Hostname: page-component-669899f699-swprf Total loading time: 0 Render date: 2025-04-26T12:34:48.496Z Has data issue: false hasContentIssue false
  • English
  • Français

INECO Frontal Screening: an Instrument to assess Executive Dysfunction in Schizophrenia

Published online by Cambridge University Press:  15 April 2014

Tânia Silva ,
Luís Monteiro  and
Emanuela Lopes
Tânia Silva*
Affiliation:
Instituto Superior de Ciências da Saúde - Norte (Portugal)
Luís Monteiro
Affiliation:
Instituto Superior de Ciências da Saúde - Norte (Portugal)
Emanuela Lopes
Affiliation:
Centro Hospitalar do Alto Ave, E.P.E., (Portugal)
*
*Correspondence concerning this article should be addressed to Tânia S. Silva. Instituto Superior de Ciências da Saúde - Norte. Rua Central de Gandra, 1317. 4585–116. Gandra (Portugal). Phone: +351–224157100/+351–224157102. E-mail: tanya_sylva@live.com.pt
Get access Rights & Permissions [Opens in a new window]

Abstract

Although several brief sensitive screening tools are available to detect executive dysfunction, few have been developed to quickly assess executive functioning. The INECO Frontal Screening (IFS) is a brief tool which has proved be useful for the assessment of the executive functions in patients with dementia. The aim of this study was to explore whether the IFS is as sensitive and specific as the BADS, a battery designed to assess the dysexecutive syndrome, in schizophrenia. Our sample comprised a group of 34 schizophrenic patients (Mean age = 39.59, DP = 10.697) and 31 healthy controls (Mean age = 35.52, DP = 10.211). To all groups were administered the BADS, Wisconsin Card Sorting Test and IFS. The results suggest that schizophrenic patients performed significantly worse than the control group in all tests (p < .05). The IFS total score was 13.29 for the experimental group and 26.21 for the control group (p < .001). Considering a cut-off of 14 points, the IFS sensitivity was 100% and specificity 56% in detection of executive dysfunction in schizophrenia, compared with the BADS, that if we consider a cut-off of 11 points, was a sensitivity of 100% and a specificity of 50%. Thus, IFS is a brief, sensitive and specific tool for the detection of executive dysfunction in schizophrenia.

