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Digital Clock Drawing: Differentiating “Thinking” versus “Doing” in Younger and Older Adults with Depression

Published online by Cambridge University Press:  15 September 2014

Jamie Cohen ,
Dana L. Penney ,
Randall Davis ,
David J. Libon ,
Rodney A. Swenson ,
Olusola Ajilore ,
Anand Kumar  and
Melissa Lamar
Jamie Cohen
Affiliation:
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
Dana L. Penney
Affiliation:
The Lahey Clinic, Burlington, Massachusetts
Randall Davis
Affiliation:
MIT Computer Science and Artificial Intelligence Laboratory, Cambridge, Massachusetts
David J. Libon
Affiliation:
Department of Neurology, Drexel University, Philadelphia, Pennsylvania
Rodney A. Swenson
Affiliation:
University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota
Olusola Ajilore
Affiliation:
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
Anand Kumar
Affiliation:
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
Melissa Lamar*
Affiliation:
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, Illinois
*
Correspondence and reprint requests to: Melissa Lamar, University of Illinois at Chicago, 1601 West Taylor Street (MC912), Chicago, IL, 60612. E-mail: mlamar@psych.uic.edu
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Abstract

Psychomotor slowing has been documented in depression. The digital Clock Drawing Test (dCDT) provides: (i) a novel technique to assess both cognitive and motor aspects of psychomotor speed within the same task and (ii) the potential to uncover subtleties of behavior not previously detected with non-digitized modes of data collection. Using digitized pen technology in 106 participants grouped by Age (younger/older) and Affect (euthymic/unmedicated depressed), we recorded cognitive and motor output by capturing how the clock is drawn rather than focusing on the final product. We divided time to completion (TTC) for Command and Copy conditions of the dCDT into metrics of percent of drawing (%Ink) versus non-drawing (%Think) time. We also obtained composite Z-scores of cognition, including attention/information processing (AIP), to explore associations of %Ink and %Think times to cognitive and motor performance. Despite equivalent TTC, %Ink and %Think Command times (Copy n.s.) were significant (AgeXAffect interaction: p=.03)—younger depressed spent a smaller proportion of time drawing relative to thinking compared to the older depressed group. Command %Think time negatively correlated with AIP in the older depressed group (r=−.46; p=.02). Copy %Think time negatively correlated with AIP in the younger depressed (r=−.47; p=.03) and older euthymic groups (r=−.51; p=.01). The dCDT differentiated aspects of psychomotor slowing in depression regardless of age, while dCDT/cognitive associates for younger adults with depression mimicked patterns of older euthymics. (JINS, 2014, 20, 1–9)

Keywords

Psychomotor slowingClock drawingDigital technologiesAgeMajor depressive disorder
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 20 , Issue 9 , October 2014 , pp. 920 - 928
Copyright
Copyright © The International Neuropsychological Society 2014 

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