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  Subjects -> PSYCHOLOGY (Total: 946 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 3)
Acta Colombiana de Psicología     Open Access   (Followers: 5)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 3)
Acta Psychologica     Hybrid Journal   (Followers: 27)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 2)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 9)
Addictive Behaviors Reports     Open Access   (Followers: 8)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 23)
ADHD Report The     Full-text available via subscription   (Followers: 10)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 44)
Advances in Mental Health     Hybrid Journal   (Followers: 78)
Advances in Methods and Practices in Psychological Science     Full-text available via subscription   (Followers: 6)
Advances in Physiotherapy     Hybrid Journal   (Followers: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 63)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 33)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 5)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 452)
Aggressive Behavior     Hybrid Journal   (Followers: 18)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 42)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 20)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 43)
American Journal of Community Psychology     Hybrid Journal   (Followers: 29)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 24)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 5)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 21)
American Journal of Psychology     Full-text available via subscription   (Followers: 33)
American Psychologist     Full-text available via subscription   (Followers: 200)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analitika : Jurnal Magister Psikologi Uma     Open Access  
Analysis     Full-text available via subscription   (Followers: 3)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 77)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 33)
Annual Review of Psychology     Full-text available via subscription   (Followers: 246)
Anuario de investigaciones (Facultad de Psicología. Universidad de Buenos Aires)     Open Access   (Followers: 1)
Anuario de Psicología / The UB Journal of Psychology     Open Access   (Followers: 1)
Anuario de Psicología Jurídica     Open Access   (Followers: 1)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 21)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 17)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 75)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 40)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 21)
Applied Psycholinguistics     Hybrid Journal   (Followers: 22)
Applied Psychological Measurement     Hybrid Journal   (Followers: 21)
Applied Psychology     Hybrid Journal   (Followers: 170)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 53)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 24)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30)
Archives of Scientific Psychology     Open Access   (Followers: 4)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Art Therapy Online     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 10)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Behavioural Studies     Open Access  
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 9)
Assessment     Hybrid Journal   (Followers: 13)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 14)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 13)
Australasian Journal of Organisational Psychology     Hybrid Journal   (Followers: 9)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription  
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 8)
Australian Journal of Psychology     Hybrid Journal   (Followers: 20)
Australian Journal of Rehabilitation Counseling     Full-text available via subscription   (Followers: 4)
Australian Psychologist     Hybrid Journal   (Followers: 12)
Autism Insights     Open Access   (Followers: 13)
Autism Research     Hybrid Journal   (Followers: 41)
Autism Research and Treatment     Open Access   (Followers: 26)
Autism's Own     Open Access   (Followers: 3)
Autism-Open Access     Open Access   (Followers: 6)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 21)
Balint Journal     Hybrid Journal   (Followers: 2)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 41)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 11)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 4)
Behavior Analyst     Hybrid Journal   (Followers: 5)
Behavior Modification     Hybrid Journal   (Followers: 11)
Behavior Research Methods     Hybrid Journal   (Followers: 19)
Behavior Therapy     Hybrid Journal   (Followers: 51)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 12)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 55)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 27)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 8)
Behaviormetrika     Hybrid Journal  
Behaviour     Hybrid Journal   (Followers: 12)
Behaviour Change     Full-text available via subscription   (Followers: 13)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 20)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 145)
Behavioural Processes     Hybrid Journal   (Followers: 8)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 7)
BMC Psychology     Open Access   (Followers: 18)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 11)
Boletim Academia Paulista de Psicologia     Open Access  
Boletim de Psicologia     Open Access  
Brain Informatics     Open Access  
British Journal of Clinical Psychology     Full-text available via subscription   (Followers: 159)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 38)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 36)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 47)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 20)
British Journal of Psychology     Full-text available via subscription   (Followers: 63)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 68)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 35)
Buletin Psikologi     Open Access  
Burnout Research     Open Access   (Followers: 8)
Cadernos de psicanálise (Rio de Janeiro)     Open Access  
Cadernos de Psicologia Social do Trabalho     Open Access  
Canadian Art Therapy Association     Hybrid Journal  
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 5)
Canadian Journal of Experimental Psychology     Full-text available via subscription   (Followers: 15)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 14)
Case Studies in Sport and Exercise Psychology     Hybrid Journal   (Followers: 1)
Castalia : Revista de Psicología de la Academia     Open Access  
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 30)
Child Development Research     Open Access   (Followers: 18)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access   (Followers: 3)
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 9)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 12)
Clinical Psychological Science     Hybrid Journal   (Followers: 12)
Clinical Psychologist     Hybrid Journal   (Followers: 18)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 74)
Clinical Psychology and Special Education     Open Access   (Followers: 4)
Clinical Psychology Review     Hybrid Journal   (Followers: 42)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 22)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 9)
Coaching : Theorie & Praxis     Open Access   (Followers: 1)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 2)
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 43)
Cognitive Behaviour Therapist     Hybrid Journal   (Followers: 13)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 17)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 35)
Cognitive Psychology     Hybrid Journal   (Followers: 74)
Cognitive Research : Principles and Implications     Open Access   (Followers: 3)
Consciousness and Cognition     Hybrid Journal   (Followers: 32)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 4)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 6)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 27)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling et spiritualité / Counselling and Spirituality     Full-text available via subscription   (Followers: 2)
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 13)
Counseling Psychologist     Hybrid Journal   (Followers: 17)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 12)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 27)
Counselling and Values     Hybrid Journal   (Followers: 6)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 14)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 7)
Creativity Research Journal     Hybrid Journal   (Followers: 24)
Creativity. Theories ? Research ? Applications     Open Access   (Followers: 5)
Criminal Justice Ethics     Hybrid Journal   (Followers: 10)
Cuadernos de Neuropsicología     Open Access   (Followers: 1)
Cuadernos de Psicologia del Deporte     Open Access  
Cuadernos de Psicopedagogía     Open Access  
Cultural Diversity and Ethnic Minority Psychology     Full-text available via subscription   (Followers: 17)
Cultural-Historical Psychology     Open Access   (Followers: 2)
Culturas Psi     Open Access  
Culture and Brain     Hybrid Journal   (Followers: 4)
Current Addiction Reports     Hybrid Journal   (Followers: 12)
Current Behavioral Neuroscience Reports     Hybrid Journal   (Followers: 2)
Current Directions In Psychological Science     Hybrid Journal   (Followers: 61)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 4)
Current Opinion in Psychology     Hybrid Journal   (Followers: 8)
Current Psychological Research     Hybrid Journal   (Followers: 14)
Current Psychology     Hybrid Journal   (Followers: 14)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 17)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 17)
Decision     Full-text available via subscription   (Followers: 6)
Depression and Anxiety     Hybrid Journal   (Followers: 25)
Depression Research and Treatment     Open Access   (Followers: 14)
Development and Psychopathology     Hybrid Journal   (Followers: 9)
Developmental Cognitive Neuroscience     Open Access   (Followers: 18)
Developmental Neuropsychology     Hybrid Journal   (Followers: 20)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 47)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 2)
Discourse     Full-text available via subscription   (Followers: 10)
Diversitas : Perspectivas en Psicologia     Open Access  

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Journal Cover
Archives of Clinical Neuropsychology
Journal Prestige (SJR): 0.731
Citation Impact (citeScore): 2
Number of Followers: 30  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0887-6177 - ISSN (Online) 1873-5843
Published by Oxford University Press Homepage  [396 journals]
  • Population Health Solutions for Assessing Cognitive Impairment in
           Geriatric Patients
    • Authors: Perry W; Lacritz L, Roebuck-Spencer T, et al.
      Pages: 655 - 675
      Abstract: In December 2017, the National Academy of Neuropsychology convened an interorganizational Summit on Population Health Solutions for Assessing Cognitive Impairment in Geriatric Patients in Denver, Colorado. The Summit brought together representatives of a broad range of stakeholders invested in the care of older adults to focus on the topic of cognitive health and aging. Summit participants specifically examined questions of who should be screened for cognitive impairment and how they should be screened in medical settings. This is important in the context of an acute illness given that the presence of cognitive impairment can have significant implications for care and for the management of concomitant diseases as well as pose a major risk factor for dementia. Participants arrived at general principles to guide future screening approaches in medical populations and identified knowledge gaps to direct future research. Key learning points of the summit included:recognizing the importance of educating patients and healthcare providers about the value of assessing current and baseline cognition;emphasizing that any screening tool must be appropriately normalized and validated in the population in which it is used to obtain accurate information, including considerations of language, cultural factors, and education; andrecognizing the great potential, with appropriate caveats, of electronic health records to augment cognitive screening and tracking of changes in cognitive health over time.Summit Participants Deb Adler1, Christopher Alban, MD, MBA2, Mark Bondi, PhD3, Michelle Braun, PhD4, Xavier Cagigas, PhD5, Morgan Daven6, Robert L. Denney, PsyD7,8, Lisa Drozdick, PhD9, Norman L. Foster, MD10,11, Ula Hwang, MD12–15, Laurie Ivey, PsyD16, Grant Iverson, PhD7,17, Joel Kramer, PsyD18, Laura Lacritz, PhD7,19, Melinda Lantz, MD20, Lisa Latts, MD, MSPH, MBA21, Shari M. Ling, MD22, Ana Maria Lopez, MD23–26, Michael Malone, MD27,28, Lori Martin-Plank, PhD, MSN, MSPH, RN29, Katie Maslow, MSW30, Don Melady, MSc(Ed), MD31–33, Melissa Messer34, John Meyers, PsyD7, Charles E. McConnel, PhD19, Randi Most, PhD36, Margaret P. Norris, PhD37, William Perry, PhD7,85,39, Neil Pliskin, PhD40, David Shafer, MBA41, Nina Silverberg, PhD42, Tresa Roebuck-Spencer, PhD43,44, Colin M. Thomas, MD, MPH45, Laura Thornhill, JD46, Jean Tsai, MD, PhD10,47, Nirav Vakharia, MD48, Martin Waters, MSW49Organizations RepresentedAlzheimer’s Association, Chicago, ILAMA/CPT Health Care Professionals Advisory Committee, Chicago, ILAmerican Academy of Clinical Neuropsychology (AACN), Ann Arbor, MIAmerican Academy of Neurology (AAN), Minneapolis, MNAmerican Association of Geriatric Psychiatry (AAGP), McLean, VAAmerican Association of Nurse Practitioners (AANP), Austin, TXAmerican Board of Professional Neuropsychology (ABN), Sarasota, FLAmerican College of Emergency Physicians (ACEP), Philadelphia, PAAmerican College of Physicians (ACP), Philadelphia, PAAmerican Geriatrics Society (AGS), New York, NYAmerican Psychological Association (APA), Washington, DCBeacon Health Options, Boston, MACanadian Association of Emergency Physicians, Ottawa, ON, Canada Collaborative Family Healthcare Association (CFHA), Rochester, New YorkGerontological Society of America, Washington, DCHispanic Neuropsychological Society (HNS), Los Angeles, CAIBM Watson Health, Denver, COInternational Federation of Emergency Medicine, West Melbourne, AustraliaInternational Neuropsychological Society (INS), Salt Lake City, UTNational Academy of Neuropsychology (NAN), Denver, COOptum of UnitedHealth Group, Minneapolis, MNPearson, New York City, New YorkPsychological Assessment Resources, Inc, Lutz, FLSociety for Clinical Neuropsychology, Washington, DCU.S. Department of Veterans Affairs, Washington, DC*Please note that participation in the Summit does not constitute organizational endorsement of this report
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy052
      Issue No: Vol. 33, No. 6 (2018)
       
  • Presidential Address National Academy of Neuropsychology Conference Boston
           2017
    • Authors: Meyers J.
      Pages: 676 - 687
      Abstract: This presidential address attempts to predict the future directions of neuropsychology. Predicting the future is always a difficult thing. By examining population trends such as aging and demographics, a clearer picture becomes visible. The population is getting older and more ethnically diverse. Also, examination of the spending trends in health care indicates that neuropsychology needs to be able to adapt to working with larger population-based patient care as well as individual patient care. Shifts in the demographics of neuropsychology, in that the profession previously was 70% male dominate and now is >70% female dominant are also discussed. Trends in NAN’s speaker and leader demographics are examined as well as the need to stay current in the trends and latest neuropsychological research lest we become dinosaurs in the next 5–10 years. Recommendations for new neuropsychologists and post-doctoral fellows are also presented.
      PubDate: Sat, 05 May 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy039
      Issue No: Vol. 33, No. 6 (2018)
       
  • AGR - 1A Case of Autoimmune Encephalitis Dementia
    • Authors: Willis P.
      Pages: 688 - 689
      Abstract: Objective: Neurocognitive and psychological changes associated with rapid-onset autoimmune encephalitis have been well characterized in the neuropsychological literature. This presentation seeks to expand knowledge of more slowly developing conditions by presenting a case of progressive neurocognitive decline over a period of about 6 years and resulting in a moderate to severe dementia. Method: A 54 year old man had a history of PTSD to include a recent traumatic event. He was referred for neuropsychological evaluation due to a disproportionate degree of cognitive impairment. Testing revealed a moderate to severe global dementia. Review of medical records indicated that a neurologist had seen significant cognitive dysfunction 4 years prior to presentation. The patient’s wife reported mild cognitive lapses as far back as 6 years, progressing gradually over time. Neurological evaluation indicated right superior quadrantanopia. Serial MRI indicated a small area of abnormal signal in the right cerebellar hemisphere. EEG was normal. Findings suggestive of a possible encephalitis led to testing with a paraneoplastic panel that returned positive for N-type calcium channel antibody. The patient was treated with IVIG (intravenous immunoglobulin) with some reported observed improvement in cognitive status. Results: (Pretreatment) Moderate to severe dementia with WAIS-IV (Wechsler Adult Intelligence Scale-IV Full Scale IQ score of 57, severely impaired reasoning skills with Wisconsin Card Sorting Test 0 Categories achieved, profound cognitive slowing, some preservation of visuospatial ability with scores in the low average range, language sparse, performance validity tests at chance level. Conclusions: Earlier detection of the more gradually progressive autoimmune encephalitis conditions could lead to improved recovery.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy058.01
      Issue No: Vol. 33, No. 6 (2018)
       
  • AGR - 2A Case Study on Young-Adult Patient with Nonverbal Learning
           Disability
    • Authors: Olsen D; Fallows R.
      Pages: 688 - 689
      Abstract: Objective: Nonverbal Learning Disability (NLD) is a controversial diagnosis which continues to lack an agreed upon diagnostic taxonomy despite its half-of-a-century existence. This case study reviews a young-adult patient with NLD and discusses academic, employment, and personal challenges encountered. In doing so, it emphasizes importance of early diagnostic accuracy but also the effect of developmental conditions on adult patients. Method: A 25-year-old female college junior presented for neuropsychological evaluation needing documentation for academic accommodations in math and reading. Chief complaints included lifelong functionally interfering difficulties with attention, surface dyslexia, math, and social functioning. Medical history was significant for headaches, hypermobility syndrome (hands), and sleep apnea. Results: Results of performance validity measures were within acceptable limits. The patient’s VCI was in the very superior range (VCI = 150) while her PRI was in the borderline range (PRI = 77), a split which occurs in less than 0.2% of the population. She also demonstrated superior word decoding abilities while her math facts knowledge was at the low end of borderline. Similarly, although her visual learning and memory was within normal limits, they were significantly weaker than her verbal memory which was consistently high average to superior. Finally, her visuoconstruction was significantly impaired and her manual dexterity was impaired bilaterally. Conclusions: The constellation of symptoms reported by the patient, combined with results of neuropsychological assessment, was highly congruent with prototypical nonverbal learning disability. This case demonstrates the importance of proper diagnosis during childhood, the role of neuropsychological evaluation in SLD assessment, and lasting effects of a developmental condition on adult functioning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy058.02
      Issue No: Vol. 33, No. 6 (2018)
       
  • AGR - 3Hindsight is 20/20: Integrated Care Models, Confirmatory Bias, and
           the Man Who Lost His Identity
    • Authors: Miller J.
      Pages: 688 - 689
      Abstract: Objective: Patient is a married, right-handed, man in his mid-40s with high school education who is currently on medical leave due to rapidly progressive difficulties with language, navigation, and memory that emerged abruptly following a heart attack with multiple stent placement. He was evaluated by Dr. Neurologist, who noted severe impairment on cognitive screening; neurological exam was unremarkable. Patient was clinically referred for differential diagnosis and treatment planning, including need for permanent disability. Interview was notable for disorientation to time and place, difficulty answering questions, and inability to recall autobiographical information (e.g., mother’s name, birthplace), though there were no obvious indications of language impairment. Comprehensive testing, including stand-alone and embedded validity indices, revealed floor-level impairments across domains with few exceptions, though inconsistencies were noted (e.g., impaired letter sequencing with normal trails-switching) and performance was in stark contrast with reported functional independence. There were no clear indications of emotional difficulty, behavioral disturbances, or functional decline. Method: Case study, including neuropsychological evaluation and medical record review. Results: A clinical diagnosis was reached based on neurological examination findings, neuropsychological evaluation, and updated structural and functional brain imaging completed after the neuropsychological evaluation. Conclusions: This case highlights the importance of approaching cases from a multidisciplinary perspective and incorporating as much information as possible when formulating clinical impressions. The potential of developing a confirmatory bias in clinical decision making is also highlighted by this case, as is the veracity of performance validity indices, even in the context of severe cognitive impairment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy058.03
      Issue No: Vol. 33, No. 6 (2018)
       
  • PGR - 1Fetal Alcohol Syndrome in the Context of Multiple Etiological
           Factors
    • Authors: Lennon J.
      Pages: 690 - 691
      Abstract: Objective: Case of 14-year-old, Caucasian, heterosexual, right-handed male presenting for neuropsychological assessment for clarification of diagnosis due to past Attention-Deficit/Hyperactivity Disorder (ADHD), Bipolar I Disorder, and Oppositional Defiant Disorder (ODD) diagnoses and to rule-out of Fetal Alcohol Syndrome (FAS) due to aggression, impulsivity, difficulties with authority, and history of legal issues. Method: Pt was born at 29 weeks gestation. Pt’s adoptive mother reported developmental delays in walking, as well as regression in talking, due to suspected prenatal alcohol (ETOH) exposure, neglect, and abuse in first two years of life prior to being adopted. Pt is currently in detention setting due to recent verbalized homicidal ideation toward 12-year-old adoptive brother. Pt reported lack of insight regarding impulsive behaviors and remorse following each incident. Neuropsychological/psychological tests were conducted to assess for FASD and clarify previous diagnoses, for which psychostimulant and antipsychotic medications have proved ineffective. Results: Tests suggest impairment in intellectual domains with average working memory (Table 1), academic achievement concerns in only sentence comprehension, executive dysfunction specifically in inhibition, inefficient learning with early plateau, and externalizing behaviors. Adaptive functioning difficulties isolated to self-direction and safety. No evidence of brain atrophy, delayed physical development, abnormal facial features in childhood. Conclusions: Wide range of etiological factors with unconfirmed prenatal ETOH exposure, such as neglect, trauma, and school attendance, suggests that FAS and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE) may not present as expected when other factors are involved. Criteria for ND-PAE and FAS may be revisited as it relates to confirmed ETOH exposure when history does not permit. Table 1.Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V)CompositeSum of Scaled ScoresComposite ScorePercentile Rank95% Confidence IntervalQualitative DescriptionVerbal Comprehension Index (VCI)1176570–86Very LowVisual Spatial Index (VSI)16892382–98Low AverageFluid Reasoning Index (FRI)14821276–90Low AverageWorking Memory Index (WMI)17912784–99AverageProcessing Speed Index (PSI)969264–82Extremely LowFull Scale IQ (FSIQ)4474469–81Very LowAncillaryIndex ScoreVerbal (Expanded Crystallized; VECI)2274469–82Very LowExpanded Fluid (EFI)2272367–80Very LowQuantitative Reasoning (QRI)1380975–87Low AverageAuditory Working Memory (AWMI)18943487–102AverageNonverbal Index (NVI)4278773–85Very LowGeneral Ability Index (GAI)3175570–82Very LowCognitive Proficiency Index (CPI)2676570–85Very LowComplementaryNaming Speed (NSI)186902583–99AverageSymbol Translation (STI)272892383–96Low AverageStorage & Retrieval (SRI)179861880–94Low Average
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy059.01
      Issue No: Vol. 33, No. 6 (2018)
       
  • PGR - 2Neuropsychological Functioning Following Methotrexate Neurotoxicity
           Stroke in an 11-Year-Old Female with Acute Lymphoblastic Leukemia
    • Authors: Katz L; Sunnquist M, Garagozzo A, et al.
      Pages: 690 - 691
      Abstract: Objective: An 11-year-old female was referred for neuropsychological assessment regarding current functioning given history of methotrexate (MTX) neurotoxicity stroke in July 2015 during treatment for Acute Lymphoblastic Leukemia (ALL). Research has demonstrated that MTX related neurotoxicity occurs in approximately 3.8% of pediatric ALL patients (Bhojwain et al., 2014). Specific neurocognitive problems are associated with MTX, particularly regarding attention and executive functioning, and may be dose related (Cheung & Krull, 2015; Moleski, 2000). There is a lack of literature regarding neurocognitive difficulties associated with MTX neurotoxicity stroke. This case provides guidance on neurocognitive outcomes associated with intrathecal (IT) MTX treatment and potential negative effects. Method: The patient was diagnosed with ALL in January 2015 and was treated with oral, intravenous, and intrathecal (IT) MTX through July 2015, when she experienced a left-hemisphere MTX neurotoxicity related stroke. Patient evidenced generalized right side weakness; however, within 6 months, she regained full control of her right side. Chemotherapy was terminated in April 2017 and she has been in remission since then. She continues to experience chronic headaches, acute widespread physical pain, dizziness, blurry vision, and difficulties concentrating. She also demonstrates emotional and behavioral difficulties across environments. Results: Results of neuropsychological testing revealed superior general cognitive functioning with notable variability across multiple neurocognitive domains (e.g., WISC-V: FRI = 140, VSI = 122, VCI = 106, WMI = 103, PSI = 100). Academically, she performed at grade level with low average academic fluency. There were notable gaps associated with material covered during illness-related absences. She presented with average to low average range scores across attention and executive functioning tasks. Patient and caregiver reported symptoms of depression and low self-esteem. Imaging will be shared. Conclusions: While no baseline neuropsychological data are available, the discrepancy between this patient’s FRI and VCI occurs at a base rate of 0.9 percent, and indicates that her verbal skills were impacted by her stroke, as were executive and attentional capacities. This case highlights the range of challenges that can arise not only within the context of MTX history, but also in the context of MTX neurotoxicity. This adds to our understanding of MTX and its associated complications neurocognitively.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy059.02
      Issue No: Vol. 33, No. 6 (2018)
       
  • PGR - 3Case Study of Cockayne Syndrome, Type 3 in 15-Year-Old Female
    • Authors: Mission P; Kessler-Jones A.
      Pages: 690 - 691
      Abstract: Objective: Cockayne Syndrome (CS) is a rare and progressive autosomal recessive disorder associated premature aging and early-onset dementia. Little neuropsychological research during adolescence has been conducted due to mortality rates1. We present findings on an adolescent with CS type 3 and discuss findings for the purposes of informing treatment. Method: Patient is a 15-year-old female with global developmental delays, microcephaly, photosensitivity, tremors, ataxia, balance problems, and unsteady gait. Patient has dysmorphic craniofacial features. MRI revealed dysmyelination from periventricular zones to subcortical regions. Whole exome sequencing identified two mutations consistent with CS. Results: Self, parent and teacher-report measures indicated elevated internalizing and externalizing problems and executive dysfunction with intact adaptive skills. Tremors, distractibility, frustration, poor motor coordination, tangential speech, and word finding difficulties were very evident during testing. Validity testing was acceptable. Low average verbal and nonverbal reasoning. Attention was poor with weak inhibition. She displayed poor executive functioning on sequencing tasks and impaired set switching. Impaired working memory and processing speed were noted. Low average verbal and visual memory with stronger recognition. Weak visual scanning, motor-speed, and motor-coordination. Academic performance was average. Conclusions: Diagnoses were neurocognitive disorder and anxiety. Patient exhibited many low average abilities, but deficits in memory, attention, are executive dysfunction were already noticeable. Emotional and behavioral difficulties have been problematic and may be exacerbated by cognitive deficits. Results provide important information about the progression of CS type 3 on cognitive and emotional functioning in adolescence and underscore the need for collaboration with medical teams throughout the evolution and treatment of the disorder.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy059.03
      Issue No: Vol. 33, No. 6 (2018)
       
  • Adult Concussion - 1Commonly Used IQ Measures and Their Suitability in
           Predictive Models of Cognitive Impairment After Concussion
    • Authors: Ahrens A; Cole W, Schwab K.
      Pages: 692 - 702
      Abstract: Objective: Controlling for IQ using Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) full scale IQ (FSIQ) in models of cognitive impairment post-concussion may bias estimates of the impact of injury. Our goal is to determine if concussion impacts any of the components of FSIQ, especially processing speed (PSI) and working memory (WMI). Method: Soldiers with (N = 222) and without (N = 272) acute concussion completed two randomly assigned computerized neurocognitive assessment tools (NCATs: Automated Neuropsychological Assessment Metrics, version 4 [ANAM4]; CogState; CNS Vital Signs [CNS-VS]; Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and the WAIS-IV. The Armed Services Vocational Aptitude Battery (ASVAB) General Technical (GT) score (a military entry examination providing pre-morbid IQ estimate) was also obtained. Participants were recruited from various military settings, including a TBI Clinic, and the groups were largely demographically similar. Injured and non-injured soldiers were compared on the IQ measures, controlling for pre-service IQ, using one-way ANOVA. Impact of IQ scores on NCAT reaction time performance was also explored using Mann-Whitney U. Results: When stratifying participants based on ASVAB, injured and non-injured cohorts primarily differed in PSI and FSIQ, e.g. for mean ASVAB, F(1,133) = 9.583, p = .002, F(1,133) = 9.704, p = .002, respectively, though the group with highest ASVAB also differed on WMI, F(1,78) = 5.569, p = .021. Injured and non-injured cohorts did not differ on other WAIS-IV measures. Injured soldiers who performed worst on NCAT reaction time subtests (≤15th percentile) differed from those ≤15th percentile on FSIQ, PSI, and WMI only, U = 820.5–904.5, p = .029–.044, U = 725.5–729.5, p = .006–.049, U = 803.0–838.0, p = .009–.032, respectively, and not on pre-injury IQ or other WAIS-IV measures. Conclusions: Our findings suggest that components of WAIS-IV FSIQ (e.g. PSI and WMI) are likely affected by acute concussion, and, therefore, it may be a biased estimate of intelligence. Controlling for FSIQ may mask associations between assessments and functional deficits. Pre-morbid estimates or estimates of “crystallized intelligence” are likely more appropriate for accounting for intelligence in predicting functional deficits from concussion. Disclosure: The views expressed in this manuscript are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.19
      Issue No: Vol. 33, No. 6 (2018)
       
  • Adult Concussion - 2Changes in Activity Level and Symptom Recovery from
           Acute Mild Traumatic Brain Injury
    • Authors: Bailie J; Remigio-Baker R, Cole W, et al.
      Pages: 692 - 702
      Abstract: Objective: Treatment of concussion involves reduction of physical and cognitive activity in the <72 h of injury with gradual increased activity as symptoms resolve. This study examined the impact of increases in activity level during concussion recovery. Method: 65 military personnel with a concussion were assessed within 72 hours of injury (<72 h), 1 week (1 w), 1 month (1 m), and 3 months (3 m) following injury. Outcome measures were the Neurobehavioral Symptom Inventory (NSI) and a 60-item Activity Survey (AS) measuring physical, cognitive, and lifestyle-related activities (e.g., alcohol intake, smoking). Results: The AS scores increased over time between the <72 h to 1 w (M = 12.85, SD = 19.54), 1 w to 1 m (M = 22.63, SD = 23.22), and 1 m to 3 m (M = 5.18, SD = 18.61). An unadjusted linear regression explored the relationship between changes in activities at the 3 time points (<72 h to 1 w, 1 w to 1 m, & 1 m to 3 m) to NSI scores at 3 months. Changes in activity were predictive of NSI score at 3 m (p = 0.001, Adj. R2 = 0.211). Increased activity between the &lt;72 h to 1 w (β = −0.437, p = 0.001) and 1 w to 1 m (β = −0.498, p < 0.001) was significantly associated with lower symptoms at 3 m, but not the change from 1 to 3 m. Conclusions: Low levels of activity in acute recovery is standard clinical care for concussion with graded increases in activity over time. Increased activity in the first week and the first month appear to be most impactful to recovery, with change in activity from 1 to 3 months being less influential. This may be because most individuals are recovered and at normal activity levels by 1 month.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.20
      Issue No: Vol. 33, No. 6 (2018)
       
  • Adult Concussion - 3Long-Term Neuropsychological and Neurobehavioral
           Outcomes in Combat Veterans with and Without Mild TBI and PTSD
    • Authors: Merritt V; Jurick S, Keller A, et al.
      Pages: 692 - 702
      Abstract: Objective: Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are highly prevalent comorbid conditions in military Veterans. However, lack of appropriate control groups clouds interpretation of the chronic effects of these conditions. The present study evaluated the long-term neuropsychological and neurobehavioral outcomes associated with history of mTBI and PTSD in a well-characterized sample of combat exposed Veterans. Method: Participants were 68 Veterans (91.2% male; age: M = 33.60, SD = 6.20) divided into four groups: history of mTBI and current PTSD (comorbid; n = 20), mTBI-only (n = 20), PTSD-only (n = 14), and combat exposed controls with no history of mTBI or PTSD (CC; n = 14). Participants were administered a comprehensive neuropsychological assessment and completed several questionnaires assessing psychiatric distress and neurobehavioral symptoms. Results: A MANOVA revealed no significant differences between groups on measures of neuropsychological functioning (F(57, 129) = 0.81, p = .82). However, significant MANOVAs were found for measures of psychiatric distress (F(6, 122) = 6.71, p < .001) and neurobehavioral symptoms (F(18, 165) = 3.40, p < .001). Univariate tests showed significant differences across groups for all psychiatric and neurobehavioral measures (all p < .001). In general, post-hoc analyses revealed that the comorbid and PTSD-only groups endorsed the most severe symptoms, followed by the mTBI-only and CC groups, respectively. Conclusions: Although comparable neuropsychological performance was observed among CC, mTBI-only, PTSD-only, and comorbid groups, findings suggest that Veterans with comorbid mTBI and PTSD are at greatest risk for experiencing chronic psychiatric and neurobehavioral dysfunction. Furthermore, those with history of mTBI but no psychiatric comorbidity are more similar to combat controls. Findings highlight the importance of primary treatment of mental health symptoms in combat exposed Veterans.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.21
      Issue No: Vol. 33, No. 6 (2018)
       
  • Adult Concussion - 4Mild Traumatic Brain Injury and Comorbid
           Post-Traumatic Stress Disorder is Associated with Peripheral Tau
           Concentrations
    • Authors: Pattinson C; Gill J, Brickell T, et al.
      Pages: 692 - 702
      Abstract: Objective: Mild traumatic brain injuries (mTBIs) with comorbid post-traumatic stress disorder (PTSD) is common in military personnel following recent deployments. Given that TBI and PTSD are associated with an increased risk of Alzheimer’s disease and related dementias, we aimed to examine if mTBI and comorbid PTSD had cumulative effects on peripheral tau concentrations in two cohorts of military veterans and service members. Method: Cohort 1 included military personnel who were treated at Walter Reed National Military Medical Center following mTBI. Participants were divided into three groups: mTBI-Neg/PTSD-Neg (n = 18), mTBI-Pos/PTSD-Neg (n = 64), and mTBI-Pos/PTSD-Pos (n = 21); Age M = 34.1years (SD = 10.1). Cohort 2 included personnel who were referred to the Madigan Sleep Disorders Clinic. Participants were split into four groups: mTBI-Neg/PTSD-Neg (n = 59), mTBI-Neg/PTSD-Pos (n = 11), mTBI-Pos/PTSD-Neg (n = 17), and mTBI-Pos/PTSD-Pos (n = 25); Age M = 33.3 years (SD = 7.9). The cohorts were analyzed separately using ANOVA models, with Bonferroni adjustment. Results: For Cohort 1, ANOVA showed significant group differences on tau (p < .01). Post-hoc analyses revealed that the mTBI-Pos/PTSD-Pos group had significantly higher tau than the mTBI-Neg/PTSD-Neg group (p = .02) and trended towards higher than the mTBI-Pos/PTSD-Neg group (p = .06). The mTBI-Pos/PTSD-Pos and mTBI-Neg/PTSD-Pos groups did not significantly differ (p > .05). These results were validated with Cohort 2; ANOVA showed group differences on tau (p < .05). Post-hoc analyses revealed that the mTBI-Pos/PTSD-Pos group had significantly higher tau than both the mTBI-Neg/PTSD-Neg and mTBI-Pos/PTSD-Neg groups (p < .05). Conclusions: These results are the first to identify that a history of mTBI and comorbid PTSD is associated with increased peripheral tau. This provides insight into potential pathways for intervention and monitoring to ameliorate negative outcomes following mTBI in military personnel.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.22
      Issue No: Vol. 33, No. 6 (2018)
       
  • Aging & Dementia - 1History of Alcohol Misuse is Associated with an
           Earlier Onset of Alzheimer’s Disease
    • Authors: Becker J; Schaffert J, LoBue C, et al.
      Pages: 692 - 702
      Abstract: Objective: A history of alcohol misuse has been found to be a risk factor for an earlier onset of dementia. However, it is unclear if misuse increases risk for an earlier onset of Alzheimer’s Disease (AD). Using data from the National Alzheimer’s Coordinating Center, we explored the relationship between alcohol misuse and the age of AD onset.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.01
      Issue No: Vol. 33, No. 6 (2018)
       
