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Few papers have been published concerning the efficacy of community-based memory and dementia screening programs. This article examines the descriptive, clinical, and outcome characteristics of participants attending the Memory Screening Outreach Program (MSOP). The program provided free screenings of participants' short-term memory processes, neurocognitive complaints, and depressive and psychiatric symptomatology. Screening results were subsequently forwarded to participants and their designated healthcare providers (HCPs), and approximately 8 weeks later, participants who received follow-up recommendations were mailed a survey assessing screening-related outcomes. One thousand community-based persons aged 44 to 91 participated in the program at 16 screening sites. Results indicated that 44.3% of the MSOP participants received follow-up recommendations secondary to age-inappropriate memory impairments, depressive or psychiatric symptomatology, significant neurocognitive complaints, need for respite, or a combination thereof. Memory impairments and depressive or psychiatric symptomatology contributed, at least in part, to the recommendations of 24.0% and 30.9% of the sample, respectively. The prevalence of impaired Wechsler Memory Scale-III subtest performances ranged from 20.5% to 5.4%, and 28.7% of the participants exhibited elevated depression inventory scores. Of the participants who returned follow-up surveys, 49.5% visited their primary HCPs regarding their screening results; of the participants who had not followed up, 36.8% indicated plans to do so. Of the participants who followed up, contributing conditions and diagnoses were identified in 50.9%, medication or supplement recommendations or regimen changes were provided to 47.1%, and 17.0% were referred to healthcare specialists. Overall, the MSOP proved efficacious in identifying age-inappropriate memory impairments, notable depressive and psychiatric symptomatology, and significant neurocognitive complaints in an appreciable portion of a large, community-based, sample of middle-aged and older adults, which, in turn, contributed to the identification and treatment of a diversity of conditions at follow-up.

There has been a relative absence of studies that have examined the neuropsychological profiles of potential lung transplant candidates. Neuropsychological data are presented for 134 patients with end-stage pulmonary disease who were being evaluated as potential candidates for lung transplantation. Neuropsychological test results indicated that a significantly greater proportion of the patients exhibited impaired performances on a number of Selective Reminding Test (SRT) tasks as compared to the expected population frequency distributions for these measures. The highest frequencies of impairment were observed on the SRT’s Immediate Free Recall (46.43%), Long-term Retrieval (41.67%), and Consistent Long-term Retrieval (51.19%) variables. On the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)/Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A), patients’ mean clinical profile revealed elevations on Scales 1 (Hypochondriasis) and 3 (Conversion Hysteria). This profile indicated that they were experiencing an array of symptomatology ranging from somatic complaints to lethargy and fatigue, and that they may have been functioning at a reduced level of efficiency. Findings are discussed in light of patients’ end-stage pulmonary disease and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also provided.

There appears to be a relative absence of studies that have examined the prevalence of cognitively intact individuals who reside in extended care facilities. Prevalence data were collected on 296 persons who resided in 3 extended care nursing facilities in Central Virginia. Cognitive intactness was evaluated via the Minimum Data Set Cognitive Performance Scale (CPS) and an author-generated survey (i.e., Cognitively Intact Survey [CI Survey]) of select nursing staff members at each facility. The Mini-Mental State Examination (MMSE) was utilized to examine the accuracy of the two measures in identifying cognitive intactness. Findings indicated that prevalence rates of cognitively intact residents varied as a function of the measures utilized to assess intactness. Specifically, a significantly greater proportion of the total sample of residents was judged to be cognitively intact via the CI Survey (34.12%) as compared to the CPS (26.01%). The level of interjudge agreement between the two measures was found to be moderately high (K = 0.68). When the MMSE was employed to verify individuals' levels of intactness, the percentages of residents predicted to actually be cognitively intact were somewhat lower for each measure. Specifically, based on the data obtained via the CI Survey, 22.75% of the total sample were predicted to actually be cognitively intact, whereas 17.85% of the sample were predicted to be intact based on the CPS results. Findings are discussed in light of factors that may have contributed to the differential prevalence rates of cognitively intact individuals obtained across the measures utilized in this study. Concerns regarding the utilization of the MMSE as a criterion measure of cognitive intactness in persons residing in extended care nursing facilities are provided, along with data on the living environments/roommate statuses of those residents judged to be intact via the CI Survey. Implications for the design of future extended care nursing units, as well as future research, are also included.

