Abstract Introduction Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. Objectives To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. Methods Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). Results Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). Discussion Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.

Abstract Introduction Rapid automatized naming (RAN) is the ability to name, as fast as possible, symbols such as letters, digits and figures. The present study aimed to investigate intragroup performance patterns on RAN tasks in children with attention deficit hyperactivity disorder (ADHD) symptoms alone, children with reading disability (RD) alone and controls with typical development. Methods A total of 216 Brazilian children between 8 to 11 years old were selected from public schools located in two Brazilian capitals, namely Porto Alegre and Belo Horizonte, to participate in the study. Mixed 3 (participant group: ADHD symptoms, RD or control group) × 3 (type of stimulus: letters, numbers or figures) ANOVAs were performed using response time and number of errors as dependent variables. Only intragroup comparisons are described in this paper. Results The groups with ADHD symptoms and RD showed similar performance results on naming speed. There were no differences between letters and numbers within each group, but we found slower responses in figure naming compared to the other tasks for both groups. Concerning accuracy, children with ADHD symptoms showed a similar number of errors in all three tasks. These patterns were distinct from the performance of the control group. Conclusion Results suggest a shared deficit in naming speed of alphanumeric stimuli in children with ADHD symptoms and those with RD, and impairments in naming digits correctly in children with ADHD symptoms.

Abstract Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen’s d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood.

RESUMO Introdução: Dificuldades de leitura (DL) e sintomas do Transtorno de Déficit de Atenção e Hiperatividade (TDAH) frequentemente coocorrem em crianças escolares. Métodos: O presente estudo comparou o desempenho em FE “frias” e processamento fonológico de 216 crianças brasileiras de 3ª e 4ª anos, que foram divididas em três grupos: apenas com sintomas de TDAH, apenas em DL e controles. Resultados: As análises de MANOVA, controlando para idade e inteligência não-verbal, indicaram que o grupo com DL apresentou desempenho significativamente inferior ao grupo com sintomas de TDAH nas medidas de processamento fonológico (consciência fonológica, memória verbal de curto prazo e acesso lexical) e em componentes das FE “frias” (fluência verbal ortográfica e velocidade de processamento). O grupo com sintomas de TDAH não se diferiram do grupo controle na maior parte das tarefas de FE “frias”. Ambos os grupos com sintomas de TDAH e DL apresentaram desempenhos significativamente menores (mais erros) em comparação às crianças de desenvolvimento típico na tarefa de Nomeação Seriada Rápida de figuras que avalia o componente de controle inibitório, e o desempenho foi semelhante entre os grupos. Conclusão: Conclui-se que crianças com DL apresentam maior comprometimento em processamento fonológico e FE “frias” em comparação àquelas com sintomas de TDAH e que déficits no controle inibitório podem ser compartilhados entre crianças com ambas as condições.

ABSTRACT Introduction: Reading disability (RD) and Attention Deficit Hyperactivity Disorder (ADHD) symptoms often co-occur in school-age children. Methods: The present study evaluated the performance of 216 Brazilian children from 3rd and 4th grades on “cool” executive function (EF) abilities and phonological processing. The children were divided into three groups: those with ADHD symptoms only, those with RD only, and controls. Results: MANOVA analyses, controlling for age and nonverbal intelligence, showed worse performance for the RD group, compared to the ADHD symptoms group, on measures of phonological processing (phonemic awareness, phonological short-term memory, and lexical access) and “cool” EF components (orthographic verbal fluency and processing speed). The ADHD symptoms group did not differ from the control group on the majority of the “cool” EF tasks. Compared to the control group, the ADHD symptoms group and the RD group both showed significantly more errors in rapid automatized naming of figures, which evaluates the inhibition component of EF; performance on this task was similar for these groups. Conclusion: We conclude that children with RD have greater impairment in phonological processing and “cool” EF compared to those with ADHD symptoms. Furthermore, deficits in inhibitory control may be shared among children with both conditions.

Resumen Se comparó el número total de palabras producidas, el número de clusters y switches y la media del tamaño de clusters en fluencia verbal con criterio semántico y ortográfico, y el desempeño entre estas tareas en cada uno de los grupos. Se analizaron correlaciones entre estas variables y datos sociodemográficos. En la muestra hubo 43 adultos con lesión cerebrovascular (11 con lesión en el hemisferio cerebral derecho - LHD, 32 con lesión en el hemisferio cerebral izquierdo -LHE) y 40 adultos neurológicamente saludables. Los resultados principales indicaron un mayor número de palabras producidas, número de clusters y switches en ambas tareas de fluencia verbal en los adultos del grupo control en comparación con el grupo con LHE, pero un rendimiento similar en el grupo con LHD. En la tarea con criterio ortográfico, el grupo con LHD produjo mayor número de palabras, clusters y switches que el grupo con LHE. Los grupos presentaron mejor desempeño en fluencia verbal semántica en comparación con la ortográfica. Análisis cualitativos permitieron identificar procesos cognitivos distintos en fluencia verbal después de lesión cerebrovascular unilateral.