Keywords

schizophrenianeuropsychologyexecutive dysfunctionINECO frontal screening
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 17 , 2014 , E19
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Baddeley, A. D. (1986). Working memory. Oxford, UK: Clarendon Press.Google ScholarPubMed
Báez, S., Gleichgerrcht, E., Urquina, H., Lischinsky, A., Roca, M., Manes, F., & Torralva, T. (2011, May). Utility of the INECO Frontal Screening (IFS) for the detection of executive dysfunction in patients with adult ADHD and bipolar disorder. Paper presented at the Third International Congress on ADHD: From Childhood to Adult Disease. Berlin, Germany.Google Scholar
Barbosa, M., & Monteiro, L. (2008). Recurrent criminal behavior and executive dysfunction. The Spanish Journal of Psychology, 11, 259–265.Google Scholar
Burgess, P. W., & Shallice, T. (1996). Bizarre responses, rule detection and frontal lobe lesions. Cortex, 32, 241–259. http://dx.doi.org/10.1016/S0010-9452(96)80049-9 CrossRefGoogle ScholarPubMed
Caldeira, M. J. (2011). Adaptation and validation of INECO Frontal Screening (Master’s Thesis). Instituto Superior de Ciências da Saúde – Norte: Gandra, Portugal.Google Scholar
Carter, C. S., Barch, D. M., Bullmore, E., Breiling, J., Buchanan, R. W., Butler, P., … Wykes, T. (2011). Cognitive neuroscience treatment research to improve cognition in schizophrenia II: Developing imaging biomarkers to enhance treatment development for schizophrenia and related disorders. Biological Psychiatry, 70, 7–12. http://dx.doi.org/10.1016/j.biopsych.2011.01.041 Google Scholar
Chan, R. C., Chen, E. Y., & Law, C. W. (2006). Specific executive dysfunction in patients with first-episode medication-naïve schizophrenia. Schizophrenia Research, 82, 51–64. http://dx.doi.org/10.1016/j.schres.2005.09.020 Google Scholar
Clark, L., & Manes, F. (2004). Social and emotional decision-making following frontal lobe injury. Neurocase, 10, 398–403. http://dx.doi.org/10.1080/13554790490882799 Google Scholar
Clark, L., Manes, F., Antoun, N., Sahakian, B. J., & Robbins, T. W. (2003). The contributions of lesion laterality and lesion volume to decision-making impairment following frontal lobe damage. Neuropsychologia, 41, 1474–1183. http://dx.doi.org/10.1016/S0028-3932(03)00081-2 Google Scholar
Cornblatt, B. A., Lenzenweger, M. F., Dworkin, R. H., & Erlenmeyer-Kimling, L. (1992). Childhood attentional dysfunction predicts social isolation in adults at risk for schizophrenia. The British Journal of Psychiatry, 161, 59–68.Google Scholar
Crawford, J. (1998). Introduction to the assessment of attention and executive function. Journal of Neuropsychological Rehabilitation, 8, 209–211. http://dx.doi.org/10.1080/713755574 Google Scholar
Damasio, A. R. (1995). Toward a neurobiology of emotion and feeling: Operational concepts and hypotheses. The Neuroscientist, 1, 19–25. http://dx.doi.org/10.1177/107385849500100104 Google Scholar
Davidson, M., Reichenberg, A., Rabinowitz, J., Weiser, M., Kaplan, Z., & Mark, M. (1999). Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. The American Journal of Psychiatry, 156, 1328–1335.Google Scholar
Eisenberg, D. P., & Berman, K. F. (2010). Executive function, neural circuitry, and genetic mechanisms in schizophrenia. Neuropsychopharmacology, 35, 258–277. http://dx.doi.org/10.1038/npp.2009.111 Google Scholar
Eslinger, P. J., & Grattan, L. M. (1993). Frontal lobe and frontal-striatal substrates for different forms of human cognitive flexibility. Neuropsychologia, 31, 17–28. http://dx.doi.org/10.1016/0028-3932(93)90077-D Google Scholar
Ettlin, T., & Kischka, U. (1999). Bedside frontal lobe testing. The “frontal lobe score”. In Miller, B. L., & Cummings, J. L. (Eds.), The human frontal lobes. New York, NY: The Guilford Press.Google Scholar
Evans, J. J., Chua, S. E., McKenna, P. J., & Wilson, B. A. (1997). Assessment of the dysexecutive syndrome in schizophrenia. Psychological Medicine, 27, 635–646. http://dx.doi.org/10.1017/S0033291797004790 Google Scholar
Everett, J., Lavoie, K., Gagnon, J., & Gosselin, N. (2001). Performance of patients with schizophrenia on the Wisconsin Card Sorting Test (WCST). Journal of Psychiatry and Neuroscience, 26, 123–130.Google ScholarPubMed
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. http://dx.doi.org/10.1016/0022-3956(75)90026-6 CrossRefGoogle Scholar