Although there have been past literature reviews which have addressed the psychological adjustment, consequences, and impact/reaction to spinal cord injury, as well as reviews of depression after spinal cord injury, there appears to be an absence of reviews which have focused primarily on the relationship between spinal cord injury and anxiety. The purpose of this paper is to present a comprehensive review of the relatively recent (the past 23-31 years depending on the database utilized) scientific literature as it pertains to anxiety reactions in spinal cord injured individuals. Specifically, this paper provides reviews of the prevalence/presence of anxiety reactions, as well as the correlates of anxiety, in the spinal cord injured population. Furthermore, this paper reviews the relatively few articles which have addressed the treatment of such symptomatology in spinal cord injured individuals. Methodological concerns and limitations of the existing literature and directions for future research are also provided.

To date, there has been a relative absence of studies which have examined the utility and effectiveness of sensory stimulation procedures in comatose, spinal-cord-injured patients. This report describes the interdisciplinary utilization (within an acute care setting) of a comprehensive sensory stimulation programme with a 21-year-old, comatose, tetraplegic male patient. To promote behavioural arousal, multiple sensory stimulation sessions were conducted with the patient daily. Within each session (and across sensory modalities), the effectiveness of sensory stimulation procedures was evaluated via use of A-B-A within-subject designs. Results indicated that the patient exhibited significantly greater behavioural arousal during sensory stimulation (B1), as compared to pre-(A1) and post-(A2) treatment baselines. There was also a non-significant trend of increased behavioural arousal during the post- as compared to the pre-treatment baselines (i.e. carry-over effect). By termination of this programme, the patient exhibited an overall increased level of arousal/behavioural responsiveness (i.e. decreased coma) as compared to his level at the initiation of this programme. These findings are discussed in light of factors that may affect the effectiveness and implementation of such sensory stimulation programmes with comatose, tetraplegic patients in acute care settings.

Few studies have examined the neuropsychological sequelae associated with end-stage pulmonary disease. Neuropsychological data are presented for 47 patients with end-stage chronic obstructive pulmonary disease (COPD) who were being evaluated as potential candidates for lung transplantation. Although patients exhibited a diversity of neurocognitive deficits, their highest frequencies of impairment were found on the Selective Reminding Test (SRT). Specifically, over 50% of the patients completing the SRT exhibited impaired immediate free recall and consistent long-term retrieval deficits, while more than 44% of these individuals displayed deficient long-term retrieval. Deficient SRT long-term storage strategies, cued recall, and delayed recall were exhibited by between 26% and 35% of these patients, while more than 32% of this sample displayed elevated numbers of intrusion errors. Over 31% of the patients completing the Wisconsin Card Sorting Test (WCST) failed to achieve the expected number of categories on this measure, while more than 23% of these individuals demonstrated elevated numbers of perseverative errors and total errors. Clinically notable frequencies of impairment (greater than 20% of the sample) were also found on the Trail Making Test (TMT): Part B and the Wechsler Memory Scale-R (WMS-R) Visual Reproduction II subtest. Minnesota Multiphasic Personality Inventory-2 (MMPI-2) personality assessments indicated that patients were experiencing a diversity of somatic complaints and that they may have been functioning at a reduced level of efficiency. These findings are discussed in light of patients' end-stage COPD and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also included.