  • Aging &amp; Dementia - 2The Neurocognitive Domains of Advanced
           Parkinson’s Disease
    • Authors: Matusz E; Brown D, Barrett M, et al.
      Pages: 692 - 702
      Abstract: Objective: To identify the structure of cognitive domains underlying neuropsychological assessments in patients with advanced Parkinson’s disease (PD), in order to facilitate improved validity of cognitive research in this population. Method: We analyzed a primarily pre-surgical clinical cohort of 432 patients with PD. Patients were administered neuropsychological evaluations that included: Stroop Color and Word Test (SCWT), Wechsler Adult Intelligence Scale-IV Digit Span (DS) and Matrix Reasoning (MR), letter (FAS) and category (Animals) fluency, Trail Making Test (TMT), Wisconsin Cart Sorting Test-64 (WCST-64), Hopkins Verbal Learning Test-Revised (HVLT-R), and the Brief Visuospatial Memory Test-Revised (BVMT-R). We employed exploratory factor analysis (EFA), using principal axis factoring and oblique direct oblimin rotation, to identify underlying cognitive domains. The optimal model was determined based on eigenvalues, cumulative variance, and scree plot inspection. Results: The EFA yielded a four-factor solution that explained 73.57% of the total variance (Table 1). SCWT Color Naming and Word Reading, FAS and Animals, TMT Parts A and B, DS, and MR loaded on the first factor, representing Processing Speed and Attention/Working Memory. WCST-64 Perseverative Responses and Total Errors loaded onto the second factor, representing Concept Formation/Perseveration. BVMT-R Total Learning and Delayed Recall and Stroop Interference comprised the third factor, representing Visual Attention and Memory. HVLT-R Total Learning and Delayed Recall loaded on the fourth factor, representing Verbal Learning and Memory. Conclusions: These four dimensions may best represent the neurocognitive domains in advanced PD. Future studies should take caution using theory alone when classifying neuropsychological tests as markers of a specific cognitive domain.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.02
      Issue No: Vol. 33, No. 6 (2018)
       
  • Aging & Dementia - 3Exploring the Dose-Response Effect of Physical
           Activity and Cognition in Healthy Aging Older Adults
    • Authors: Osuna J; Mestre Z, Wierenga C, et al.
      Pages: 692 - 702
      Abstract: Objective: Physical Activity (PA) has been implicated as a protective factor against age-related cognitive decline. Yet, research examining the dose-response effect of different intensities of objectively-measured PA and cognition is lacking. To address this gap, we examined the preliminary association between Low Light PA, High Light PA, and Moderate to Vigorous Physical Activity (MVPA), and cognition in older adults. Method: Seventeen cognitively normal older adults ages 65–79, were recruited from the community and ongoing studies at UC San Diego. Participants underwent PA monitoring using tri-axial accelerometry for a week and completed comprehensive neuropsychological testing. Low Light activity was defined as 100–1,040 CPM, High Light as 1,041–1,951 CPM, and MVPA as ≥1,952 CPM. Partial correlations investigated the association between all PA intensities and tests of executive and memory functions. All models adjusted for age and education. Results: Above and beyond the effects of age and education, Low Light PA was significantly associated with tests of memory (recall on a word list and story paragraphs) and executive functions (phonemic fluency) (rs = .56–.65, p < .05), while MVPA was significantly associated with a test of executive function (phonemic fluency) (r=.69, p < .01). High Light PA was not associated with cognition (p>.05). Conclusions: These preliminary findings suggest that Low Light-intensity activities may have a broader effect on cognition than MVPA, with MVPA possibly selectively targeting executive functions rather than memory in cognitively healthy older adults. Future research with larger samples should continue to determine the dose-response of PA on cognition to develop tailored preventative interventions.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.03
      Issue No: Vol. 33, No. 6 (2018)
       
  • Aging & Dementia - 4Risk Factors for Earlier Onset of Dementia in Pure
           Alzheimer’s Disease, Mixed Alzheimer’s with Lewy Bodies, and Pure Lewy
           Body Disease: Autopsy-Confirmed Cases from the National Alzheimer’s
           Coordinating Center
    • Authors: Schaffert J; LoBue C, Lacritz L, et al.
      Pages: 692 - 702
      Abstract: Objective: Clinical cases of dementia from Alzheimer’s disease (AD) and Lewy Body disease (LBD) often involve mixed AD and LBD pathology, with risk factors for these conditions poorly understood. We compared risk factors for earlier dementia onset in autopsy-confirmed cases of AD, neuropathologically mixed AD and LBD (AD + LBD), and LBD. Method: Data were obtained from the National Alzheimer’s Coordinating Center, with cohorts of AD (n = 647), AD + LBD (n = 221), and LBD (n = 63) defined using autopsy criteria. Six established general risk factors for dementia were entered simultaneously into multiple linear regressions as predictors of clinician-estimated age of dementia onset: sex, education, a cardiovascular risk composite score, family history of dementia, history of depression, and number of apolipoprotein E ɛ4 (Apoe4) alleles. Results: Risk factors varied across groups. In AD, male sex and Apoe4 alleles each predicted a 2-year earlier onset, and depression predicted a 3-year earlier onset (p’s < .05). In AD + LBD, male sex, Apoe4 alleles, and depression each predicted a 3-year earlier onset (p’s < .05). In LBD, more years of education was associated with earlier onset, and depression predicted a 5.5-year earlier onset (p’s < .05). Conclusions: Results suggest that men and Apoe4 carriers have greater risk of earlier dementia onset from AD but not LBD pathology. Depression may pose a risk for earlier dementia onset in AD, LBD, and AD + LBD. Because depression is a potentially modifiable risk factor, future studies should evaluate if depression factors (i.e., course, duration, treatment, severity) impacts risk. Furthermore, risk associated with additional psychosocial, psychiatric, and medical factors should be explored using autopsy-confirmed cases.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.04
      Issue No: Vol. 33, No. 6 (2018)
       
  • Aging &amp; Dementia - 5Cognitive Contributors to Financial Capacity
           in Older Adults
    • Authors: Sunderaraman P; Omollo S, Ho S, et al.
      Pages: 692 - 702
      Abstract: Objective: Financial Capacity (FC) is not a unidimensional construct, and therefore it cannot be assumed that all elements of FC decline with aging. Indeed, aspects of FC that rely on crystallized knowledge could be expected to improve rather than decline with age. The current study sought to thoroughly investigate the cognitive correlates of FC dimensions in older adults (OAs). Method: The sample included 31 healthy older adults (Dementia Rating Scale mean score = 140.9 (2.56); 73.51% female, 70.6% Caucasian) with an average age of 67.9 (SD = 5.28) and 16.12 (SD = 2.07) years of education. Financial items from the Financial Competency Assessment Inventory (FCAI) were used to measure overall FC and its five dimensions - Everyday Financial Abilities (EFA), Financial Judgement (FJ), Estate management (EM), Financial Cognition (FC), need for Support Resources (SR). Cognition was measured using a comprehensive battery of tests measuring aspects of crystallized (vocabulary, financial literacy) and fluid (inhibition, working memory) abilities. Results: After adjusting for multiple associations, vocabulary was associated with EFA, FJ and FC, whereas inhibition was related to FJ and EM. Overall FC was associated with both vocabulary (r = .67, p < .001) and inhibition (r = .61, p < .001). Financial literacy was not associated with any dimension, but written arithmetic was correlated with EFA, FC and FJ, and oral arithmetic with EM. Conclusions: In OAs, we present partial evidence for the multidimensional nature of FC as different cognitive abilities uniquely relate to specific FC dimensions. However, the influence of crystallized versus fluid abilities is not clear cut, as a few FC dimensions correlated with both of these abilities. Thus, whereas some FC dimensions such as EFA may be preserved or may improve with age, others such as FJ may decline, and still others such as EM may not show a clear pattern. Longitudinal studies or case-control matched studies will help shed light on the trajectories of FC dimensions.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.05
      Issue No: Vol. 33, No. 6 (2018)
       
  • Assessment - 1Attention-Deficit/Hyperactivity Disorder and Driving:
           Self-Reported Behaviors and Simulator Performance
    • Authors: Bernstein J; Calamia M, Roye S, et al.
      Pages: 692 - 702
      Abstract: Objective: To compare those with and without Attention-Deficit/Hyperactivity Disorder (ADHD) on subjective and objective driving measures. Method: College undergraduates with ADHD (n = 16, 37.5% female, mean = 20.2 years of age, SD = 2.7) or without ADHD (n = 72, 65.3% female, mean = 19.2 years of age, SD = 1.6) completed self-report measures of aberrant driving behaviors (i.e., the Driving Behavior Questionnaire) and one-item ratings of their driving ability. They also completed a driving simulator measure designed to induce boredom in which they drove several laps around a short track. Participants also completed a self-report regarding mind wandering experienced while in the simulator (i.e., Attention-Related Cognitive Errors Scale). Results: Compared to those without ADHD history, individuals who self-reported an ADHD diagnosis rated their everyday driving ability more negatively than did those without ADHD (p = .01). They also endorsed greater lapses in attention when driving everyday that pose little safety risk to others (e.g., missing an exit) (p = .04); however, they did not report more serious mistakes (e.g., nearly hitting pedestrian due to inattention) or intentional transgressions that endanger others (e.g., driving drunk) (both p > .05). Individuals with ADHD also reported more mind wandering during the simulator task (p = .001) and utilized the brake (p = .01) and throttle (p = .02) more frequently. Conclusions: Among college students, those with ADHD differ from those without ADHD on both subjective and objective driving measures. Results support past findings and highlight the potential for inclusion of driving measures in ADHD assessment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.06
      Issue No: Vol. 33, No. 6 (2018)
       
  • Assessment - 2What are Computerized Neurocognitive Assessment Tools
           (NCATs) Actually Measuring' Using Principal Component Analyses to
           Compare NCATs to Traditional Neuropsychological Tests
    • Authors: Cole W; Ahrens A, Arrieux J, et al.
      Pages: 692 - 702
      Abstract: Objective: We explored the relationship between computerized neurocognitive assessment tools (NCATs) and traditional neuropsychological tests (NP), to determine if they are measuring similar cognitive constructs. Method: 272 healthy control service members were administered two randomly assigned NCATs (Automated Neuropsychological Assessment Metrics, version 4 [ANAM4]; CNS Vital Signs [CNS-VS]; CogState; Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and a NP battery (WAIS-IV, CVLT-II, RCFT, DKEFS, CPT-2). Standardized scores from NP and NCATs were subjected to principal component analysis (PCA), with Varimax rotation, to detect which NCAT scores formed distinct patterns with NP scores. Results: For all PCAs, there were 3–6 components identified, with the first 1–3 representing within test (e.g. NP or NCAT) relationships and accounting for almost all the variance. The other components demonstrate which NCAT scores load with a NP score. Results are summarized as the percent of each NCAT’s total scores that loaded with at least one NP score (e.g. ANAM4 has 8 scores × 5 NPs = 40 total ANAM4 scores included in PCA). ANAM4: 34.3%; CNS-VS: 11.7%; CogState: 20.0%; ImPACT: 30.0%. Notable observations include multiple NCAT scores loading with only one NP score or vice versa, most NCAT scores loading with NP scores of processing speed or response time, and no clear pattern of NCAT scores consistently loading with NP of supposedly similar cognitive constructs. Conclusions: Findings suggest NCATs are measuring different cognitive functions than traditional NP, even if they are labeled similarly (e.g. “Memory”). Evaluating NCATs via direct comparisons to NP may mask the true clinical utility of NCATs. Disclaimer: The views expressed in this manuscript are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.07
      Issue No: Vol. 33, No. 6 (2018)
       
  • Assessment - 3Assessment of Medication Management Capacity in Ethnically
           Diverse Adults with Intractable Epilepsy
    • Authors: Margolis S; Gonzalez J, Spindell J, et al.
      Pages: 692 - 702
      Abstract: Objective: Antiepileptic drug (AED) nonadherence is an avoidable cause of morbidity/mortality in epilepsy. As self-reported adherence may be unreliable, nonadherence may go undetected. This study assessed the criterion validity of a performance-based measure of medication management capacity in adults with intractable epilepsy. Method: Participants were 50 ethnically-diverse adults (age = 42 ± 14 years, 60% female, 82% Black, 20% Hispanic/Latino) with ≥2 seizures in preceding 6 months. AED adherence was electronically monitored for one month via Medication Event Monitoring Systems (MEMS) and self-reported at follow-up (0 = very poor to 5 = excellent). The previously validated Medication Management Ability Assessment (MMAA) was administered at follow-up and scored by raters blind to adherence results. As MMAA and adherence data were negatively skewed, Spearman correlations assessed their bivariate associations. Results: On average, participants self-reported good-to-very good adherence. According to MEMS, participants took AEDs as prescribed 72% of the time (percentage of days correct number of doses taken); most participants (58%) missed >3 doses and 56% took ≥1 extra dose. The MMAA demonstrated strong internal consistency (KR-20 = 0.81; total score = 27.50 ± 4.65) and was significantly associated with MEMS: percentage of days doses were taken correctly (rs = 0.29, p = 0.04) and frequency of missed doses (rs = −0.31, p = 0.03). The MMAA was not significantly associated with extra doses or self-reported adherence (p’s ≥ 0.14). Conclusions: These findings provide preliminary evidence of the MMAA’s criterion validity as a measure of capacity to manage AEDs. It may prove useful in cases where nonadherence is suspected but unreported by patients. Its lack of significant association with self-reported adherence is consistent with prior reports; however, future studies should replicate these findings with larger samples.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.08
      Issue No: Vol. 33, No. 6 (2018)
       
  • Assessment - 4Retest Reliability of the Immediate Post-Concussion
           Assessment and Cognitive Test Using a Two-Factor Theory with Various
           Interval Schedules
    • Authors: Riberdy C; Rindge M, Daniel M, et al.
      Pages: 692 - 702
      Abstract: Objective: Although the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is the most widely used computerized neuropsychological battery for sport-related concussion, reliability findings vary and research regarding its factor structure is limited. The purpose of this study was to examine ImPACT’s retest reliability using a two-factor model proposed by Schatz and Maerlender (2013). Method: Participants included 109 NCAA Division III male and female athletes who did not have a concussion and volunteered to undergo ImPACT retesting from 24 hours to 4.6 years after baseline. A Memory factor score was the average of Verbal and Visual Memory composite scores and a Speed factor score was the average Visual Motor Speed and Reaction Time composites. Results: Based on Slick’s (2006) guidelines, intraclass correlation coefficients (ICCs) ranged from low to high for the following retest intervals from baseline: to 12 months (n = 54, ICC = .46–.81), to 12–24 months (n = 20, ICC = .77–.81), and to over 24 months (n = 35, ICC = .7–.72). Conclusions: These results are comparable to the two-factor ICC values reported in Schatz and Maerlender but higher than the ICC values for ImPACT’s four composite scores from the same sample (ICCs = .3–.81).
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.09
      Issue No: Vol. 33, No. 6 (2018)
       
  • Assessment - 5The Impact of ADHD and Short Sleep Duration on Preseason
           Symptom Reporting in Adolescent Student Athletes
    • Authors: Terry D; Cook N, Maxwell B, et al.
      Pages: 692 - 702
      Abstract: Objective: Sleep duration the night before preseason testing can affect baseline symptoms, but the interaction between neurodevelopmental disorders and less sleep is unknown. We examined the relationship between sleep duration, Attention-Deficit/Hyperactivity Disorder (ADHD), and baseline symptom reporting in student athletes. Method: From a baseline database of 30,771 athletes ages 13–18 who had not sustained a concussion in the past 6 months and completed all sections of ImPACT®, including the number of hours slept the night before, 21,866 denied having developmental/health conditions (controls) and 1,029 reported only having ADHD (total sample: age M = 15.4, SD = 1.3; 47.4% girls). Athletes completed the Post-Concussion Symptom Scale within ImPACT®. Athletes were divided into four groups based on their sleep duration the night before testing (≤5, 5.5–6.5, 7–8.5, and ≥9 hours). Mann-Whitney U-Tests were used to compare baseline symptom reporting between athletes with ADHD and controls, stratified by sex and sleep duration. Results: Athletes with ADHD reported greater symptom severity than controls when matched on sex and sleep duration (all ps < .05). Effect sizes between ADHD/Control groups were greater for girls than boys. In athletes who slept 5 or fewer hours, 93% of girls and 49% of boys with ADHD reported having a symptom burden resembling an ICD-10 diagnosis of postconcussional syndrome, compared to 49% of girls and 33% of boys without any comorbidities (girls: χ2(1) = 11.08, p = .002; boys: χ2 = 3.89, p = .049). Conclusions: Poor sleep and ADHD, in combination, confound baseline concussion-like symptom reporting. It may be important to consider the effects of preexisting health conditions, sex, and sleep duration when interpreting baseline symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.10
      Issue No: Vol. 33, No. 6 (2018)
       
  • Executive Function - 1Executive Function Training to Improve Weight Loss
    • Authors: Galioto R; Britton K, Gunstad J, et al.
      Pages: 692 - 702
      Abstract: Objective: Behavioral weight loss (BWL) interventions are considered the first line treatment for obesity and typically result in modest weight loss. However, many patients fail to achieve optimal outcomes, which could be due in part to executive dysfunction, given our recent work linking executive functions (EF) and weight loss in this population. This study examined whether EF training improved weight loss among participants of a BWL program. Method: Patients enrolled in a BWL program (n = 29) completed either 8 weeks (30 min, 5 days per week) of computerized EF training (n = 17) or active control (online games; n = 12). Cognitive function and weight (through chart review) were assessed at baseline and 8 weeks. Results: There were no group differences for baseline (cognitive, demographic, anthropometric) variables. EF training participants averaged 16.9 ± 18.6 training days (range = 0–53); those with ≤5 training days (n = 4) were excluded from group comparisons. EF training participants exhibited significantly faster reaction time on the CPT (p = .04) and trended toward faster reaction time on the N-back (p = .05) at 8 weeks compared to controls. Results revealed small to medium effects (Cohen’s d = .3–.4) of EF training on weight loss indicators. There was a trend toward a positive relationship between EF training days and weight loss (p = .09–.10). Conclusions: Results suggest that EF training may improve processing speed/reaction time and weight loss outcomes among individuals who participate in BWL. However, poor adherence to EF training limits these results and future research should investigate methods to improve training adherence.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.16
      Issue No: Vol. 33, No. 6 (2018)
       
  • Executive Function - 2Randomized Controlled Trial of e-Unstuck On-Line
           Parent Training Modules Versus In-Person Training
    • Authors: Kenworthy L; Childress D, Verbalis A, et al.
      Pages: 692 - 702
      Abstract: Objective: Unstuck and On Target is a school- and home-based cognitive behavioral intervention. It has been shown effective in two RCTs at improving executive functions (EF) and classroom behavior in autistic children. Two in-person parent trainings were provided in the RCTs, but in-person trainings are not practical outside of research. We developed an on-line parent training platform (e-Unstuck) that leverages technology for providing parents with interactive practice with EF concepts, and opportunities to individualize materials/training for their child’s specific needs. In this study, we investigate whether e-Unstuck is an effective alternative to in-person parent trainings. Method: 85 parents of autistic children (mean age = 10.3 years;mean IQ = 104) were randomized to receive e-Unstuck (n = 41) or two in-person trainings (n = 44). Outcomes were all parent-rated: self-ratings of sense of strain, empowerment, and competence, and ratings of child’s executive function problems and their interference in daily life. Results: ANCOVAs assessing change over time as a result of parent training while controlling for pre-training baseline scores, child IQ and parent education, revealed no group differences in outcomes (all p’s > 0.27). Significant, albeit small, improvement in all parent self-ratings, as well as parent ratings of their child’s executive function problems, indicated that parents (and their children) in both groups benefitted from the training they received (all p’s < 0.01). Acceptability and feasibility was rated positively in both groups, with no significant differences between the groups. Conclusions: e-Unstuck is a viable alternative to in-person parent trainings. It leverages technology to increase access to training materials for families seeking to support generalization of EF skills.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.17
      Issue No: Vol. 33, No. 6 (2018)
       
  • Executive Function - 3Self-Reported Complexity of Daily Life Moderates the
           Association Between Executive Functioning and Daily Medication Management
           in Community Dwelling Older Adults
    • Authors: Suchy Y; Ziemnik R, Niermeyer M, et al.
      Pages: 692 - 702
      Abstract: Objective: In group studies, executive functioning (EF) is consistently shown to be a strong predictor of instrumental activities of daily living. However, clinicians often find that EF is a poor predictor of daily functioning for individual patients, suggesting that additional contextual factors may play a role. The purpose of this study was to examine whether patients’ life complexity moderates the association between EF and medication management (MM). Method: Community-dwelling older adults (N = 50, age 60–85) completed the Push-Turn-Taptap task (a measure of EF) and a structured interview about the complexity of their daily life (e.g., time spent at work and in home-making and avocational activities). At 8 weekly visits, participants’ prescription pills were counted to monitor the percentage of pills taken correctly over the course of the 8 weeks. Results: In a linear regression, both EF and the interaction term between EF and life complexity emerged as significant predictors of MM [B = −6.781, p < .001 and B = −2.80, p = .006, respectively]. Supplementary analyses, conducted to unpack this interaction, revealed that participants who were characterized by a combination of low EF (the bottom tertile of the sample) and high life complexity (the top tertile of the sample) exhibited significantly poorer MM than the remainder of the sample. Conclusions: EF alone is often an inadequate predictor of daily functioning for individual patients likely because other factors, such as the complexity of patients’ daily lives, moderate the association between EF and functionality. Future research should focus on identifying additional individual- difference factors that moderate the association between EF and daily functioning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.18
      Issue No: Vol. 33, No. 6 (2018)
       
  • Pediatrics - 1Measures of Academic Functioning in Youth with Pediatric
           Stroke: A Systematic Review
    • Authors: Champigny C; Kahnami L, Desrocher M.
      Pages: 692 - 702
      Abstract: Objective: An important cause of acquired brain injury in children, pediatric stroke causes sequelae across a wide range of cognitive domains, including language, attention, memory, and processing speed. As a result, children with stroke are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Few studies have examined the academic profile of these youths. The current systematic review explores the methodologies chosen by researchers to measure school functioning in a pediatric stroke population. An analysis of the methods used is necessary to gain a clear understanding of the strengths and weaknesses of research conducted thus far, and will help inform improved methodologies for future studies. Method: In November 2017, three databases were searched using criteria pertaining to pediatric stroke and academic functioning. The initial search yielded 370 articles. The initial screening resulted in the exclusion of 322 articles. Remaining articles were evaluated for eligibility. A total of 41 articles are included in the review. Results: Two raters read and discussed the full texts to assess methodologies. Descriptive statistical analyses were conducted. Conclusions: Evaluation of the 41 studies unearthed five problematic methodology choices: 1) heterogeneity of measures; 2) lack of ecological validity of measures; 3) focus on parent reports rather than direct youth reports; 4) lack of transparency in disclosing measures; 5) narrow quantity of measures used to assess such a multi-faceted construct as academic functioning. We discuss ways in which to improve methodology to better elucidate the academic profiles and personal school experiences of youth with stroke.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.11
      Issue No: Vol. 33, No. 6 (2018)
       
  • Pediatrics - 2Childhood Primary CNS Vasculitis: A Series of Case Studies
    • Authors: Holder C; Shay N.
      Pages: 692 - 702
      Abstract: Objective: Childhood primary central nervous system (CNS) vasculitis is an understudied neurological disease. We are unaware of any current research assessing neurocognitive or neuropsychological functioning in children following a diagnosis of CNS vasculitis. The current research will provide neuropsychological information on six cases of children with the condition and assist in establishing expectations for outcomes following such a diagnosis.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.12
      Issue No: Vol. 33, No. 6 (2018)
       
  • Pediatrics - 3Halstead Category Test Sensitivity to Brain Disturbances in
           Fetal Alcohol Exposed and Cognitively Disordered Children
    • Authors: Sperbeck D; Craig P, Zelig M, et al.
      Pages: 692 - 702
      Abstract: Objective: The Halstead Category Test (HCT) has been found to be sensitive to a variety of brain disturbances and executive functioning impairments in adults and children. Children exposed to alcohol and other neurotoxins are known to suffer from deficits in their executive functions, abstraction skills, concept formation skills, and cognitive flexibility in the face of complex and novel problem solving. However, the extent of these deficits, rate of improvement with age, relationship to socio-cultural factors, relationship to other acquired cognitive disorders, and association with working memory skills is largely unknown. The purpose of this study was to evaluate the relationship between fetal alcohol exposed (FAE) and non FAE children as a function of age, ethnicity, working memory and executive functioning as measured in HCT errors. Method: 813 psychiatrically hospitalized children aged 9–17 years underwent comprehensive neuropsychiatric evaluations at admission (average LOS = 30 days). 295 individuals were diagnosed with FAE, 201 individuals were diagnosed with non-FAE acquired cognitive disorders, and 317 individuals were determined to suffer from no diagnosable cognitive impairments (control subjects). All participants completed a neuropsychological evaluation which included the HCT-Intermediate Version and the Weschsler Intelligence Scale for Children-IV (WISC-IV). Results: Compared with the cognitively unimpaired control group, FAE children and non-FAE cognitive disordered children produced higher (one-way ANOVA p < .001) HCT errors across all age groups regardless of gender, or ethnicity. FAE and non-FAE cognitively impaired children did not differ significantly in their error rates. HCT error rates improved steadily with age, regardless of the magnitude and degree of cognitive disorders or fetal alcohol exposure. The WISC-IV Working Memory Index was associated with fewer HCT errors across all age groups and cognitive impairment/control groups. A simultaneous multiple regression analysis revealed that the WISC-IV Full Scale IQ factor and age of participant significantly predicted fewer HCT errors with the non-FAE acquired cognitive disorders group producing the most HCT errors. Analysis of the developmental improvement slope (i.e. improvement with age) revealed weakest improvement over time for the non-FAE acquired cognitive disordered children. Conclusions: The HCT consistently distinguished cognitively impaired children from non-impaired children regardless of neuropatholgic etiology, gender, age, or ethnicity.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.13
      Issue No: Vol. 33, No. 6 (2018)
       
  • Pediatrics - 4Differences in Persistent Post-Concussive Symptoms Following
           Motor Vehicle Accident Versus Sports Injury in Adolescents
    • Authors: Tarkenton T; Wilmoth K, Hynan L, et al.
      Pages: 692 - 702
      Abstract: Objective: Persistent post-concussive symptoms and post-traumatic stress symptoms often appear comorbidly and have significant overlap. Current research suggests youth sustaining a mild traumatic brain injury (mTBI) during a motor vehicle accident (MVA) endorse greater symptoms compared to youth with sports-related concussion (SRC), perhaps because of coexisting post-traumatic stress symptoms. The aim of this study was to examine symptomatic factors that characterize mTBI sustained in MVAs versus sports. Method: Participants (aged 7–25) with persistent symptoms (i.e., >30 days) following mTBI due to MVA (n = 69) or SRC (n = 428) were selected from the North Texas Concussion Registry (ConTex). Measures included a four-factor symptom checklist (physical, cognitive, sleep, and emotional), in addition to pre-injury characteristics (e.g. depression). A logistic regression was used to characterize differences between the MVA and SRC groups. Results: The Homer-Lemeshow goodness of fit test showed an excellent fit of the model to the data (p = .497). Physical, cognitive, and emotional symptoms, as well as premorbid depression and time since injury contributed significantly to the model (all ps < .01). Participants in the MVA group were 2.4x more likely to endorse premorbid depression and were slightly more likely (OR 1.01) to demonstrate longer persistence of symptoms following injury than their athlete counterparts. Cognitive and emotional postconcussive symptoms were more likely associated with the MVA injury group (ORs = 1.09 and 1.14, respectively) and physical symptoms were less likely in the MVA injury group (OR = 0.96) compared to the athletes. Conclusions: Results demonstrate that mTBI youth with persistent symptoms following MVA may experience greater cognitive and emotional symptoms and more persistent symptomatology than athletes, possibly related to the context of trauma. More research is needed to distinguish the effects of the trauma itself. Additionally, premorbid emotional functioning may play a greater role in the persistence of symptoms for those who sustain mTBI in a MVA.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.14
      Issue No: Vol. 33, No. 6 (2018)
       
  • Pediatrics - 5Post-Concussive Anxiety Symptoms Predict Later Recovery in
           Adolescent Student Athletes
    • Authors: Wilmoth K; Curcio N, Tarkenton T, et al.
      Pages: 692 - 702
      Abstract: Objective: Variability in recovery time following sports-related concussion (SRC) is poorly understood in youth. We explored psychological sequelae as predictors of prolonged return-to-play (RTP) in adolescents, controlling for established injury-related and demographic risk factors. Method: Student athletes (aged 12–18, N = 141) were evaluated through ConTex study clinics 0–2 weeks after SRC and completed the General Anxiety Disorder-7 Item (GAD-7), Patient Health Questionnaire-9 Item (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), and Sports Concussion Assessment Tool-3rd Edition symptom scale. At 3 months, medical record review confirmed return-to-play (RTP) date. Logistic regression for earlier RTP (post-injury day 0–21) and later RTP (post-injury day 30–90) included self-reported injury/medical predictors (gender, prior concussion, loss of consciousness, amnesia, and initial symptom severity score) and psychological predictors (GAD-7, PHQ-9, and PSQI overall sleep quality). Receiver operating characteristic (ROC) and Area Under the Curve (AUC) analyses were also employed. Results: 64% of the 141 participants had RTP ≤21 days from injury, and 23% RTP ≥30 days. The GAD-7 (M = 2.1, SD = 3.1) was the only significant individual predictor of return-to-play length (p = .001), with a 1.4 times [95%CI 1.2–1.8] greater chance of protracted recovery for every 1-point increase in GAD-7 total score. No other factors discriminated between recovery groups (ps > .05). ROC curve analysis determined an initial GAD-7 score ≥3 was associated with longer recovery (sensitivity = 60.6%, specificity = 84.4%, AUC = 0.79). Conclusions: Our findings linked even minimal post-concussive anxiety symptoms to prolonged return to sport in adolescent athletes, with higher predictive power over previously reported injury/medical risk factors. Brief anxiety screeners may help identity individuals at increased risk for prolonged recovery.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy060.15
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 01Web Camera Based Eye Tracking on a Visual Paired Comparison Task:
           Replication and Relationships with Preclinical Alzheimer Cognitive Indices
           
