Serotonin Transporter Polymorphism, Memory, and Hippocampal Volume

Serotonin Transporter Polymorphism, Memory, and Hippocampal Volume

Cognitive Battery

The following contains a more detailed description of each of our Cognitive measures. All selected measures are widely used and have proven reliability

The Rey Auditory Verbal Learning Test: (RAVLT1)was included as a measure of verbal learning and memory. It consists of five trials of a 15 word list read aloud, with each trial followed by a free-recall test. After a twenty-minute delay, subjects are asked to recall the original list without further presentation of the list. We employed the RAVLT measure of delayed recall.

The Stroop Color and Word Test (SCW2) measures selective attention and cognitive flexibility, and is sensitive to age-related decline in speed of processing. Subjects are asked to read randomized color names; then to name colors of printed XXXs; and, then they are asked to name the color in which conflicting color names are printed, requiring them to disregard the verbal content. Total time to name the color in which conflicting color names are printed served as the primary outcome measure.

The Judgment of Line Orientation (JLO3) test assesses visuospatial ability by requiring subjects to identify the correct orientation of 30 pairs of stimulus lines. Total number correctly identified served as the outcome measure.

The Boston Naming Test (BNT4) measures verbal and naming ability and consists of 60 large pen-and-ink drawings of items ranging in familiarity. Total number of correctly named items served as our measure of verbal ability.

The MMSE5 was included as a brief mental status examination to quantify global cognitive functioning by assessing orientation, language, calculation, memory, and visuospatial reproduction.

Assessment of Mood and Cumulative Life Stress

The Geriatric Depression Scale (GDS6) is a widely-used depression screening device specifically designed for the elderly.On the 30-item version of the GDS, a score of 11 or higher is indicative of the presence of depression, yielding 84% sensitivity and a 95% specificity.

The Life Stressor Checklist—Revised (LSC-R7), a 30-item questionnaire, assesses the number of traumatic stressors and negative events occurring over one’s lifetime, the age at which the event occurred, the duration and perceived impact of these event. It was designed as a screen for life events that meet DSM-IV criteria for trauma. Total score for the perceived impact of stressful events across the lifespan was employed. The different subcomponentsof the LSC-R include:

1.) Have you ever been in a serious disaster (for example, a massive earthquake, hurricane, tornado, fire, explosion)?

2.) Have you ever seen a serious accident (for example, a bad car wreck or an on-the-job accident)?

3.) Have you ever had a very serious accident or accident-related injury (for example, a bad car wreck or an on-the-job accident)?

4.) Was a close family member ever sent to jail?

5.) Have you ever been sent to jail?

6.) Were you ever put in foster care or put up for adoption?

7.) Did your parents ever separate or divorce while you were living with them?

8.) Have you ever been separated or divorced?

9.) Were Have you ever had serious money problems (for example, not enough money for food or a place to live)?

10.) Have you ever had a very serious physical or mental illness (for example, cancer, heart attack, serious operation, felt like killing yourself, hospitalized because of severe nerve problems)?

11.) Have you ever been emotionally abused or neglected (for example, being frequently shamed, embarrassed, ignored, or repeatedly told that you were “no good”)?

12.) Have you ever been physically neglected (for example, not fed, not properly clothed, or left to take care of yourself when you were too young or ill)?

13.) WOMEN ONLY: Have you ever had an abortion or miscarriage (lost your baby)?

14.) Have you ever been separated from your child against your will (for example, the loss of custody or visitation or kidnapping)?

15.) Has a baby or child of yours ever had a severe physical or mental handicap (for example, mentally retarded, birth defects, can’t hear, see, walk)?

16.) Have you ever been responsible for taking care of someone close to you (not your child) who had a severe physical or mental handicap (for example, cancer stroke, Alzheimer’s disease, AIDS, felt like killing themselves, hospitalized because of nerve problems, can’t hear, see, walk)?

17.) Has someone close to you died suddenly or unexpectedly (for example, an accident, sudden heart attack, murder, or suicide)?

18.) Has someone close to you died (do not include those who died suddenly or unexpectedly)?

19.) When you were young (before age 16) did you ever see violence between family members (for example, hitting, kicking, slapping, punching)?

20.) Have you ever seen a robbery, mugging, or attack taking place?

21.) Have you ever been robbed, mugged, or physically attacked (not sexually) by someone you did not know?

22.) Before age 16, were you ever abused (not sexually) or physically attacked (hit, slapped, choked, burned, or beat up) by someone you knew (for example, a parent, boyfriend, or husband)?

23.) After age 16, were you ever abused (not sexually) or physically attacked (hit, slapped, choked, burned, or beat up) by someone you knew (for example, a parent, boyfriend, or husband)?

24.) Have you ever been bothered or harassed by sexual remarks, jokes, or demands for sexual favors by someone at work or school (for example, a co-worker, a boss, a customer, another student, a teacher)?

25.) Before age 16, were you ever touched or made to touch someone else in a sexual way because they forced you in some way or threatened to harm you if you didn’t?

26.) After age 16, were you ever touched or made to touch someone else in a sexual way because they forced you in some way or threatened to harm you if you didn’t?

27.) Before age 16, did you ever have sex (oral, anal, genital) when you didn’t want to because someone forced you in some way or threatened to harm you if you didn’t?

28.) After age 16, did you ever have sex (oral, anal, genital) when you didn’t want to because someone forced you in some way or threatened to harm you if you didn’t?

29.) Are there any events we did not include that you would like to mention?

30.) Have any of them events mentioned above ever happened to someone close to you so that even though you didn’t see or experience the event yourself, you were seriously disturbed by it?

31.) Of all the events you experienced which three have the greatest impact on you currently?

References

1.Lezak MD, Howieson DB, Loring DW. Neuropsychological Assessment. 4th ed. New York: Oxford University Press; 2004.

2.Golden CJ, Hammeke TA, Purisch AD. Diagnostic validity of a standardized neuropsychological battery derived from Luria's neuropsychological tests. J Consult Clin Psychol 1978;46:1258-65.

3.Benton AL, Hamsher K, Varney NR, Spreen O. Contributions to Neuropsychological Assessment. New York: Oxford University Press; 1983.

4.Kaplan E, Goodglass H, Weintraub S. The Boston Naming Test. Boston (MA): Kaplan & Goodglass; 1978.

5.Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-98.

6.Yesavage JA, Brink T, Rose T, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 1983;17:37-49.

7.Wolfe JW, Kimerling R, Brown PJ, Chrestman KR, Levin K. Psychometric review of The Life Stressor Checklist-Revised. In: Stamm BH, editor. Measurement of Stress, Trauma, and Adaptation. Lutherville, MD: Sidran Press; 1996.