Few investigations have examined the effectiveness of Ginkgo biloba extract for enhancing cognitive abilities in individuals with no history of significant neurocognitive dysfunction. The purpose of this research was to examine the relatively short-term (i.e., 6 weeks) efficacy of Ginkgo biloba extract EGb 761 on the cognitive functioning of cognitively intact persons over the age of 55 years via a diverse battery of neuropsychologic tests and measures.From the 48 cognitively intact participants between the ages of 55 and 86 years who initially enrolled in this study, 21 males and 19 females successfully completed the study's protocol and provided valid data sets.A 6-week, double-blind, fixed-dose, placebo-controlled, parallel-group experimental design was utilized. Participants were randomly assigned to either a Ginkgo biloba extract EGb 761 (180 mg/d) or placebo control group. To evaluate participants' cognitive and behavioral functioning, series of neuropsychological tests were administered to them prior to the initiation of the Ginkgo biloba extract/placebo therapy (i.e., pretreatment baseline) and again, just prior to the termination of the treatment regimen (i.e., after 6 weeks).Participants who received 180 mg of Ginkgo biloba extract EGb 761 daily for 6 weeks exhibited significantly more improvement on a task assessing speed of processing abilities (i.e., Stroop Color and Word Test color-naming task) by the end of treatment as compared to participants who received placebo. Trends favoring improved performances in the Ginkgo biloba group were also demonstrated in three of the four remaining tasks that involved a timed, speed of processing component, although they did not reach statistical significance. Furthermore, a significant relationship was found between the type of treatment (Ginkgo biloba extract or placebo) and participants' ratings of their overall abilities to remember. Specifically, more participants in the Ginkgo biloba extract group rated their overall abilities to remember by the end of treatment as "improved," as compared to the placebo group. In contrast, no significant differences were found between the Ginkgo biloba and placebo groups by treatment end on any of the four objective memory measures.Taken together, the findings from standardized neuropsychologic assessment and a subjective, self-report questionnaire suggested that relatively short-term (i.e., 6 weeks) utilization of Ginkgo biloba extract EGb 761 may prove efficacious in enhancing certain neurocognitive functions/processes of cognitively intact older adults.

There has been a relative absence of studies that examine the neuropsychological profiles of patients suffering from cystic fibrosis. Data are presented here for 18 individuals with end-stage cystic fibrosis who were also potential candidates for lung transplantation. Neuropsychological test results indicated a diversity of memory and executive control deficits, the most frequent of which were immediate and delayed free recall and retrieval impairments on a memory measure involving noncontextual verbal material. The majority of this sample of patients suffering from cystic fibrosis also exhibited clinically significant elevations on the Minnesota Multiphasic Personality Inventory-2 and Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-2/MMPI-A), which are suggestive of heightened levels of psychological distress (e.g., depressive symptomatology) and multiple somatic complaints. These findings are discussed in light of factors associated with end-stage cystic fibrosis. Implications for clinical practice and future research are also provided.

Psychologists are increasingly asked to make decisions regarding patient candidacy for transplantation. Despite the growing incidence of lung transplantation, normative research regarding cognitive functioning and end-stage obstructive lung disease is lacking. Hence, data are presented on 100 consecutively referred candidates for lung transplantation. The group data suggest essentially normal functioning on most cognitive tests for the majority of transplant candidates. Exceptions were seen on measures of attentional set shifting and short-term visual memory, which were impaired in nearly one fourth of this population. Additionally, one half of the patients displayed deficient performance on the Buschke Selective Reminding Test, with subjects at greater risk for severe rather than mild deficits. Unlike prior research, our group data suggest that there is potential risk of short-term noncontextual verbal memory difficulties because of end-stage pulmonary disease. Personality testing data, e.g., elevations on MMPI-2 scales measuring depression and anxiety, are also discussed.

Longitudinal follow-ups of the cessation of long-term Naltrexone administration (1 year of drug therapy) were conducted with a young woman (in her early 30s) with profound mental retardation who had previously displayed dramatic decreases in her self-injurious behaviors (SIB) both during, and for a period of at least 6 months following termination of drug treatment. After 2 and 4 years, post-Naltrexone therapy, the subject continued to exhibit near-zero rates of SIB episodes despite significant turnovers in her direct care staff by the 2-year follow-up, and changes in her physical/living environment and fellow residents by 4-year follow-up. These findings provide further support to the idea that long-term Naltrexone administration may result in highly durable reductions in SIB long after treatment ends and argue against certain aspects of the subject’s environment affecting her rates of SIB significantly. These results are discussed in light of the endogenous opiate system theories of SIB. A functional analysis and discussion of the effectiveness of behavioral treatments for her few remaining SIB episodes are also provided.

