Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1,...
-
Upload
francisco-wooley -
Category
Documents
-
view
214 -
download
1
Transcript of Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1,...
![Page 1: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/1.jpg)
Qualitative Assessment of The Writing Sentence Item in The MMSE
I. Biran1, J.P. Newman1, A. Gal1, N. Levin1, G. Friedman2
Departments of Neurology(1) and Geriatrics(2)Hadassah Hebrew University Medical Center
Special Thanks to Dr. Gitit Kave (Tel-Aviv University)
![Page 2: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/2.jpg)
![Page 3: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/3.jpg)
![Page 4: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/4.jpg)
![Page 5: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/5.jpg)
![Page 6: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/6.jpg)
![Page 7: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/7.jpg)
![Page 8: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/8.jpg)
![Page 9: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/9.jpg)
![Page 10: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/10.jpg)
![Page 11: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/11.jpg)
Narrative Approach
• Content• Self Generated• Related to the individual’s
experience• Opens a window to the inner world
![Page 12: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/12.jpg)
Pt - 1• Parkinson’s Disease patient, normal MMSE, pre-op
(Deep Brain Stimulation) evaluationOnce more into the breach, once more, or fill the breach with our English dead
• William Shakespeare, King Henry V, Act 3, Scene I (before Harfleur)
Once more unto the breach, dear friends, once more;Or close the wall up with our English dead.In peace there's nothing so becomes a manAs modest stillness and humility:But when the blast of war blows in our ears,Then imitate the action of the tiger;
• Personality type? Coping with disease…
![Page 13: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/13.jpg)
Pt - 2
AgeClock Drawing
CDIS
MMSESentence
701722I LVOE MY WIFE
711122I LOVE MY WIFE
72618 OVE MY WIFE
![Page 14: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/14.jpg)
MMSE
Psycho-analysis
… the fundamental rule of psycho-analysis which lays it down that what ever comes into one’s head must be reported without criticizing it… (Freud S., The Dynamics of Transference, Standard Edition, XII, 107)
… You will be tempted to say to yourself that this or that is irrelevant… …you must never give in to these criticism… … say whatever goes through your mind… (Freud S., On Beginning the Treatment, Standard Edition, XII, 135)
![Page 15: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/15.jpg)
Hypothesis
• The MMSE can probe psychodynamic processes
![Page 16: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/16.jpg)
Design
AD / Control Subjects
MMSE
Sentence Item score=0Perseverations – “No ifs and or buts”
Excluded
Sentence Item Score=1No Perseverations
Item Analyzed
![Page 17: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/17.jpg)
Demographics
ADControls
N - Total1963
N - Analyzed1655
Sex (F/M)9/733/22
Age80.8±6.372.6±5.4
Education (years)
12.8±3.613.0±3.4
MMSE21.8±2.928.8±1.1
![Page 18: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/18.jpg)
Informative Sentences
Does a sentence convey information which might be new to the examiner?
ADControlsP
2/1628/55<0.05
![Page 19: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/19.jpg)
Information Regarding The Current Situation
Is the sentence related to the current situation?“I am embarrassed by these questions”
ADControlsP
9/1617/55n.s. (0.08)
![Page 20: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/20.jpg)
Related to Oneself?
Is the subject = 1st person?“I want to be healthy”
ADControlsP
10/1623/55n.s. (0.07)
![Page 21: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/21.jpg)
Positive information
Sentence contains positive adjectives/adverbs“You are nice…”
ADControlsP
6/1622/55n.s.
![Page 22: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/22.jpg)
Conclusions
• The MMSE sentence writing item, although regarded as a linguistic item, can be utilized for affective co-morbidity in AD subjects
• The MMSE sentence writing item can serve
as a “red flag” for psychodynamic processes
![Page 23: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/23.jpg)
![Page 24: Qualitative Assessment of The Writing Sentence Item in The MMSE I. Biran 1, J.P. Newman 1, A. Gal 1, N. Levin 1, G. Friedman 2 Departments of Neurology(1)](https://reader033.fdocuments.net/reader033/viewer/2022051614/551c55f9550346a66a8b4e60/html5/thumbnails/24.jpg)