    • Authors: Bott N; Lange A, Rentz D, et al.
      Pages: 703 - 794
      Abstract: Objective: This study investigated the relationship between a commercial grade eye-tracking camera, (60 frames per second (FPS)), and a manually scored procedure using a laptop-embedded web camera (3 FPS) on a 30-minute Visual Paired Comparison (VPC) recognition memory task. Based upon previous investigation, we further examined performance on the VPC task with tasks of learning and memory, processing speed and executive function. Method: Fifty-one clinically normal older adults completed a 30-min VPC recognition memory task with simultaneous recording of eye movements by a commercial grade eye-tracker camera and a laptop-embedded web camera. Pearson correlations were used to investigate the correlation between VPC performance using the commercial camera and the laptop web camera, as well as the relationship between web camera VPC performance and the Preclinical Alzheimer Cognitive Composite (PACC), NIH Toolbox (NIH) composite, and the Cogstate learning & memory (Cogstate) composite. Results: Robust relationships were observed between the 60 FPS eye tracker and 3 FPS laptop-embedded web camera on both trial level VPC NP (r = 0.81) and overall mean VPC NP (r = 0.92). Moderate relationships were seen between mean VPC NP and the PACC (r = 0.46, p = .004), NIH composite (r = 0.38, p = .02), and Cogstate composite (r = 0.37, p = .03). Conclusions: Manual scoring of a VPC decisional task using a laptop-embedded web camera correlated strongly with automated scoring of the same task using a commercial grade eye- tracking camera. Performance on the 30-min VPC task correlated moderately with cognitive composites that serve as preclinical Alzheimer cognitive indices.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.01
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 02The Relationship Between Apolipoprotein E4 Status and Cognition and
           Depression in the NACC Database
    • Authors: Bryant A; Suhr J.
      Pages: 703 - 794
      Abstract: Objective: Apolipoprotein E (APOE) is risk factor in the development of dementia. We examined the relationship of APOE status on global cognition, memory, executive functioning, and depression in individuals diagnosed with dementia. Method: 9,401 participants from the National Institute on Aging’s National Alzheimer’s Coordinating Center database were examined (E4-0 = 4,221; E4-1 = 4058; E4-2 = 1162). We conducted ANCOVAs controlling for age with APOE status entered as the independent variable and Mini Mental Status Examination (MMSE), Immediate Logical Memory (LM-1), Delayed Logical Memory (LM-2), Semantic Fluency (SF), Trail Making Test-B (TMT-B) and Geriatric Depression Scale (GDS) entered as the dependent variables. Results: E4-0 scored higher on the MMSE, LM-1, LM-2, and TMT-B compared to other groups (all p’s < .01). E4-2 had the lowest scores on LM-1 and LM-2 compared to both other groups (both p’s < .01), while there were no differences on TMT-B between E4-1 and E4-2 (p = .32). There were no differences in SF between groups (p = .53). GDS scores were higher in E4-0 compared to E4-1 and E4-2 (p’s < .01). GDS was correlated with global cognition and executive functioning in E4-0 group only (p’s < .05). Conclusions: Individuals with one or more APOE-4 alleles performed more poorly on several measures of cognition. Neuropsychological testing showed that E4-2 appeared more amnestic compared to other groups. Interestingly, E4-0 had higher depression scores compared to all groups, suggesting that their cognitive concerns may be related to psychiatric status rather than dementia. Further research should examine the impact of depression on cognition in individuals with low genetic risk for dementia.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.02
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 03Implications of Sex and Race/Ethnicity on History of Traumatic Brain
           Injury and Age of Alzheimer’s Disease Onset
    • Authors: Burmaster S; Schaffert J, Bailey K, et al.
      Pages: 703 - 794
      Abstract: Objective: Dementia risk can vary among ethnicities and has been associated with a history of traumatic brain injury (TBI) in some individuals. However, previous studies on the long-term effects of remote TBI on developing dementia have been limited to predominantly non-diverse samples. We evaluated age of Alzheimer’s disease (AD) onset in those with and without a history of TBI in three racial/ethnic cohorts. Method: Data were obtained from the National Alzheimer’s Coordinating Center. Clinician-estimated age of AD onset was compared among non-Hispanic Caucasian (n = 721), non-Hispanic African American (n = 74), and Hispanic (n = 57) groups. Cohorts were dichotomized based on history of remote TBI with loss of consciousness (LOC; >1 year prior to first visit with no chronic deficits). Controlling for education, ANCOVAs were used to evaluate mean differences in age of AD onset in males and females with and without history of TBI. Results: TBI history was associated with an approximately 3-year earlier onset in non-Hispanic Caucasians (p < .001) and non-Hispanic African Americans (p = .003), with no interaction by sex (p’s > .05). In the Hispanic group, an interaction was observed between sex and TBI (p = .018). TBI was not related to earlier onset in Hispanic males (p = .610), but was related to a 5-year earlier onset in Hispanic females (p = .007). Conclusions: Remote TBI with LOC was a risk factor for earlier AD onset across racial/ethnic groups, but sex may play a role within Hispanic populations. Future studies should examine if cultural, genetic, or other factors contribute to the potentially earlier disease expression in female Hispanics with a history of TBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.03
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 04Apathy Symptom Severity and Progression Across Empirically-Derived
           Mild Cognitive Impairment Subtypes
    • Authors: De Vito A; Calamia M.
      Pages: 703 - 794
      Abstract: Objective: The aim of this study was to examine apathy severity at baseline and its progression over time in empirically derived mild cognitive impairment (MCI) subtypes. Method: Participants in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study diagnosed with MCI by ADNI protocol using conventional clinical criteria (n = 788) were re-classified using cluster analysis as amnestic, dysnomic, or dysexecutive MCI, and cluster-derived normal using neuropsychological criteria. Cognitively normal participants (n = 207) were also identified. Apathy severity was measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q), which was administered from baseline and every 6 months thereafter, through 4-year follow-up. Two multilevel models (i.e., clinical vs. neuropsychological criteria) were used to determine apathy symptom severity progression over time by cognitive subtype. Results: Using clinical and neuropsychological criteria, amnestic MCI individuals were identified as having more severe apathy symptoms than cognitively normal participants at baseline. However, only clinical criteria identified dysexecutive individuals as having more severe apathy symptoms compared to cognitively normal controls at baseline. Both models identified a significant worsening of apathy symptoms over time for dysexecutive and amnestic groups, but not dysnomic participants, relative to cognitively normal participants. Conclusions: This study demonstrates that apathy severity and progression differs across MCI subtypes. Identification of individuals who may be at risk of developing more severe symptoms is important given apathy’s association with functional impairment, even after controlling for cognitive impairment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.04
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 05The Effects of Sleep Apnea on Cognitive Deficits in Individuals with
           Alzheimer’s Disease
    • Authors: Fornalski N; Tran V, Ramandesh D, et al.
      Pages: 703 - 794
      Abstract: Objective: Evaluating sleep apnea’s contribution to declining general cognitive and executive functioning in Alzheimer’s disease. Method: Data analyzed was derived from a de-identified database of participants from the National Alzheimer’s Coordinating Center (NACC). The current study consisted of 1,009 diagnosed Alzheimer’s disease participants, aged 65 and older (55.6% female, 86.5% Caucasian, MEd = 16.71 years, SDEd = 11.91 years) divided into three groups: 1) no prior history of sleep apnea, 2) current sleep apnea, and 3) sleep apnea in remission. All participants completed the Montreal Cognitive Assessment (MoCA) and Trail Making Test. Results: Results derived from a MANOVA demonstrated a significant overall effect for the model at α = .05, Wilk’s λ = .987, F(6,2008) = 2.239, p = .037. No significant differences were found between participants without a history of sleep apnea and those with sleep apnea in remission. Participants with current sleep apnea obtained significantly lower Trails B scores than did participants without a history of sleep apnea. Conclusions: Poor sleep is a risk factor for both cognitive impairment and Alzheimer’s disease. However, research has yet to explain the nature and extent of impairment that poor sleep has on cognition in individuals with Alzheimer’s disease. The current study revealed that participants with sleep apnea demonstrated poorer executive functioning. This deficit can significantly impact one’s functional capability, as executive functioning mediates abilities such as planning, organization, and emotional control. Complications of sleep apnea are regrettable, considering its effects are treatable. Future studies should explore the benefit of early corrective treatment of sleep apnea in alleviating cognitive decline in Alzheimer’s patients.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.05
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 06Association of Medial Temporal Atrophy and Amyloid Load on Cognitive
           Performance Among Hispanic and White Non-Hispanic Older Adults
    • Authors: Garcia P; Mendoza L, Rodriguez M, et al.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to explore the relationship between AD biomarkers (regional brain atrophy on structural MRI and amyloid load on PET) and cognitive performance among Hispanic and White non-Hispanic (WNH) older adults. Method: Cross-sectional analyses of 59 participants were split: cognitive-normal Hispanics (CN-H, n = 28, Mean age = 70.53, SD = 6.443) and WNH (CN-WNH, n = 31, Mean age = 72.80, SD = 7.458). Multiple regression analysis was used to develop a model for predicting effects of medial temporal atrophy (MTA) and amyloid deposition on the following measures: HVLT Immediate and Delayed, Category and Phonemic Fluency, TMT-A & B, Block Design, and BNT tasks. Results: Among the CN-H group, significant associations were noted: (1)TMT-A scores with right-entorhinal volume (β = −.660 p = .006) and Amyloid load (β = .527, p = .005), explaining more than 70% of the variance in performance on this task [F(2, 11) = 16.387, p = < .001, R2 = .749]; (2) HVLT (Immediate) scores and right parahippocampal volume (β = .576, p = .007); (3) Block Design scores with right-entorhinal volume (β = .710, p = .028) and Amyloid (β = −.543, p = .050). Among CN-WNH, the only significant association was between TMT-A scores and right-entorhinal volume (β = −1.134, p = .010). Conclusions: These findings indicate that among CN-H cohort, there appears to be a strong predictive relationship between AD biomarkers and processing speed, immediate memory, and visual spatial functions, with more atrophy being associated with poorer performance. Only medial temporal atrophy was significantly associated with processing speed among CN-WNH. Future studies should examine individual cultural factors contributing to these findings and examine these relationships among clinical samples.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.06
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 07The Role of Metabolic Syndrome in Alzheimer’s Disease
           Progression: A Retrospective Study
    • Authors: Parker A; Schaffert J, Smith E, et al.
      Pages: 703 - 794
      Abstract: Objective: Although individual components of metabolic syndrome (MetS) are linked to faster disease progression, previous research evaluating these relationships in MetS and Alzheimer’s disease (AD) has yielded mixed results. We evaluated autopsy-confirmed cases of AD to determine if the presence of MetS was related to the age of disease onset and life expectancy. Method: 1055 subjects with autopsy-confirmed AD (Braak neurofibrillary tangle stages ≥3 combined with at least moderate neuritic amyloid plaques) were obtained from the National Alzheimer’s Coordinating Center database. Subjects with co-occurring neuropathological diagnoses were excluded. MetS was defined using International Diabetes Federation parameters. Subjects were classified as having MetS (n = 116) if they had obesity and ≥2 additional conditions (diagnosis/treatment of: diabetes, hypertension, or lipid abnormality). Obese subjects with one other MetS condition were classified as “at risk” (n = 136). Analyses of covariance (ANCOVA) were used to assess if clinician-estimated age of onset and time from onset to death differed between those with and without MetS, controlling for education, race, gender, and apolipoprotein ε4 status. Results: Average age of onset differed between groups by a maximum of 1 year, which was not statistically significant (F(2,1048) = 0.238, p = .79). Similarly, average life expectancy differed by < 1 year between groups and did not differ statistically (F(2,946) = 0.341, p = .71). Conclusions: MetS status was not significantly related to disease onset or life expectancy in this autopsy-confirmed AD sample. It is possible that treatment for MetS component conditions may moderate the relationship between MetS and AD in patients without co-occurring neuropathological diagnoses, and future studies should examine this relationship.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.07
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 08Wechsler Adult Intelligence Scale-4th Edition Digit Span Performance
           in Normals, Amnestic Mild Cognitive Impairment, and Early Alzheimer’s
           Disease
    • Authors: Ruchinskas R.
      Pages: 703 - 794
      Abstract: Objective: The Digit Span (DS) subtest from the Wechsler Adult Intelligence Scale-4th Edition (WAIS-IV) was changed after 50 years to better measure working memory as preliminary, albeit unreplicated, studies showed that sequencing tasks had an ability to differentiate normal from neurologic groups. This study examines performance on DS for individuals from a memory disorder clinic diagnosed with Amnestic Mild Cognitive Impairment (MCI), early Alzheimer’s disease (AD) or normal aging. Method: 706 individuals were drawn from consecutive referrals who underwent a standard neuropsychological evaluation and obtained a consensus diagnosis from the neuropsychologist and neurologist of AD, MCI amnestic type, or normal aging. This resulted in a 290 individuals with AD, 255 individuals with Amnestic MCI, and 161 normals. Results: Those with AD performed significantly worse for DS total score, digits forwards, and digits backwards versus those with MCI and normals, whose performances were similar. Digit sequencing was significantly different in each group (AD Conclusions: While all components of the Digit Span subtest differentiated those with AD from MCI and normals, only the Sequencing component significantly differed between the three groups. Also the perseveration (continuing to repeat digits backwards) rate for those with AD was approximately three times greater than for those with MCI or normals. Thus the DS Sequencing component taps working memory and other executive processes and aids diagnoses of the MCI/Alzheimer’s spectrum.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.08
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 09The Role of Self, Informant, and Physician Reports of Language
           Ability in Objective Language Performance in Mild Cognitive Impairment
    • Authors: Thompson J; Montgomery V, Kauzor K, et al.
      Pages: 703 - 794
      Abstract: Objective: Limited insight into cognitive deficits is a hallmark of Alzheimer’s disease (AD), and changes in insight in Mild Cognitive Impairment (MCI), the risk state of dementia, need to be established. Neuropsychologists gather reports from patients, their significant others, and physician ratings on any language changes, in addition to objectively assessing language ability. The current study investigated the role of these factors in neuropsychological assessment. Method: Participants included 41 healthy older controls and 40 persons with MCI. Self and informant reports of language changes in daily life were obtained using the Everyday Cognition (E-Cog) language domain. Physicians evaluated language using the Clinical Dementia Rating (CDR) scale section on language. Hierarchical regression analyses were conducted for each diagnostic group, with the E-Cog self-report, E-Cog informant report, and physician CDR as predictors and the Boston Naming Test (BNT) and Category Fluency as separate outcome measures of objective language performance. Results: For the MCI group, self-reported declines in language accounted for 20% of the variance in Category Fluency scores. For healthy older controls, informant-reported declines in language accounted for 28% of the variance in BNT scores. Conclusions: For healthy older adults, significant-other reports of their language ability were predictive of objective confrontation naming ability. In contrast, individuals with MCI who endorsed language decline had deficits in semantic fluency. This suggests that individuals with MCI have insight into changes in specific language abilities. Physician ratings of language were not predictive of language functions.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.09
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 10Rapid Decline for a Patient of Suspected Dementia at Reevaluation
           Despite Low Risk Factors
    • Authors: Wood A; Werry A, Schmitt A.
      Pages: 703 - 794
      Abstract: Objective: Recent research efforts have highlighted a prototypical pattern of risk factors for rapid decline. Fewer studies have examined rate of decline for highly educated, healthy individuals who do not have the research derived risk factors. The present case study aims to highlight a pattern of rapid cognitive decline in the context of minimal risk factors. Method: Test-retest data were analyzed for a 73-year-old Caucasian woman who was referred for an outpatient neuropsychological evaluation. Reevaluation was 20 months the initial evaluation. At the time of the evaluations, the patient had no medical risk factors; was not taking any medications; and was following a healthy lifestyle, including exercise, social engagement, and quality nutrition. She was evaluated using Grooved Pegboard, Phonemic Fluency, Repeatable Battery of the Assessment of Neuropsychological Status (RBANS), Semantic Fluency, Stroop Color and Word Test, Trail Making Test, selected subtests from Wechsler Adult Intelligence Scale-IV, and Wisconsin Card Sorting Test-64. Reliable Change Indexes were calculated to determine significant change between evaluations. Results: The results of the initial evaluation did not warrant a diagnosis. At the time of reevaluation, RBANS Immediate Memory and Delayed Memory; Trails A and B; Similarities; and Phonemic Fluency had significantly declined. RBANS Visuospatial/Constructional and Grooved Pegboard for the dominant hand significantly improved. Major Neurocognitive Disorder due to probable Alzheimer’s disease, without behavioral disturbance was diagnosed at the reevaluation. Conclusions: These results demonstrate a pattern of rapid decline for an individual with minimal risk factors at 20 month follow-up.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.10
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 11Differentiating Neuropsychological Profiles Between Prion Disease
           and Vascular Dementia
    • Authors: Boix Braga M; Jeffrey M, Garcia J, et al.
      Pages: 703 - 794
      Abstract: Objective: To differentiate the neuropsychological profile between Prion Disease-Dementia and Vascular Dementia. Method: Participants were selected from a de-identified longitudinal database of older adults with neurodegenerative disorders. Individuals with Prion Disease Dementia [(PrionD)(N = 108)] and Vascular Dementia [(VD)(N = 499)] were selected. A MANOVA was conducted to compare their performance in measures of narrative memory (Logical Memory- Immediate and Delayed), confrontation naming (BNT), semantic fluency (Animal Fluency), and executive functioning (Trails-B). Scores were age and education were adjusted. Results: A MANOVA was found significant at the participants’ baseline level at the ≤.001 level (Welch’s F(5, 601) = 11.62, p < .001; Wilks’ Λ = .912; partial η2 = .08). Tests with the higher clinical significance included Logical Memory immediate trial, partial η2 = .073, Boston Naming, partial η2 = .077, and Logical Memory delayed trial, partial η2 = .8. Individuals with PrionD consistently performed worst in all measures in comparison to those with VD. Conclusions: Research has demonstrated that Prion Disease-related Dementia is often misdiagnosed as dementias due to other etiologies, including vascular disease, making it necessary to delineate which measures accurately differentiate various dementias. These data suggest a pattern of rapid cognitive decline in prion disease, even when compared to vascular disease. In particular, tests of narrative memory and confrontation naming may be helpful in differentiating PrionD from VD as VD is less characterized by deficits in memory and expressive language, particularly in earlier stages. These neuropsychological findings could provide information needed to accurately diagnose and treat these disorders and their symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.11
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 12Aging, Initial Planning, and Task Execution
    • Authors: Brown K; Schmitter-Edgecombe M.
      Pages: 703 - 794
      Abstract: Objective: Planning ability declines with age. Models of planning suggest the importance of differentiating between initial planning that takes place before a task is executed, and concurrent (online) planning that occurs while a task is being executed. There is currently little understanding about how initial planning influences task execution within the aging literature. Method: Sixty-one older adults (Mage = 72) completed a naturalistic task in which they were required to prepare for a day out, interweaving eight subtasks in way that felt natural and efficient. Participants were instructed to create an initial plan before executing the task. Initial plans were codified and plan efficiency scores (judicious sequencing of tasks) and accuracy scores (number of task-relevant items and locations reported) were developed, which were then compared to task execution efficiency and accuracy scores. Results: Regression analyses revealed that the initial planning scores accounted for a significant 11% of the variance in execution accuracy, F(2,58) = 3.64, p = .03, with plan sequencing being a significant predictor, B = −.99, p = .01. For execution efficiency, the initial planning scores accounted for a significant 23% of the variance, F(2, 58) = 8.65, p = .001, with both plan efficiency, B = .45, p < .001, and plan accuracy, B = −.09, p = .03, being significant predictors. Conclusions: Efficient initial plans predicted task execution accuracy and efficiency. Accuracy of an initial plan had less impact on task execution. Interventions designed to increase older adults’ initial planning efficiency might also improve task performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.12
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 13Who Knows Best' Reliability of Informant- and Self-Reported
           Compensatory Strategies for Everyday Medication Use in Community-Dwelling
           Older Adults
    • Authors: Chudoba L; Weakley A, Schmitter-Edgecombe M.
      Pages: 703 - 794
      Abstract: Objective: This study examined the relationship between self-reported difficulties with medication adherence and use of compensatory strategies. Accuracy of self- and informant-report of strategy use was also compared to observed use. Method: Thirty-nine community-dwelling older adults completed self-report measures of quality-of-life (QOL) and instrumental activities of daily living (IADLs) and rated their difficulty with remembering to take medications. These participants and twenty-one informants reported whether the following five compensatory strategies were used by participants to support everyday medication use: pillbox, notes or alarms, routine, medication visible, and strategy to know whether medication was taken. Participants also walked an examiner through their daily medication routine in their own home, and the examiner recorded presence of the five compensatory strategies. Results: Point Biserial correlations revealed that self-reported difficulty remembering to take medications was significantly related to greater self-reported compensation (p = .03), greater observed compensation (p = .03), decreased QOL (p = .01), and decreased IADL ability (p < .001). For each method of compensation, Chi-square tests of independence revealed no significant difference between examiner observed and self-endorsed compensatory strategy use. Informants tended to overreport use of compensation, with overreporting of pillbox use reaching significance (p = .045). Conclusions: The results indicate the importance of attending to subjective memory complaints of community dwelling older adults as they relate to medication adherence. Self-reported difficulty remembering to take medications related to self-reported deficits in functional abilities and quality of life. Community-dwelling older adults appear to be more reliable raters than informants about compensation methods used to improve medication adherence.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.13
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 14Cobalamin Deficiency and Declining Cognition in Older Adults with
           Neurocognitive Disorders
    • Authors: Garcia J; Tran V, Radmanesh D, et al.
      Pages: 703 - 794
      Abstract: Objective: To evaluate Vitamin B-12’s contribution to declining cognitive functioning in older adults with neurocognitive disorders. Method: Data analyzed was derived from a de-identified longitudinal database consisting of older adults. The current study consisted of 101,064 individuals diagnosed with various neurocognitive disorders who fell under three groups: no B-12 deficiency (N = 80,258), active/recent B-12 deficiency (N = 17,220), and inactive/remote B-12 deficiency (N = 3,586). A MANOVA was conducted to compare their performance in measures of narrative memory (Logical Memory- Immediate and Delayed), processing speed (WAIS-R: Coding) and executive functioning (Trails-B). Scores were age and education adjusted. Results: Results derived from a MANOVA demonstrated a significant overall effect for the model, Wilk’s λ = .999, F(12,268925) = 7.495, p < .001. Significant differences were found between participants without a history of B-12 deficiency and those with active/recent B-12 deficiencies in all studied measures, in which participants with active/recent deficiencies obtained significantly lower scores than those without a history. Conclusions: Cobalamin plays a pivotal role in normal brain and nervous system functioning, and cobalamin deficiency has been associated with several dementias (e.g., Alzheimer’s, Frontontemporal, etc.). Results from the current study found dementia participants with B-12 deficiency performed significantly worse on measures of verbal memory, processing speed, and executive functioning. Cognitive deficits caused by other factors (e.g., vitamin deficiency) may obscure the clinical picture, and thus, reduce diagnostic accuracy. Preliminary research has shown B-12 deficiency treatment via dietary supplementation has proven effective in abating cognitive decline in dementia patients, thus prolonging the period of cognitive functionality and improving quality of life.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.14
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 15Non-Uniform Age-Related Differences and Neuropsychological
           Correlates of Subjective Memory Complaints in Cognitively Normal Older
           Adults
    • Authors: Gracian E; Wright D, Austiff M, et al.
      Pages: 703 - 794
      Abstract: Objective: The aims of this study are to determine if non-uniform age-related differences exist on the Prospective and Retrospective Memory Questionnaire (PRMQ), and to clarify the neuropsychological correlates of the PRMQ. Previous investigators dichotomized cognitively normal older adults into impaired-older (IO) and unimpaired-older (UO) subsets, and found that IO adults were disproportionately deficient in memory abilities that could be predictive of forthcoming Alzheimer’s disease, including a memory dependent medication management assessment. Further, the literature on the relationship among subjective and objective memory measures is inconclusive. Critically, researchers have not investigated whether UO and IO differ on subjective measures of memory complaints, nor identified the neuropsychological correlates of the PMRQ in older adults. Method: Twenty-eight older adults (Women n = 27; Mean Age = 73 years, SD = 8.1) completed measures of executive function (EF), memory, and the PRMQ which consisted of 16 questions that assessed perceived problems concerning retrospective and prospective memory, and the level of frustration with each problem. Older adults were classified as IO (n = 13) or UO (n = 15) based on performance on a verbal learning test; IO adults did not perform within the normal range. Results: UO adults reported significantly more subjective prospective memory complaints (p = .009; Cohen’s d = 1.08) and more frustration (p = .016; d = .99) than IO adults. No group differences were observed on other subscales (p > .05). Additionally, the prospective memory scale is significantly correlated with standardized measures of memory and EF (p < .05). Conclusions: UO adults reported more subjective prospective memory problems than IO adults, possibly due to sharper insight in the UO group, or lesser insight in the IO group. Similarly, UO adults could be more sensitive to subjective memory decline that might explain the higher levels of frustration. Further, neuropsychological findings suggest that both EF and memory are critical for subjective prospective memory.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.15
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 16Individual Differences in Affective Traits Role in Physical and
           Cognitive Performance
    • Authors: Halpin A; MacAulay R.
      Pages: 703 - 794
      Abstract: Objective: Poor physical performance and negative affect (NA) have both been linked to worse executive function. However, little is understood about the relationship between trait NA and physical performance, particularly in older adults. It is possible that NA, and its motivational properties, plays a role in the relationship between executive function and physical decline. Hierarchical multiple regression was thus used to examine whether and the extent to which NA traits and executive function contributed to performance on the short performance physical battery (SPBB), while adjusting for the demographic factors of age and socioeconomic status (income and education). Method: 32 community-dwelling older adults (Mage = 69 years, SD = 5.4) participated in the Maine Understanding Sensory and Cognition (MUSIC) project. Exclusion criteria included scores of >11 on the Geriatric Depression Scale, scores of <19 on the Montreal Cognitive Assessment, diagnosis of a neurodegenerative disease, severe mental illness or a stroke within the last year. The Positive Affect and Negative Affect Schedule (PANAS) measured trait NA. The Trail Making Test (TMT Trails A and B) measured components of attention/processing and executive function. Results: NA associated with significantly worse TMT performance, ps < .001. Regression analyses indicated that socioeconomic status,TMT, and NA each significantly predicted SPPB performance, accounting for 56.9% of the variance. Conclusions: Results replicated other research that has linked SPPB and TMT performance, and extended these findings by investigating whether NA and sociodemographic factors contributed to physical performance. Our findings suggest that trait NA plays a role in poorer physical and executive function performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.16
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 17The Aging Well Through Interaction and Scientific Education
           (AgeWISE) Program: Examining Changes in Attitudes Toward Cognitive Aging
           in Older Veterans at Six-Month Follow-Up
    • Authors: Indorewalla K; Sugarman M, Daley R, et al.
      Pages: 703 - 794
      Abstract: Objective: Public awareness and education regarding cognitive aging and dementia is limited, and there is a need for education and skills training programs for older adults. This study reports the results of a pilot study exploring the impact of AgeWISE (Aging Well through Interaction and Scientific Education), a 12-week psychoeducational and skills training intervention on cognitively intact older Veterans designed to enhance understanding of normal and pathological aging. Method: Forty-nine cognitively intact veterans aged 62–87 participated in this randomized controlled trial. Eligible veterans were randomized to the AgeWISE Intervention (n = 25) or wait-list Control (n = 24) groups and completed questionnaires regarding knowledge of Alzheimer’s disease and attitudes regarding cognitive aging at baseline, after the group, and at six-month follow-up. Results: The Intervention group demonstrated enhanced contentment with their memory compared to the Control group after the intervention, and this gain was maintained after 6 months (Time x Group Interaction: F(2,94) = 5.61, p = .01. The Intervention group also reported more positive beliefs about potential improvements they could make in their cognitive functioning (Time x Group Interaction: (F(2,94) = 5.70, p = .01] 6-month post intervention. No significant differences were observed between groups with regard to their overall knowledge of Alzheimer’s disease, beliefs about current memory abilities, or self-reported use of compensatory memory strategies. Conclusions: AgeWISE participants reported enhanced beliefs regarding their memory contentment and ways in which they could improve their memory after completing a 12-week cognitive rehabilitation group. These gains were maintained six months after their participation in the program. Results support the use of AgeWISE for promoting positive views about cognitive aging.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.17
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 18Stability of MoCA Scores for Patients Seen in a Memory Disorders
           Clinic
    • Authors: Krishnan K; Thompson N, Bonner-Jackson A.
      Pages: 703 - 794
      Abstract: Objective: To determine the rate of change in Montreal Cognitive Assessment (MoCA) scores over time among patients evaluated in a memory disorders clinic. Method: At each visit, a physician assigned the following diagnoses based on clinical evaluation; cognitively intact (CI); cognitive dysfunction- not neurodegenerative (CD); Mild cognitive impairment (MCI), Alzheimer’s disease (AD), and other dementia (FTD, DLB, PPA). Of 1632 patients included in this study, 470 patients completed 2 or more MoCA’s with same diagnosis over a 6-year period. Results: Of the 339 patients with 823 visits, 13 remained classified as cognitively intact, 41 as cognitive dysfunction (did not meet criteria for MCI), 180 MCI, 45 AD, and 60 classified as other dementia. Average age 68.0 (SD = 8.5) and 69% had more than 12 years of education. There were significant group differences in age and baseline MoCA score. The average time between MoCA completions was 390.6 days (SD = 273.7). Results of the mixed-effects linear regression model showed about 1 point/year change in patients with MCI (estimate = −0.95, P = 0.04) as well as patients in “other dementia” category (estimate = −1.08, P = 0.039) compared to those cognitively intact. Patients with AD declined 2.19 points/year compared to the cognitively intact (P < 0.001). Age and education were not significantly related to MoCA score. Conclusions: MoCA Total scores showed significant decline in older adults with cognitive impairment over a period of 1–4 years but not in the cognitively intact. Results provide clinically relevant information regarding expected change in MoCA scores over time.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.18
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 19Moderating Effect of White Matter Integrity on Brain Activation
           During Dual-Task Walking in Older Adults
    • Authors: Lucas M; Wagshul M, Izzetoglu M, et al.
      Pages: 703 - 794
      Abstract: Objective: In aging, mobility decline is common and associated with adverse outcomes. Knowledge of brain systems of mobility, however, is scarce given limitations of traditional imaging methods. Using functional Near Infrared Spectroscopy (fNIRS), we have established the key functional role of the PFC in cortical control of locomotion in aging. The current study, using Diffusion Tensor Imaging (DTI) and fNIRS, determined moderating effects of white matter integrity (WMI) in whole brain and select tracts on PFC oxygenated hemoglobin (HbO2) levels assessed during active walking under single and dual-task conditions. Consistent with neural inefficiency, we hypothesized worse WMI would be associated with greater increase in PFC HbO2 from single- to dual-task walking in the context of worse or similar gait performance. Method: 60 cognitively-healthy older adults (mean age = 74.53, 53.2% women) underwent DTI to derive measures of Fractional Anisotropy (FA) and fNIRS, which measured PFC HbO2 during normal-walking (NW) and walk-while-talk (WWT). Results: Linear mixed effects model (LMEM) demonstrated HbO2 levels increased from single to dual-task walking (p < 0.01, 95% confidence interval [CI] = −0.68,−0.46) given greater cognitive demands inherent in the latter condition. Consistent with predictions, LMEM showed whole brain FA moderated the change in PFC HbO2 levels from NW to WWT (p = .035, 95%CI = 0.46,12.47), with lower FA associated with greater change in PFC HbO2 from NW to WWT. A similar moderating effect was found in the genu of the corpus callosum (p < .001, 95%CI = 1.88,6.15). A number of other tracts were explored. Conclusions: Results suggest compromised WMI in anterior commissural fibers may underlie inefficient PFC response to cognitive demands of locomotion.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.19
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 20Positive Effects of Body Mass Index on Memory Performance,
           Irrespective of Activity Level, in Healthy Aging Older Adults
    • Authors: Mestre Z; Osuna J, Zlatar Z, et al.
      Pages: 703 - 794
      Abstract: Objective: The number of people aged 65 and older is projected to reach 83.7 million by 2050. In middle age, a higher body mass index (BMI) is associated with poorer cognitive performance (e.g., memory, executive functioning). However, this association is less clear in older adults as a higher BMI has been associated with better cognitive performance, and lower risk of Alzheimer’s disease. This study sought to better understand the relationship between weight and cognitive performance in healthy older adults, and determine whether this association is affected by activity level (i.e., sedentary time, and light to moderate physical activity). Method: Forty older adults ages 65 to 85 years old (age = 72.6 ± 5.1, BMI = 25.4 ± 4.1, 37.5% male) were recruited from ongoing research studies at the University of California San Diego and VA San Diego Healthcare System. Participants completed neuropsychological testing and wore an accelerometer to determine activity levels. Exclusion criteria included mild cognitive impairment (MCI) or dementia, history of stroke or cardiovascular disease, psychoactive medications, or depression. Results: After accounting for age, education, and sedentary time, linear regression models showed that a higher BMI was associated with better performance on measures of immediate memory recall (t = 2.243, p = 0.03) and delayed memory recall (t = 2.43, p = 0.02). Total amount of light and moderate physical activity did not significantly affect this association. Conclusions: Our results provide preliminary support that a higher BMI in healthy older adults may be associated with better cognitive performance. Future studies should examine the causal direction of this relationship.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.20
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 21Poorer Memory and Executive Functioning Across the Lifespan:
           Contributions of Alexithymia
    • Authors: Paitel E; Correro A, Byers S, et al.
      Pages: 703 - 794
      Abstract: Objective: Alexithymia is a trait characterized by difficulty identifying feelings (DIF), describing feelings (DDF), and externally oriented thinking (EOT). Limited alexithymia research suggests poorer memory for emotive materials and possible executive functioning (EF) impairment. As alexithymia, memory, and EF all worsen with age, we predicted poorer EF and delayed memory associated with higher alexithymia in healthy, cognitively intact adults across the lifespan. Method: Experiment 1: 40 young adults (age 18–35, 29 female) and 104 elders (age 48–86, 68 female) completed tests of EF (Trail-making (TMT), symbol-digit modalities, category fluency), and alexithymia (Toronto Alexithymia Scale-20 (TAS-20)). Experiment 2: 34 young adults (19 female, age 18–22) and 87 elders (62 female, age 50–92) completed the TAS-20 and TMT, and a subset completed delayed narrative memory tests (34 young, 42 elders). Results: Across both studies, hierarchical regression significantly predicted EF by age (p < .001) and sex (p < .05) in Step 1, with significant addition by alexithymia in Step 2 via DIF (p < .05). In Experiment 2, age and sex predicted memory in Step 1 (age p < .001; sex p = .01), with EOT contributing in Step 2 (p = .07). In elders where memory scores had greater range, EOT made a strong contribution (p = .007). Conclusions: EF was poorer in older age, male sex, and higher alexithymia (DIF) in young and older adults. Delayed memory was similarly predicted but by EOT, especially in elders. Moreover, memory effects were apparent with neutral memoranda in this large sample. Thus, alexithymia should be considered in future studies due to its influence on cognitive functioning across the lifespan.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.21
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 22A Case Study Involving Multiple Medical Conditions and Memory
           Deficits
    • Authors: Shumaker G; Nolty A.
      Pages: 703 - 794
      Abstract: Objective: A 71-year-old Hispanic woman had subjective memory complaints. Accompanying health concerns included prediabetes, hypertension, hyperlipidemia, vestibular issues, sleep apnea, ovarian cancer, bilateral hip pain, mood dysregulation, and complicated bereavement, thereby reducing the clarity of the underlying etiology. This case study therefore expands upon the literature of mild cognitive impairment (MCI). Method: Severe vertigo and left-sided headache focalized around the temples resulted in hospitalization in 2015. A subclinical lacunar infarct was determined via imaging. Two years later, confusional episodes and vestibular difficulties again resulted in hospitalization and neurological consultation. Complaints of subjective decline in memory and cognitive functioning were noted, resulting in a referral for neuropsychological testing. Testing was conducted over two sessions. Results: Reductions were evidenced in phonemic fluency, complex divided attention, and processing speed, and there was increased difficulty on visuoconstructive tasks, especially those requiring mental rotation. Encoding inefficiencies were prevalent; however, repeated exposure improved learning curves. The stress on the system from predisposing vascular medical issues rendered it difficult to rule out the differential of vascular dementia. However, deficits in frontal/temporal, and parietal functioning, along with reduction in cortico-cortical connections were consistent with a diagnosis of a multidomain MCI. The grieving process, appropriate for the magnitude of the family losses, augmented the symptoms associated with this diagnosis, as did chronic pain. She also met criteria for a recurrent, major depressive disorder of moderate severity. Conclusions: Through a diagnosis of MCI (and not vascular dementia), we advocated for a more holistic treatment plan, therefore augmenting the possibility of substantial improvement in her memory.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.22
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 23The Effect of Medication Regimen Complexity Index on Medication
           Management Performance-Based Assessments
    • Authors: Sumida C; Norman S, Weakley A, et al.
      Pages: 703 - 794
      Abstract: Objective: Important predictors of medication nonadherence include medication management abilities and cognition. Less is known about how an individual’s home medication regimen complexity might affect their performance on laboratory performance-based measures of medication management. Method: The Medication Management Abilities Assessment (MMAA), the medication subtest of the Revised Observed Tasks of Daily Living (OTDL-R), and personal medication regimen information were collected from community dwelling older adults (N = 41, Mage = 73.0, SDage = 9.53; Medu = 15.3, SDedu = 2.7). A Medication Regimen Complexity Index (MRCI), which included number of medications, frequency of dose and medication rules (e.g., take with food), was calculated from participants’ medication information. Participants also completed neuropsychological tests of processing speed, working memory, executive functioning and memory. Results: Separate Poisson regression analyses were performed to examine the effect of MRCI on MMAA and OTDL-R outcome measures, while controlling for cognitive variables. MRCI did not significantly predict medication management performance in any of the regressions. However, processing speed and working memory positively and significantly predicted MMAA and OTDL-R performance, respectively, while accounting for MRCI and the other cognitive variables. Conclusions: Although MRCI, medication management abilities and cognition are all considered important aspects of everyday medication adherence, relationships among these variables are not well understood. MRCI did not predict medication management abilities as assessed by performance-based laboratory tests. MRCI and medication management abilities may capture different aspects of everyday medication adherence. Future work is needed to examine how MRCI, medication management abilities and cognition contribute to medication adherence in the real-world.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.23
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 24Neuropsychological Assessment of Dementia in Individuals with an
           Intellectual Disability
    • Authors: Adams L; Rice T, Harris A, et al.
      Pages: 703 - 794
      Abstract: Objective: Like the general population, there is an increase of dementia cases in individuals with an Intellectual Disability (i.e., Intellectual Developmental Disorder; ID/IDD). There remains a paucity of empirically based practices to detect dementia in this population. Standard neuropsychological measures come with a variety of challenges that may include misunderstanding instructions, underlying receptive language disorders, and lack of normative and/or premorbid functioning data. The purpose of the following systematic review is to examine the literature, case study data, and commonly used neuropsychological measures and to report a summary of findings. Data Selection: A search was conducted using the PsychINFO, PubMed, and MEDLINE databases with a combination of the terms “neuropsychological assessment,” “neuropsychological,” or “assessment;” “dementia;” and “intellectual disability” or “intellectual disabilities,” which resulted in N = 3,439 total articles. After excluding irrelevant studies lacking individuals who were intellectually disabled, N = 30 articles remained. Data Synthesis: A review of the articles yielded three systematic review studies that identified the effectiveness of instruments used in the screening, assessment, and diagnosis of dementia in adults with ID/IDD. Other articles discussed the utility of screening instruments, discrepancies between checklists in determining dementia, differences in presentation of dementia in those with ID/IDD versus the general population, and pilot studies for new instruments. Conclusions: This review identified the continued need for empirically based assessment methods, either developed or modified, for the use and purpose of diagnosing dementia in the ID/IDD community. Further analysis of specific assessment measures with an in-depth understanding of its’ utility in assessing neurocognitive impairments in individuals with ID/IDD is warranted.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.24
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 25Executive Attention Predicts Agitation in Older Adults with
           Cognitive Impairment and Dementia
    • Authors: Becker C; Choi E, Gonzalez Catalan M, et al.
      Pages: 703 - 794
      Abstract: Objective: Individual tests of executive functioning and working memory have been used to predict behavioral problems such as agitation in older adults with cognitive deficits (e.g., Vance et al., 2003). Theoretical models of executive functioning and working memory have been made, but less so with the model of combining them as executive attention (EA) (McCabe et al., 2010). This study examined if the factor EA can be used with older adults with cognitive impairments and if the factor EA, compared to individual executive functioning and working memory tests, will better predict agitation. Method: From a large diverse community study, 721 older adults with a range of mild cognitive impairment and dementia diagnosis were included. Neuropsychological tests (Serial 7s Subtraction Total, Animal Fluency Total Score, Controlled Oral Word Association Total Score, and Trails Part B Total Seconds to Complete) were used in a factor analysis to create the factor EA. Agitation was measured by the Neuropsychiatric Inventory (NPI). Results: EA explained 54 % of the variance of the working memory and three executive function tests. Multiple regressions indicated that EA explained 3.5% of the variance for agitation, whereas the individual tests of executive functioning and working memory explained 1% to 2.9%. Conclusions: The factor EA was created for older adults with varying levels of cognitive impairments. EA was just as good, if not better, at predicting agitation in these older adults. This study suggests that further research is needed on EA in older adults with mild to more severe neurocognitive disorders in predicting behavioral problems.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.25