Freedman, D., & Brown, A. (2011). The developmental course of executive functioning in schizophrenia. International Journal of Developmental Neuroscience, 23 , 237–243. http://dx.doi.org/10.1016/j.ijdevneu.2010.11.003 Google Scholar
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). BRIEF: Behavior rating inventory of executive function professional manual. Lutz, FL: PAR.Google Scholar
Goldberg, T. E., David, A., & Gold, J. M. (2003). Neurocognitive deficits in schizophrenia. In Hirsch, S. R., & Weinberger, D. R. (Eds.), Schizophrenia (pp. 168–184). Oxford, UK: Blackwell Science.Google Scholar
Goldman-Rakic, P. S. (1994). Working memory dysfunction in schizophrenia. The Journal of Neuropsychiatry and Clinical Neurosciences, 6, 348–357.Google Scholar
Graham, S., Phua, E., Soon, C. S., Oh, T., Au, C., Shuter, B., … Yeh, , I. B. (2009). Role of medial cortical, hippocampal and striatal interactions during cognitive set-shifting. NeuroImage, 45, 1359–1367. http://dx.doi.org/10.1016/j.neuroimage.2008.12.040 Google Scholar
Green, M. F., Kern, R. S., & Heaton, R. K. (2004). Longitudinal studies of cognition and functional outcome in schizophrenia: Implications for MATRICS. Schizophrenia Research, 72, 41–51. http://dx.doi.org/10.1016/j.schres.2004.09.009 Google Scholar
Greve, K. W., Stickle, T. R., Love, J. M., Bianchini, K. J., & Stanford, M. S. (2005). Latent structure of the Wisconsin Card Sorting Test: A confirmatory factor analytic study. Archives of Clinical Neuropsychology, 20, 355–364. http://dx.doi.org/10.1016/j.acn.2004.09.004 CrossRefGoogle ScholarPubMed
Groth-Marnat, G. (2000). Neuropsychological assessment in clinical practice: A guide to test interpretation and integration. Hoboken, NJ: Wiley.Google Scholar
Heinrichs, R. W., & Zakzanis, K. K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12, 426–445. http://dx.doi.org/10.1037//0894-4105.12.3.426 CrossRefGoogle ScholarPubMed
Ihara, H., Berrios, G. E., & McKenna, P. J. (2000). Dysexecutive syndrome in schizophrenia: A cross-cultural comparison between Japanese and British patients. Behavioral Neurology, 12, 209–220.Google Scholar
Jansma, J. M., Ramsey, N. F., van der Wee, N., & Kahn, R. S. (2004).Working memory capacity in schizophrenia: A parametric fMRI study. Schizophrenia Research, 68, 159–171. http://dx.doi.org/10.1016/S0920-9964(03)00127-0 Google Scholar
Jonides, J., Schumacher, E. H., Smith, E. E., Koeppe, R. A., Awh, E., Reuter-Lorenz, P. A., … Willis, , , C. (1998). The role of parietal cortex in verbal working memory. The Journal of Neuroscience, 18, 5026–5034.Google Scholar
Keefe, R., Goldberg, T. E., Harvey, P. D., Gold, J. M., Poe, M. P., & Coughenour, L. (2004). The brief assessment of cognition in schizophrenia: Reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophrenia Research, 68, 283–297. http://dx.doi.org/10.1016/j.schres.2003.09.011 Google Scholar
Kerns, J. G., Nuechterlein, K. H., Braver, T. , S., & Barch, D. M. (2008). Executive functioning component mechanisms and schizophrenia. Biological Psychiatry, 64, 26–33. http://dx.doi.org/10.1016/j.biopsych.2008.04.027 Google Scholar
Koren, D., Seidman, L. J., Harrison, R. H., Lyons, M. J., Kremem, W. S., Caplan, B., … Tsuang, , M. T. (1998). Factor structure of the Wisconsin Card Sorting Test: Dimensions of deficit in schizophrenia. Neuropsychology, 12, 289–302. http://dx.doi.org/10.1037//0894-4105.12.2.289 Google Scholar
Krabbendam, L., Vugt, E., Derix, M., & Jolles, J. (1999). The Behavioral Assessment of the Dysexecutive Syndrome as a tool to assess executive functions in Schizophrenia. The Clinical Neuropsychologist, 13, 370–375. http://dx.doi.org/10.1076/clin.13.3.370.1739 Google Scholar
Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment (4 th Ed.). New York, NY: Oxford University Press.Google Scholar
Liddle, P. F., & Morris, D. L. (1991). Schizophrenic symptoms and frontal lobe performance. The British Journal of Psychiatry, 158, 340–345. http://dx.doi.org/10.1192/bjp.158.3.340 CrossRefGoogle ScholarPubMed
Manes, F., Sahakian, B., Clark, L., Rogers, R., Antoun, N., Aitken, M., & Robbins, T. (2002). Decision-making processes following damage to the prefrontal cortex. Brain, 125, 624–639. http://dx.doi.org/10.1093/brain/awf049 Google Scholar
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latency variable analysis. Cognitive Psychology, 41, 49–100. http://dx.doi.org/10.1006/cogp.1999.0734 CrossRefGoogle Scholar