There has been a relative absence of studies that have examined comprehensively the neuropsychological profiles of females with Triple X Syndrome across a battery of tests and measures. A case is reported of a 9 1/2-year-old female with Triple X Syndrome whose neuropsychological test results were suggestive of greater right- versus left-cerebral hemisphere dysfunction. Overall, the patient's neuropsychological profile was indicative of the syndrome of Nonverbal Learning Disabilities (NLD) as proposed by Rourke (Rourke 1987, 1988, 1995; Rourke & Tsatsanis, 1996). The results are discussed in light of Rourke's NLD Syndrome and the related white matter model.

There is a relative absence of studies which longitudinally examine the neuropsychological correlates of bilateral thalamic infarctions across a range of tests purported to be sensitive to the executive functions and memory. A case is reported of a patient with bilateral paramedian thalamic infarctions who, upon repeated neuropsychological examinations, exhibited performances indicative of impaired executive functions and memory. The neuropsychological findings corresponded with the patient's computerized tomograph (CT) and magnetic resonance imaging (MRI) results which confirmed the presence of paramedian thalamic hypodensities that were greater on the left than on the right side. The longitudinal findings indicated that the patient's neurocognitive impairments were relatively chronic and long-standing. Possible anatomical mechanisms that may be responsible for these results are discussed.

To date, there appear to be only nine published studies in the scientific literature that have examined the effects of cocoa- and chocolate-related products on neurocognitive functioning. The majority (i.e., seven of nine) of the published studies that have examined the effects of cocoa- and chocolate-related products on neurocognitive processes have found that the compounds are associated with significantly improved and/or preserved aspects of cognitive functioning. Increasing evidence suggests that dietary flavonoids and methylxanthines, such as those commonly found in cocoa and chocolate products, may possess neuroprotective, neuroenhancing, and neurostimulating effects.

Twenty-four right-handed subjects (12 men and 12 women), half within each sex classified as with depressed mood and the other half as nondepressed, participated in a tachistoscopic study of the influence of depressive symptomatology on the hemispheric processing of emotional faces (happy, angry, and neutral). Slower emotional processing was found in women with depressed mood than was found in nondepressed women, whereas diametrically opposite effects were seen in men. Cerebral asymmetry was also found as a function of affective valence, with a right-hemisphere advantage for the identification of angry faces. Symmetry was found in the identification of happy faces. Additionally, women with depressed mood more often identified neutral faces as angry, whereas depressive symptomatology reduced the strong negative response bias in men, with increased ambivalence or uncertainty in neutral affect perception. These results are discussed in light of hypothesized differences in cerebral asymmetry with depression and according to sex.

The influence of depression on the cerebral hemispheric motor functioning of 40 right-handed women, half of whom had been classified as depressed, the other half as nondepressed, was examined. The depressed women were also characterized by elevated state and trait anxiety, suggestive of an anxious-depressive state with heightened arousal. A hand dynamometer was used as a standardized measure of hemispheric motor functioning such as hand-grip strength, perseveration, and fatigue. Primary findings indicated that depressed women displayed significantly less perseveration at the left hand than did nondepressed women, but a nonsignificant trend only was noted for less perseveration at the right hand. These results suggest possible differential arousal of the left and right cerebral hemispheres in this sample of anxious-depressed women and are discussed in terms of arousal theory.

We behaviorally evaluated the hypothesis that pica in some individuals with mental retardation may be maintained or exacerbated by the use of neuroleptics. Three older adolescents, with profound me...

A posthumous biographical profile is presented of John N. Buck, an early clinical psychologist who gained national recognition for his diverse contributions to the field. In addition to developing the House-Tree-Person (H-T-P) Projective Technique and an array of other psychological inventories, he was instrumental in establishing clinical psychology in Virginia. Buck served on the first Examining Board for Certification of Clinical Psychologists in Virginia (and the nation) and was later its chairman. He published his research in peer-reviewed journals and presented guest lectures at respected universities. These professional achievements were quite remarkable in light of the fact that Buck was paraplegic and had no college degree and only scattered formal training in psychology.