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 26Awareness of Psychiatric Symptoms and Caregiver Distress Among Older
           Adults in a Memory Disorders Clinic
    • Authors: Brunet H; Cummings J, Banks S, et al.
      Pages: 703 - 794
      Abstract: Objective: Reduced awareness of symptoms is common in dementia and contributes to caregiver burden. Unawareness of psychiatric symptoms, in which a patient does not agree with a caregiver report, is not well understood. This study aims to characterize the frequency with which unawareness of psychiatric symptoms occurs in patients with cognitive impairment and its influence on caregiver distress. Method: Adults aged 65 and older (M = 74) seen at an outpatient neurology clinic for neuropsychological evaluation (N = 855, 52% female) were studied. The presence or absence of psychiatric symptoms was based on self-report using published criteria for the 30-item Geriatric Depression Scale (>10) and the Beck Anxiety Inventory (>8). Caregiver ratings of depression and anxiety, and associated distress, were determined using the Neuropsychiatric Inventory Questionnaire. Unawareness was defined as when a caregiver rates a patient as depressed or anxious and the patient self-report does not agree. Results: Among patients rated as depressed by caregivers, 65% of patients also reported depression while 26% did not. The unaware group had lower ratings of caregiver distress than the group with awareness (p < 0.01). Among patients rated as anxious by caregivers, 61% of patients agreed and 18% did not. There were no differences in caregiver distress between patients with or without awareness of anxiety (p = 0.096). Conclusions: Unawareness of psychiatric symptoms is common in this clinical sample and may signify challenges for treatment or need for caregiver education. Additionally, unlike unawareness of cognitive or functional decline, unawareness of psychiatric symptoms is not associated with increased caregiver distress.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.26
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 27A Case Study of Primary Progressive Aphasia
    • Authors: Eng K.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this case study is to describe the neuropsychological profile of a complex case of Primary Progressive Aphasia (PPA). Differentials between Semantic vs. Logopenic variants are explored. Method: The patient is a 62-year-old left-handed female who was referred by her neurologist after being diagnosed with PPA. The patient reported noticing a problem with language and memory approximately two years ago. Positron Emission Tomography (PET) scan of the brain indicated symmetric decrease in activity of the anteromedial temporal lobes. Magnetic Resonance Imaging (MRI) of the brain indicated some fronto-parietal atrophy. She underwent a comprehensive neuropsychological battery. Results: Results of neuropsychological testing revealed some motor slowing in her dominant hand and primary areas of cognitive difficulty were seen in the areas of attention, language, and executive functioning. Language dysfunction included poor comprehension for complex information, repetition, frequent paraphasias, impaired fluency, and declines in word reading. Executive dysfunction was evidenced by trouble solving novel problems, motor sequencing difficulties, source memory errors on memory testing, and a tendency to perseverate. She took a disorganized and poorly planned approach when copying a complex figure. Processing speed was an area of strength and memory was generally intact. Emotional assessment indicated minimal symptoms of anxiety and depression. Conclusions: Performance on testing was highly variable, and most prominent for language and executive functioning. Relatively speaking, memory was intact and there was no evidence of semantic dementia. Pattern was suggestive of frontotemporal dementia, with considerations for primary progressive aphasia. Differentials between Semantic vs. Logopenic variants of PPA are explored.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.27
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 28The Quick Dementia Rating System and Ecological Validity in a Memory
           Disorders Cohort
    • Authors: Junod A; Childs K, Stewart P.
      Pages: 703 - 794
      Abstract: Objective: Neuropsychological testing is often used in the detection and differential diagnosis of dementia. Available evidence suggests moderate correlations between cognitive test performance and functional status in the context of dementia and mild cognitive impairment (e.g., Mitchell, Dick, Wood, Tap, & Ziegler, 2015). Nevertheless, the ecological validity of cognitive tests in this population is not entirely clear. The present study aimed to further explore the relationship between cognitive test performance and functional status as quantified by an informant report measure, the Quick Dementia Rating System (Galvin, 2015). Method: Participants were 68 elderly individuals who underwent neuropsychological evaluation for memory-related concerns, had completed a battery of cognitive tests, and an informant rated QDRS. Both mild cognitive impairment and dementia were well represented in the study group. Measures included: Neuropsychological Assessment Battery (NAB; List Learning and Digit Span), Trail Making Test A & B, The Complex Ideational Material, Phonemic Fluency, Semantic Fluency, Repeatable Battery for the Assessment of Neuropsychological Status (Figure Copy) and the QDRS. Results: Absolute partial correlations controlling for age and education demonstrated moderate to strong relationships between cognitive test variables and the QDRS total score (r = .317 to r = .600, p < 0.01), with the exception of RBANS Figure Copy. Conclusions: These findings indicate a significant relationship between cognitive test scores and functional status as measured by the QDRS, supporting the ecological validity of neuropsychological testing in this population. Future studies predicting functional status from cognitive test data and clarifying the cognitive variables responsible for this relationship are warranted
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.28
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 29Review of Cognitive Functioning for Persons with Post-Traumatic
           Stress Disorder and Associated Risk of Dementia
    • Authors: Modesto M; Valdivia R, Rodriguez M.
      Pages: 703 - 794
      Abstract: Objective: Individuals with an existing diagnosis of Post-Traumatic Stress Disorder (PTSD) may be at heightened risk for dementia, due to shared hippocampal atrophy and corticosteroids. A combined diagnosis of PTSD and dementia may further impair functioning and adaptability to future stress and trauma. The aim of this study was to review the impact of stress on cognitive functioning and highlight the susceptibility of those with PTSD in developing dementia. Data Selection: A systematic search was conducted and data included details of methodology, demographics, clinical characteristics, and study criteria. Inclusion criteria consisted of the following: English language, peer reviewed, year range 2010–2018, full texts available, and PTSD. Excluded articles that did not meet criteria for the quality of research and reporting. Data Synthesis: Eight studies were selected for this review with a combined total of 746,398 participants; more than 90% of them male, aged 55 and older. The studies included focused on the disease process of PTSD and co-morbidity of dementia. Findings suggested that PTSD has over a 70% co-morbidity rate with dementia. One study examined longitudinal data on life experience and development of dementia evidenced a decrease in daily functioning, cognitive performance and profound memory impairments. Conclusions: Individuals with PTSD and dementia experience greater severity of symptoms and further deficits in daily functioning and quality of life. These results may help guide clinicians and caregivers to disease comprehension, symptom tracking, and engagement in specific skills training to improve quality of life as an attempt to compensate for any potential decline in their current abilities.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.29
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 30Premorbid Intellectual Functioning and Functional Assessment in Mild
           Cognitive Impairment
    • Authors: Montgomery V; Thompson J, Kauzor K, et al.
      Pages: 703 - 794
      Abstract: Objective: A decline in functional abilities is required for a diagnosis of dementia. In Mild Cognitive Impairment (MCI), patients may have subtle changes in everyday functions but are still generally independent. Researchers are increasingly using performance-based assessments, such as the Everyday Problems Test (EPT), to provide an objective estimation of functional abilities in older adults. However, the use of performance-based assessments that depend heavily upon written formats may be impacted by premorbid intellectual functions. The current study investigated the impact of estimated premorbid intelligence on EPT performance. Method: Seventy-six older adults (Normal Cognition, N = 39; MCI, N = 37) participated in the study. The Wechsler Test of Adult Reading (WTAR), which measures the ability to pronounce irregularly spelled words, was used as an estimate of premorbid intelligence. The EPT, which uses printed material to assess everyday activities essential to independent living, was also administered to all participants. Results: Regression analyses established that premorbid intelligence significantly predicted functional abilities for both the Normal Cognition and MCI groups. In the Normal Cognition group, premorbid intelligence accounted for 15% of the variance in functional ability. In the MCI group, premorbid intelligence accounted for 20% of the variance in functional ability. Conclusions: Early, subtle functional changes may occur in Mild Cognitive Impairment. For objective measures that require reading ability, consideration of premorbid intelligence is important for a thorough assessment of everyday skills with older adults, whether they have normal cognition or MCI. Therefore, clinicians should include premorbid intelligence estimates when assessing performance-based functioning in addition to using years of education.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.30
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 31A New Measure of Functional Gait Assessment to Distinguish Amnestic
           and Non-Amnestic MCI
    • Authors: Nitsch K; Wager M, Milano N.
      Pages: 703 - 794
      Abstract: Objective: To test whether functional gait assessment can differentiate patients with amnestic versus non-amnestic mild cognitive impairment (MCI). Method: Data from a neurology memory clinic was analyzed. Neuropsychological assessment included gait velocity measurement (feet/second), which was calculated for: (1) average single-task walking speed over two trials; and (2) average dual-task walking speed over two trials, during which participants walked while spelling a five-letter word backwards. Determination of amnestic and non-amnestic MCI was made according to Petersen (2004) criteria. Analyses of variance assessed for group differences across gait-task conditions. Repeated-measures analysis of variance assessed for within-subjects change in gait velocity across single- and dual-task conditions. Results: 59 participants (amnestic MCI n = 20; non-amnestic MCI n = 39) were included. Findings revealed group differences for single-task gait velocity (F = 11.18, p = .002), with non-amnestic MCI patients being slower, but not dual-task gait velocity (F = 0.003, p = .958). Repeated-measures analysis of variance revealed a significant main effect, with overall reduced gait velocity between single-task and dual-task gait conditions, but no significant interaction between task condition and MCI group assignment. Between-group word-spelling error rates differed significantly, with amnestic MCI patients making more spelling errors on “arrow” backwards than non-amnestic patients (F = 3.49, p = .027). Conclusions: Functional gait assessment is a new, brief psychometric tool that differentiated patients with amnestic vs. non-amnestic MCI. Non-amnestic MCI patients were significantly slower during single-task gait conditions when compared to amnestic MCI patients. During the dual-task gait condition error rate was significantly higher in the amnestic group.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.31
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 32The Shepherd Verbal Learning Test: Simple 10-Item Supraspan Test for
           Use in a Memory Clinic Population
    • Authors: Norheim N; Kissinger-Knox A, Cheatham M, et al.
      Pages: 703 - 794
      Abstract: Objective: List-learning tasks provide rich measures of auditory-verbal learning and memory. The Shepherd Verbal Learning Test (SVLT) was developed in 2007; this 10 one-syllable English word list-learning test has 5 learning trials and one unannounced 10-minute delay trial. The present study provides normative data for community dwelling elders who presented at a memory clinic and who were diagnosed as falling within normal limits. Method: The SVLT was administered as part of a brief memory screen or a brief neuropsychological evaluation. Following comprehensive case and/or chart review, 184 participants (M = 76.60, SD = 7.04, 52.2% female, 87.5% Caucasian, range 60–98) were diagnosed as scoring within normal limits (WNL), and their SVLT data are shown here. Results: With a total possible total memory score out of 50, participants immediately recalled an average of 35.11 (SD = 5.26) words on the SVLT over 5 learning trials. The average score on Trial one was 4.60 (SD = 1.42) and on Trial five 8.36 (SD = 1.22). The average best trial score was found to be 8.72 (SD = 1.07). The average delayed memory score was found to be 7.21 (SD = 1.69). The average correct recognitions was 9.40 (SD = 0.84). Conclusions: In order to diagnose neurodegenerative disease at any stage, verbal list learning tasks provide key tools of measurement. However, some list learning tasks neglect to take into account the floor effect, often present in the learning patterns of the elderly and cognitively challenged. The present study describes the development and validation of a 10-item word list task (Shepherd Verbal Learning Task) comprised of monosyllabic words following paradigms suggested by CERAD.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.32
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 33Jogging Your Memory: A Systematic Review and Meta-Analysis of the
           Effects of Exercise Interventions on Global Cognitive Functioning in
           Patients with Dementia
    • Authors: Ogram Buckley C; Williams R.
      Pages: 703 - 794
      Abstract: Objective: Medication is often the primary intervention for treating the symptoms of dementia; however, these medications often come with adverse side effects and do not promote lasting cognitive improvements. This meta-analysis explored the effects of exercise as a potential cognitive intervention for patients with dementia by analyzing data from randomized controlled trials that investigated the impact of an exercise intervention on Mini-Mental State Exam (MMSE) scores. Data Selection: Searches of PsycINFO and PubMed databases were conducted in January and February 2018 to identify randomized controlled trials investigating the effect of exercise on global cognition in patients with a diagnosis of dementia. Studies investigating multimodal interventions (i.e. more than exercise) were excluded. Sample search terms included “exercise,” “physical activity,” and “dementia.” Studies were included if they utilized representative samples and provided sufficient data to calculate mean and standard deviation of MMSE scores of the experimental and control groups. Weighted effect sizes were calculated using random effects models. Data Synthesis: 4,549 titles and abstracts were initially screened; 65 studies were selected for full abstract review, and 24 studies for full-length review. A total of 4 studies (n = 135) were included in the final analysis. Preliminary analysis had a mean difference of 4.66 (Z = 8.25, p < 0.0001, I2 = 37%) favoring the exercise intervention. Conclusions: Results suggest that physical activity programs are potentially effective interventions to improve global cognitive functioning in patients with dementia. Future studies should see if this positive cognitive change is accompanied by improvements in activities of daily living.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.33
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 34Examining the Relationship Between Apathy and Depression with
           Cerebral Amyloid and Hippocampal Atrophy Among Cognitively Normal and
           Cognitively Impaired Older Adults
    • Authors: Rodriguez Granda A; Greig-Custo M, Garcia P, et al.
      Pages: 703 - 794
      Abstract: Objective: To evaluate associations between AD biomarkers (hippocampus and amyloid load) with the frequency of apathy and depression among participants in 1Florida Alzheimer’s Disease Research Center. Method: Cross sectional analysis of 136 participants (mean age = 71.18, SD = 7.603) were diagnosed as Cognitively Normal (CN, n = 42), Mild Cognitive Impairment (MCI, n = 64), and Dementia (D, n = 30). 61% of participants reported being Hispanics. Presence of depression was determined using the GDS, 5+ score. Apathy was determined using the NPI, 1+ score. Amyloid (Am+) and hippocampal atrophy (HP+) positivity were categorized as 0-absence, 1-presence. Frequency of depression and apathy among diagnostic and ethnic groups based on MTA+ and Am+ was evaluated using chi-square. Results: Apathy increased with severity of cognitive impairment (CN-10%, MCI-25%, D-50%, χ2 (2, N = 136) = 15.0, p = .001) but not with atrophy (HP + 31% vs HP- 18%) or Amyloid (Am + 34% vs Am- 21%). Frequency of depression did not change with increasing cognitive impairment (CN-22%, MCI-25%, D-30%). Among the cognitively impaired combined group (MCI + D), depression was more frequent in those without amyloid (40% vs 13%); χ2 (1, N = 94) = 8.48, p = .004), but it was not related to HP. Frequency of apathy and depression did not differ among ethnic groups (Hispanics vs non-Hispanics). Conclusions: Novel findings from our study indicate that depression may contribute to cognitive impairment independent of amyloid pathology, but it was not associated with HP atrophy. Our results suggest that apathy may be a consequence of cognitive impairment, independent of the underlying neurodegenerative pathology.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.34
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 35Cognitive Progression of Neurofibromatosis Type 1
    • Authors: Scharaga E; Chang A.
      Pages: 703 - 794
      Abstract: Objective: There is limited research on the cognitive functioning of patients diagnosed with Neurofibromatosis type 1 (NF1) across the lifespan. NF1 is an autosomal dominant genetic disorder, characterized by neurofibromas, axillary and/or inguinal freckling, Lisch nodules, and café-au-lait spots. Majority of studies in NF1 have been in pediatrics due to functional difficulties across development. We aim to present serial cognitive testing in an older adult with NF1 to identify cognitive progression and to enhance current literature. Method: A case study of a 65-year-old male, diagnosed with NF1 as a teenager. We compared outpatient neuropsychological evaluations completed in 2013 and 2017, to assess for cognitive and functional change. Results: In four years the patient demonstrated declines in visuospatial function, as expected, from his history of an optic glioma. Verbal functioning, verbal memory, and aspects of executive function also deteriorated. Mood-related distress and limited insight into cognitive deficiencies were also observed. Conclusions: Patient evidenced further decline in nearly all aspects of cognition. Furthermore, functional abilities and mood function also deteriorated within the four year span. Documented progressive decline in a patient diagnosed with NF1 is contrary to previously literature. Our case highlights the vulnerability of elderly NF1 patients for cognition decline, beyond the general aging population. Particularly, specific cognitive decline with increased vegetative symptoms and apathy further impact their daily function.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.35
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 36A Neuropsychological Case Study of Auditory Charles Bonnet Syndrome
    • Authors: Sekunda V; Black J.
      Pages: 703 - 794
      Abstract: Objective: Complex visual hallucinations following visual sensory/perceptual loss were the historical hallmark of Charles Bonnet Syndrome (CBS). Studies suggest a relationship between visual CBS and dementia, though little is known about the neurocognitive profile of auditory CBS (Russell, Harper, Allen, Baldwin, & Burns, 2018), which is only recently being recognized as a distinct clinical syndrome (Hori, Terao, & Nakamuro, 2001; Greener, 2014). This case provides one of the only known examples of a neuropsychological profile in auditory CBS. Method: 81-year-old, right-handed, Caucasian female with near total hearing loss treated with bilateral hearing aids. Onset of constant, complex musical hallucinations began in 2017; she was diagnosed with auditory CBS by her neurologist. She presented with worsening memory difficulties and decline in instrumental activities of daily living. No prior psychiatric history. Results: Her performance on a test used to estimate premorbid verbal functioning fell within the average range which was consistent with her score as predicted by her demographic history (i.e., education, occupation, region, sex, and race/ethnicity). Her overall objective testing indicated that she demonstrated difficulty encoding, consolidating, and recognizing visual information. She appeared to variably benefit from repetition of auditory information and she was able to encode, consolidate, and recognize auditory information. Conclusions: Counterintuitively, despite markedly decreased auditory acuity and constant auditory hallucinations, the patient demonstrated relative strengths for auditory versus visual memory and intact simple auditory attention. This paradox highlights the need for further investigation of the neuroanatomical correlates of auditory CBS and its longitudinal neurocognitive profile.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.36
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 37Performance Validity Testing in Veterans with Cognitive Impairment
    • Authors: Smith A; McBride W, Cottingham M.
      Pages: 703 - 794
      Abstract: Objective: There is a scarcity of research examining the utility of established performance validity tests (PVTs) in patients suspected of having dementia. The goal of this study was to examine the utility of 6 PVTs in a veteran population with cognitive impairment at a southeastern Veterans Affairs Hospital. Method: This study utilized archival data from 98 veterans diagnosed with either a major or mild neurocognitive disorder [NCD; mean-age = 72.47 (8.70); mean-education = 12.59 (2.98); 94% male] and examined test specificity using established cut-offs for 4 PVTs [Trail Making Test (TMT) Ratio; California Verbal Learning Test-II (CVLT-II) Forced Choice (FC); Rey Complex Figure Test (RCFT) Copy; Test of Memory Malingering (TOMM) Trial 1] and 2 additional cut-offs [Wechsler Adult Intelligence Scale-III or IV (WAIS-III/WAIS-IV Vocabulary minus Digit Span (VDS); WAIS-III/WAIS-IV Reliable Digit Span (RDS)] derived from prior research with dementia populations. Results: VDS and TMT Ratio had excellent specificity (> 90%) across both major and mild NCD groups as well as for the total sample. In contrast, specificity for the remaining 4 PVTs ranged from 38% to 87% when examining the total sample. Moreover, when analyzing the major and mild groups separately, only TOMM Trial 1 and CVLT-II FC had adequate specificity (94% and 100%, respectively) in the mild NCD group. Lastly, adjustments were made to cut-offs to set specificity to ≥90% among the two NCD groups and total sample when appropriate. Conclusions: Certain PVTs are more useful than others in discriminating credible from non-credible performance in veterans with varying levels of cognitive impairment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.37
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 38The Diabetic Brain and Cognitive Decline
    • Authors: Tran V; Garcia J, Radmanesh D, et al.
      Pages: 703 - 794
      Abstract: Objective: This study investigated the influence of Type 1 and Type 2 diabetes on cognitive functioning in the geriatric population. Method: Data analyzed was derived from a de-identified database of participants from the National Alzheimer’s Coordinating Center (NACC). The current study consisted of 83,395 participants, aged 65 and older (58.3% female, 85% Caucasian, MEd = 15.69 years, SDEd = 6.51 years) sorted into three groups 1) Type 1 diabetes diagnosis, 2) Type 2 diabetes diagnosis, and 3) no diabetes diagnosis. All participants completed a neuropsychological battery. Results: Results derived from a MANOVA demonstrated a significant overall effect for the model at α = .05, Wilk’s λ = .922, F(28,166758) = 246.27, p < .001. Participants with any history of diabetes performed significantly worse on tests of auditory memory, visual memory, simple attention, working memory, processing speed, confrontational naming, and phonemic fluency. No significant differences between Type 1 and Type 2 diabetes were found on any test of cognitive functioning. Conclusions: Prior research has shown that diabetes mellitus is associated with decreased cognitive functioning and higher risk for dementia; therefore, participants with a history of diabetes were expected to perform significantly worse on tasks of cognitive functioning than would subjects with no history of diabetes. Data derived from this study supported the hypothesis, substantiating the deleterious influence of diabetes on cognition, and reinforced the importance of diabetes prevention and treatment. Specifically, insulin therapy may play a crucial role in the managing cognitive deterioration in individuals with diabetes. Future studies, incorporating longitudinal data, should explore the potential benefits of insulin treatment on cognition within this population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.38
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 39SPECT Cerebral Blood Flow Differences Between Self-Reported Low and
           High Levels of Social Skills in Geriatric Sample
    • Authors: Trinidad B; Bennett R, Harcourt S, et al.
      Pages: 703 - 794
      Abstract: Objective: To assess which brain areas, as measured by SPECT, are related to self-reported levels of social skills. Method: Using a symptom checklist, participants were determined based on their self-reported levels of social skills. The participants were part of a large archival de-identified database that received SPECT scans. A total of 453 geriatric aged clinical sample were categorized into low levels of self-reported social skills group (N = 315, Female = 49.5%, Mean age = 72.35) and high levels of self-reported social skills group (N = 138, Female = 37.7%, Mean age = 70.22) who were primarily male (54.1%) with a mean age of 71.70. Participants were placed in their respective groups based on whether their responses fell at or below the 25th percentile or at or above the 75th percentile. The two groups were then compared in 17 brain areas at baseline. Results: An Independent samples t-test showed hyper-perfusion in the high social skills group in left Cerebellum t(451) = −1.412, p < .010 and left Temporal t(451) = −1.146, p < .007. Hyper-perfusion in the low social skills group in the left Motor Sensory t(451) = 1.395, p < .027. Conclusions: The hyper-perfusion in the cerebellum and temporal lobe provide further evidence supporting the protective factor of social skills in the geriatric population. Previous studies have identified social interactions and physical exercise as the top protective factors. The temporal lobe acquires auditory direction and interprets the information while the cerebellum provides the coordination to accomplish desired action. These hyper-perfusions allow for greater awareness in social cues therefore, increasing social interactions. Future analysis can focus on motor sensory by eliminate diagnoses such as dementia.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.39
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 40Cardiovascular Status as a Predictor of Verbal Memory Performance
    • Authors: Eversole K; Valentine T, Gries J, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine the contribution of cardiovascular health status to rote versus contextual verbal memory performance in community-dwelling, neurologically healthy adults. Method: Using a retrospective, cross-sectional design, N = 89 community-dwelling adults completed an outpatient neuropsychological evaluation (Age 54.42 ± 11.81 years; Education 14.84 ± 2.84 years; Female 67.4%). Exclusion criteria included primary neurologic or severe mental illness, and/or invalid performance. Measures included Wechsler Memory Scale-IV Logical Memory I & II and California Verbal Learning Test-II (CVLT-II). Data were collected via self-report and medical record review. A series of one-way MANCOVAs examined the relationship between cardiovascular conditions (i.e., hypertension (HTN), hyperlipidemia, diabetes mellitus) and verbal memory performance. Covariates included age, education, anticholinergic medications, and psychiatric comorbidity. Results: Controlling for all covariates, hypertensive status was significantly associated with overall CVLT-II performance (F = 4.04, p = .003, Λ = .794, η2 = .206). Follow-up univariate tests indicated main effects for CVLT-II Trials 1–5 (F = 8.48, p = .005, η2 = .094; No HTN 50.18 ± 1.60, HTN 43.06 ± 1.70), SDFR (F = 8.29, p = .005, η2 = .092; No HTN 10.53 ± 5.4, HTN 8.17 ± .57), LDFR (F = 12.25, p = .001, η2 = .130; No HTN 11.05 ± .56, HTN 8.06 ± .60), and recognition hits (F = 16.61, p = .000, η2 = .168; No HTN 14.72 ± .38, HTN 12.36 ± .41) with a trend for false positive errors. Results of hyperlipidemia, diabetes mellitus, and WMS-IV analyses were non-significant. Conclusions: Independent of demographic and health variables, hypertensive status uniquely predicted performance on rote but not contextual verbal memory. These findings demonstrate that hypertensive status produces a distinct memory profile among cardiovascular conditions. Future investigations should replicate these findings in larger samples and examine the effects of other cardiovascular conditions on verbal memory performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.40
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 41Post-Stroke Anxiety: A Case Study
    • Authors: Miller K; Penna S.
      Pages: 703 - 794
      Abstract: Objective: Rehabilitation from stroke generally focuses on cognitive and physical aspects of recovery, but over 20% of stroke survivors experience post-stroke anxiety (Chalmers et al, 2017). The current case exemplifies the need to address emotional aspects as well. Method: Ms. A suffered a thrombolytic occlusion of her right internal carotid artery (ICA). MRI of the head revealed involvement of the right basal ganglia corresponding to known acute/subacute infarction seen on CT. Ms. A underwent successful thrombectomy with complete recanalization of the intracranial ICA, with follow up CT showing reconstituted flow for affected areas. A full neuropsychological battery was administered four months post-stroke assessing aspects of cognitive, fine motor, and emotional functioning. Follow-up assessment was completed one year post-stroke. Results: Ms. A demonstrated impaired attention and visual spatial skills, mild left neglect, motor deficits lateralized to the left, impaired deductive reasoning, and apathy at the time of her initial assessment. Despite her self-report of no improvement since her initial testing, follow-up testing one year later showed overall improvement in all cognitive domains with only mild visuospatial cognitive difficulties remaining. However, the patient had significant levels of anxiety, which contributed to her subjective difficulties in functioning, and limited independent activities, such as driving and housework. Conclusions: Involvement in traditional rehabilitation services assisted in Ms. A’s recovery of cognitive and physical functioning following stroke. However, anxiety levels exacerbated her subjective perception of deficits and hindered her functional outcome. Careful monitoring of post-stroke adjustment should be included in a comprehensive rehabilitation program.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.41
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 42Case Study of Bilateral Stroke in an Individual with X-Linked
           Lymphoproliferative Syndrome
    • Authors: Myers B; Hutchinson K, Lawrence D, et al.
      Pages: 703 - 794
      Abstract: Objective: X-linked lymphoproliferative syndrome is a rare disease associated with a recessive gene. Exposure to Epstein-Barr virus increases risk of many complications, including blood clotting. Studies of the neuropsychological functioning of individuals with these complications, including blood clotting is highly limited. The purpose of this study was to explore the neuropsychological functioning of an individual with bilateral frontal and left occipital stroke. Method: This case study involved a 43 year old man in inpatient physical and cognitive rehabilitation. Measures included the MoCA, Zung Anxiety Self-Assessment Scale, Zung Self-Rating Depression Scale, SDMT, Short Category Test, Trail Making Test, Animal Naming Test, K-BIT-2, Rey Osterieth Complex Figure Test, and WMS-III-Abbreviated. Results: The results revealed MoCA score in the mild impairment range; Complex Figure Test Copy subtest in the severe range, Immediate Recall subtest in the borderline range, and Delayed Recall subtest in the mild impairment range; anxiety in the marked to severe range, and motor speed in the mild impairment range. Results on tests of executive functioning, category fluency, and intellectual functioning were in the low average to average range. Conclusions: The findings provide implications for future research on neuropsychological functioning associated with complications related to x-linked lymphoproliferative syndrome. They also appear to suggest resilience in an individual who survived beyond the typical age of survival for someone with his condition and particular in multiple Special Olympics.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.42
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 43The Relationship Between Cardiovascular Risk Factors and Verbal
           Memory Performance
    • Authors: Valentine T; Eversole K, Gries J, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine the relationship between cardiovascular risk factors and verbal memory performance in neurologically healthy adults. Method: Eighty-nine neurologically healthy outpatients (Age 54.42 ± 11.81 years; Education 14.84 ± 2.84 years; 67.42% female) referred for cognitive concerns to a university-affiliated medical center completed a neuropsychological evaluation. Cardiovascular risk variables were collected via medical record review and included hypertensive status (hypertension vs. no hypertension) and body mass index (BMI) category (normal vs. overweight/obese). Verbal memory performance was assessed via the California Verbal Learning Test-II (CVLT-II). A one-way MANCOVA examined the relationship between cardiovascular risk factors and CVLT-II raw scores. Covariates included age, education, anticholinergic medications, number of psychiatric conditions, and number of sleep disorders. Results: Controlling for covariates, a significant interaction between hypertensive status and BMI category was observed when predicting CVLT-II performance (F = 2.32, p = .03, Λ = .816, η2 = .184). Univariate analyses were significant for interactions predicting CVLT-II SDCR (F = 7.18, p = .009, η2 = .084), LDCR (F = 5.46, p = .02, η2 = .065), and Recognition Hits (F = 6.15, p = .02, η2 = .073), such that individuals who were both hypertensive and overweight/obese had worse CVLT-II performance than individuals who were hypertensive but not overweight/obese. Individuals who were not hypertensive but overweight/obese exhibited worse CVLT-II performance than individuals who were not hypertensive and also not overweight/obese. Hypertensive status and BMI category did not exhibit main effects on CVLT-II performance. Conclusions: Hypertension and BMI interact to predict verbal memory performance in neurologically healthy adults, independent of other possible predictors of cognitive functioning. Cardiovascular factors may have a cumulative effect, such that individuals who are both hypertensive and overweight are at greatest risk for cognitive impairment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.43
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 44Sleep Disturbances After Mild Traumatic Brain Injury: A Needs
           Assessment and Program Development Study
    • Authors: Barbuscak C; Piszczor R, Dell’Angela K.
      Pages: 703 - 794
      Abstract: Objective: Taken alone, sleep disturbances can affect many areas of functioning. However, problems are further exacerbated when combined with traumatic brain injury (TBI). While research has addressed the prevalence of sleep disorders in the TBI population (Baumann, Werth, Stocker, Ludwig, & Bassetti, 2007) and the impact on the recovery process (Holcomb et al., 2016), information regarding how to intervene remains relatively undetermined. Method: A mixed methods needs assessment electronic survey examined the perspectives of clinicians in the health and mental health field (n = 70) with experience in TBI. It explored the necessity for a sleep program for individuals with mild TBI (mTBI) and ascertained the feasibility for implementation. Brief interviews (n = 2) were also conducted. Utilizing the results from the survey, sleep programming was then developed. Results: Survey questions were analyzed using modal response, with most participants agreeing to the benefit (52%) and need (50%) for sleep programming. Feasibility was also considered, with willingness to address sleep issues (53.13%) and offer services (41.27%). Qualitative themes elaborated on the unique needs within the population and endorsed the necessity for increased provider awareness of post-injury sleep. Conclusions: The data obtained through this study confirmed that sleep disturbances following mTBI can exacerbate symptoms and impact recovery. Therefore, an interdisciplinary educational toolkit was developed to increase awareness of post-injury sleep disturbances and to initiate intervention. A supplemental manual that is sensitive to the unique needs of the mTBI population was also created to be utilized alongside sleep intervention, mainly Cognitive Behavioral Therapy for Insomnia (CBT-I).
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.44
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 45Effect of Self-Reported Fatigue on Neuropsychological Test
           Performance in Mild Traumatic Brain Injury
    • Authors: Bens M; Noachtar I, Ruff R.
      Pages: 703 - 794
      Abstract: Objective: This study examined the effect of self-reported fatigue on neuropsychological test performance in individuals with Mild Traumatic Brain Injury (mTBI). Method: Fifty-three adults meeting diagnostic criteria for mTBI (age 18 to 71 years) were selected from a clinical cohort of patients referred for neuropsychological evaluations. Post-mTBI fatigue was endorsed by 33 patients, and denied by 20 patients. Comparisons of fatigued and non-fatigued groups were made using the standard results from the 5-minute Ruff 2&7 Selective Attention Test, and WAIS-IV Coding, Digit Span and Matrix Reasoning subtests. We also examined fatigability scores comparing performance at the end of the Ruff 2&7 to performance at the beginning. Results: Results of Mann-Whitney U tests comparing the fatigue and non-fatigue groups indicated a significant difference in Ruff 2&7 automatic detection error fatigue scores (z = − 2.226; p = .026), with the fatigue group demonstrating increased automatic detection errors toward the end of the test. The rate of errors in the controlled condition approached, but did not reach significance (z = −1.761; p = .078). Both groups achieved a similar number of hits at the end of the automatic and controlled trials of the Ruff 2&7 test (z = −0.074; p = .941), and no significant differences were found between the two groups on standard Ruff 2&7 scores or WAIS-IV subtest performances. Conclusions: Findings indicate that self-reported fatigue does not significantly affect standard neuropsychological test scores. However, subtle performance differences can be measured that may help elucidate the influence of fatigue in post-mTBI functioning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.45
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 46Post-Concussion Symptom Reporting within the First 5-Years of the
           Recovery Trajectory Following Uncomplicated Mild Traumatic Brain Injury: A
           Cross-Sectional Perspective
    • Authors: Brickell T; Lippa S, French L, et al.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to examine the prevalence of self-reported post-concussion symptoms within the first 5-years following uncomplicated mild traumatic brain injury (MTBI) and poly-trauma. Method: Participants were 422 U.S. military service members (Age: M = 33.3, SD = 9.4; 85.3% male) prospectively enrolled in a nation-wide 15-year longitudinal study (205 uncomplicated mild TBI [MTBI], 131 trauma controls [TC], 86 healthy controls [HC]). Participants completed the Neurobehavioral Symptom Inventory (NSI) at one or more time periods post-injury: < 8-months, 1-year, 2-years, 3-years, and 5-years. Results: The MTBI and TC groups consistently reported more NSI symptoms compared to the HC group at all time periods (all p’s < .004). In addition, the MTBI group consistently reported more NSI symptoms compared to the TC group at all time periods (all p’s < .014), except in the acute phase of recovery (p = .681). The proportion of participants that met ICD-10 criteria for Postconcussion Syndrome (PCS) was high across all groups and all time periods (i.e., MTBI = 34.1–56.9%; TC = 24.0–34.0%; HC = 14.0%). A higher proportion of the MTBI group met criterion for PCS compared to both the TC and HC groups at 2, 3, and 5 years’ post-injury (all p’s < .042). Within the first year post-injury, a higher proportion of the MTBI and TC group met criterion for PCS compared to the HC group (all p’s < .05). Conclusions: These results once again demonstrate that self-reported post-concussion symptoms are not unique to mild TBI. Self-reported post-concussion-like symptoms long after a remote mild TBI are likely due to many factors unrelated to the brain injury itself and should not be used to support a diagnosis of mild TBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.46
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 47Acute Cognitive Effects Following a Concussion Among Adolescent
           Athletes with Two or More Prior Concussions
    • Authors: Cook N; Brett B, Terry D, et al.
      Pages: 703 - 794
      Abstract: Objective: People with multiple prior concussions might be at risk for greater acute effects from a future concussion. We examined cognitive test performance acutely after a concussion among adolescent athletes who reported a history of two or more concussions. Method: A total of 39,161 adolescent athletes underwent baseline testing and 3,730 were re-assessed following a suspected concussion. Of those with a suspected injury, 467 without co-occurring neurodevelopmental problems were evaluated within 3 days of injury and 37 reported two or more prior concussions (i.e., the index injury represents at least their third concussion). Using a nested case-control design, each participant with two or more prior concussions was individually matched to two youth without a history of concussions (“injured controls”; index injury represents their first concussion) based on age, sex, and sport (total n = 111; age: M = 16.2, SD = 1.1). ImPACT® composite scores were examined with a Multivariate Mixed ANOVA (Between-Subjects = group, Within-subjects = time). Results: There was a main effect of time (Λ = 0.86, F = 4.21, p < 0.01, ηp2 = 0.14), with worse cognitive test performance acutely following injury, specifically in Verbal Memory (p < 0.001, ηp2 = .11, medium effect) and Reaction Time (p = .02, ηp2 = .05, small effect). There was not a significant main effect for group (Λ = 0.94, F = 1.72, p = 0.15) or group-by-time interaction (Λ = 0.95, F = 1.29, p = 0.28). Conclusions: Both groups had worse verbal memory and reaction time acutely following concussion, but the groups had similar magnitudes of decline from baseline. Having a history of two or more prior concussions was not associated with worse cognitive test performance acutely following a subsequent concussion.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.47
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 48Baseline Symptoms from the Sports Concussion Assessment Tool (SCAT)
           Predict Concussion Recovery Time in Collegiate Athletes
    • Authors: DaCosta A; Dugan S, Grueninger K, et al.
      Pages: 703 - 794
      Abstract: Objective: Previous research has shown that greater level of symptoms following a concussion is associated with prolonged recovery time (Meehan et al., 2013; Barth et al., 2003). However, there is a lack of research regarding how an athlete’s baseline level of symptoms prior to a concussion affects their recovery time. Method: 72 college athletes (M = 19.69, SD = 1.54; 54.8% female) completed either the SCAT-3 or SCAT-5 at the pre-participation baseline and post-concussion. A multiple linear regression was used to determine how SCAT symptoms predicted recovery time. Results: Median recovery time was 13.5 days (M = 20.58, SD = 16.76), ranging from 4 days to 81 days. Recovery time was calculated as total days from trauma to medical clearance. A step-wise multiple linear regression was used to create a model of symptoms from the SCAT that best predicted recovery time. The combination of “More Emotional” (R = .345, p = .002), “Blurred Vision” (R = .444, p = .010), and “Sensitivity to Noise” (R = .492, p = .044) predicted 21% of the variance in concussion recovery (Adjusted R2 = .210). Conclusions: The concussion symptoms “More Emotional,” “Blurred Vision,” and “Sensitivity to Noise,” reported at baseline assessment, were significant predictors of recovery time. In accounting independently for the variance in recovery time, these symptoms also represented two of the four categories of post-concussion symptoms (emotional and physical). The emotional symptom category was the primary predictor, while physical category symptoms contributed to the predicted variance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.48
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 49Quality of Life Inventory After Traumatic Brain Injury (QOLIBRI)
           Scale: A More Holistic View of TBI
    • Authors: Deragon K; Marker C.
      Pages: 703 - 794
      Abstract: Objective: Approximately 2.8 million traumatic brain injury (TBI) related hospital visits occurred in 2014. (CDC, 2017). The Quality of Life Inventory After Brain Injury (QOLIBRI) assesses physical, social, psychological and Daily life aspects (von Steinbucechel et al). This literature review will assess the psychometric properties of the QOLIBRI and its suitability for individuals that sustained a severe TBI. Data Selection: Data sources included Psych INFO, Google Scholar, and PubMed. A systematic review of the literature on these databases was examined using the specific term (QOLIBRI, severe TBI, and adults). Collectively, 278 results were found. Exclusionary criteria included research on individuals under 18 years of age and less than one-year post-injury. Data Synthesis: The QOLIBRI has been published in 6 languages and is currently being evaluated against measures such as the Glasgow Scale Extended (GOSE) and the Hospital Anxiety and Depression Scale (HADS). Variations within certain subscales have been noted among different cultures. Conclusions: The QOLIBRI has good validity and reliability. However, individuals with severe TBI scored lower on the QOLIBRI, possibly due to greater cognitive deficits and physical limitations. Quality of Life directly correlated with emotional and cognitive factors indicating the importance of neuro-rehabilitation.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.49
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 50Effects of Expecting Functional Disability Following Moderate/Severe
           Traumatic Brain Injury
    • Authors: Fedio A; Sexton J, Roper C, et al.
      Pages: 703 - 794
