title: The functional implications of motor, cognitive, psychiatric, and social problem-solving states in Huntington's disease.
abstract: OBJECTIVE
  Huntington's disease (HD) is a genetic, neurodegenerative disorder characterized by motor, cognitive, and psychiatric dysfunction. In HD, the inability to solve problems successfully affects not only disease coping, but also interpersonal relationships, judgment, and independent living. The aim of the present study was to examine social problem-solving (SPS) in well-characterized HD and at-risk (AR) individuals and to examine its unique and conjoint effects with motor, cognitive, and psychiatric states on functional ratings.
  
  
  METHODS
  Sixty-three participants, 31 HD and 32 gene-positive AR, were included in the study. Participants completed the Social Problem-Solving Inventory-Revised: Long (SPSI-R:L), a 52-item, reliable, standardized measure of SPS. Items are aggregated under five scales (Positive, Negative, and Rational Problem-Solving; Impulsivity/Carelessness and Avoidance Styles). Participants also completed the Unified Huntington's Disease Rating Scale functional, behavioral, and cognitive assessments, as well as additional neuropsychological examinations and the Symptom Checklist-90-Revised (SCL-90R). A structural equation model was used to examine the effects of motor, cognitive, psychiatric, and SPS states on functionality.
  
  
  RESULTS
  The multifactor structural model fit well descriptively. Cognitive and motor states uniquely and significantly predicted function in HD; however, neither psychiatric nor SPS states did. SPS was, however, significantly related to motor, cognitive, and psychiatric states, suggesting that it may bridge the correlative gap between psychiatric and cognitive states in HD.
  
  
  CONCLUSIONS
  SPS may be worth assessing in conjunction with the standard gamut of clinical assessments in HD. Suggestions for future research and implications for patients, families, caregivers, and clinicians are discussed.
authors.forename: Charles
authors.initials: C
authors.lastname: Van Liew
authors.forename: Shea
authors.initials: S
authors.lastname: Gluhm
authors.forename: Jody
authors.initials: J
authors.lastname: Goldstein
authors.forename: Terry A
authors.initials: TA
authors.lastname: Cronan
authors.forename: Jody
authors.initials: J
authors.lastname: Corey-Bloom
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001526:Behavioral Symptoms / Q000503:physiopathology* / Q000523:psychology; D003071:Cognition / Q000502:physiology; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000235:genetics / Q000503:physiopathology* / Q000523:psychology*; D007398:Interpersonal Relations; D007600:Judgment / Q000502:physiology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009048:Motor Skills / Q000502:physiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011340:Problem Solving; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index