Abstract We compared the total number of words generated, the raw number of clusters and switches and mean cluster size in verbal fluency with semantic and phonemic criteria, and the performance between these tasks in each group. We analyzed the correlations between these variables and sociodemographic data. The sample consisted of 43 adults after stroke (11 with right cerebral hemi-sphere lesion - RHL; 32 with left cerebral hemisphere lesion - LHL) and 40 neurologically healthy adults. The main results indicated better performance on the total number of words and the raw number of clusters and switches in both verbal fluency tasks of healthy adults compared to LHL, but similar performance to RHL. In the task with phonemic criteria, the RHL group had a higher total number of words, number of clusters and switches than LHE. The groups presented a better performance in semantic verbal fluency than phonemic verbal fluency. Qualitative analysis identified cognitive processes underlying the total number of words evoked in verbal fluency after unilateral stroke.

Resumo Comparou-se o número total de palavras evocadas, número de clusters e de switches e média do tamanho de clusters em fluência verbal com critério semântico e ortográfico, e o desempenho entre essas tarefas em cada grupo. Analisaram-se correlações entre essas variáveis e dados sociodemográficos. Participaram 43 adultos após lesão cerebrovascular (11 com lesão no hemisfério cerebral direito - LHD; 32 com lesão no hemisfério cerebral esquerdo - LHE) e 40 adultos neurologicamente saudáveis. Os principais resultados indicaram maior número de palavras evocadas e número de clusters e de switches em ambas tarefas de fluência verbal dos indivíduos saudáveis em relação ao grupo com LHE, mas desempenho similar ao grupo com LHD. Na tarefa com critério ortográfico, o grupo com LHD evocou maior número de palavras, de clusters e de switches do que o grupo com LHE. Os grupos apresentaram melhor desempenho em fluência verbal semântica, em relação à ortográfica. Análises qualitativas permitiram identificar processos cognitivos distintos em fluência verbal após lesão cerebrovascular unilateral.

RESUMO. Instrumentos de triagem são ideias no contexto clínico hospitalar, uma vez que são fáceis de administrar, rápidos, tem baixo custo e são sensíveis para amostras específicas. Portanto, há a necessidade de se verificar as propriedades psicométricas de instrumentos de triagem para pacientes pós acidente vascular cerebral. Objetivo: Este estudo investigou as propriedades psicométricas (procedimentos metodológicos) de triagens cognitivas para pacientes com doenças cerebrovasculares. Métodos: Foi realizada uma revisão sistemática de artigos publicados em PsycINFO, Web of Knowledge, PubMed e Science Direct (2005 a 2016). Apenas 55 artigos permaneceram após a aplicação dos critérios de exclusão. Resultados: As amostras variaram de 20 a 657 pacientes; a maioria dos artigos avaliou indivíduos idosos, com quatro a 13 anos de educação, que sofreram AVC isquêmico e hemorrágico. Houve uma tendência para encontrar evidências de validade relacionadas ao critério e analisar a sensibilidade/especificidade dos instrumentos. Embora os estudos frequentemente apliquem o Mini Exame do Estado Mental (MMSE) e o Montreal Cognitive Assessment (MoCA) para buscar evidências de validade e de fidedignidade, o uso desses instrumentos em pacientes com AVC é criticado por razões relacionadas às suas propriedades psicométricas e funções neuropsicológicas avaliadas. Conclusão: Embora não exista uma triagem padrão-ouro para avaliação de adultos pós-AVC, os instrumentos construídos especificamente para esta população mostraram-se promissores. Este estudo de revisão contribui tanto aos pesquisadores quanto aos clínicos que desejam selecionar o rastreio mais apropriado para identificar comprometimento cognitivo em adultos pós-AVC.

ABSTRACT. Screening instruments are ideal for acute clinical settings because they are easy to apply, fast, inexpensive and sensitive for specific samples. However, there is a need to verify the psychometric properties of screening in stroke patients. Objective: This study investigated the psychometric properties (methodological procedures) of cognitive screening for patients with cerebrovascular diseases. Methods: A systematic review of papers published on PsycINFO, Web of Knowledge, PubMed and Science Direct (2005 to 2016) was performed. Results: A total of 55 articles remained after applying exclusion criteria. The samples ranged from 20 to 657 patients. Most articles evaluated elderly individuals with four to 13 years of education who had experienced ischemic or hemorrhagic stroke. There was a tendency to find evidence of validity for criteria and to analyze the sensitivity/specificity of the instruments. Although the studies frequently used the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to seek evidence of validity and reliability, the use of these instruments among stroke patients has been criticized due to their psychometric properties and the neuropsychological functions evaluated. Conclusion: Although there is no gold standard screen for assessing adults post-stroke, instruments devised specifically for this population have shown promise. This review helps both researchers and clinicians to select the most appropriate screen for identifying cognitive impairment in adults post-stroke.