Few papers have been published concerning the efficacy of community-based memory and dementia screening programs. This article examines the descriptive, clinical, and outcome characteristics of participants attending the Memory Screening Outreach Program (MSOP). The program provided free screenings of participants' short-term memory processes, neurocognitive complaints, and depressive and psychiatric symptomatology. Screening results were subsequently forwarded to participants and their designated healthcare providers (HCPs), and approximately 8 weeks later, participants who received follow-up recommendations were mailed a survey assessing screening-related outcomes. One thousand community-based persons aged 44 to 91 participated in the program at 16 screening sites. Results indicated that 44.3% of the MSOP participants received follow-up recommendations secondary to age-inappropriate memory impairments, depressive or psychiatric symptomatology, significant neurocognitive complaints, need for respite, or a combination thereof. Memory impairments and depressive or psychiatric symptomatology contributed, at least in part, to the recommendations of 24.0% and 30.9% of the sample, respectively. The prevalence of impaired Wechsler Memory Scale-III subtest performances ranged from 20.5% to 5.4%, and 28.7% of the participants exhibited elevated depression inventory scores. Of the participants who returned follow-up surveys, 49.5% visited their primary HCPs regarding their screening results; of the participants who had not followed up, 36.8% indicated plans to do so. Of the participants who followed up, contributing conditions and diagnoses were identified in 50.9%, medication or supplement recommendations or regimen changes were provided to 47.1%, and 17.0% were referred to healthcare specialists. Overall, the MSOP proved efficacious in identifying age-inappropriate memory impairments, notable depressive and psychiatric symptomatology, and significant neurocognitive complaints in an appreciable portion of a large, community-based, sample of middle-aged and older adults, which, in turn, contributed to the identification and treatment of a diversity of conditions at follow-up.

Background In recent years, there has been increased interest in the potential health-related benefits of antioxidant- and phytochemical-rich dark chocolate and cocoa. Objective The objective of the study was to examine the short-term (6 wk) effects of dark chocolate and cocoa on variables associated with neuropsychological functioning and cardiovascular health in healthy older adults. Design A double-blind, placebo-controlled, fixed-dose, parallel-group clinical trial was used. Participants (n = 101) were randomly assigned to receive a 37-g dark chocolate bar and 8 ounces (237 mL) of an artificially sweetened cocoa beverage or similar placebo products each day for 6 wk. Results No significant group (dark chocolate and cocoa or placebo)-by-trial (baseline, midpoint, and end-of-treatment assessments) interactions were found for the neuropsychological, hematological, or blood pressure variables examined. In contrast, the midpoint and end-of-treatment mean pulse rate assessments in the dark chocolate and cocoa group were significantly higher than those at baseline and significantly higher than the midpoint and end-of-treatment rates in the control group. Results of a follow-up questionnaire item on the treatment products that participants believed they had consumed during the trial showed that more than half of the participants in both groups correctly identified the products that they had ingested during the experiment. Conclusions This investigation failed to support the predicted beneficial effects of short-term dark chocolate and cocoa consumption on any of the neuropsychological or cardiovascular health-related variables included in this research. Consumption of dark chocolate and cocoa was, however, associated with significantly higher pulse rates at 3- and 6-wk treatment assessments.

The aim of this research was to conduct the first known clinical trial of the short-term (i.e., 6 weeks) efficacy of cranberry juice on the neuropsychologic functioning of cognitively intact older adults.Fifty (50) community-dwelling, cognitively intact volunteers,or = 60 years old, who reported no history of dementia or significant neurocognitive impairments, participated in this study.A 6-week, double-blind, placebo-controlled, randomized, parallel-group, clinical trial was utilized. Participants were randomly assigned to receive either 32 ounces/day of a beverage containing 27% cranberry juice per volume (n = 25) or placebo (n = 25) for 6 weeks, and administered a series of neuropsychologic tests at both pretreatment baseline and again after 6 weeks of either cranberry juice or placebo treatment to assess treatment-related changes.Efficacy measures consisted of participants' raw scores on the following standardized neuropsychologic tests: Selective Reminding Test, Wechsler Memory Scale-III Faces I and Faces II subtests, Trail Making Test (Parts A and B), Stroop Color and Word Test, and the Wechsler Adult Intelligence Scale- III Digit Symbol-Coding subtest. A subjective Follow-up Self-report Questionnaire was also administered to participants at the conclusion of the end-of-treatment phase assessments.Two-factor, mixed analyses of variance (ANOVA) revealed no significant group (cranberry juice and placebo) by trial (pretreatment baseline and end-of-treatment assessments) interactions across all of the neuropsychologic tests and measures utilized in this study when a Bonferroni corrected alpha level was used to correct for multiple comparisons (i.e., .05/17 group by trial comparisons = .003). Pearson Chi-Square analyses of the groups' self-reported changes over the 6-week treatment phase in their abilities to remember, thinking processes, moods, energy levels, and overall health on the Follow-up Self-report Questionnaire revealed no significant relationships. However, a nonsignificant trend (X2(1) = 2.373, p = 0.123) was noted for participants' self-reported overall abilities to remember from pretreatment baseline to the end-of-treatment assessment. Specifically, more than twice as many participants in the cranberry group (n = 9, 37.5%) rated their overall abilities to remember by treatment end as "improved" as compared to placebo controls (n = 4, 17.4%).Taken together, no significant interactions were found between the cranberry and placebo groups and their pretreatment baseline and end-of-treatment phase (after 6 weeks) standardized neuropsychologic assessments. A nonsignificant trend was noted, however, on a subjective, self-report questionnaire where twice as many participants in the cranberry group rated their overall abilities to remember by treatment end as "improved" compared to placebo controls.

