Background/Aims: The aims of this study were to validate the newly developed version of theAddenbrooke's Cognitive Examination (ACE-III) against standardised neuropsychological tests and its predecessor (ACE-R) in early dementia. Methods: A total of 61 patients with dementia (frontotemporal dementia, FTD, n = 33, and Alzheimer's disease, AD, n = 28) and 25 controls were included in the study. Results: ACE-IIIcognitive domains correlated significantly with standardised neuropsychological tests used in the assessment of attention, language, verbal memory and visuospatial function. The ACE-III also compared very favourably with its predecessor, the ACE-R, with similar levels of sensitivity and specificity. Conclusion: The results of this study provide objective validation of the ACE-III as a screening tool for cognitive deficits in FTD and AD.
We aimed to explore the nature of verbal repetition deficits and infer the cognitive systems involved in primary progressive aphasia (PPA) and Alzheimer's disease (AD). A total of 63 patients (13 semantic variant (sv-PPA), 17 nonfluent/agrammatic variant (nfv-PPA), 10 logopenic variant (lv-PPA), 23 AD) and 13 matched healthy controls completed a battery of tests that included naming, word comprehension, digit span, repetition of multisyllabic single words, monosyllabic word span presented under similar and dissimilar phonological conditions, and sentence repetition. All patient groups displayed some level of impairment, however, specific patterns emerged in each variant. Participants with sv-PPA were the least impaired, showing marginal difficulties exclusively for sentence repetition, whereas those with lv-PPA had the worst overall performance. Cases with nfv-PPA showed compromised repetition of multisyllabic and phonologically similar words. The deficit in cases with AD was confined to span tasks. These distinctive patterns of language impairments can assist in the differential diagnosis of PPA variants and point toward the vulnerability of specific cognitive systems in each syndrome.
This study explored how psychologists and psychiatrists working in Australian youth mental health services constructed their professional identity, and whether and how implementing Open Dialogue transformed this. Nine clinicians (psychologists, clinical psychologists and psychiatrists) were interviewed after completing Open Dialogue training. Interviews were subjected to discourse analysis. First, two general pre‐existing discursive professional identity positions were constructed: (i) psychiatrists rhetorically distancing themselves from the medical model as ‘fixers’ of mental illness; and (ii) psychologists and psychiatrists rhetorically embracing their personal identity. Second, participants’ responses about implementing Open Dialogue revealed opportunities and discomforts, including: (i) dialogical approaches offering psychiatrists an alternative identity to ‘fixers’; and (ii) dialogical approaches generating discomfort at the risk of exposing participants’ own vulnerability. Participants’ professional identities comprised contrasting positions.
Practitioner points
Clinicians’ professional identities comprised contrasting positions
Clinicians constructed their professional identities by othering themselves from perceived dominant professional paradigms
Clinicians incorporated dialogical approaches into existing clinical work after being exposed to Open Dialogue
Clinicians identified Open Dialogue as offering opportunities to construct alternative professional identities
Clinicians appeared uncomfortable with dialogical approaches in situations of high risk within risk‐averse settings
Neither the initial neuropsychological assessment nor projected performances can reliably distinguish the totality of bvFTD and AD individuals. Nevertheless, annual rates of progression on cognitive tasks provide valuable information and will potentially help establish the impact of future therapeutic treatments in these dementia syndromes.
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