Resumo Objetivo: Este estudo objetivou avaliar crianças e adolescentes com transtornos de ansiedade leve e moderada nas funções neuropsicológicas de atenção, memória episódica verbal, memória de trabalho, habilidades visuoconstrutivas, funções executivas e cognição global, comparando o seu desempenho ao de crianças com desenvolvimento típico. Métodos: Participaram do estudo 68 crianças e adolescentes com idade de 10 a 17 anos (41 com diagnósticos clínicos atuais de transtornos de ansiedade e 27 controles), selecionados de uma amostra transversal mais ampla de adolescentes da comunidade. Os adolescentes com diagnóstico foram divididos ainda em dois grupos com base na gravidade dos transtornos (leve ou moderado). Todos os participantes realizaram uma avaliação neuropsicológica individual das funções de atenção, memória episódica verbal, memória de trabalho, habilidades visuoconstrutivas, funções executivas e cognição global. Resultados: Nenhum dos testes neuropsicológicas demonstrou diferenças significativas, sendo a única exceção a tarefa de span de dígitos ordem inversa, na qual o grupo com ansiedade leve apresentou desempenho superior ao do grupo com ansiedade moderada e também ao dos controles (p = 0.041; η2 = 0.11). Conclusão: Os resultados sugerem que não só os transtornos de ansiedade podem preservar as principais funções cognitivas durante a adolescência, mas que podem até melhorar certos processos de memória de trabalho.

Abstract Objective: The aim of the present study was to assess children and adolescents with mild and severe anxiety disorders for their performance in attention, verbal episodic memory, working memory, visuoconstructive skills, executive functions, and cognitive global functioning and conduct comparative analyses with the performance of children free from anxiety disorders. Methods: Our sample comprised 68 children and adolescents aged 10 to 17 years (41 with current diagnoses of anxiety disorders and 27 controls) selected from a larger cross-sectional community sample of adolescents. Children and adolescents with anxiety disorders were categorized into two groups on the basis of anxiety severity (mild or severe). All participants underwent a neuropsychological assessment battery to evaluate attention, verbal episodic memory, working memory, visuoconstructive skills, and executive and cognitive functions. Results: No differences were found in any neuropsychological tests, with the single exception that the group with mild anxiety had better performance on the Digit Span backward test compared to subjects with severe anxiety and to controls (p = 0.041; η2 = 0.11). Conclusions: Not only might anxiety disorders spare main cognitive functions during adolescence, they may even enhance certain working memory processes.

Resumo Este artigo objetiva apresentar uma adaptação ao português brasileiro dos critérios metodológicos para análises de clustering e switching em tarefas de fluência verbal semântica (FVS) e ortográfica (FVO). São descritas as seis etapas realizadas no processo de adaptação destes critérios, incluindo o processo de extração das variáveis de clustering e switching a partir de dados de amostras de crianças (N=419) e a análise da fidedignidade da concordância entre juízes (N=6). As variáveis avaliadas são número total de palavras evocadas, número de clusters, média do tamanho dos clusters e número de switches. Houve forte associação entre juízes (Coeficientes de Correlação Intraclasse entre 0,95 a 0,99) indicando fidedignidade do método de análise. Este estudo contribui com a avaliação da FVS e FVO para além do escore geral, permitindo investigar os processos cognitivos subjacentes a esta função neuropsicológica.

Abstract The objective of this study was to describe an adaptation to Brazilian Portuguese of the methodological criteria for analysis of clustering and switching in semantic verbal fluency (SVF) and phonemic verbal fluency (PVF) tasks. The adaptation process consisted of six steps, including the selection of the clustering and switching variables based on data from a sample of 419 children and the analysis of inter-rater reliability (six raters). The following variables were scored: the total number of words generated the raw number of clusters, the mean cluster size, and the raw number of switches. There was a significant association between raters (intra-class correlation coefficients between 0.95 and 0.99), showing that the analytical method was reliable. Our study provides an evaluation of SVF and PVF tasks that goes beyond the overall score, making it possible to investigate the cognitive processes underlying this neuropsychological function.

Resumen Este artículo presenta una adaptación para el portugués brasileño de criterios metodológicos de análisis de estrategias de agrupación (clustering y switching) en tareas de fluidez verbal semántica (FVS) y fluidez verbal fonológica (FVF). El proceso de adaptación de estos criterios consiste en seis pasos, incluyendo el proceso de extracción de las variables de clustering y switching de una muestra formada por 419 niños y el análisis de fiabilidad entre seis jueces. Se investigaron las siguientes variables: número total de palabras generadas, número de grupos de palabras (clusters), tamaño medio de los grupos y número de saltos (switches). Hubo una fuerte asociación entre jueces (coeficientes de correlación intraclase entre 0,95 y 0,99), indicando así la fiabilidad del método analítico. Este estudio contribuye a la evaluación de la FVS y FVF más allá de la puntuación global, lo que permite investigar los procesos cognitivos subyacentes a esta función neuropsicológica.