      Abstract: Objective: This study explored effects on self-concept and treatment motivation in individuals with TBI who were told by health care professionals to expect problems in physical, cognitive, and/or emotional functioning as a result of their injury. Method: Seventeen individuals with moderate/severe TBI (10M, 7F; mean age 35; 4 yrs post) were asked what they had been told by health professionals to expect regarding functional changes. Measures included the Neurobehavioral Functioning Inventory, Tennessee Self-Concept Scale, and Motivation for Rehabilitation Treatment Questionnaire. Results of Pearson and point biserial correlational analyses (p < .05) are reported. Results: NFI and TSCS:2 results placed within the average clinical range. Patients’ expectation of cognitive impairments related to higher personal self-concept (r = .41). Anticipating more impairments, specifically regarding cognitive or emotional functioning, was associated with less reliance on professional help (r = −.51, −.48, −.48), and negatively related to patients’ moral self-concept (r = −.49). Physical and social self-concept negatively related to anger (r = −.57, −.49). Gender differences revealed that female patients endorsed less denial (rpb = .43), while patients with female family raters endorsed higher family self-concept and behavioral ratings (rpb = .55, .45). Conclusions: Having been told to expect post-TBI cognitive problems led to a more positive self-image in patients four years post injury. An expectation of more functional problems was associated with greater sensitivity to impulsive behaviors and less reliance on professional help. Involvement of a female family member enhanced patients’ family self-concept. Findings underscore the importance of having health professionals inform patients of post-TBI changes, particularly in areas related to cognition and emotions. This procedure promotes an opportunity to address problems early that emerge during recovery from TBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.50
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 51Differences in Blood Flow in a Former NFL Population Based on
           Self-Reported Executive Functioning Difficulties
    • Authors: Fitzgibbon K; Diah K, Sattaur Z, et al.
      Pages: 703 - 794
      Abstract: Objective: To determine differences in blood flow at baseline based on self-report executive functioning difficulties in a cohort of former NFL players. Method: SPECT data came from a de-identified database of 2,493 subjects. Seventeen ANOVAs were used to determine differences in blood flow in those with high(n = 25; M_age = 55.09;100% male;68.8% Caucasian) and low(n = 25;M_age = 51;100% male;68.8% Caucasian) self-reported executive functioning problems. Symptoms included difficulty planning, problem solving, and staying organized. High and low groups were created based off the top and bottom third of sum scores on these items, respectively. Seventeen regions of interest (ROIs) were analyzed. Blood flow was measured at baseline. Results were analyzed at the .05 level. Results: Results revealed significant differences between high and low groups at baseline in cerebellum-left (F(1,16) = 5.727,p = 0.48) and parietal-left(F(1,16) = 3.848,p = .046). The high group displayed significantly increased blood flow in cerebellum-left and significantly less in parietal-left. Conclusions: Impairment in problem solving, planning and organization can make daily activities of living extremely challenging. Understanding how and why this occurs, especially in a population of former athletes, can help to tailor treatment and intervention approaches in order to assure that athletes are able to maintain a high quality of life even after retiring from sports. Results suggest that there are subtle differences in those with high and low self-reported symptoms. Increased blood flow in the left-cerebellum in the high group suggests that there is perhaps dysfunction with motor planning and processing of sensory information. Decreased blood flow in left-parietal in this group could suggest difficulty with object perception and orientation.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.51
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 52Changes in Parent-Reported EF Deficits Predict Select
           Parent-Reported Adaptive Functioning Deficits in Pediatric Survivors of
           Mild-to-Severe TBI
    • Authors: Hague C; Tan A, Tarkenton T, et al.
      Pages: 703 - 794
      Abstract: Objective: Following traumatic brain injury (TBI), children may exhibit difficulties with executive functioning (EF), sometimes associated with adaptive deficits. Our longitudinal study investigated whether changes in parent-reported EF are associated with changes in parent-reported adaptive functioning for pediatric survivors of moderate-to-severe TBI. We hypothesized that declines in parent-reported EF would predict declines in parent-reported adaptive functioning. Method: Thirty-four participants (M = 7.55 years) with moderate-to-severe TBI completed acute and 10-month follow-up neuropsychological assessment including the Behavior Rating Inventory of Executive Function (BRIEF), Behavior Assessment System for Children, Second Edition (BASC-2), Adaptive Behavior Assessment System, Second Edition (ABAS-2), and Vineland Adaptive Behavior Scale, Second Edition (VABS-2) at both timepoints. Change scores between timepoints were calculated for all BRIEF subscales, BASC-2 adaptive subscales, ABAS-2 Conceptual, Social, and Practical composites, and VABS-2 Adaptive Behavior Assessment Scale composite. Multiple regression analyses examined whether BRIEF subscale change scores predicted changes in adaptive functioning. Results: Survivors who demonstrated declines in BRIEF Monitor, Plan, and Initiate were more likely to show declines in BASC-2 Social Skills (p = .004), while declines in Monitor, Organization of Materials, Plan/Organize, and Emotional Control collectively predicted declines in BASC-2 Adaptability (p = .018). BRIEF change scores did not significantly predict ABAS or VABS-2 change scores. Conclusions: Results raise the possibility that the BASC-2 may be more sensitive than the ABAS-2 or VABS-2 in identifying adaptive deficits related to declines in EF in children who have experienced moderate-to-severe TBI. Alternatively, BASC-2 adaptive scoring may over-pathologize. Clinical considerations, limitations, and future directions will be discussed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.52
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 53Blast Exposure Moderates the Association Between Post-Traumatic
           Stress Disorder and Cognition in Veterans with Mild or Moderate Traumatic
           Brain Injury
    • Authors: Holiday K; Clark A, Merritt V, et al.
      Pages: 703 - 794
      Abstract: Objective: Although there is evidence to suggest that blast exposure and posttraumatic stress disorder (PTSD) may independently negatively influence cognition in Veterans with mild or moderate traumatic brain injury (mmTBI), the combined effects of blast exposure and PTSD on cognitive performance remain poorly understood. The current study therefore examined whether history of blast exposure interacts with PTSD to negatively influence cognition in Veterans with mmTBI. Method: 105 Veterans with mmTBI (89% male; age: M = 32.2, SD = 7.36) completed neuropsychological testing, the PTSD Checklist-Military Version (PCL-M), and were divided into two groups: Veterans with mmTBI who were (mmTBI+Blast; n = 63) and were not (mmTBI-nonBlast; n = 42) exposed to blast. Dependent variables included a global cognitive composite of 18 tests, and three subdomain composites (processing speed, verbal memory, executive functioning). Results: Multiple regression analyses revealed a significant blast exposure group x PTSD symptoms interaction on the global cognition (p = .003; B = −.25; 95% CI –[.41–.08]), processing speed (p = .005; B = −.28; 95% CI –[.46–.10]), and verbal memory (p = .036; B = −.29; 95% CI –[.56–.02]) composites. Simple main effects revealed that in mmTBI+Blast group, more severe PTSD symptoms were associated with worse cognitive performance (r’s = −[.45–.26]; p’s = .001–.032); in contrast, no significant associations were observed in the mmTBI-nonBlast group (r’s = −.04–.07, p’s = .655–786). Conclusions: Results suggest that the combination of blast exposure and PTSD symptoms negatively affects cognition, especially verbal memory and processing speed. Our findings provide evidence that blast exposure may complicate clinical outcomes through exacerbation of mmTBI-related neurotrauma. Future neuroimaging research may clarify the contribution of PTSD and blast exposure to poor cognitive or functional outcomes in Veterans with mmTBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.53
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 54Demographic Factors and Likelihood of Sport Concussion
    • Authors: Hussey J; Witoslawski D, Sheikh R, et al.
      Pages: 703 - 794
      Abstract: Objective: The Immediate Post-Concussion and Assessment and Cognitive Testing (ImPACT) assesses cognitive abilities before and after sport concussion. Research suggests that demographic factors such as education, sex, and sport affect the frequency of concussions in athletes (Daneshvar, Nowinski, McKee, & Cantu, 2011). Specifically, Covassin, Swanik, and Sachs (2003) demonstrated that among collegiate athletes, men’s lacrosse and women’s soccer have the highest injury rate of concussion. The current study assessed whether demographic variables such as education level, sex, and sport predicted group membership between concussed (C) and non-concussed (NC) samples. Method: Participants included 3,507 athletes (Mage = 15.4; Meducation = 9.2; 33.9% female; concussed n = 1809) from across the state of Nevada who were assessed pre- or post-concussion. A binomial logistic regression was performed to determine the effects of demographic factors (education, sex, and sport) on the likelihood that an athlete had received a concussion. Results: The logistic regression was statistically significant (χ2(26) = 593.89, p < .001). The model explained 22.2% (Naglkerke R2) of the variance in concussion and correctly classified 67.6% of cases. Sensitivity was 56.7% and specificity was 78.3%. Females were 1.47 times more likely to experience concussions than males. Conclusions: Results from the current study demonstrate that rates of concussion can be predicted based on demographic variables (education level, gender, and sport), which is consistent with past research showing demographic differences in concussion rates. Interestingly, females were more likely to experience concussion than males. Further research is needed to determine what demographic factors help to predict sport concussion rates, which can inform prevention efforts.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.54
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 55Concussion Rate Differences Across Football Positions
    • Authors: Hussey J; Ng W, Witoslawski D, et al.
      Pages: 703 - 794
      Abstract: Objective: Sport concussion occurs most frequently in football; however, research evaluating positions’ effect on concussion rate is scarce (Urban et al., 2013). The purpose of this study was to evaluate concussion rates by position in football players using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Method: Participants included 1,263 football players (Mage = 15.2; Meducation = 9.6; 100% male; concussed n = 646) from the state of Nevada who were assessed pre- or post-concussion from 2008 to 2012. Football positions were split into the following categories: offensive line, defensive line, running back, linebacker, defensive back, tight end, wide receivers, quarterbacks, and multiple positions (Baugh et al., 2015). Chi-square test of homogeneity was performed to evaluate the difference in concussion rates across football positions. Results: A statistically significant difference in concussion rate across positions was observed (χ2 = 24.49; p < .01). Post hoc analysis involved pairwise comparisons using the z-test of two proportions with a Bonferroni correction. The tight end concussion rate was significantly lower than athletes in the offensive line, defensive line, linebacker, and defensive back positions (proportion concussed = 17.2%, p < .05). All other positions’ concussion rates were not significantly different, p > .05. Concussion rates across positions (excluding tight ends) ranged from 40.5% to 57.3%. Conclusions: Results indicate that tight ends experienced significantly lower concussion rates relative to other football positions which were not significantly different from each other. Among the remaining football positions, concussion rates which prompted further assessment were about 50%. Given this high proportion of concussions across positions, further investigation is needed to inform prevention efforts for football concussion.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.55
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 56Rates of Sport Concussion in Contact and Non-Contact Sports
    • Authors: Hussey J; Ng W, Flood S, et al.
      Pages: 703 - 794
      Abstract: Objective: Over 300,000 sport concussions occur every year and rates continue to increase as participation increases (Gessel, Fields, Collins, Dick, & Comstock, 2007). Given that even limited contact sports can result in concussion, evaluation of contact in sport is beneficial to inform prevention efforts (Rice, 2008). The purpose of the current study was to investigate the difference in concussion rates in sports with differing amounts of contact during play. Method: Participants included 3,319 athletes (Mage = 16.0; Meducation = 9.4; 65.7% male; concussed n = 1,812) from Nevada who were assessed pre- or post-concussion from 2008 to 2012. Athletes used for analyses had head injury that required ImPACT assessment, and athletes for comparison were limited to those with valid baselines and no self-reported concussion history. Sport types were divided: collision (C), contact (CN), limited contact (LC), and non-contact sports (NC; Brett & Solomon, 2017; Rice, 2008). Chi-square test of homogeneity was performed to evaluate the difference in concussion rates across sport types. Results: A significant difference in concussion rates across groups was observed (χ2 = 820.92; p < .01). Post hoc analysis involved pairwise comparison using the z-test of two proportions with a Bonferroni correction. All sport types differed significantly in concussion rates with C showing the highest proportion of concussion (74.8%), followed by CN (53.1%), LC (22.1%), and NC with no concussions, p < .05. Conclusions: Results indicate that athletes involved in collision or contact sports have the highest rate of concussion. Future research is needed to further evaluate the rules or techniques for play to minimize these concussion rates.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.56
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 57Comparison of Seven Executive Functioning Composite Scores in
           Service Members with and Without Acute Mild Traumatic Brain Injury
    • Authors: Ivins B; Karr J, Silverberg N, et al.
      Pages: 703 - 794
      Abstract: Objective: To compare seven composite scores for measuring executive functioning deficits following acute mild traumatic brain injury (mTBI). Method: Overall performance on the Delis-Kaplan Executive Function System (D-KEFS) in service members (SMs) with (n = 157) and without (n = 232) mTBI was assessed using seven new and existing composite scores: Overall Test Battery Mean (OTBM), Global Deficit Score (GDS), Neuropsychological Deficit Score A (NDS-A), Neuropsychological Deficit Score B (NDS-B), Neuropsychological Deficit Score C (NDS-C), number of scores that were one or more standard deviations below the normative mean, and the number of scores that are at or below the fifth percentile. The composites were derived from seven Total Achievement Scores from the following tests: Trail Making (one score), Verbal Fluency (four scores), and Color-Word Interference (two scores). Ability level (AL) was determined using the Wechsler Adult Inteligence Scale Fourth Edition. All SMs with mTBIs were evaluated within seven days of injury. Results: SMs with mTBI and AL = 90–99 performed worse than controls with similar AL using all of the composites with small to medium effect sizes (d = 0.35 to 0.54). SMs with mTBI and AL = 100–109 performed worse than controls with similar AL using five of the composites with small effect sizes (d = 0.27 to 0.33). SMs with mTBI and AL > =110 performed worse than controls with similar AL using all of the composites with small to medium effect sizes (d = 0.25 to 0.64). Conclusions: The executive function composite scores differentiated those with mTBIs from controls with small to medium effect sizes. The composites generally had similar effect sizes within each ability level.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.57
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 58Mild Traumatic Brain Injury Not Related to More Neuropsychological
           Problems in a Clinical Sample
    • Authors: Kaufman N; Martinez V, Davis A, et al.
      Pages: 703 - 794
      Abstract: Objective: Our objective was to see if those with a history of one or more mild traumatic brain injuries (mTBIs) would score lower on common neuropsychological tests. Method: A quasi-experimental research design was employed using de-identified archival data on participants (Nmin = 180; Nmax = 217) referred for clinical neuropsychological testing. The sample was evenly split, 50/50, across sex; 60.9% were Persons of Color (POC); 29.2% were White; and 9.9% were mixed White/POC. The average age was 16.1 years (SD = 12.1; Mode = 7.3). Dependent variables included the Wechsler Full-Scale IQ (FSIQ), the Adaptive Behavior Assessment System-3rd Edition (ABAS-III) general composite (GAC), Wisconsin Card Sorting Test (WCST) total errors, Wechsler Individual Achievement Test-3rd Edition (WIAT-III) Pseudoword Decoding and Numerical Operations, and Test Observation Form (TOF) total problems. History of mTBI was based on self- and/or parent-report using the American Congress of Rehabilitation Medicine definition of mTBI (Committee, 1993). Results: No group differences were found using independent-samples t-tests, with one exception: a history of mTBI(s) meant less test-taking behavior problems, as compared to those without a history of mTBI(s). Conclusions: A history of one or more mTBIs did not result in more lower scores on common neuropsychological tests; it did, counterintuitively, relate to fewer behavior problems during testing. References: Committee, M. T. B. I. (1993). American Congress of Rehabilitation Medicine, Head Injury Interdisciplinary Special Interest Group (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8(3), 86–87.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.58
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 59Comorbidities and Sequelae for Mild Traumatic Brain Injury in a
           Clinical Population
    • Authors: Kessler-Jones A; Ferrazzano P.
      Pages: 703 - 794
      Abstract: Objective: Most research on concussion and mild traumatic brain injury (mTBI) in children has focused on sports-related injuries. In our follow-up clinic for children with acquired brain injury, we have a large cohort of mTBI patients with a wide variety of injury mechanisms. The goal of this project is to describe the demographics, injury mechanisms, comorbidities and clinical assessments in this population. Method: Our clinical database was reviewed for a quality improvement project aimed at optimizing the clinical assessments and interventions in our clinic. Clinic assessments included a structured interview, the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), and psychiatric screening measures. Results: In our clinical cohort of children with acquired brain injury, we found a male predominance (57%), and a bimodal age distribution (peaks at age ≤1 and 17). Most patients are recovering from TBI (88%), and the most common causes included motor vehicle accident (38%), falls (24%) and sports-related (24%). Sixty percent of patients with mTBI demonstrated mild impairment (scores <5%ile) in at least one cognitive domain, and 10% in multiple domains. Additionally, TBI resulted in a large amount of missed school (80% ≥2 days, 30% ≥7 days) and was associated with a high incidence of psychiatric diagnoses (50% with pre-injury diagnosis, 30% with new post-injury diagnosis). Conclusions: Most children in our clinic present with non-sports-related TBI. mTBI results in a large burden of missed school days, and is associated with a high incidence of psychiatric symptoms. This information can be used to direct counseling and therapies in this high-risk population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.59
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 60Ten Year Neurobehavioral Outcome Following Mild, Moderate, Severe,
           and Penetrating Traumatic Brain Injury in U.S. Military Service Members
    • Authors: Lange R; Lippa S, French L, et al.
      Pages: 703 - 794
      Abstract: Objective: Research examining long-term outcome following traumatic brain injury (TBI) in civilians or military populations is scarce. The purpose of this study was to examine neurobehavioral outcome 10-or-more years following military-related mild, moderate, severe, and penetrating TBI. Method: Participants were 288 U.S. service members (Mean Age = 38.8, SD = 8.9; 90.6% male) prospectively enrolled in a longitudinal study, divided into four groups: 120 uncomplicated mild TBI (MTBI), 41 complicated mild, moderate, severe, and penetrating TBI (STBI), 43 trauma controls (TC), and 84 healthy controls (HC). Participants completed the Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist (PCL-C), and 14 subscales from the TBI-Quality of Life (TBI-QOL), 10-or-more years’ post-injury (M = 11.1 years, SD = 1.9, range=9–19). Results: Compared to the HC group, participants in the TC, MTBI, and STBI groups had significantly worse scores (all p < .01) on the PCL-C, NSI, and nine TBI-QOL subscales (i.e., Anger; Emotional/Behavioral-Dyscontrol; Grief/Loss; Self-evaluation; Fatigue; Headaches; Pain Interference; Cognitive Complaints-Executive & General). There were no significant pairwise differences between the TC, MTBI, and STBI groups on these measures (all ps > .05). There were also no significant pairwise differences on the Anxiety, Depression, and Positive affect/Well-being (all ps > .05), except that the MTBI group had worse scores on these measures compared to the HC group (ps < .01). Conclusions: These findings suggest that the etiology of neurobehavioral symptoms reported 10-or-more years following an injury is multifactorial. Although TBI severity and/or the presence/absence of TBI did not differentiate the degree of psychological distress, the presence of either variable is a potential risk factor for long-term self-reported neurobehavioral symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.60
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 61Postconcussion Symptom Reporting is not Associated with White Matter
           Integrity in the Sub-Acute to Chronic Phase of Recovery Following Mild
           Traumatic Brain Injury
    • Authors: Lange R; Yeh P, Lippa S, et al.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to examine the relation between white matter integrity of the brain, as measured by diffusion tensor imaging (DTI), and postconcussion symptom reporting in the sub-acute to chronic phase of recovery following mild traumatic brain injury (MTBI). Method: Participants were 109 U.S. military service members (91.7% male) who had sustained a MTBI (n = 88; i.e., 79.5% uncomplicated, 20.5% complicated) or an orthopedic injury without TBI (Trauma Controls [TC]; n = 21). Participants completed the Neurobehavioral Symptom Inventory (NSI), PTSD-checklist, TBI-Quality of Life scale, and DTI of the whole brain, on average, 44.9 months post-injury (SD = 42.3). Measures of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were generated for 18 regions of interest (ROIs). Participants in the mild TBI group were divided into two sub-groups based on ICD-10 Category C criteria for postconcussional syndrome (PCS): MTBI/PCS-Present (n = 41) and MTBI/PCS-Absent (n = 47). Results: The MTBI/PCS-Present group had significantly worse scores on all 13 neurobehavioral measures compared to the MTBI/PCS-Absent group (p < .001; d = 0.87–2.50) and TC group ( p< .003; d = 0.84–2.06). For the 18 ROIs, there were no significant main effects across the three groups for FA, MD, AD, and RD (all p’s > .03). Pairwise comparisons revealed no significant differences for all ROIs when using FA and RD, and only a handful of significant pairwise differences were found when using MD and AD (e.g., anterior thalamic radiation and cingulate gyrus [supracallosal] bundle). Conclusions: Consistent with past research, postconcussion symptom reporting was not associated with white matter integrity in the sub-acute to chronic phase of recovery following MTBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.61
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 62Neuropsychological Outcome Ten Years After Traumatic Brain Injury in
           U.S. Military Service Members
    • Authors: Lippa S; Lange R, Brickell T, et al.
      Pages: 703 - 794
      Abstract: Objective: Examine neuropsychological outcome ten years after military-related Traumatic Brain Injury (TBI). Method: Participants were 51 service members who sustained an uncomplicated mild (MTBI; n = 27) or complicated mild, moderate, severe, or penetrating TBI (STBI; n = 24) ten years post-injury, and 24 controls prospectively enrolled in a nation-wide 15-year longitudinal study. Participants completed an extensive battery, including the MMPI-2-RF and 20 common neurocognitive measures. Participants were excluded for invalid performances. Results: There were no significant overall effects or pairwise comparisons across the three groups (MTBI, STBI, Controls) for all neurocognitive scores and MMPI-2-RF scales (all ps > .01). However, this was likely due to small sample sizes. Many moderate effect sizes were found (i.e., pairwise comparisons) indicating that the [a] STBI group performed worse than controls on the overall test battery mean, processing speed, immediate memory, and executive functioning (d = .53–.67), [b] MTBI group performed worse than controls in attention (d = .46) and executive functioning (d = .48), and [c] the STBI group performed worse than the MTBI group on processing speed (d = .47). Similarly, on the MMPI-2-RF scales, the STBI group demonstrated worse symptomatology than controls on RC1 (d = .41) and RC2 (d = .54), but better functioning on RC3 (d = .40) and RC6 (d = .58). The MTBI group reported worse symptomatology than controls on RC2 (d = .45), but better functioning than controls on RC2 (d = .56). Conclusions: There were moderate effects of TBI presence/severity, with the STBI group performing worse than controls across most neurocognitive domains and the MTBI group demonstrating worse attention and executive functioning. Findings regarding psychological symptomatology were inconsistent. Continued research with larger sample sizes 10-years post-TBI is needed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.62
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 63The Relationship Between Plasma Tau and Amyloid, Neuropsychological
           Test Performance, Diffusion Tensor Imaging, and Cortical Thickness
           Following Traumatic Brain Injury in U.S. Military Service Members
    • Authors: Lippa S; Gill J, Brickell T, et al.
      Pages: 703 - 794
      Abstract: Objective: Examine whether plasma tau and amyloid are associated with neuropsychological performance and neuroimaging following traumatic brain injury (TBI). Method: Participants were 118 service members (Age M = 33.9 years, SD = 9.4; Time Since Injury M = 59.0 months, SD = 35.9) with a history of uncomplicated mild TBI (MTBI), or complicated mild, moderate, and severe TBI (STBI). Participants gave a plasma sample from which tau and amyloid levels were obtained. Fifty-seven MTBI and 51 STBI participants completed neuropsychological testing and passed performance validity measures. Twenty neuropsychological tests were averaged to create five cognitive domain scores and an overall score. Thirty-eight MTBI and 35 STBI participants underwent neuroimaging. Using diffusion tensor imaging, fractional anisotropy (FA) and mean diffusivity (MD) scores were generated across 18 regions of interest (ROIs) and the whole brain, as well as cortical thickness measures across 13 ROIs. Results: A series of hierarchical regression analyses were used to examine the relationship between tau and amyloid with each neuropsychological summary score. Three sets of stepwise regressions were conducted aimed at predicting tau and amyloid levels using three independent variables: 1) FA ROIs, 2) MD ROIs, or 3) cortical thickness ROIs. Significant covariates were included in the first step of all models. Tau and amyloid levels were not significantly related to neuropsychological summary scores or any FA ROIs (all ps > .05). There were some statistically significant, but inconsistent, relationships between MD and cortical thickness ROIs with plasma tau and amyloid. Conclusions: In this sample, there was no consistent association between plasma tau or amyloid levels and neuropsychological performance or neuroimaging following TBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.63
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 64Clinical Utility of WAIS-IV ‘Excessive Decline from Premorbid
           Functioning’ Scores to Detect Poor Effort Following Traumatic Brain
           Injury
    • Authors: Moore R; Lippa S, Lange R, et al.
      Pages: 703 - 794
      Abstract: Objective: Excessive Decline from Premorbid Functioning (EDPF), an atypical discrepancy between demographically predicted and obtained WAIS-IV scores, has been recently proposed as a potential embedded performance validity test (EPVT). This study examined the clinical utility of EDPF scores to detect poor effort following traumatic brain injury (TBI). Method: Participants were 194 U.S. military service members who completed neuropsychological testing on average 2.4 years (SD = 4.0) following TBI (Age: M = 34.0, SD = 9.9). Using TBI severity and PVT performance, participants were classified into three groups: Uncomplicated Mild TBI-PVT Fail (MTBI-Fail; n = 18), Uncomplicated Mild TBI-PVT Pass (MTBI-Pass; n = 97), and Complicated Mild to Severe TBI-PVT Pass (CM/STBI-Pass; n = 79). Seven EDPF measures were calculated by subtracting WAIS-IV obtained index scores from TOPF demographically predicted scores (i.e., EDPF-FSIQ, EDPF-VCI, EDPF-PRI, EDPF-WMI, EDPF-PSI, EDPF-VW [VCI + WMI], and EDPF-PP [PRI+ PSI]). Cutoff scores to detect poor effort were examined for each EDPF measure separately. Results: The MTBI-Fail group had higher scores than the MTBI-Pass and CM/STBI-Pass groups on EDPF-FSIQ, EDPF-PSI, EDPF-VCI, EDPF-VW, and EDPF-PP (p < .05). Overall, the EDPF-PSI was the most useful measure to detect poor effort. A cutoff score of ≥17 was considered optimal as an indicator of ‘possible’ exaggeration (sensitivity = 67.7%, specificity = 91.8%, positive predictive power = 81.3%, and negative predictive power = 83.6%) and ≥25 as an indicator of ‘probable’ exaggeration (sensitivity = 27.8%, specificity=99.0%, positive predictive power = 93.6%, and negative predictive power = 71.8%). Conclusions: These findings provide support for the use of EDPF measures as a tool to screen for poor effort when administering the WAIS-IV. However, EDPF measures are not recommended for use as stand-alone EPVTs due to low sensitivity.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.64
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 65The Influence of Gender on Neuropsychological Test Performance and
           Symptom Reporting in Individuals with Prolonged Concussion Symptoms
    • Authors: Pardini J; Garrett R, Allred R, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine whether gender differences exist on neurocognitive testing in patients with persistent concussion symptoms (30 days to one year post injury). Method: Data were acquired through IRB-approved chart review. Subjects were 92 patients who had sustained a concussion (39% male) and were referred for neuropsychological evaluation at a southwestern concussion clinic. Patients reported prolonged post-concussion symptoms (30–365 days), including cognitive complaints. Analysis of Variance (ANOVA) testing was used to examine gender differences on a variety of neuropsychological measures and on a self-report measure of symptoms. Results: Gender groups did not differ in age or days from injury to testing (ps > .05). When examining test performance using standard scores, no significant differences existed between performance of males and females on Trail Making Tests A and B, Learning and Delayed Memory scores of the HVLT or BVMT, WAIS-IV subtests (Picture Completion, Coding, Digits Forward, Digits Backward), or DKEFS subtests of Letter Fluency and Category Fluency (ps > .05). Total score on the Post Concussion Symptom Scale was also not significantly different by gender, though scores followed trends observed in prior studies with females reporting more symptoms (p > .05, female mean = 43.92, male mean = 35.35). Conclusions: Although gender differences have been observed in post-concussion neurocognitive functioning and symptom report when patients were evaluated with computerized testing and more acutely post injury (e.g., Broshek et al., 2005; Colvin et al., 2009), differences were not observed in this sample of patients with prolonged symptoms assessed with paper and pencil neuropsychological tests. This suggests that patients who take longer to recover from concussion may represent a unique group on which further research should be completed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.65
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 66The Polytrauma Triad: Impact of PTSD Symptom Clusters on Cognitive
           Complaints in Post-9/11 Veterans
    • Authors: Shepard P; Akagi K, Everett S, et al.
      Pages: 703 - 794
      Abstract: Objective: A growing body of research has observed the polytrauma triad [the presence of a history of traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and chronic pain] in post-9/11 veterans. However, the polytrauma triad has not been extensively studied in terms of PTSD symptom clusters. The purpose of this study was to examine the impact of specific PTSD symptomatology, mTBI status, and current pain on post-concussive cognitive complaints in post-9/11 veterans. We hypothesized that there would be main effects of mTBI status and pain on self-reported cognitive complaints, and made no specific prediction regarding how PTSD symptom clusters would predict cognitive complaints. Method: 138 participants of post-9/11 combat veterans were recruited from Jesse Brown VA Medical Center. Participants completed a Clinician-Administered PTSD Scale (CAPS-IV), Neurobehavioral Symptom Inventory (NSI), the Defense and Veterans Brain Injury Center TBI screening tool, and a numerical evaluation of their current pain at the time of testing. Results: Findings suggested no significant main effects of mTBI status or pain on self-reported cognitive symptoms. However, both avoidance (partial η2 = .05) and numbing (partial η2 = .11) symptoms predicted cognitive complaints. Additionally, results a significant interaction was observed between screened mTBI and avoidance symptoms, such that in the absence of avoidance symptoms, post-9/11 veterans with and without mTBI reported similarly low levels of cognitive complaints, but as avoidance symptoms increased, those with mTBI reported significantly greater cognitive symptoms. Conclusions: The present findings add to the literature of post-9/11 veterans by exploring their specific presentation of PTSD, mTBI, and pain on self-reported cognitive complaints. Treatment implications and future research will be discussed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.66
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 67Post-Concussive and Mood Symptoms of Traumatic Brain Injury Patients
           in a Clinical Population
    • Authors: Slonim T; Holguin G, VanLandingham H, et al.
      Pages: 703 - 794
      Abstract: Objective: The cognitive deficits and mood symptoms of traumatic brain injuries (TBI) vary from patient to patient. However, little information is known about the severity of TBI and its relation to post-concussive and psychiatric symptoms. This study aims to investigate the potential relationships among TBI severity, post-concussive symptoms and psychiatric symptoms. Method: 53 patients (28 male; mean age 43 ± 15.7) presented to a community based practice for neuropsychological testing with self-report of closed head injury. Patients were categorized into groups defining TBI severity by VA/DoD guidelines (Version 2.0, 2016) as follows: 43.4% Mild, 17% Moderate, 11.3% Severe and 28.3% fell outside the guidelines. The Neurobehavioral Symptom Inventory (NSI) was used to measure self-reported post-concussive symptoms (i.e. affect, somatosensory, vestibular, cognitive), and the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to examine self-reported mood symptoms. Results: Results demonstrated significant positive correlation between both the BDI and BAI with NSI total score (r = .836, p < 0.01; r = .842, p < 0.01, respectively), but not the subscales. A one-way ANOVA did not show a significant relationship between TBI severity and NSI total score (p = 0.930). Conclusions: Patients who reported a higher level of psychiatric symptoms also reported more severe post-concussive symptoms. The severity of TBI as outlined by VA/DoD guidelines did not predict the severity of post-concussive symptoms. Taken together, this suggests the need for concomitant assessment of TBI severity, post-concussion symptoms and mood symptoms to fully characterize the sequelae of TBI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.67
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 68Relationships Between Neuropsychological Test Scores and Frontal
           Executive Behaviors in Chronic Traumatic Brain Injury
    • Authors: Smith E; Smith J, Juengst S.
      Pages: 703 - 794
      Abstract: Objective: To identify neuropsychological test scores associated with functional behavioral outcomes after TBI, we explored relationships between cognitive domain and cognitive process scores from seven neuropsychological tests and both self- and other-reported frontal executive behaviors. Method: Participants/Setting: Cross-sectional study of community-dwelling adults (n = 65) with a > 6-month history of TBI (31% complicated mild, 20% moderate, 49% severe) were recruited from academic research registries and local community groups serving adults with TBI. Participants were 49.9 years old (SD = 16.5), predominantly male (80%), Caucasian (97%), and had 14.6 years (SD = 2.6) of education. Median time since injury was 55.0 months (interquartile range = 14.0–104.5). Variables/Measures: Both a self-reported and significant other-reported Frontal Systems Behavior Scale (FrSBe) measured frontal executive behaviors in the domains of apathy, disinhibition, and executive dysfunction. Neuropsychological tests included the California Verbal Learning Test II (CVLT-II), Trail Making Test (TMT), Symbol Digit Modalities Test (SDMT), Verbal Fluency (FAS/Animals), and the Wisconsin Card Sorting Test (WCST). Results: Pearson correlations were significant ( r = 0.258–0.415, p < .05) between frontal executive behaviors and numerous cognitive scores, particularly cognitive process scores (e.g., errors on the CVLT-II, TMT, WCST, and Verbal Fluency). Table 1 presents the statistically significant correlations (p < 0.05). Conclusions: This study identified several cognitive scores that correlated significantly with the frontal executive behavioral domains of apathy, disinhibition, and executive dysfunction as reported by both the participant with TBI and their significant other. Scores capturing errors, including cognitive intrusions, may be ecologically valid indicators of behavioral outcomes in TBI. Future studies using multivariable models will examine which cognitive scores significantly predict these functional behavioral domains.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.68
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 69Generic Graded Physical Activity Advice for Concussion Increases
           Planned Physical Activity
    • Authors: Sullivan K; Finnis S.
      Pages: 703 - 794
      Abstract: Objective: Concussion recovery advice is rapidly evolving, especially in relation to the role of rest and exercise. This study compared the effect on planned physical activity in the week following a hypothetical injury of two different types of advice. Method: 219 participants were randomly allocated to receive a concussion description and the advice that for that for one week after that injury they should undertake either no physical activity (NPA condition n = 115) or graded physical activity (GPA condition, n = 104). The participants rated amount of activity that they would undertake using the Mild Traumatic Brain Injury Rest/Activity Questionnaire (MTBI-RAQ). Results: On average, there was a significant group difference in the amount of planned physical activity (NPA&lt;GPA overall and for each of the 16 MTBI-RAQ items, p’s ≤.001, medium-to-large effects). The average NPA response indicated a significant planned reduction from “usual” for almost all behaviours (n = 14) and only two behaviours that were not expected to change (walking, housework). For the GPA group, the number of reduced, unchanged, or increased behaviours was 7, 5, and 4 respectively. The behaviours that the GPA group proposed to increase were relatively low concussion-risk behaviours (e.g., swimming, walking). Both groups proposed to decrease the highest risk behaviours (e.g., martial arts, heavy lifting). Conclusions: As expected, fewer activity restrictions were proposed by people who received GPA advice than NPA advice. However, within each condition the generic advice was interpreted differently for specific behaviours. If generic advice is used, we recommend discussing it with the individual to confirm if plans are appropriate.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.69
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 70Differences in Recovery Between Adolescents with and Without ADHD
           After Sport Concussion
    • Authors: Tarkenton T; Bunt S, Hicks C, et al.
      Pages: 703 - 794
      Abstract: Objective: Debate exists regarding concussion recovery in adolescents with ADHD, as studies have been equivocal about prolonged symptom recovery and/or different or more severe postconcussion cognitive dysfunction in this population. Furthermore, previous studies have used mixed methodology to select non-ADHD controls to provide comparison data. This study’s aim was to investigate the effects of ADHD upon postconcussion computerized cognitive test results and reported symptom levels using a carefully selected concussion control group matched on age, gender, sport, and days post injury. Method: Data were collected from the North Texas Concussion Registry (ConTex). Participants aged 12–18 with and without self-reported ADHD who sustained SRC were matched on demographic and injury factors (n = 30 per group). Participants completed the ImPACT at initial clinic visit (<28 days post-injury), as well as a Concussion Symptom Log at both initial visit and 3-month follow-up. The Symptom Log is a 22-item measure that assesses severity of physical, cognitive, emotional, and sleep symptoms. Mann-Whitney tests were used to compare neurocognitive scores at initial visit and symptom severity levels at both time points between the matched groups. Results: At initial visit, ADHD subjects scored lower on ImPACT timed tasks, specifically Visual Motor Speed (p = 0.018) and Reaction Time (p = 0.011). However, they reported few differences in symptom severity aside from greater ‘Sensitivity to light’ (p = .03) and ‘Sleeping more than usual’ (p=.02). At 3-month follow-up, no significant group differences were seen on any symptom measures. Further, both ADHD and non-ADHD groups reported a significant decline in symptoms (ps < .01), suggesting similar recovery. Conclusions: Similar to some previous studies, soon after concussion, adolescents with ADHD performed lower on timed measures of neurocognitive ability. However, severity of symptom levels compared to matched non-ADHD counterparts were nearly equivalent at initial visit. Further, having ADHD did not appear to adversely affect SRC recovery, as both groups reported a significant decrease in symptoms by 3-month follow-up.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.70
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 71Influence of Perceived Pressure on Concussion Reporting Behavior
    • Authors: Walker I.
      Pages: 703 - 794
      Abstract: Objective: This study sought to explore the nature of pressure placed on athletes and the relationship between this pressure and athletes’ concussion reporting behavior. Method: Participants included 77 university athletes from men’s soccer (n = 30), women’s soccer (n = 11), women’s cheerleading (n = 22), men’s football (n = 7), and women’s field hockey (n = 7) teams. Athletes were administered a survey developed for the purposes of this study. Primary variables of interest were experience of pressure from others, nature of pressure experienced (i.e. implicit or explicit), and concussion symptom reporting as it relates to the experience of pressure. Results: About half of the participants who endorsed experiences of pressure indicated that this pressure influenced their decision to report symptoms. Explicit experiences of pressure were endorsed by 26% of the sample, and implicit experiences were endorsed by approximately 31% of the sample. Almost half of the sample acknowledged instances of failing to report symptoms for fear of loss of valued commodities (i.e. scholarship, position on the team, admiration). Conclusions: Though the majority of the sample denied experiences of “pressure,” higher rates of endorsement were seen for fear of loss of valued commodities, explicit statements regarding continuing to play after a head impact, and implicit feelings of judgement or disappointment from others. Similar rates of implicit and explicit pressure were found. The results from this study can hopefully promote change in the norms of concussion reporting by exposing attitudes to reporting behavior to make supportive environments for reporting the new norm.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.71
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 72A Systematic Review of Singing Therapy as a Treatment for Language
           Disorders
    • Authors: Maresco A; Ahmad S, Wehrle L, et al.
      Pages: 703 - 794
      Abstract: Objective: This review examines the effectiveness of singing therapy or Melodic Intonation Therapy (MIT) for aphasia. Data Selection: A systematic literature review was conducted, which returned 17 studies. Empirical and case studies were included. Literature reviews and articles older than 2008 were excluded. Outcome measures across studies included tests of repetition, naming, word finding/fluency, articulation, communication, content, aphasia, apraxia, mood, therapy effectiveness, and overall language. Data Synthesis: Findings indicated improvements in the following: spontaneous speech, repetition, mood, verbal communication, and functional communication. MIT demonstrated significant improvements in the repetition of trained items, greater outcomes than speech repetition therapy (SRT) sessions, and activation of both temporal lobes symmetrically and right frontal cortices. Delaying MIT was related to less improvements in the repetition of material. For Singing Therapy (ST), only five out of 10 patients demonstrated improvements. Choir practice (CP) indicated no significant changes post-treatment between groups, but individual analyses demonstrated various significant changes participants. Additionally, choir singing therapy improves mood, language, breathing, and voice. Speech-Music Therapy for Aphasia (SMTA) indicated improvements in intelligibility and comprehensibility. Lastly, a combination of music therapy and speech language therapy (MT and SLT) yielded better results in treating aphasia. Conclusions: Results revealed that treatment with singing therapy can improve speech language output in aphasic patients. Findings suggest that participation in choral singing therapy has positive effects on mood, self-confidence, and motivation. Additionally, results indicated that MIT was more effective than speech therapy using only repetition, and that rhythm and pitch therapy had stronger effects than rhythm alone or normally-spoken speech therapy.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.72
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 73The Effects of Task-Oriented Coping and Stress on Depression
           Symptomology in Individuals with Moderate to Severe Brain Injury
    • Authors: Perez L; Lindgren K, Inala S.
      Pages: 703 - 794
      Abstract: Objective: This study aimed to analyze whether the use of task-oriented (problem-solving) coping style and perceived stress are associated with depressive symptomology in a sample of individuals with acquired brain injury (ABI). Method: Linear multiple regression analyses were used. Data was obtained through self-report questionnaires: Stress was measured with the Perceived Stress Scale (PSS). Coping style was measured with the Coping Inventory for Stressful Situations (CISS). Depression symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). Demographically, the full sample consisted of 71.9 % males (N = 23) and 28.1 % females (N = 9), with a mean age of 47.41 and an age range of 25 to 67. Of these participants, 96.9 % were Caucasian (N = 31) and 3.1 % Asian (N = 1). On average, the number of years living with a brain injury was 22.03, with a range of 5 to 48 years. Participants were required to score at least 2/3 on Object Naming and 5/10 on Orientation questions from the Mini-Mental State Examination (MMSE) to rule out aphasic and disorientation symptoms that would interfere with their ability to complete self-report questionnaires. Results: Significant effects of Task-Oriented Coping and Perceived Stress on Depression (p < .05) were found. A positive correlation revealed that individuals with higher scores on the PSS also endorsed more PHQ-9 symptoms (β = .507, p < .05). Additionally, Task-Oriented Coping was negatively correlated with PHQ-9 symptoms (β = −.386, p < .05), indicating that those who reported using more problem-solving strategies also endorsed fewer depression symptoms. Conclusions: This study supports that Task-Oriented coping and stress are correlated with depression. That is, individuals who reported feeling more confident in their ability to overcome difficulties, experiencing lower levels of stress, and using more active problem-solving strategies also endorsed fewer depression symptoms. Consistent with these findings, it can be inferred that the use of task-oriented (problem-solving) coping may be associated with less perceived stress, and in turn, these factors may influence depression. This information can be helpful when developing specific interventions aimed at preventing mood disturbances by focusing on increasing problem-solving coping strategies and decreasing stress within the ABI population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.73
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 74Intonation-Based Therapy Effectiveness on Language Impairment in
           