Hemispheric asymmetry in 14 left- and 14 right-handed persons shown tachistoscopically presented emotional stimuli to left and right visual fields was examined using a forced-choice, reaction-time paradigm in which subjects were asked to identify positive and negative faces. Neutral faces were included within the two-alternative forced-choice paradigm. Reaction time and response-bias measures were recorded. Analysis indicated differential lateralization for left-handed and right-handed subjects with respect to neutral affective stimuli. While right-handed subjects' perceptions of neutral stimuli remained consistent across visual fields, left-handed ones identified neutral stimuli as more positive (happy) when presented to the left visual field and negative (angry) when presented to the right visual field. Implications for differential lateralization patterns among left- and right-handed adults are discussed.

There has been a relative absence of studies that have examined the neuropsychological profiles of potential lung transplant candidates. Neuropsychological data are presented for 134 patients with end-stage pulmonary disease who were being evaluated as potential candidates for lung transplantation. Neuropsychological test results indicated that a significantly greater proportion of the patients exhibited impaired performances on a number of Selective Reminding Test (SRT) tasks as compared to the expected population frequency distributions for these measures. The highest frequencies of impairment were observed on the SRT’s Immediate Free Recall (46.43%), Long-term Retrieval (41.67%), and Consistent Long-term Retrieval (51.19%) variables. On the Minnesota Multiphasic Personality Inventory-2 (MMPI-2)/Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A), patients’ mean clinical profile revealed elevations on Scales 1 (Hypochondriasis) and 3 (Conversion Hysteria). This profile indicated that they were experiencing an array of symptomatology ranging from somatic complaints to lethargy and fatigue, and that they may have been functioning at a reduced level of efficiency. Findings are discussed in light of patients’ end-stage pulmonary disease and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also provided.

