible executive dysfunction. (A)</p> Signup and view all the answers

In individuals with Major Depressive Disorder (MDD), what is a common discrepancy observed regarding cognitive function?

<p>Subjectively reported symptoms of cognitive impairment are inconsistent with objective test performance. (C)</p> Signup and view all the answers

Why are bedside cognitive function tests like the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) often insufficient for assessing cognitive dysfunction in depression?

<p>They lack the sensitivity to detect the milder forms of cognitive dysfunction seen in depression. (B)</p> Signup and view all the answers

What is the primary benefit of using self-rated cognitive questionnaires in evaluating cognitive abilities?

<p>They provide insight into an individual's subjective experience of their cognitive abilities. (A)</p> Signup and view all the answers

In the Digit Symbol Substitution Test (DSST), what cognitive domain is primarily being assessed?

<p>Speed of processing and psychomotor speed (C)</p> Signup and view all the answers

What is the main purpose of the Rey Auditory Verbal Learning Test (RAVLT)?

<p>To measure immediate and delayed recall of verbally presented information. (B)</p> Signup and view all the answers

A clinician is evaluating a patient with suspected cognitive impairment related to depression. The patient performs well on the MoCA but reports significant difficulties with memory and concentration. What is the most appropriate next step?

<p>Administer self-rated cognitive questionnaires to capture the patient's subjective experience of their cognitive abilities. (D)</p> Signup and view all the answers

A researcher is designing a study to investigate the effectiveness of a new cognitive training program for individuals with depression. Which combination of cognitive assessments would provide the most comprehensive evaluation of treatment outcomes?

<p>DSST, RAVLT, and self-rated cognitive questionnaire (D)</p> Signup and view all the answers

An individual scores poorly on the Digit Symbol Substitution Test (DSST). Which of the following factors could potentially contribute to this result, aside from cognitive impairment?

<p>Motor skill impairments (B)</p> Signup and view all the answers

Flashcards

Trail-Making Test, Part B

A test where patients connect circles alternating between numbers and letters.

Executive Function

Executive function involves higher-level cognitive processes like planning, problem-solving, and working memory.

Hot Cognition

Cognitive processes influenced by emotion and linked to responses to feedback.

Cold Cognition

Emotionally independent, logical thinking and executive control.

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MDD Cognitive Discordance

Subjective cognitive complaints may not align with objective test performance in MDD.

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Hot Cognition and Mood Disorders

Linked to emotional processing and negative feedback.

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Brain areas of Hot Cognition

Linked to activity in the ventral medial prefrontal cortex and emotional processing areas like the amygdala.

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Bedside Cognitive Tests

Screens for significant cognitive decline, but may miss milder impairments.

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Brain areas of Cold Cognition

Associated with non-emotional cognition, sensory and motor areas.

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Self-Rated Cognitive Questionnaires

Tests where individuals rate their own cognitive abilities through questionnaires.

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Digit Symbol Substitution Test

Assesses processing speed by matching symbols to digits under time constraints.

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Dorsal Lateral Prefrontal Cortex

The dorsal lateral prefrontal cortex (DLPFC) is associated with non-emotional cognition.

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RAVLT (Auditory Learning)

Evaluates immediate and delayed recall of a list of spoken words.

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California Auditory Verbal Learning Test

A variant of the RAVLT.

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Immediate Recall

Asking the test-taker to immediately repeat words that were heard.

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Delayed Recall

Asking the test-taker to repeat words from the list after a delay.

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Cognitive Impairment

Disturbances in brain circuitry, from gene transcription to network communication, can cause dysfunction in cognitive domains.

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Cognitive Domains

Attention, learning, memory, and speed of processing are examples of cognitive domains often affected in mental illnesses.

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Cognitive Dysfunction in Mental Illnesses

Many mental illnesses show cognitive dysfunction due to dysregulation in complex brain systems.

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Cognitive Symptoms in DSM-5

The DSM-5 includes 'diminished ability to think or concentrate' as one of the criteria for diagnosing a major depressive episode.

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Cognitive Assessment Methods

Subjective self-reports, clinician ratings, and objective neuropsychological tests are methods of cognitive assessment.

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Subjective Cognitive Assessment

These involve patients reporting on their own cognitive abilities.

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Clinician Ratings

Clinicians evaluate cognitive function through interviews and observation.

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Objective Neuropsychological Tests

Objective neuropsychological tests use tools, varying from paper to virtual reality, to gauge cognitive abilities.

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Study Notes

  • Cognitive impairment is a factor in numerous mental illnesses.
  • Brain circuitry disturbances can impair cognitive domains like attention, learning, memory, and processing speed.
  • Multiple mental illnesses exhibit cognitive dysfunction due to dysregulation.
  • DSM-5 identifies cognitive symptoms as a criteria for major depressive episode diagnosis.
  • One diagnostic criterion for depression is "A diminished ability to think or concentrate nearly every day, either by subjective account or observed by others."
  • Cognitive symptoms of depression can be assessed through subjective self-reports and objective measures.
  • Clinician ratings, interviews, behavioral observation, and objective neuropsychological tests are used in cognitive assessment.
  • Subjectively reported symptoms and objectively measured deficits often differ in major depressive disorder (MDD).
  • Cognitive function bedside tests like the Mini Mental State Examination and Montreal Cognitive Assessment (MoCA) can assess cognitive impairment.
  • These tests are screens for significant cognitive impairments but aren't adequate for the milder cognitive dysfunction in depression.
  • Self-rated cognitive questionnaires, like Perceived Deficits Questionnaire, offer insight into a person's subjective experience of their cognitive abilities.
  • The Digit Symbol Substitution Test requires matching symbols with digits which measures a speed of processing.
  • The score represents the number of correct symbols drawn in 90 seconds, with a maximum score of 93.
  • The Auditory Verbal Learning Test (RAVLT) is used to assess immediate and delayed recall.
  • Patients with depression perform worse on RAVLT compared to age-matched individuals.
  • Executive function, captured by the Trail-Making Test, Part B, involves connecting circles alternating between numbers and letters.
  • Results are reported as time to complete; higher scores indicate greater impairment and executive dysfunction.
  • In the Trail-Making Test, most people finish in three minutes.
  • Hot cognition relates to emotional processing and response to negative feedback.
  • Changes in the hot system are linked to antidepressant response and general mood.
  • Cold cognition relates to emotion-independent, logical thinking and executive control.
  • Hot cognition is linked to the ventral medial prefrontal cortex and emotional processing areas like the amygdala.
  • Cold cognition is associated with the dorsolateral prefrontal cortex via the basal ganglia and parietal cortex.

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Description

Cognitive impairment affects attention, learning, memory, and processing speed. Brain circuitry disturbances can cause this impairment. Cognitive symptoms in depression are assessed using self-reports, interviews, and neuropsychological tests.

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