    • Authors: Perez T; Rodriguez M, Tourgeman I.
      Pages: 703 - 794
      Abstract: Objective: Socio-communicative impairment is commonly observed among patients with Autism Spectrum Disorder (ASD). Data suggests that intonation-based therapy (IBT) may improve language capability. The purpose of this review was to examine treatment effects of IBT on language deficits in individuals diagnosed with ASD. Data Selection: Databases included: PsycARTICLES, PsychINFO, and EBSCOhost. Keywords included: “autism spectrum disorder,” “melodic intonation therapy,” “auditory motor mapping,” “intonation”, “language”, and “imaging”. Inclusion criteria were peer-reviewed articles published after 2007 that examined IBT, language deficits, and their coinciding brain functionality. Exclusion criteria were articles from non-academic sources and case-studies. Initial searches yielded a total of 233 articles of which nine met inclusion criteria. Data Synthesis: Three articles revealed that ASD patients consistently demonstrated greater attention to prosody over content. This finding may be due to atypical rightward cerebral asymmetry frequently identified in this population. Two studies described reduced leftward lateralization, and increased right hemisphere activity in core language brain areas. Four studies indicated that IBT significantly improved expressive language deficits compared to traditional speech therapy treatments that did not include an intonation component. Conclusions: Reported positive outcomes suggest that IBT is a potentially effective intervention for language impairment in individuals with ASD. IBT’s potential to engage right hemisphere language-capable regions can provide reasoning for its effectiveness in improving socio-communicative skills. Study limitations included small sample sizes, lack of control groups, and an absence of randomized control trials. Future investigation with larger sample sizes and stronger study methodology for examining benefits of IBT on language skills in individuals with ASD is warranted.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.74
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 75A Case of Obsessive-Compulsive Disorder in Multiple Sclerosis
           (OCD-MS): Significance of Neuropsychological Test Findings and MRI
           Documented Right Mesial Temporal Sclerosis
    • Authors: Pimental P; Christopher J, Jandak J, et al.
      Pages: 703 - 794
      Abstract: Objective: Patients with MS exhibit a lifetime prevalence of OCD of 8.6%, higher than 2.5% in the general population (Korostil & Feinstein, 2007). Tinelli et al. (2012) reported that patients who endorsed moderate (16–23) to extreme (32–50) OCD symptoms on the Yale-Brown Obsessive Compulsive Scales (Y-BOSC), exhibited neuroradiographic evidence of reduced gray matter volume in the right inferior and middle temporal gyri and inferior frontal gyrus. Method: The present case involved a 45-year-old, right-handed, Caucasian female with MS, referred for neuropsychological evaluation of cognitive deficits, and an emergent pattern of OCD. The Y-BOSC-II was utilized to investigate OCD symptomatology. Results: Neuropsychological testing revealed mild neuropsychological deficits in memory and executive functioning. The Y-BOSC-II was in moderate range (23). Follow-up MRI revealed increased T2/FLAIR signal in the right mesial temporal lobes and right mesial temporal sclerosis, co-occurring with the onset of OCD symptomology, compared with other prior MRI chronic white matter changes. Conclusions: MRI studies of OCD-MS are limited (Bonavita, 2003). Research exists on right frontotemporal disease burden and OCD-MS (Tinelli et al., 2012), but there is a paucity of studies which analyze neuropsychological test data, OCD measures, and MRI findings. Our case of neuropsychological testing with neuroimaging provides evidence of an association between new OCD-MS symptoms, increased T2/FLAIR signal in the right mesial temporal lobes, and asymmetric right mesial temporal sclerosis. Neuropsychological testing in OCD-MS which includes measures such as the Y-BOSC-II, elucidated severity and type of impairment, provided clinical correlation with neuroimaging findings, and proved to be important in determining prognosis and rehabilitation planning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.75
      Issue No: Vol. 33, No. 6 (2018)
       
