Family Tree Test the new test of executive functions

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Family Tree Test the new test of executive
functions

• Marek Preiss

Prague Psychiatric Centre preiss_at_pcp.lf3.cuni.cz
And Jirí Lukavský Akademie ved Praha Klára
Vraná Ceská televize, Praha Helena tolfová FF
UK Praha Hana Kucerová Psychiatrická klinika FN MU
Daniel Korínek Psychiatrické centrum Praha Milan
Kopecek Psychiatrické centrum Praha Mabel
Rodriguez Psychiatrické centrum Praha Pavel
Mohr Psychiatrické centrum Praha
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Cognitive functions in schizophrenia
Primary Field of Assessment, Secondary Field
of Assessment
Tuma I, Lenderová Z. Schizofrenie a kognitivní
funkce. Psychiatrie, 2001, 4, 275-282
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Neuropsychological tests
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Family Tree Test (FTT) 1st version
PETER Weiss Grandson of Filip
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Grandparents
Parents
14 cards with names and relations Speed (time)
and quality (mistakes)
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PETER Weiss Grandson of Filip
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• Computer program for administration
• and evaluation of FTT
• (dr.Jirí Lukavský
• http//vyzkum.jinak.cz/fttest)
• Training session
• Working with mouse
• Formal instructions to the patient
• Evaluation of own performance
• Number of good and false
• movements
• Activity/passivity and other
• parametres
• - Sequence of the progress

Close together following the process of creating
Rey-Osterrieth Figure (CFT)
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FOUR SAMPLES
Controls and schizophrenics had the same avarage
age and malefemale ratio
Controls were matched with patients in age, sex
and education
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Age and FTT Speed

• SCHI (18-61 yrs) and controls 1 (18-57 yrs)
• MOOD (21-69) and controls 2 (20-66 yrs)

• SCHI - (-) 0.37 (n.s.)
• CON1 0.37 (n.s.)
• MOOD 0.37 (p.09)
• CON2 0.44 (p.03)

• results seems to be miscellany, but
• acute state in young people with schizophrenia
  could reverse the trend of reduce speed with age
• as CON2 shows larger samples are needed

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Education and FTT
FTT should be easy for all educational levels, no
relationship to education should be found!
SPEED
MISTAKES
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Performance - speed
Time in minutes

• Both clinical samples need more time
• Schizophrenics have significantly increased time
  to finish FTT
• No one schizophrenic was able to finish within 6
  minuts, although ½ of controls finished it

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Performance - speed
MOOD sample did not differentiate from controls,
but schizophrenics were
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Performance - quality

• Both clinical samples make more mistakes
• Schizophrenics have significantly increased
  number of mistakes
• No schiz.patient without a mistake

Number of mistakes
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Mistakes in schizophrenia and controls
76 controls and 0 schizophrenics made no mistake
High frequency of 0 mistakes in controls
Zero frequency of no mistakes in schi
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Convergent validity
Relationships with common frontal
neuropsychological tests were used in MOOD sample
MISTAKES

• No relationship between speed/mistakes and
  common neuropsychological tests was found
• if planning is a major latent variable, Tower of
  Hanoi/London should be used?
• - findings in schizophrenia should be added

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Alternative forms

• A B versions were constructed as alternative

SPEED
MISTAKES

• MOOD sample could be too much dependent on
  actual state, tiredness
• Correlations show sufficient alternativeness of
  both forms

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Strategies to solve the test

• Chaotic approach
• Finding non-existing informations
• Upside down strategy
• Long hesitating in the beginning
• The best subjects use working memory and fast
  attention shifts
• From parents to grandparents

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Discussion

• Does it enough appropriate that FTT
  differentiate between schizophrenia subjects and
  controls for a new test?
• Focuse on qualitative side of performance could
  be a strong advantage of this approach

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Discussion

• FTT as frontal test?
• If there is no correlation with WCST and other
  executive tests?

• Future research should be more oriented to
  comparisons with the tests of planning ability
  (like Tower tests)

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Future

• Validization study on large sample of healthy
  subjects
• Focus on strategy to solve FTT and qualitative
  aspects
• Study the influence of intelligence on FTT
• To include FTT into evaluation of rehabilitation