Norman, D. A., & Shallice, T. (1986). Attention to action: Willed and automatic control of behavior. In Davidson, R. I., Schwartz, G. E., & Shapiro, D. (Eds.), Consciousness and self−regulation: Advances in research and theory. New York, NY: Plenum Press.Google Scholar
Norris, G., & Tate, R. (2000). The Behavioral Assessment of the Dysexecutive Syndrome (BADS): Ecological, concurrent and construct validity. Neuropsychological Rehabilitation, 10, 33–45. http://dx.doi.org/10.1080/096020100389282 Google Scholar
Palmer, B. W., & Heaton, R. K. (2000). Executive dysfunction in schizophrenia. In Sharma, T. & Harvey, P. D. (Eds.), Cognition in schizophrenia: Impairments, importance and treatment strategies (pp. 51–72). New York, NY: Oxford University Press.CrossRefGoogle Scholar
Palmer, C., Heiby, E., Fujii, D., & Kameoka, V. (2008). Executive functioning in schizophrenia: The contributions of attention, working memory, processing speed, and general intelligence. Graduate Student Journal of Psychology, 10, 38–45.Google Scholar
Reeder, C., Newton, E., Frangou, S., & Wykes, T. (2004). Which executive skills should we target to affect social functioning and symptom change? A study of a cognitive remediation therapy program. Schizophrenia Bulletin, 30, 87–100. http://dx.doi.org/10.1093/oxfordjournals.schbul.a007070 Google Scholar
Rothlind, J. C., & Brandt, J. (1993). A brief assessment of frontal and subcortical functions in dementia. Journal of Neuropsychiatry and Clinical Neurosciences, 5, 73–77.Google Scholar
Royall, D. R., Mahurin, R. K., & Gray, K. F. (1992). Bedside assessment of executive cognitive impairment: The executive interview. Journal of American Geriatrics Society, 40, 1221–1226.Google Scholar
Shallice, T. (1988). From neuropsychology to mental structure. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Shallice, T., & Burgess, P. W. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727–741. http://dx.doi.org/10.1093/brain/114.2.727 Google Scholar
Snitz, B. E., Macdonald, A. W., & Carter, C. S. (2006). Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: A meta-analytic review of putative endophenotypes. Schizophrenia Bulletin, 32, 179–194. http://dx.doi.org/10.1093/schbul/sbi048 Google Scholar
Strauss, E., Sherman, E., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms and commentary. (3 rd Ed.). Oxford, UK: Oxford University Press.Google Scholar
Stuss, D. T., Alexander, M. P., Shallice, T., Picton, T. W., Binns, M. A., Macdonald, R., … Katz, D. I. (2005). Multiple frontal systems controlling response speed. Neuropsychologia, 43, 396–417. http://dx.doi.org/10.1016/j.neuropsychologia.2004.06.010 Google Scholar
Stuss, D. T., & Benson, D. F. (1986). The frontal lobes. New York, NY: Raven Press.Google Scholar
Szöke, A., Schurhoff, F., Mathieu, F., Meart, A., Ionescu, S., & Lebover, M. (2005). Tests of executive functions in first-degree relatives of schizophrenic patients: A meta-analysis. Psychological Medicine, 35, 771–782. http://dx.doi.org/10.1017/S0033291704003460 Google Scholar
Tanibuchi, I., & Goldman-Rakic, P. S. (2003). Dissociation of spatial-, object-, and sound-coding neurons in the mediodorsal nucleus of the primate thalamus. Journal of Neurophysiology, 89, 1067–1077. http://dx.doi.org/10.1152/jn.00207.2002 Google Scholar
Torralva, T., Kipps, C. M., Hodges, J. R., Clark, L., Bekinschtein, T., Roca, M., … Manes, , , F. (2007). The relationship between affective decision-making and theory of mind in the frontal variant of frontotemporaldementia. Neuropsychologia, 45, 342–349. http://dx.doi.org/10.1016/j.neuropsychologia.2006.05.031 Google Scholar
Torralva, T., Roca, M., Gleichgerrcht, E., López, P., & Manes, F. (2009). INECO Frontal Screening (IFS): A brief, sensitive, and specific tool to assess executive functions in dementia. Journal of the International Neuropsychological Society, 15, 777–786. http://dx.doi.org/10.1017/S1355617709990415 Google Scholar
Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H. E., & Evans, J. J., (1996). Behavioral assessment of the dysexecutive syndrome. Suffolk, UK: Thames Valley Test Company.Google Scholar
Wilson, B. A., Evans, J. J., Emslie, H., Alderman, N., & Burgess, P. (1998). The development of an ecologically valid test for assessing patients with a dysexecutive syndrome. Neuropsychological Rehabilitation, 8, 213–228. http://dx.doi.org/10.1080/713755570 Google Scholar