  • A - 76The Role of Age in Early Functional Outcomes for Children Diagnosed
           with Anti-NMDA Receptor Encephalitis During Inpatient Rehabilitation
    • Authors: Watts S; Krentzel A, Blackwell L, et al.
      Pages: 703 - 794
      Abstract: Objective: Anti-NMDA receptor encephalitis (Anti-NMDA) is a rare autoimmune disease with a predictable clinical course resulting in neurocognitive symptoms and functional deficits. Previous research demonstrates age differences in symptom presentation; however, scant research exists exploring the role of age in functional outcomes, particularly in children. The current study examines age differences in functional outcomes at admission and discharge from an inpatient rehabilitation unit (IRU). Method: Data was collected through retrospective chart review. 27 patients were identified (63% female; 63% African-American; mean age 10.59 years). Patients were grouped by age (younger = <9 years; older = ≥9 years). Functional outcome scores [i.e., Developmental Functional Quotient of the Functional Independence Measure for Children (DFQWeeFIM)] were obtained at time of admission and discharge. Length of stay on the IRU ranged from 14 days to 108. Results: A Two-Way Mixed ANOVA showed a significant interaction between Age Group and time of WeeFIM administration (F(1, 24) = 7.14, p = .05). Post-hoc analyses revealed no significant simple main effect between Younger (M = 24.09) and Older (M = 32.29) children at admission; however, significant simple main effects were found between Younger (M = 37.13) and Older (M = 66.87) at discharge (F(1, 24) = 10.74, p < .05) and from admission (M = 28.95) to discharge (M = 54.85; F(1, 25) = 31.65, p = .001) for the entire sample. Conclusions: Results indicate that younger children diagnosed with Anti-NMDA demonstrated less improvement in functioning compared to older children during an inpatient stay, suggesting age differences may play a meaningful role in recovery from Anti-NMDA. Further research is needed to explore confounding factors that may place younger children at greater risk for prolonged deficits in functioning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.76
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 01Working Memory Training for Individuals with ADHD: Examining the
           Outcomes by ADHD Subtype
    • Authors: Elliot A; Vivian J.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to examine differences in computer-based working memory training outcomes by ADHD subtype (inattentive type versus combined type). Method: In this study, 40 participants completed 5 weeks of Cogmed Working Memory Training, a computer-based intervention that is designed to reduce symptoms of ADHD. Performance-based pretests and posttests of attention and inhibition were completed. Data were analyzed to compare outcomes for attention and inhibition by ADHD subtype (inattentive type versus combined type). Results: Overall, both groups showed substantial gains in both attention and inhibition. When results were compared by ADHD subtype, individuals with combined type ADHD demonstrated greater increases in inhibition as compared to individuals with inattentive type ADHD. For attention, both groups showed equally significant gains. Conclusions: In this study, computer-based working memory training led to a large effect size for increased scores on a performance-based measure of attention and inhibition for individuals ADHD. Individuals with both inattentive-type and combined type ADHD both appeared to benefit equally from computer-based working memory training in terms of gains in attention, but individuals with combined-type ADHD showed even more gains in inhibition. Some of the disparities in the outcome research for working memory training programs may be related to variations in the subtype of individuals with ADHD. Further research is needed to examine factors that may moderate the outcomes of working memory training.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.77
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 02Using the Diffusion Model as a Diagnostic Tool for ADHD
    • Authors: Galloway-Long H; Huang-Pollock C.
      Pages: 703 - 794
      Abstract: Objective: Deficits in processing speed and executive functions such as inhibitory control and working memory have been proposed as core components of the etiology of ADHD. However, only about 30% to 50% of children with ADHD show deficits on neuropsychological tests relative to normative samples, suggesting poor sensitivity. The computational method Diffusion Modeling may be a possible solution, given its unique algorithm, which simultaneously considers both error rate and reaction time. Recently, studies have found that children with ADHD show slower drift rates than typically-developing peers. The current study examined the utility of DM parameters in identifying children with ADHD, using two computerized forced-choice tasks. Method: Children with ADHD (N = 78) and age-matched typically developing controls (N = 32) completed a Stop-Signal Reaction Time (SSRT) task, and a Go-No-Go (GNG) task. Drift Diffusion Model (DDM) parameters were estimated from correct “Go” trials during the SSRT and GNG tasks and from commission errors during the GNG task. DDM parameters were fit to Receiver Operating Characteristic (ROC) curves and the Area Under the Curve (AUC) was used to determine diagnostic utility. Results: Drift rate of commissions during GNG (AUC = .720, p < .001), and the inverse of drift for correct “Go” responses during GNG and SSRT (AUC = .378, p = .046; and AUC = .328, p = .005) were significantly diagnostic of ADHD. No other parameters were diagnostic. Conclusions: Current clinical tools overly rely on measures of mean RT and mean accuracy, which may lead to flawed interpretations of performance. Developing normative values for drift rate may prove to be an invaluable component of clinical neuropsychological assessments and research.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.78
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 03The Impact of Pregnancy Problems on Measures of Verbal Fluency in
           Children Diagnosed with Attention Deficit Hyperactivity Disorder: An
           Empirical Study
    • Authors: Perez Delgadillo P; Tourgeman I, Hernandez L, et al.
      Pages: 703 - 794
      Abstract: Objective: Attention Deficit/Hyperactivity Disorder (ADHD) has been linked to prenatal conditions and history of maternal pregnancy problems. While research has also shown a trend of reduced semantic fluency performance in children with ADHD, pediatric fluency studies are limited. The present study sought to evaluate whether maternal pregnancy problems are associated with impaired performance on measures of verbal fluency, including phonetic, semantic and category switching in children diagnosed with ADHD. Method: Sixty-six culturally diverse patients between 8 to 18 years of age received a comprehensive neuropsychological evaluation at the pediatric neuropsychology and rehabilitation department of a major public South Florida Hospital between 2009 and 2017. An ANOVA was conducted with pregnancy problems as the factor and performance on verbal fluency measures as the dependent variable. Results: A trend approaching clinical significance was observed between pregnancy complications and no pregnancy complications when evaluating Wilks Lambda F = 3.077, p = 0.058 (Semantic Fluency) and F = 3.099, p = 0.059 (Category switching). Conclusions: The preliminary results were commensurate with current literature identifying semantic fluency and category switching as areas of verbal executive dysfunction in a pediatric population with ADHD. Moreover, results demonstrated a trend to significance approximation of clinical relevance for subjects in a diverse clinical sample with comorbid prenatal maternal conditions related to their performance on semantic fluency and category switching. Further research with a larger sample is recommended.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.79
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 04Differences Between Gender in Athletes with ADHD on Baseline
           Neurocognitive Scores
    • Authors: Datoc A; Burgess J, Bennett R, et al.
      Pages: 703 - 794
      Abstract: Objective: To investigate differences between gender in baseline neurocognitive scores of youth and adolescent athletes with Attention Deficit Hyperactivity Disorder (ADHD). Method: The data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database in South Florida. Athletes (n = 15,062) aged 10–18 (Mage = 15.43, SD = 1.29; 57.3% male) were included in the sample if they completed a baseline ImPACT, had no history of concussion, and no psychiatric history other than a diagnosis of ADHD. Among athletes with ADHD (n = 655, Mage = 15.42, SD = 1.35), 480 were male (Mage = 15.39, SD = 1.38) and 175 were female (Mage = 15.49, SD = 1.28). Results: ANOVA (alpha < .001) was significant in four of five composite scores of the ImPACT: verbal memory F[2,15059] = 22.978, visual memory F[2,15059] = 9.239, visual motor speed F[2,15059] = 16.710, and impulse control F[2,15059] = 18.881. Females outperformed males on verbal memory (Mfemale=80.16, Mmale = 78.33), visual motor speed (Mfemale = 33.2, Mmale = 32.04), and impulse control (Mfemale = 7.08, Mmale=8.02), while males outperformed females on visual memory (Mfemale = 67.50, Mmale = 67.83). Conclusions: Previous research has revealed decreased neurocognitive performance in individuals with ADHD compared to control subjects, and these findings are consistent among youth and adolescent athletes. Further, evidence exists proposing the development of separate normative data for athletes with ADHD (Elbin et al., 2013). This study supports these findings and calls for separate normative data based on gender in athletes with ADHD, considering the significant differences in performance at baseline between boys and girls with ADHD. Future research is needed to better understand why these specific differences between gender exist and clinicians should be cognizant of these differences when developing concussion management protocols.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.80
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 05Influence of Learning Disorders on Baseline Neurocognitive Scores
           Within Gender
    • Authors: Datoc A; Burgess J, Lashley L, et al.
      Pages: 703 - 794
      Abstract: Objective: Explore within-gender differences of baseline scores in youth athletes with Learning Disorders (LD) and without LD. Method: Data was derived from a de-identified Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) database in Florida. Due to disproportionate sample sizes between athletes with LD (n = 104) and without (n = 17,445), random sampling was used. Athletes (n = 304) were included if they completed a baseline ImPACT, had no prior concussions, and no comorbid diagnoses. Of the males (n = 166), 66 had LD (mean age = 15.91, SD = 1.30, mean education=9.16, SD = 2.66); 100 did not (mean age = 15.79, SD = 1.35, mean education = 9.60, SD = 1.80). 38 females had LD (mean age = 15.40, SD = 1.36, mean education = 9.11, SD = 1.72); 100 did not (mean age = 15.41, SD = 1.32, mean education = 9.12, SD = 1.75). Results: ANOVA (alpha=.01) revealed athletes without LD preformed significantly better than athletes with LD on four composites of ImPACT: verbal memory, visual memory, visual-motor speed, and reaction time. Within females, those without LD performed better in visual-motor speed (F[1,136] = 21.141) and reaction time (F[1,136] = 13.409). Within males, those without LD scored higher in verbal memory (F[1,164] = 7.465), visual memory (F[1,164] = 9.041), visual-motor speed (F[1,164] = 12.349), and reaction time (F[1,164] = 5.661). Conclusions: Results are congruent with previous literature that found differences between athletes with LD and without on ImPACT at baseline, supporting evidence for separate normative data for athletes with LD (Elbin et al., 2013). Small effect sizes (η2 < .14) in every difference suggests the proportion of variance is attributed to the diagnosis of LD, which was true within both males and females. Further, males with LD had lower performance on more composites than females. This highlights the need to carefully consider gender and LD when interpreting baseline and post-concussion ImPACT scores of youth athletes.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.81
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 06The Relationship Between Executive and Social Functioning in
           Children with Autism Spectrum Disorder
    • Authors: Bednarz H; Kana R.
      Pages: 703 - 794
      Abstract: Objective: Executive function (EF) deficits are well documented in autism spectrum disorder (ASD). Recent work indicates EF may be related to social impairment in ASD. This study further explores the relationship between EF and social functioning in ASD using a larger sample. We hypothesize that EF would predict social functioning in ASD. Method: Data were obtained from the ABIDE-II database. Social functioning and EF were measured using parent raters: Social Responsiveness Scale (SRS), Behavior Rating Inventory of Executive Functioning (BRIEF). Final sample consisted of 109 ASD and 195 typically developing (TD) children (5–13 years). Hierarchical multiple regressions were used to examine the effect of BRIEF Index T-scores (Metacognition, MI; Behavioral Regulation, BRI) on SRS total and subscale T-scores in ASD. Another hierarchical regression tested the potential moderating effect of diagnosis on the relationship between BRIEF and SRS. Bonferroni correction was applied (p < 0.0071). Results: Among ASD participants, MI (ß = .40, p < .001) and BRI (ß = .50, p<.001) were statistically significant predictors of SRS Total scores (∆R2 = .37, F(2,103) = 35.19, p < .001). MI and BRI also significantly predicted all SRS subscales in ASD. Among ASD and TD participants, MI (ß = .40, p < .001) and BRI (ß = .50, p < .001) predicted overall social functioning (∆R2 = .79, F(5,295) = 351.89, p < .001). Diagnosis of ASD did not show significant interaction with MI or BRI. Conclusions: EF influences multiple domains of social functioning in ASD. Diagnosis did not moderate the effect of EF on overall social functioning among ASD and TD. Future work will include neuroimaging data to examine how neural markers of EF may relate to social functioning in ASD.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.82
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 07Language Impairment and Neurofibromatosis Type 1: A Case-Study
           Examining a Child with English as a Second Language
    • Authors: Bracken M; Franzen M, Dean-Hill H.
      Pages: 703 - 794
      Abstract: Objective: Neurofibromatosis Type 1 (NF-1) is a genetic disorder that results in both benign and malignant tumors within the central and peripheral nervous systems (Gutmann et al., 2017). While cognitive deficits in NF-1 vary widely, most common are language, attention, executive functioning, intellectual disability, learning disability, and visual-spatial impairments (Hyman, Shores, & North, 2005). Similar language impairments are also found in internationally adopted children without a neurological disorder who are fully immersed in the English language (Pierce, Klein, Chen, Delcenserie, & Genesee, 2014). Method: 8-year-old, Asian, English-speaking, adopted female. Fully immersed into English and American culture at age 5. Multiple café au lait spots led to diagnosis of NF-1 at age 7, confirmed by genetic testing. Her academic performance declined in the second grade. Results: Neurocognitive assessment documented impairments in expressive language, visual-spatial skills, and fine motor skills bilaterally. Strengths included verbal learning and memory, quantitative reasoning, visual working memory, and abstract verbal reasoning. Academic performance was adequate, though with greater difficulty with more complex tasks. Conclusions: To our knowledge, no research exists examining the impact of NF-1 on language skills in nonnative English speakers. Additionally, few studies examined the neurocognitive performance of older children who have been fully immersed into the English language. There is some suggestion of a neuroanatomical change that could cause sensitivity to the native language, even if it is no longer spoken (Pierce et al., 2014). This case highlights the need for more research regarding language impairment in diverse populations with NF-1, as well as in diverse populations in general.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.83
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 08Neuropsychological Profile of Wolf-Hirschhorn Syndrome
    • Authors: Culotta S; Blackwell M.
      Pages: 703 - 794
      Abstract: Objective: This case study examined neurocognitive features associated with Wolf-Hirschhorn Syndrome (WHS), a rare genetic condition caused by a partial deletion of the short arm of chromosome four. WHS is marked by congenital malformations and neurodevelopmental disabilities, and occurs in 1 in 50,000 births. Manifestations include hypotonia, motor deficits, language disorders, intellectual disabilities, and seizures. Distinctive features include a broad, flat nose bridge and high forehead. Children with WHS demonstrate strong socialization skills, and some studies have suggested that communication may improve over time. Method: This single subject design examined a 14-year-old female referred for neuropsychological assessment secondary to significant neurodevelopmental delays related to WHS. The child was first evaluated in 2013 and re-evaluated in 2017. Results: Results of 2013 and 2017 assessments were consistent with an overarching diagnosis of Neurodevelopmental Disorder secondary to WHS. Assessment results consistently indicated cognitive, language, executive, and motor deficits, as well as borderline adaptive functioning. Strengths were apparent in social intent and social skills. Gains were not evident in communication. Conclusions: This child’s profile revealed many features consistent with the sparse literature on WHS. Inconsistent with previous studies, her communication skills did not significantly improve over time. Of note, this youngster continued to demonstrate strengths in her capacity and desire for socialization. These results raise interesting questions regarding the underlying neurogenetics and neurobiological mechanisms of spared social behaviors in select genetic disorders such as WHS, William Syndrome, and Down Syndrome. These results also reflect the value of early and repeated neuropsychological assessment in the management of rare genetic disorders.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.84
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 09Executive Functioning Abilities Predict Pre-Reading Skills in
           Preschoolers
    • Authors: Figuccio M; Walker H.
      Pages: 703 - 794
      Abstract: Objective: Executive functioning (EF) involves a variety of cognitive processes, such as attention, inhibition, working memory, and cognitive flexibility. Prior research indicates that EF plays a role in the development of academic skills including reading. The objective of the current study is to assess whether EF abilities predict pre-reading skills in preschoolers. Method: 20 typically developing preschoolers (M = 54.25 months, SD = 3.37, 8 males) participated in the current study. Participants completed a cognitive-linguistic battery. Children also completed a developmentally appropriate flanker task via touchscreen. Children were presented with 120 trials divided evenly between congruent, incongruent, and neutral conditions. Results: A positive correlation was observed between flanker overall accuracy and elision scaled scores, r = .484, p = .036, 95% CI [.036, .931]. Positive correlations were also observed between flanker congruent accuracy and elision scaled scores, r = .505, p = .027, 95% CI [.064, .947], and flanker incongruent accuracy and elision scaled scores, r = .466, p = .044, 95% CI [.013, .919]. Additionally, a positive correlation was observed between flanker overall accuracy and blending scaled scores, r = .511, p = .025, 95% CI [.072, .951]. Positive correlations were also observed between flanker congruent accuracy and blending scaled scores, r = .489, p = .034, 95% CI [.042, .935], and flanker incongruent accuracy and blending scaled scores, r = .490, p = .033, 95% CI [.044, .936]. Flanker neutral accuracy was not correlated with either elision, r = .414, p = .070, 95% CI [−.090, .856], or blending scaled scores, r = .277, p = .237, 95% CI [−.006, .908]. Conclusions: Flanker task accuracy predicted measures of phonological awareness in preschoolers. Prior research has shown the importance of EF in various measures of scholastic achievement. The current study adds to this body of research illustrating the importance of EF abilities in the preschool period.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.85
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 10Underlying Brain Mechanisms of Children Prone to Aggression Using
           SPECT Imaging
    • Authors: Grodner K; Harcourt S, Sattaur Z, et al.
      Pages: 703 - 794
      Abstract: Objective: To compare blood perfusion in brain areas, as measured by SPECT, between children who are prone to high and low levels of aggression. Method: Participants were part of a large de-identified clinical database that received SPECT scans of various brain regions (N = 1392). Individuals were grouped based on a self-report measure of aggression, participants (70% male, Mage=11.73, SD = 3.546) were determined aggressive (n = 710, 67% male, Mage=11.72, SD = 3.546) if they endorsed aggressive symptoms in the top 10% of sample, or non-aggressive (n = 682, 73% male, Mage=11.74, SD = 3.476) if they endorsed symptoms in the bottom 10% of the sample. Cerebral blood perfusion for each participant was assessed using SPECT while participants were at rest within 17 brain areas. Results: A MANCOVA controlling for age and gender conducted at α=.01, yielded significant differences in blood perfusion between a children who are aggressive compared to those who are nonaggressive, Wilks’ λ=.977. Participants who were more aggressive yielded significantly lower blood perfusion in right frontal lobe, right parietal lobe, and significantly higher perfusion in the vermis compared to those who were nonaggressive. Conclusions: One possible explanation to these differences is that those who are more prone to aggressive behaviors have a less activation in brain regions that are important in bidirectional control of more subcortical structures that influence aggressive and emotional behavior. For example, a decreased activation of the frontal lobe may result in an inability to inhibit emotional and aggressive reactions that stem from areas of the limbic system. These results indicate that SPECT analyses could potentially be valuable in the neurological component of future research on understanding predispositions to aggressive behavior. Future research will aim to determine the relationship between brain areas and their associated symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.86
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 11Neuropsychological Predictors of Social Functioning in Children with
           Fetal Alcohol Spectrum Disorders
    • Authors: Jay M; Tangen R, Bothe D.
      Pages: 703 - 794
      Abstract: Objective: Children with Fetal Alcohol Spectrum Disorders (FASD) have significant social functioning deficits, but research on neuropsychological predictors of social deficits has been limited. Executive functioning (EF) skills (working memory, switching attention, and inhibitory control) as well as social affective functions (pragmatic language and emotion regulation) were hypothesized to predict poorer social functioning in children with FASD. Method: 74 children were evaluated through a multidisciplinary FASD Clinic. (Mean Age = 10 years; 59.7% female; FSIQ above 70). Social functioning measures included the parent Vineland Socialization and Child Behavior Checklist (CBCL) Social Problems subscales. EF and language measures included the Test of Everyday Attention (TEA-Ch), Wechsler Intelligence Scale for Children (WISC)- Processing Speed (PSI) and Working Memory (WMI) indices, Test of Language Competence (TLC), and Behavior Rating Inventory of Executive Function (BRIEF)- Emotional Control subscale. Results: Regression analyses showed that CBCL social problems were predicted by TEA-Ch Same World (β = −.549, p = .02) and Opposite World (β = .597, p = .01) and higher ratings on BRIEF Emotional Control (β = .318, p = .01). TEA-Ch Creature Counting (β = −.400, p = .005) and BRIEF Emotional Control (β = −.460, p = .000) were also predictive of poorer Vineland Socialization ratings. The TLC, PSI, and WMI were not predictive of social functioning. Conclusions: Aspects of executive function, including attention switching, inhibition, and emotional control were predictive of poorer social functioning in children with FASD. Focus on executive function and social problem solving could be a treatment target in this population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.87
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 12Associations Between Cognitive, Mental Health, and Motor Outcomes in
           Patients with Acquired Dystonia After Pediatric Stroke
    • Authors: Ledochowski J; Desrocher M, Westmacott R.
      Pages: 703 - 794
      Abstract: Objective: Dystonia is the most common post-stroke movement disorder in children, and cognitive and mental health difficulties have been noted in this population. The objective of this study was to investigate associations between cognitive, mental health, and motor outcomes in children with acquired dystonia and stroke only. Method: Participants: 79 children, 27 with dystonia (Mean age = 11.59), 52 stroke only (Mean age = 11.36) from the Stroke Program at SickKids Hospital. Measures: Wechsler Intelligence Scale for Children- 4, D-KEFS Color-Word Test, and Behavioural Assessment for Children-2. Motor outcomes were assessed using the Pediatric Stroke Outcome Measure. Mann-Whitney U and Pearson correlations were used to examine group differences and associations. Results: Children with dystonia had poorer motor outcomes (p < .001) verbal (p = .006) and non-verbal reasoning (p = .012), inhibition (p = .004), mental flexibility (p = .010), greater depressive symptoms (p = .039), and a trend towards greater anxiety symptoms (p = .076). There were no group differences on working memory or processing speed. No significant associations between cognitive, mental health, and motor variables were found in the dystonia group. In contrast, the stroke only group showed associations between motor outcomes and verbal (p = .003) and non-verbal reasoning (p < .001), working memory (p = .003), processing speed (p < .001), and inhibition (p = .034). There were no other significant associations. Conclusions: Results support the presence of cognitive and mental health difficulties in children with post-stroke dystonia. The lack of associations between cognitive, mental health, and motor outcomes in the dystonia group suggests that these features are independent of one another in this population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.88
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 13Distinguishing Between Functional Neurological Symptom Disorder and
           Intentional Poor Performance on Neuropsychological Testing in Two
           Preadolescent Males
    • Authors: Lewandowski A; Kunzer K, Lewandowski C, et al.
      Pages: 703 - 794
      Abstract: Objective: While the use of performance validity measures (PVTs) is an accepted standard practice in adult neuropsychological evaluations, it is less common in pediatric cases outside of forensic settings. In recent years research has supported the incorporation of PVTs in clinical pediatric assessments even when there is no apparent secondary gain. Method: We describe a case study of two nine-year-old males presenting separately at the request of pediatrics for comprehensive neuropsychological evaluation pursuant to a reported uncomplicated concussion followed by atypical cognitive and physical symptoms that included variable memory loss and transient hemiparesis. While neither patient had prior contact with each other, the presenting etiologies and complaints were quite similar. In addition to our standard pediatric test battery (modified for symptom limitations), two standalone PVTs (Test of Memory Malingering and Word Memory Test) and one embedded PVT (Reliable Digit Span) were included to support diagnostic decision making and medical care coordination. Results: Both data and behavioral observations revealed inconsistent performance for each patient. While one child’s pattern on PVTs was substantially below chance-level, the other performed well above established cutoffs. Differential responding is attributed to a deliberate vs. unconscious performance effort, and the respective diagnoses were subsequently confirmed by psychiatry, neurology, and pediatrics. Conclusions: The use of PVTs was essential in the clinical differentiation between a functional neurological symptom disorder and malingering. These cases demonstrate the importance of validity measures in detecting suboptimal effort in pediatric assessments and emphasize the value of incorporating PVTs in clinical pediatric cases despite the apparent lack of secondary gain.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.89
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 14Neuropsychological Outcomes in a Pediatric Population with Autism
           Spectrum Disorder and/or Anxiety
    • Authors: Manjarres Cohen D; Fredrick A.
      Pages: 703 - 794
      Abstract: Objective: This research investigated the impact that comorbid anxiety and Autism Spectrum Disorder (ASD) has on the neurocognitive performances of a pediatric population. Method: Archival data was obtained from a private practice in an affluent suburb of Chicago, Illinois. A total of eighty-three children (ages 5–16) who had completed comprehensive neuropsychological testing were selected based on their diagnosis. Subjects were assigned to one of four groups: normal control (n = 19), anxiety (n = 20), ASD (n = 24), or ASD and anxiety (n = 20). Domains assessed included intellectual functioning; academic achievement in math, reading, and writing; verbal and visual immediate and delayed memory; higher order cortical functioning; expressive and receptive language; visual-motor integration; and motor dexterity. A one-way between-groups analysis of variance was conducted to explore the impact of anxiety on neuropsychological domains in children diagnosed with and without ASD. Results: As predicted, the ASD with comorbid anxiety group, performed worst on measures of: intelligence (p = 0.007), working memory (p = 0.02), processing speed (p = 0.046); rote calculation (p = 0.003), math problem solving (p = 0.005); written expression (p = 0.027); verbal delayed memory (p = 0.037); selective auditory attention (p = 0.039); divided auditory attention (p = 0.003); comprehension of syntactic complex instructions (p = 0.002); rapid color naming (p = 0.022); reading fluency (p = 0.025); fine motor dexterity of the non-dominant hand (p = 0.025). Conclusions: These data support the adverse effect of anxiety on neuropsychological functioning in youth diagnosed with ASD. Therefore, treating anxiety in children with comorbid ASD could potentially improve neurocognitive outcomes and should be prioritized.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.90
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 15A Case of Adolescent Right Thalamic Ependymoma Status-Post Resection
    • Authors: Muslin S; Burciaga J.
      Pages: 703 - 794
      Abstract: Objective: Neuropsychological functioning of post-operative thalamic tumors have been discussed in adults (Van der Werf et al, 2000), and preoperative thalamic tumors in children (Chiefo et al, 2014) however little literature outlines the postoperative neuropsychological functioning of children with right thalamic tumors. This case elucidates the neuropsychological functioning in the context of a post-operative pediatric right thalamic ependymoma over two years. Method: A 13-year-old biracial Middle Eastern/Caucasian, girl initially experienced left handed weakness, headaches, fatigue, and a decline in her grades and difficulty concentrating. MRI revealed a right thalamic lesion, displacing the 3rd ventricle. Pathology confirmed the mass to be grade 2 supratentorial ependymoma of the right thalamus. Patient underwent a gross total resection of the tumor via a transcallosal approach. Post-surgical complaints included impaired memory, processing speed and balance issues. A comprehensive neuropsychological battery was administered. A re-evaluation was administered one year later after complaints of continued memory impairment. Results: Test results revealed significant improvement in processing speed compared with evaluation one year prior. Continued difficulties with learning and memory for visual information, unstructured verbal information, and executive functioning. She demonstrated continued impairment of fine motor speed, balance, dexterity, and strength with her non-dominant left hand, and overall improvement of her right hand. Conclusions: Visual memory deficits and significant impairment in left-handed motor functions are consistent with the right-thalamic location of the ependymoma and subsequent resection. Impairments had not improved from initial evaluation, with the exception of processing speed and motor functioning of her dominant hand, thus suggestive of long-term deficits. References:Van der Werf, YD., Witter, MP., Uylings, HB., Jolles, J. (2000). Neuorpsychology of infarctions in the thalamus: a review. Neuropsychologia 38 (5); pp. 613–627. Daniela Chieffo, D., Tamburrini, G., Caldarelli, M., Di Rocco, C. (2014). Preoperative neuropsychological and behavioral evaluation of children with thalamic tumors. Journal of Neurosurgery: Pediatrics. 13; pp. 507–513.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.91
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 16Neuropsychological Functioning of Early Childhood Left Temporal
           Primary CNS Neoplasm Status-Post Resection: Evidence for the “Crowding
           Out” Hypothesis
    • Authors: Muslin S; Burciaga J, Aaron H, et al.
      Pages: 703 - 794
      Abstract: Objective: In cases of insult to the left temporal lobe, particularly during periods of early development, language may lateralize to the right hemisphere, thus crowding out visual function. This is referred to as the “crowding out” hypothesis (Strauss, E., Satz, P., & Wada, J., 1990). However, comprehensive neuropsychological evidence of the hypothesis has not been presented. This study provides evidence of the “crowding out” phenomenon in a child six years status-post tumor resection. Method: An 8-year-old right-handed White female presented with academic concerns. In infancy, she was diagnosed with a left temporal primary central nervous system neoplasm (most consistent with desmoplastic infantile astrocytoma) and underwent a gross total resection at 31 months with subsequent chemotherapy. Pre-operative magnetic resonance imaging (MRI) revealed a cystic mass lesion of the medial left temporal lobe. The 4-year post-operative MRI revealed no evidence of tumor recurrence. A comprehensive neuropsychological battery was administered. Results: Strengths in verbal functioning, learning, and recall were demonstrated (Verbal Comprehension Index = 95th percentile). Average performance on visuospatial tasks that allow for verbal mediation strategies was demonstrated; however, performance was impaired on perceptual reasoning and visual memory tasks in which verbal mediation was not possible (Visual Spatial Index = 23rd percentile). Conclusions: Neuropsychological performance was consistent with strong verbal skills, with deficits in pure perceptual reasoning. Considering the utility of language, language functions may have extended to the right hemisphere. These deficits suggest the presence of “crowding out”, as the right lobe appears to be compensating some visual function for verbal. References: Strauss, E., Satz, P., & Wada, J. (1990) An examination of the crowding hypothesis in epileptic patients who have undergone the carotid amytal test. Neuropsychologica, 28 (11), pp: 1221–1227.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.92
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 17Neuropsychological Recovery in a Pediatric Case of a Cerebellar
           Cognitive Affective Syndrome Status-Post Cerebellar Tumor Resection
    • Authors: Muslin S; Peery S, Aaron H, et al.
      Pages: 703 - 794
      Abstract: Objective: This case characterizes the longitudinal neuropsychological outcome of pediatric cerebellar cognitive affective syndrome (CCAS), prior to and status-post cerebellar tumor resection, at three separate time points between ages 7 and 11. Method: A Chinese-American, bilingual girl underwent gross resection of cerebellar vermis astrocytoma at age seven. Initial magnetic resonance imaging (MRI) revealed left-to-right midline shift with partial effacement of the left lateral ventricle. A comprehensive neuropsychological battery was administered prior to resection, and at ages 9 and 11. An average Z score was calculated for each neuropsychological domain. Results: Across all sessions, the child showed blunted affect and impaired verbal initiation. The pre-operative evaluation revealed expressive and receptive language difficulties (Z = −1.70 and −1.00, respectively) and slow processing speed (Z = −1.09). Post-operative evaluation two years later revealed persistent difficulties with expressive language (Z = −1.06) and processing speed (Z = −1.22), as well as lagging social skills (Z = −0.91) and executive functions (Z = −2.23), with improved receptive language (Z = −0.25). Testing four years post-resection revealed persistent deficits of expressive language (Z = −1.78), processing speed (−1.00), and social communication with improved receptive language (Z = 0.16) and executive functioning (Z = −0.29). Conclusions: Serial neuropsychological evaluations revealed persistent deficits of expressive language, processing speed, and social skills, with improved receptive language. The child “grew into her deficits” of executive functioning prior to improving. Although affective disturbance and expressive language difficulties were seen across all evaluations, this case demonstrates gradual resolution of symptoms of CCAS.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.93
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 18How’d We Do' Results of a Brief Satisfaction Survey Following
           Outpatient Pediatric Neuropsychological Evaluation
    • Authors: Nissirios E; Baldwin F, Maerlender A, et al.
      Pages: 703 - 794
      Abstract: Objective: Increased attention has been placed on the patient experience in healthcare to better understand factors contributing to satisfaction. The aim of the present study was to examine parent/guardian satisfaction with outpatient pediatric neuropsychological services and identify factors related to overall satisfaction. Method: Participants included the parents/guardians of pediatric patients who underwent outpatient neuropsychological evaluations at a large academic medical center. Following the evaluation and provision of feedback, a four-item satisfaction survey was distributed with the written report. Each item was rated on a 4-point scale (α = 0.79), ranging from 1 (Not at all) to 4 (Yes, very much). Surveys were received from 130 families (22% return rate), 120 of which met inclusion criteria. The patient sample was 56% male with ages ranging from 5 to 18 (M = 11.76, SD = 3.35). Intellectual functioning was average (M = 92.65, SD = 16.58). Results: Mean ratings on each survey item ranged from 3.55 to 3.63, and 96% of items were rated as “Pretty much” or “Yes, very much.” Scale items were summed to provide an indicator of total satisfaction. Total satisfaction ratings did not vary according to IQ [F(1, 112) = .001, p = .97)], age [F(1, 118) = .097, p = .756)], or sex [F(1, 118) = .103, p = .749)]. Conclusions: Overall, parents/guardians were satisfied with their experience, regardless of individual patient characteristics, suggesting neuropsychological services are highly valued by caregivers of pediatric patients. Future studies can survey educators and other care providers, as well as examine additional demographic, patient, and clinician variables.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.94
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 19Septo-Optic Dysplasia (de Morsier syndrome): Neuropsychological
           Sequelae in a Four-Year-Old
    • Authors: Powell S; Tam H, Gold A, et al.
      Pages: 703 - 794
      Abstract: Objective: Septo-optic dysplasia (SOD) is a rare disease (1 in 10,000 births). This case study of a 4.4 year-old male aims to add to the understanding of neuropsychological sequelae in SOD. The patient was diagnosed with SOD as a result of fMRI results confirming midline brain abnormalities while in the NICU for perinatal oxygen loss. There was no history of clinical seizures and results of a single EEG in the NICU were normal. Nystagmus and strabismus were identified more recently. Method: Patient underwent a comprehensive neuropsychological evaluation (including Autism Diagnostic Observation Schedule) at an outpatient medical center. Results: Language milestones were acquired to a normal timeline while gross and fine motor skills were delayed. Patient exhibited a varied intellectual profile with superior verbal reasoning and impaired processing speed. Neuropsychologically, the patient demonstrated intact verbal memory, variable language skills, and weaknesses in attention and motor skills. Pre-academic skills were on target or above average. Social-communication deficits and repetitive behaviors/restricted interests were present. Collectively, the patient met criteria for: Neurodevelopmental Disorder associated with SOD, Autism Spectrum Disorder (ASD), and a Developmental Coordination Disorder. Rule out diagnoses were also stipulated for Attention-Deficit/Hyperactivity Disorder (ADHD) and anxiety. Conclusions: Patient presentation is consistent with children identified with agenesis or absence of the corpus callosum in terms of deficits in pragmatic language, presence of restricted interests and repetitive behaviors, as well as other features of ASD.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.95
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 20Implementation of a Flexible Model of Neuropsychological Assessment
           in a Pediatric Oncology Program
    • Authors: Powell S; Ares K, Goldman S.
      Pages: 703 - 794
      Abstract: Objective: Children with a history of cancer or brain tumor are at elevated risk for cognitive deficits, such that neuropsychological testing is a common component of long-term care. This places high demands on clinics that may have limited providers, families who balance multiple appointments, and children who confront additional school absences. A flexible model that can streamline neuropsychological assessments would be beneficial to all parties. This study assessed the feasibility of such a model in a pediatric academic medical center. Method: The Flexible Neuropsychological Assessment Clinic (Flex-NAC) at Ann & Robert H. Lurie Children’s Hospital takes a formalized approach to triaging patients to targeted or comprehensive evaluations, using an algorithm based on clinical concerns, practice variables, and medical factors, informed by published standards (e.g., COG). This flexibility is maintained via a post-evaluation review tool, confirming the appropriateness of the initial triage decision and allowing for additional testing as indicated. The model also includes a follow-up visit 3-months post, after which functional outcomes and parent satisfaction are assessed. Results: Using the Flex-NAC model, 78 patients from the Division of Hematology/Oncology/Stem Cell Transplantation were triaged, 54 of whom were assigned to targeted neuropsychological evaluations. Primary referral groups display relatively even triage to targeted evaluations (brain tumor 76%, leukemia 61%, solid tumor 67%). Moreover, outcomes data indicate consistently high parent satisfaction and clinical utility across evaluation type. Conclusions: This model allows a responsive allocation of resources, reserving comprehensive neuropsychological evaluations for those patients most in need and limiting clinic visits for patients and families while maintaining quality care.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.96
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 21Effect of Loss of Consciousness After Traumatic Brain Injury on
           Digit Span Backwards
    • Authors: Radmanesh D; Tran V, Garcia J.
      Pages: 703 - 794
      Abstract: Objective: To explore whether loss of consciousness duration in older adults is associated with decreased working memory as measured by digit span backward on the WAIS-IV. Method: The current study consisted of 358 older adult participants who completed a neuropsychological battery. Researchers conducted a one-way analysis of variance (ANOVA) to examine whether there are differences in digit span scores between participants who suffered no LOC, brief LOC (up to 5 minutes), and extended LOC (>5 minutes) after a TBI. Results: Results revealed a significant overall effect for the model at α = .05, Welch’s F(2, 354) = 2.57, p = .037. Post hoc comparisons, using the Bonferroni post-hoc procedure showed a significant difference in digit span scores between no LOC and the extended LOC group. Conclusions: The consequences of TBI are profound and debilitating, such as physical disability, emotional lability, and cognitive decline. Arguably, cognitive impairment may particularly worsen outcomes in individuals who sustained a TBI. Deficits in working memory capacity, as evidenced by reduced digit span backward scores, are one of many sequelae following extended LOC. Impaired working memory can cause barriers to successful recovery following TBI, as individuals with compromised cognitive faculties find it more challenging to adhere to treatment recommendations, return to work or school, or engage in activities that he or she enjoyed prior to the injury. Future research should examine rehabilitation strategies (e.g., psychoeducation, skills training) aimed at improving cognitive functioning, and thus, improving treatment outcomes.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.97
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 22FAS BeST: Evidence of Behavior Profiles for Prenatal Exposure to
           Alcohol
    • Authors: Seiders J; Andrews G, Mara T.
      Pages: 703 - 794
      Abstract: Objective: The Fetal Alcohol Syndrome Behavioral Survey of Traits (FAS BeST) was designed to assess effects of prenatal exposure to alcohol (PEA; Andrews & Robins, 2009). Our goal was to investigate specific behaviors that indicate gender differences or overlap with other diagnoses in order to improve understanding of the effects of PEA on the developing brain. Method: Participants (n = 124) were recruited through studies that incorporated the FAS BeST (dependent variable). Data were gathered via mailed packets, volunteers at conferences, and clinic providers. Diagnoses (FASD, dysgenesis of the corpus callosum (DCC), no diagnosis) were determined independent of the researchers. Independent variables were gender and diagnostic groups. Results: A 1-way ANOVA confirmed participants with an FASD diagnosis exceeded the cutoff score on the FAS BeST total and was significantly higher than those with diagnoses of DCC and no diagnosis. Item analyses indicated symptom overlap on 11 items between FASD and DCC, and none with controls. Few differences were found between male and female participants. No interactions were found between gender and diagnosis. Conclusions: The behavioral profile for FASD has minimal overlap with behavioral symptoms found with DCC (21%). Individuals with PEA, regardless of gender, have a similar behavioral profile indicating the effects of PEA on the developing brain present unique challenges differentiating them from those with other diagnoses. The FAS BeST is a helpful tool for identifying behaviors indicative of PEA, accurately differentiating individuals with no diagnosis or with DCC, and providing data for assessment referrals.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.98