There appears to be an absence of large-scaled clinical trials that have examined the efficacy of Ginkgo biloba extract on the neuropsychological functioning of cognitively intact older adults. The importance of such clinical research appears paramount in light of the plethora of products containing Ginkgo biloba that are currently being widely marketed to predominantly cognitively intact adults with claims of enhanced cognitive performances. The purpose of this research was to conduct the first known, large-scaled clinical trial of the efficacy of Ginkgo biloba extract (EGb 761) on the neuropsychological functioning of cognitively intact older adults. Two hundred and sixty-two community-dwelling volunteers (both male and female) 60 years of age and older, who reported no history of dementia or significant neurocognitive impairments and obtained Mini-Mental State Examination total scores of at least 26, were examined via a 6-week, randomized, double-blind, fixed-dose, placebo-controlled, parallel-group, clinical trial. Participants were randomly assigned to receive either Ginkgo biloba extract EGb 761(n = 131; 180 mg/day) or placebo (n = 131) for 6 weeks. Efficacy measures consisted of participants' raw change in performance scores from pretreatment baseline to those obtained just prior to termination of treatment on the following standardized neuropsychological measures: Selective Reminding Test (SRT), Wechsler Adult Intelligence Scale-III Block Design (WAIS-III BD) and Digit Symbol-Coding (WAIS-III DS) subtests, and the Wechsler Memory Scale-III Faces I (WMS-III FI) and Faces II (WMS-III FII) subtests. A subjective Follow-up Self-report Questionnaire was also administered to participants just prior to termination of the treatment phase. Analyses of covariance indicated that cognitively intact participants who received 180 mg of EGb 761 daily for 6 weeks exhibited significantly more improvement on SRT tasks involving delayed (30 min) free recall (p < 0.04) and recognition (p < 0.01) of noncontextual, auditory-verbal material, compared with the placebo controls. The EGb 761 group also demonstrated significantly greater improvement on the WMS-III FII subtest assessing delayed (30 min) recognition (p < 0.025) of visual material (i.e. human faces), compared with the placebo group. However, based on the significant difference (p < 0.03) found between the two groups' pretreatment baseline scores on the WMS-III FII, this result should be interpreted with caution. An examination of the participants' subjective ratings of their overall abilities to remember by treatment end on the Follow-up Self-report Questionnaire also revealed that significantly more (p = 0.05) older adults in the EGb 761 group rated their overall abilities to remember by treatment end as 'improved' compared with the placebo controls. Overall, the results from both objective, standardized, neuropsychological tests and a subjective, follow-up self-report questionnaire provided complementary evidence of the potential efficacy of Ginkgo biloba EGb 761 in enhancing certain neuropsychological/memory processes of cognitively intact older adults, 60 years of age and over.

There has been a relative absence of studies that have longitudinally examined the neuropsychological profiles of patients suffering from pineal tumors. A case is reported of an adolescent girl with a pineoblastoma and spinal metastases who received extensive chemotherapy and cranio-spinal irradiation. Neuropsychological assessments conducted approximately 5 months and 2.5 years posttumor diagnosis revealed a diversity of impairments indicative of mild to moderate neuropsychological dysfunction. By the 2nd evaluation (2 years postbaseline) there was evidence of increased neurocognitive impairment suggestive of greater dysfunction of the patient's right, versus left, cerebral hemisphere. Overall, the patient's neuropsychological profile coincided with the Syndrome of Nonverbal Learning Disabilities as proposed by Rourke and his colleagues (Rourke, 1987, 1988, 1995; RourkeTsatsanis, 1996). These findings are discussed in light of the Syndrome of Nonverbal Learning Disabilities (and the related white matter model) and the possible negative impact of the patient's pineal tumor and subsequent chemotherapy and cranio-spinal irradiation on her neuropsychological functioning.

40 right-handed women, half of whom had been classified with depressed mood and the other half as nondepressed, participated in a tachistoscopic study of the influence of depressed mood on the cerebral hemispheric processing of Ekman and Friesen's 1976 happy, sad, and neutral emotional faces using a forced-choice reaction-time paradigm with only happy and sad alternatives as response manipulanda. The women with depressed mood were also characterized by elevated scores on both state and trait anxiety, suggestive of an anxious-depressive state with heightened arousal. Primary findings for the tachistoscopic data indicated that women with depressed mood as compared to nondepressed women displayed significantly faster reaction times to sad faces presented in the right visual field and happy faces presented in the left visual field. These results are suggestive of differential arousal of both the left and right cerebral hemispheres in this sample of anxious-depressed women and are discussed in light of arousal theory.

The cessation of long-term Naltrexone administration was investigated through a double-blind, placebo-controlled, withdrawal design in a 28-year-old, profoundly mentally retarded woman with a history of severe self-injurious behavior (SIB). The subject had previously exhibited a dramatic decrease in SIB subsequent to Naltrexone administration. At the end of 1 year of continuous drug treatment, the subject displayed a near-zero rate of SIB episodes. This near-zero rate continued through placebo and no-drug phases of the study and at 6-month (no-drug) follow-up. This trend suggests not only that Naltrexone may be effective in reducing SIB, but that long-term administration may produce durable results after treatment cessation. Findings are discussed in relation to the endogenous opioid system theories of SIB.

The duration of the orienting response toward the left or right hemispace as a function of bright light and noise levels was evaluated in 6 demented elderly patients. Tentative findings of cerebral asymmetry suggest light may differentially activate the left hemisphere.