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 23Oppositional Defiant Disorder Compared to Conduct Disorder: A SPECT
           Exploratory Analysis
    • Authors: Strong A; Grego A, Kieth M, et al.
      Pages: 703 - 794
      Abstract: Objective: To determine differences between Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in regional cerebral blood flow (rCBF). Method: Participants came from a de-identified database where participants were given a single photon emission computed tomography (SPECT) scan as part of a comprehensive evaluation. Blood flow was measured during a concentration task (Conners’ CPT-II) within 17 brain regions. MANOVA was used to determine differences in rCBF between ODD (n = 344, Mage = 11.64,69.2% Male,52.9% Caucasian) and CD (n = 360, Mage = 13.51,72.5% Male,47.2% Caucasian). Follow up analyses revealed demographic differences between groups on age, which was controlled for in the final analyses. Results: MANCOVA yielded significant differences at p < 0.05 in rCBF between children and adolescents with ODD and CD, Wilks’ λ = 0.947; F(16,687) = 2.398, p = 0.002. Blood perfusion was significantly higher in the ODD group in the left parietal and bilateral motor sensory regions. However, blood perfusion was significantly higher in CD in the left cerebellum and vermis regions. Conclusions: ODD and CD both involve problems in control of emotions and behaviors. There is a high comorbidity among these disorders; however, the specific nature of the shared components that comprises the externalizing continuum remains unknown. The differences in blood flow could be a representation of how individuals with these different disorders respond to different stimuli. Individuals with CD have lower blood flow compared to ODD in the bilateral motor sensory and parietal regions. This could explain why individuals with CD react in a more aggressive and destructive manner compared to ODD. Additionally, individuals with CD have higher blood flow compared to ODD in the cerebellum and vermis regions. These regions regulate heart rate and coordinate movement. Thus, perhaps individuals with CD respond to stimuli with heightened arousal. ODD and CD are similar and have high comorbidities. It is important to identify the differences between these two disorders to help better understand and treat these individuals.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.99
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 24Neuropsychological Evaluation of a Hard of Hearing High School
           Student with KBG Syndrome
    • Authors: Whitaker R.
      Pages: 703 - 794
      Abstract: Objective: KBG syndrome is caused by a change (mutation) in the ANKRD11 gene or a loss of genetic material (microdeletion) on chromosome 16q that involves the ANKRD11 gene. KBG syndrome is characterized by four main manifestations: typical facial dysmorphisms, macrodontia of upper central incisors, skeletal abnormalities, and developmental delay (Lo-Castro, Brancati, Digilio, Garaci, Bollero, Alfieri & Curatolo 2012). Hearing loss is also a common characteristic associated with the disorder (Low et. al. 2016). Case studies of individuals diagnosed with KBG syndrome revealed delayed milestones with moderate degree of developmental delays. Language development were often more affected than motor skills. Autistic Spectrum Disorders are not common with the individuals presenting with the ANKRD11 gene mutation, however over half of the individuals presenting with the 16q24.3 microdeletion had ASDs (Marshall et al., 2008; Williamsen et al., 2010, Youngs et al., 2011). An 18-year-old female with data from an evaluation and interventions following the evaluation will be presented. Method: Assessment was performed over a serious of brief sessions. Adaptations were required due to impacts of the KBG syndrome including hearing loss. Communication was through speech in an accommodated testing environment with some sign language support. She has been followed in the year since the evaluation. Results: Cognitive assessments indicated relative strengths in her visual-spatial reasoning, fluid reasoning and visual-spatial memory, while verbal comprehension was within the low range of ability. Student presented with specific deficits in making sound/symbol connections and recognition of orthographic representations of words that were in contrast to her audiological access and met the criteria for Specific Learning Disabilities (Dyslexia and Dysgraphia). Student also presented with social dysfluencies that are atypical for hard of hearing individuals. Conclusions: KBG, while rare, provides a model for multiple impact neurological developmental disorders. Interdisciplinary interventions guided by the assessment provided gains in excess of previous limited progress, and such assessment-guided interventions could be implemented with other children with multiple disabilities.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.100
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 25Patterns of Child Maltreatment in Families Referred for Clinical
           Neuropsychological Testing
    • Authors: Kaufman N; Martinez V, Davis A, et al.
      Pages: 703 - 794
      Abstract: Objective: Neuropsychological test scores are influenced by many factors (Suhr & Wei, 2013), including child maltreatment. Our goal is to report base rates of child maltreatment, along with correlates of this maltreatment, in a sample of participants referred for clinical neuropsychological testing. Method: The research design is correlational and descriptive and involves de-identified archival data from a clinical neuropsychological practice. Sample sizes ranged from 74 to 101. The average age was 21.7 years (SD = 19.8; Mode = 7.3). Most participants were persons of color (POC; 52.9%), followed by White (34.3%) and mixed White/POC (12.7%). Most participants were male (57.8%). Results: Sizeable percentages in this sample suffered child maltreatment: physical abuse (21.1%); psychological abuse (29.8%); sexual abuse (13.0%); neglect (29.8%); and exposure to domestic violence (35.9%). Child Protective Services investigated 35.4% of the families. Ethnicity was not related to child maltreatment, but being female was linked with sexual abuse and being male increased the likelihood of witnessing domestic violence. Having an unemployed father increased the odds of sexual abuse, neglect, and exposure to domestic violence. Maternal incarceration predicted physical abuse, psychological abuse, and neglect, whereas paternal incarceration predicted psychological abuse and neglect. Conclusions: Neuropsychological test scores are obtained on individuals; however, these scores may be influenced by family environments characterized by maltreatment. Our findings indicate that child maltreatment occurs frequently and is related to parent functioning. References: Suhr, J., & Wei, C. (2013). Influence in Neuropsychological Evaluation. Secondary influences on neuropsychological test performance, 182.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.101
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 26Estimating Youth Wechsler IQ With Four Demographic Variables: A
           Cross-Validation
    • Authors: Kaufman N; Martinez V, Davis A, et al.
      Pages: 703 - 794
      Abstract: Objective: Kaufman et al. (2017) used stepwise multiple regression to identify only four demographic variables that would predict Full-Scale IQs (FSIQs) among clinically-referred youth: Adjusted R2 = .202. Our objective was to cross-validate the Kaufman et al. findings with an independent sample. Method: The research design was correlational and involved de-identified data (N = 173) from a clinical neuropsychological practice. Most of the sample was male (N = 102), non-white (N = 112), receiving Medicaid (N = 148), and without a history of special education (N = 142) or speech therapy (N = 93). The average age in years was 11.87 (SD = 3.64). Actual IQs varied: Min = 44; Max = 117; Mean = 81.22; and SD = 12.75. Results: The Kaufman et al. regression model was used to compute an estimated IQ for each participant: YIQ = 93.659–9.754*SPED-5.948*Medicaid-5.316*Speech Therapy-2.685*Ethnicity. This estimated IQ score was then correlated with participants’ actual Wechsler FSIQs: r = .441 (p<.001). Conclusions: Knowing Medicaid status, Speech Therapy history, Special Education history, and Ethnic background allowed us to estimate actual FSIQs in an entirely new, independent sample with the same amount of accuracy (r2 = .19) as documented previously (Adjusted R2 = .202). Hence, we were able to cross-validate recently-published findings using a different data set. References: Kaufman, N. K., Mullins, C., Davis, A. S., Tonarelli, S., Sandoval, H., & Ramos-Duran, L. (2017). When is Neuropsychological Testing Medically Necessary for Children on Medicaid in New Mexico' Applied Neuropsychology: Child, 1–14.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.102
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 27Posttraumatic and Depressive Anhedonia: Common and Distinct
           Cognitive Profiles
    • Authors: Clendinen C; Hardy R, La Barrie D, et al.
      Pages: 703 - 794
      Abstract: Objective: Anhedonia, or the inability to experience pleasure, occurs in the context of posttraumatic stress disorder and depression, but manifests somewhat differently between these two disorders (e.g., posttraumatic anhedonia (PTA) includes feelings of detachment and numbness). No prior studies have examined different patterns of cognition associated with PTA and depressive anhedonia, which was the goal of the present study.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.103
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 28How Well do PPVT-4, EVT-2, and NDRT Vocabulary Subtest Predict
           WAIS-IV Indices and FSIQ
    • Authors: Gilmore M; Harcourt S, Strong A, et al.
      Pages: 703 - 794
      Abstract: Objective: This study examined how well Peabody Picture Vocabulary Test - fourth edition (PPVT-4), the Expressive Vocabulary Test Second Edition (EVT-2) and the Nelson-Denny Test Vocabulary subtest (NDRT-VC) predicts WAIS-IV. Method: Data stemmed from an ongoing de-identified database of clinical adults. Participants were administered the WAIS-IV, PPVT-4, EVT-2, and the NDRT. Scores included PPVT-4 (n = 70), EVT-2 (n = 70) and NDRT-VC (n = 70). The sample consisted of 50% males and 50% Caucasian participants with a Mage=32. Results: Results of the Pearson correlation indicated that there was a significant association between the WAIS-IV indices and PPVT-4, EVT-2, and NDRT-VC (p < .01). VCI was strongly correlated with EVT-2 (r = .85), PPVT-4 (r = .84), and NDRT-VC (r = .79). PRI was strongly correlated with EVT-2 (r = .69), PPVT-4 (r = .66), and moderately correlated with NDRT (r = .57). WMI was strongly correlated with EVT-2 (r = .70), PPVT-4 (r = .60) and moderately correlated with NDRT-VC (r = .58). PSI was moderately correlated with NDRT-VC (r = .59), EVT-2 (r = .55), and PPVT-4 (r = .51). FSIQ was strongly correlated with EVT-2 (r = .82), PPVT-4 (r = .77), and NDRT-VC (r = .74). Conclusions: EVT-2 was more strongly correlated with VCI and FSIQ. These results indicate that expressive language and word retrieval abilities are better able to measure intelligence than receptive vocabulary skills. PRI was strongly correlated with EVT-2 and PPVT-4 because of the visual needs of both tests. Though PSI was only moderately correlated with the three tests, NDRT-VC was the strongest due to its timed nature. The subtests on the other indices are not strictly looking at how quickly an individual can answer a question, which explains the moderate correlations with NDRT-VC for WMI and PRI.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.104
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 29An Exploratory Factor Analysis of Verbal Mediation in Visual
           Assessment Tasks
    • Authors: Greenman K; Moses J.
      Pages: 703 - 794
      Abstract: Objective: Examine the potential role of verbal mediation in visually oriented tasks as operationalized by standard neuropsychological assessment instruments. Method: The assessment records of 320 Veterans Administration patients referred for neuropsychological evaluation were examined using exploratory factor and principle component analysis. Individual assessment instruments were factored using principle component analysis. The derived factors were then co-factored to identify common sources of variance. Neurocognitive data included: Benton Visual Retention Test in recall (BVRT) and multiple-choice formats (BVRT-MC), Visual Form Discrimination Test (VFDT), Sentence Repetition test (SR), Token Test (TT), Controlled Oral Word Association Test (COWAT), and the Visual Naming Test of the Multilingual Aphasia Examination (VNT). Results: A native five-component model, explaining 81.90% of shared variance was identified. Each of the verbal language measures (SR, TT, COWAT, VNT) loaded on a single component with no significant shared variance. Notably, the fifth component had no significant verbal loading and was populated by components of the BVRT-early (0.826) and factors of VFDT/BVRT-MC (0.747). BVRT late tasks loaded on three of four language factors. TT (0.991) was the only language component that did not include a significant component of BVRT, early or late, in the final component model. Conclusions: The results indicate a strong relationship between assessed performance on language tasks and performance on visual tasks. This suggests that visual tasks may benefit from verbal mediation and are likely less independent from language than is commonly believed. Further investigation to investigate implications associated with language performance effects on apparently verbal and non-verbal assessment tools is warranted.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.105
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 30The Clinical Utility of Recaptured Baselines After Return-to-Play
    • Authors: Kissinger-Knox A; Norheim N, Cheatham M, et al.
      Pages: 703 - 794
      Abstract: Objective: Limited data address re-establishing baseline performance following return-to-play after concussion (Lynall et al., 2016). The HeadMinder CRI manual recommended that it is “crucial” to establish a new baseline after resolution of symptoms, but no supporting data were provided (Headminder, Inc., 2007). In contrast, the ImPACT management model (2013) proposes the athlete’s final follow-up ImPACT score is their new baseline. Again, no supporting data are presented. The present study determined empirically the clinical utility of recaptured baselines in college athletes. Method: Forty-one college athletes who sustained a concussion were studied in a single season across four testing sessions; baseline, post-trauma, follow-up, and rebaseline. The average participant age was 19.61 (SD = 1.51) (51.2% female) with average education of 13.32 (SD = 1.15). The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) was used to examine four composite scores; verbal memory, visual memory, visual motor. Results: The ImPACT composite scores across the four testing sessions were compared via one-way repeated measures ANOVAs. Significant differences (p < 0.001) were found across the testing sessions in all composite scores: verbal memory, visual, visual motor, and reaction time. As expected, post-hoc comparisons revealed significant differences between post-concussion evaluations versus precompetition baseline, follow-up and rebaseline assessments. There were no significant differences found between the follow-up assessments and rebaselines (p > 0.05). Conclusions: This study provides new empirical evidence that a rebaseline procedure during a year of competition is not necessary. The study unambiguously supports the use of athletes’ final follow-up evaluation as their rebaseline for the remainder of the sports season in the instance of additional concussion.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.106
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 31C3Logix Assessment of Neuropsychological Performance in Athletes and
           Non-Athletes
    • Authors: Makwana B Xu X.
      Pages: 703 - 794
      Abstract: Objective: This study investigated neuropsychological performance in uninjured athletes and non-athletes using an iPad-based neuropsychological battery called the Comprehensive Concussion Management System (C3Logix). We hypothesized that, similar to previous studies, collegiate athletes would outperform non-athletes on all neurocognitive tasks due to the presumed difference in physical activity (PA) level. Method: Ninety-five athletes and 92 non-athletes completed the iPad neurocognitive assessment modules including the Standardized Assessment of Concussion (SAC), Processing Speed, Simple Reaction Time (SRT), Choice Reaction Time (CRT) and Trail Making A and B modules. The study sample was comprised of 18- to 24- year old undergraduate students, athletes (Mean Age = 19.97, SD = 1.26; 59 males and 36 females) and non-athletes (Mean Age = 20.23, SD = 1.86; 34 males and 58 females) that are currently attending Idaho State University (ISU). Athlete data was fully archival, provided by ISU Athletics via the C3Logix database. Non-athlete participants engaged in an online screener as well as an in-person laboratory data-collection session. Results: Results showed that athletes outperformed non-athletes on reaction time tasks (SRT, p = .011; CRT, p = .013), but not in the other neurocognitive domains (SAC, Processing Speed, Trails A and Trails B modules). Conclusions: The findings demonstrate that athletes perform quicker on tasks of reaction time. The implications of this study included extending our understanding of this subfield, filling a gap in our understanding of cognition and PA in healthy young adults (including providing normative data for uninjured collegiate athletes). extending the work of previous researchers, and providing data to suggest that increased PA may enhance cognition in the realm of reaction time.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.107
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 32A Comprehensive Evaluation of Acculturation Level Among Cognitively
           Normal and Cognitively Impaired Hispanic Older Adults
    • Authors: Mendoza L; Rodriguez M, Dahlin P, et al.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to examine the effects of acculturation on cognitive performance among older Hispanics. Participants and Method: Sample consisted of 142 Hispanic cognitively normal [CN; n = 70; M = 70.44 (SD = 6.15)], mild cognitive impairment [MCI; n = 27; M = 76.19(SD = 6.17)], and dementia [D; n = 45, M = 76.98(SD = 6.96)]. Median split was used to determine acculturation level using the Short Acculturation Scale for Hispanics (SASH). Independent-sample t-test at a .05 significance level was performed to compare means between acculturation groups and cognitive tests: MMSE, COWAT-FAS and Animals, BNT, HVLT, WMS-IV LM II and VR II, Digit Span, TMT-A and B. ANCOVA covarying for age and education was also conducted. Results: Among CN, significant difference between the acculturation groups was found with BNT [t(62) = 3.032, p < . 004], LM-II [t(63) = −2.462, p < . 017], VR-II [t(61) = −2.251, p < . 028], Digit Span-forward [t(62) = −3.291, p < . 002], Digit-Span-backward [t(62) = −2.661, p < . 010], TMT-B [t(44.783) = 3.377, p = . 002], and TMT-A [t(45.985) = 3.697, p < . 001]. Among MCI, significant mean differences were seen in COWAT-FAS [t(23) = 2.243, p < . 035] and in VR-II [t(30.987)=−2.107, p<. 043] among the D group. ANCOVA results showed significance only among the CN group with LM-II [F(1,60) = 5.694, p < . 020], TMT-B [F(1,60) = 4.824, p < . 032], and TMT-A [F(1,60) = 6.003, p < . 017]. Conclusions: High acculturation level is associated with better performance in delayed episodic memory, executive functioning, and processing speed among CN elders. This is consistent with the literature examining the effects of bilingualism. Special precautions should be taken during interpretation of test results in the absence of acculturation scales, especially when using non-Hispanic normative data.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.108
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 33Verbal and Nonverbal Intelligence Components Mediate Aspects of
           Visual Memory and Perception
    • Authors: Rivera J; Moses J, Greenman K, et al.
      Pages: 703 - 794
      Abstract: Objective: We expanded on previous exploration of the relationship between language, intelligence, and visuospatial abilities by examining additional effects of age and education on performance in verbal and nonverbal tasks. Method: The sample consisted of 113 American Veterans with diverse neuropsychiatric conditions. There were no exclusion criteria. All participants completed the Multilingual Aphasia Examination (MAE), Wechsler Adult Intelligence Scale, third edition (WAIS-III), Visual Form Discrimination Test (VFDT), Judgment of Line Orientation (JLO), and Benton’s Visual Retention Test (BVRT). Results: Principal Component Analysis (PCA) of all VFDT, BVRT, and JLO items produced a two-factor solution for each measure: VFDT-1 (Items 1–4) and VFDT-2 (Items 5–16); BVRT-1 (Items 1–4) and BVRT-2 (Items 5–10); and JLO-1 (Items 1–12) and JLO-1 (Items 13–30). A secondary PCA combined these factors with variables of age and education and produced two new factors: 1) BVRT-1, VDFT-1, JLO-1, and Age (B/V/J-1_Age); and 2) BVRT-2, VDFT-2, JLO-2, and Education (B/V/J-2_Edu). A third PCA of the MAE Visual Naming (VN), Token Test (Token), Sentence Repetition (SR), and Controlled Word Association Test (COWAT) measures with the four WAIS-III subtests produced a new four-factor solution: 1) Token with Perceptual Organization (PO); 2) COWAT with Processing Speed (PS); 3) VN with Verbal Comprehension (VC); and 4) SR with Working Memory (WM). A fourth PCA combined all findings and produced four new associations: 1) Token-PO with B/V/J-1_Age; 2) COWAT-PS with B/V/J-1_Age, 3) VN-VC with B/V/J-2_Edu; and 4) SR-WM with B/V/J-2 _Edu. Conclusions: It appears some nonverbal tasks are verbally mediated while some verbal measures also assess nonverbal cognitive abilities.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.109
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 34Neurocognitive Functioning as a Predictor of Study Dropout and
           Treatment Adherence Among Employed Women with Multiple Sclerosis
    • Authors: Stimmel M; Cohen J, Foley F.
      Pages: 703 - 794
      Abstract: Objective: Adherence to medication in multiple sclerosis (MS) is sub-optimal (65–80%). Treatment adherence, (i.e., keeping appointments), has rarely been evaluated in MS. The following study seeks to identify rates of adherence to a neuropsychological intervention among employed women with MS. Predictors of missing appointments and dropping out of the intervention are examined. Method: Our study includes 69 women with MS who took part in an employment study (April 2016-January 2018) that sought to maintain employment through a neuropsychological testing intervention. Participants were screened during a clinic visit to their neurologist (Teaneck NJ). Women who indicated elevated fatigue (Fatigue Severity Scale; FSS), depression (Patient Health Questionnaire; PHQ), and/or cognitive dysfunction (Symbol Digit Modalities Test; SDMT) were included in the employment study and contacted to make appointments for neuropsychological testing. Patients’ number of missed appointments and dropout rates were evaluated. Results: 34.8% (N = 24) of employed women dropped out of this study. Of 58 women who were scheduled for neuropsychological testing, 44.8% (N = 26) missed at least one appointment. Using logistic regression, neither fatigue nor depression significantly predicted missing NP testing appointments or dropping out. Neurocognitive functioning, however, significantly predicted both the likelihood of missing a neuropsychological testing appointment (CI = .881–.994, p = .032) and of dropping out of the study (CI = .876–.983, p = .011). Conclusions: Neurocognitive slowing predicted non-adherence and dropping out of a neuropsychological testing intervention. This study reflects an objective measure of treatment adherence (i.e., physician appointments) among employed women with MS and suggests that women who are slower on the SDMT may be at greater risk for non-adherence.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.110
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 35Serial Position Recall and Cognitive Performance in an Outpatient
           Clinic Sample of Older Adults
    • Authors: Weitzner D; DeVito A, Rasmussen L, et al.
      Pages: 703 - 794
      Abstract: Objective: Serial position effects (SPE), including primacy (PE) and recency effects (RE) are thought to be mainly related to deficits in memory functioning, and the relationship between SPE and global cognition has not been fully investigated. The objective of this study was to examine whether neuropsychological measures are related to performance on PE and RE in a heterogeneous clinic sample. Method: Data from 154 older adults referred for an outpatient neuropsychological evaluation (mean age of 70.10 (SD = 10.79), range: 50–93) were used for the current study. To analyze PE and RE, the raw scores of percent recall from primacy, middle, and recency provided on the California Verbal Learning Test-2nd Edition (CVLT-II) were utilized. Results: RE was significantly related to performance on Vocabulary (r = −.22), Matrix Reasoning (r = −.27), and Similarities (r = −.34) subtests of the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II), total words on the Controlled Oral Word Association FAS (r = −.21) and Category Fluency tests (r = −.42), and total time on Trails B (r = .29). However, only WASI-II Similarities (r = .33) and Category Fluency (r = .18) performance were significantly related to PE (all correlations listed are significant at p < .05). Conclusions: Greater reliance on recall of recently presented words was associated with reduced performance across a number of cognitive domains and may reflect global impairment. However, only individuals with lower performance on WASI-II Similarities and Category Fluency demonstrated reduced PE. Given the semantic nature of these tasks, this may relate to findings showing reductions in PE in the early stages of mild cognitive impairment and Alzheimer’s disease.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.111
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 36Differentiating Parkinson’s Dementia- and Depression-Related
           Cognitive Decline
    • Authors: Jeffrey M; Boix Braga M.
      Pages: 703 - 794
      Abstract: Objective: To differentiate the effects of Parkinson’s Disease-related dementia and depression-related dementia on cognitive decline. Method: Participants were selected from a large standardized de-identified database consisting of older adults with a variety of neurodegenerative disorders. A total of 35,526 individuals with Parkinson’s Disease Dementia (PD; n = 909) and Depression were selected (n = 3,307) in addition to controls (n = 31,310). A MANOVA was conducted to compare the main and interaction effects of these disorders through measures of intelligence (WAIS-IV: Coding), memory (WMS-IV: Logical Memory-Delayed), and semantic fluency (Animal Fluency). Results: A MANOVA was significant at the participants’ baseline level at the ≤.05 level. Poor Coding performance was found to be significant in PD, F(2, 35,558) = 90.91, p < .001, partial η2 = .01, while semantic fluency performance was significant in comorbid PD and depression F(2, 35,558) = 3.523, p = .03, partial η2 < .001. Depression alone was not significant. Conclusions: Patients with PD present with motor symptoms (i.e., stiffness and involuntary muscle jerks) as well as depression. The observed findings of impaired Coding performance on individuals with PD can be explained by motor deficits, which negatively impact processing speed, whereas the interaction effect via semantic fluency can be further explained by pure motor impairments and psychomotor retardation. These findings provide further understanding of the impairments that individuals will undergo during disease progression, which allows for more informed treatment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.112
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 37Case Study of Possible PSP with Severe Functional Impairment in a
           59-Year-Old Woman
    • Authors: Lee J; Facchini R, Cohen J, et al.
      Pages: 703 - 794
      Abstract: Objective: Progressive Supranuclear Palsy (PSP) is one of a group of less common Parkinson’s-related diseases that is clinically described and neuropathologically determined. Primary features are postural instability, akinesia, visual motor disturbance, and cognitive changes in executive functions, language and memory. A complex, atypical PSP case with considerable functional impairment is presented, with consideration of diagnostic criteria. Challenges to differentiation between PSP and other dementias, and among PSP subtypes in this patient are presented. Method: Patient with three years of progressive functional decline presenting for initial assessment: difficulty with IADLs, gait and movement changes, multiple falls, vision changes, apathy, dream enactment, and delusion are described. Cognitive complaints include confusion, disorientation, memory and language difficulty. Observations: stimulus bound behavior, perseverative and tangential thought, visual and motor impairment. Neurological evaluation demonstrates ocular motor apraxia, ocular ataxia and simultagnosia. MRI revealed mild white matter changes and mild atrophy. Results: Neuropsychological evaluation revealed significant impairment in multiple domains, including motor and executive functions, memory, and language. There was dramatic impairment in visual processing, incorporating impaired perception, visual motor integration, organization, and spatial processing. In contrast, she was able to visually identify objects from the Fuld Object Memory Task and could read single words, which aided diagnostic conclusions. Judgment and insight were poor. Conclusions: Patient presents with a complex array of symptoms that may be suggestive of multiple neuropathologies. Neuropsychological evaluation favors PSP, though differentiation of subtype is limited. Consideration of atypical patient presentation in light of recently published criteria is presented.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.113
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 38Fluid Reasoning in Pediatric Epilepsy: The Relationship of Executive
           Functioning with the WISC-V
    • Authors: Loblein H; Merrill L, Nussbaum N, et al.
      Pages: 703 - 794
      Abstract: Objective: The purpose of this study was to examine construct overlap between traditional executive functioning measures and the WISC-V Fluid Reasoning Index (FRI) in a pediatric epilepsy sample. Method: This study included 114 patients (56% female) with epilepsy (age 6–15 years) who were referred for neuropsychological assessment. The following data was collected retrospectively: WISC-V FRI, WISC-V Working Memory Index (WMI), Wisconsin Card Sorting Test (WCST), Delis-Kaplan Executive Function System Trails (DKEFS), D-KEFS or NEPSY verbal fluency. Parent ratings of attention, hyperactivity, and executive functioning on the Behavior Assessment System for Children and Behavior Rating Inventory of Executive Function were included. Results: Correlation analyses indicated that the FRI was significantly related to performance on Digit Span, Picture Span, WCST, and verbal fluency. Linear regression to predict Matrix Reasoning (MR) was significant (F (8, 32) = 3.916, p < 0.01) but was not uniquely accounted for by any single measure of executive functioning. In contrast, Digit Span and letter fluency both uniquely accounted for significant variance in Figure Weights (FW) scores (F (8, 32) = 4.383, p < 0.01). Conclusions: These findings demonstrate that the FRI on the WISC-V is significantly correlated with performance on executive functioning measures in pediatric epilepsy. While MR appears to be related to global executive functioning, FW is more associated with performance on serial digit repetition and phonemic fluency tasks. This may suggest that FW is more sensitive to dominant frontal lobe functioning; however, this would be contrary to adult findings on the WAIS-IV. The relationship of these findings with seizure variables will be discussed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.114
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 39Detecting Epilepsy-Related Cognitive Problems in Children with
           Epilepsy: Is the Wechsler Intelligence Scale for Children – Fifth
           Edition a Useful Tool'
    • Authors: MacAllister W; Maiman M, Medlin C, et al.
      Pages: 703 - 794
      Abstract: Objective: Despite numerous studies on IQ in childhood epilepsy, no published data are available for the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) in pediatric epilepsy. The current study examines the sensitivity of WISC-V index and subtest scores in detecting cognitive problems in children with epilepsy and explores the relationship among WISC-V scores and epilepsy severity variables. Method: 80 clinically-referred children and adolescents with epilepsy were administered the WISC-V as part of a comprehensive neuropsychological assessment. Scores were compared to controls matched for age, gender, race/ethnicity, and parent education obtained from the standardization sample. T-tests compared WISC-V indices and subtests for patients and controls and Chi-Square analyses compared the rate of Low scores (i.e., ≤2 standard deviations below means) in patients versus controls. Correlational analyses assessed the relations between epilepsy severity factors (e.g., age of onset, duration of epilepsy, number of epilepsy medications, seizure frequency) and WISC-V variables. Results: All WISC-V composites and subtests were significantly lower in patients versus controls (p < .001). With the exception of Figure Weights (p = .70), the rate of Low index and subtest scores was greater in patients than controls (p < .01). Among epilepsy severity variables, age of seizure onset and number of epilepsy medications were adversely related to WISC-V performance, whereas seizure frequency had the weakest relationship. Conclusions: The WISC-V is sensitive to epilepsy-related cognitive problems in clinically referred children with epilepsy, though Figure Weights may be of lesser sensitivity. Early age of epilepsy onset and polypharmacy appear to be related to greater cognitive burden.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.115
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 40The Relationship of WISC-V Profiles with Seizure Variables in
           Pediatric Epilepsy
    • Authors: Merrill L; Lund E, Nussbaum N, et al.
      Pages: 703 - 794
      Abstract: Objective: The objective of this study was to examine the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) profile in a pediatric epilepsy sample, with particular attention to the relationship with disease variables. Method: Data was collected on 112 children with epilepsy who were evaluated by Pediatric Neuropsychology at Dell Children’s Medical Center. The mean age was 11.3 years (SD = 2.7 years) and 51% were female. Racial composition was mixed (47% Caucasian, 27% Hispanic, 9% African-American, 15% other). The following seizure variables were collected through chart review: epilepsy type, seizure localization, age of seizure onset (SO), number of antiepileptic drugs (AEDs) at testing. Results: The full scale IQ (FSIQ) of the group was in the low average range (M = 83.31, SD = 16.17), as was verbal comprehension (VCI; M = 88.76), visual spatial (VSI; M = 88.51), fluid reasoning (FRI; M = 86.74), working memory index (WMI; M = 86.27), and processing speed index (PSI; M = 81.64). Among subtests, Coding was relatively low, and PSI scores were significantly lower than all other indices (p < 0.01). Multiple linear regressions revealed age of seizure onset as the sole predicter of FSIQ, VCI, FRI, and WMI, while PSI was predicted by age of seizure onset and number of AEDs. Conclusions: These results reveal overall intellectual functioning that is about one standard deviation below the mean on the WISC-V, which is consistent with previous WISC versions. Age of seizure onset was the best predictor of intellectual performance, reflecting a relationship between disease severity and cognition. Processing speed was further predicted by AED treatment. The implications of these findings for clinical management will be discussed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.116
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 41A Review of Alpha-synuclein’s Contribution to
           Parkinson’s Disease
    • Authors: Miller K; Hewitt K, Mullen C.
      Pages: 703 - 794
      Abstract: Objective: Parkinson’s Disease (PD) is the second most common form of dementia. It is one of many neurodegenerative diseases categorized as an alpha-synucleinopathy, which account for 30 percent of dementia in older adults (Ordonez, Lee, & Feany, 2018). Recent findings suggest that alpha-synuclein (α-syn) aggregation originates in the intestines. It then spreads to the central nervous system (CNS) via the vagus nerve, and develops into amyloid fibrils, which play a role in cell death (Chandra et al, 2017; Zunke et al, 2018; Jha et al, 2017). The current review explores this potential relationship between aggregation of α-syn and PD symptomology. Data Selection: Peer-review publications were acquired through search engines PsycINFO, Galileo, and PubMed. Keyword searches and phrases were used to explore the existing literature (i.e., alpha-synuclein, PD, gut microbiota, gut bacteria, gut microbiome). In order to answer our overall research question, more precise investigative questions and research objectives were needed. Thus, publications were restricted to the past 5 years to ensure that the proposed relationship between α-syn and PD was addressed. Data Synthesis: A total of 23 articles were initially retained. Research demonstrated that factors such as α-syn aggregation, oxidative stress, and the microbiome play a role in development of PD. Conclusions: These results of this systematic review pose further questions related to the variables affecting PD development and intervention. Further studies are necessary to understand the causal relationships in the development of PD as its etiology remains unclear.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.117
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 42Microstructural Difference in White Matter in the Prodromal and
           Clinical Phases of Parkinson’s Disease
    • Authors: Ohlhauser L; Gawryluk J.
      Pages: 703 - 794
      Abstract: Objective: This study used diffusion tensor imaging (DTI) to investigate microstructural differences in white matter during the prodromal and clinical phases of Parkinson’s disease. Method: Participants included 20 with prodromal PD (PPD; Mean age = 67.95, SD = 5.94, 6 female) and 17 with PD (Mean age = 68.23, SD = 6.05, 6 female) from the Parkinson Progression Markers Initiative (PPMI). DTI data from PPMI (3T MRI: 64 gradient directions, b-value=1000 s/mm2). FSL was used to create fractional anisotropy (FA) and mean diffusivity (MD) maps. Tract-based Spatial Statistics were performed using randomise with threshold free cluster enhancement. Analyses compared FA and MD values between PPD and PD at the whole brain level and in a region of interest (ROI) of the substantia nigra (SN). The relationship between rapid eye movement sleep behaviour disorder (RBD) and DTI metrics were also investigated. Results: At the whole brain level, MD was lower in PD than PPD (p < .05), while no FA differences were observed. For the SN ROI, there were no significant group differences in FA or MD. Increased RBD symptoms were related to lower MD in PD, and higher FA in PPD (p<.05). Conclusions: Microstructural differences in white matter were observed between individuals with prodromal and clinical PD. Increased RBD symptoms were related to different types of microstructural changes in the brain during different phases of the disease. The direction of DTI metrics was non-conventional, but consistent with a recent meta-analysis. Further characterization of DTI metrics in PD are needed to evaluate clinical utility.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.118
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 43Untreated Congenital Hydrocephalus and Parkinson’s Disease in
           Adulthood: A Neuropsychological Case Study
    • Authors: Sekunda V; Black J.
      Pages: 703 - 794
      Abstract: Objective: Studies suggest a relationship between the impact of congenital hydrocephalus in children status-post ventricular shunting on cognitive functioning. Many patients experienced improved functioning and cognitive performance following the introduction of shunts (Mataro, Junque, Poca, & Sahuquillo, 2001; Vinchon, Baroncini, Delestret, 2012). Links between parkinsonian symptoms and normal pressure hydrocephalus have also been suggested, with improvement in symptoms following shunt placement (Molde, Soderstrom, & Laurell, 2017). This case highlights the neuropsychological profile in an adult with untreated congenital hydrocephalus and Parkinson’s disease. Method: 44-year-old, right-handed, Caucasian male born 3-months premature with untreated congenital hydrocephalus, recently diagnosed with Parkinson’s disease by his neurologist. Experienced developmental delays, but graduated with a Master’s degree in Actuarial Sciences (after more prolonged studies). Presented with worsening short-term memory and decreased balance and gait. Results: His performance on a test used to estimate premorbid verbal functioning fell within the high average range which was statistically consistent with his predicted score based on demographic history (i.e., education, occupation, region, sex, and race/ethnicity). The patient’s performance across objective measures was highly variable, falling between the impaired to high average range, though he demonstrated a relative strength for verbal comprehension and auditory attention versus processing speed tasks. His auditory and visual memory were likely affected by his slowed processing and executive etrieval deficits. Conclusions: Despite markedly decreased processing speed, the patient demonstrated relative strengths for verbal comprehension and auditory attention and memory versus visual memory and nonverbal reasoning. The link between untreated congenital hydrocephalus and Parkinson’s disease is unknown. This case likely depicts the neurocognitive implications of both congenital hydrocephalus and Parkinson’s disease in an adult.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.119
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 44Reliability Between Conners CPT-3 and CATA
    • Authors: Goulart W; Harcourt S, Horne K, et al.
      Pages: 703 - 794
      Abstract: Objective: To test reliability between Conners CATA and CPT-3 impulsivity domain measures: Commissions, Hit Reaction Time, and Perseveration. Method: Adult clinical sample was recruited from a university mental health clinic (n = 98, age = 31.00, sd = 12.35, Caucasian 47.4%, Male 47.4%). Each participant was given both Conners Continuous Performance Task 3rd Edition (CPT-3) and Conners Continuous Auditory Test of Attention (CATA). Pearson correlation was run between the T-scores for corresponding measures from each test on Comissions, Hit Reaction Time, and Perseverations which comprise the impulsivity domain. Coefficient of determination was calculated for significant correlations. Results: Conners CPT-3 and CATA were correlated at p < .05 significantly on Commissions and Hit Reaction Time at r = .283 and .342 respectively, and insignificantly on perseverations at .037. Coefficient of determination showed that the two significant correlations shared 8.01% and 11.70% variance respectively. Conclusions: According to Conners, use of the CATA with the CPT-3 raises the diagnostic accuracy for detecting ADHD from .82 to .88 (Conners, 2014). The CATA and CPT-3 have the same measures and define the measures verbatim in the manual (Conners, 2014). Consequently, these measures should share a large percentage of variance. However, the results showed weak correlations for Commissions and Hit Reaction Time, and an insignificant correlation for Perseverations, and showed low shared variance. This suggests that the two tests may measure different types of attention and results of the CATA should be interpreted cautiously. Research suggests individuals are more distracted by auditory distractors, but more research is needed to determine if this applies to continuous performance tasks.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.120
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 45Predicting Processing Speed from Measures of Impulsivity
    • Authors: Kieth M; Sattaur Z, Strong A, et al.
      Pages: 703 - 794
      Abstract: Objective: To explore the relationship between processing speed and impulsivity. Method: Data were derived from an ongoing de-identified database of adults between the ages of 16 and 80 (Mage = 33.44, n = 362). Participants consisted of 52.9% Males, and 55.4% Caucasian. A linear regression was run to examine if PSI could be predicted from two measures of impulsivity, Conners CPT-II Commissions Percentage and the WCST total number of perseverative errors. Results: A linear regression model predicting PSI from Conners CPT-II Commissions percentage and WCST total number of perseverative errors was significant, F(2, 359) = 34.02, p < 0.001, R2 = .159. Thus, 15.9% of the variance of PSI can be attributed to commissions percentage and total number of perseverative errors. Additionally, commissions percentage was a significant negative predictor of PSI, b = −.14, t(361) = −2.25, p = .025. Commissions percentage accounts for 1.2% of incremental variance of PSI. Total number of perseverative errors was also a significant negative predictor of PSI, b = −.57, t(361) = −7.70, p < 0.001. Total number of perseverative errors accounts for 13.91% of incremental variance of PSI. Conclusions: This research suggests that adults with high impulsivity on neuropsychological measures have lower scores on scales of processing speed. The total number of perseverative errors on the WCST is the client’s inability to consider the options carefully, which was negatively correlated with PSI, and was the largest predicting factor of processing speed. A high CPT-II commissions percentage suggests that a client lacks the ability to wait until they have recognized the target before responding and was also negatively correlated with PSI. Therefore, clinically, a low PSI score could be suggestive of impulsivity, and could be helpful when diagnosing disorders with impulsive symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.121
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 46Assessing Depth Perception in Patients with Right Parietal Lesions
    • Authors: Poreh A; Eskew L.
      Pages: 703 - 794
      Abstract: Objective: It is well documented that right parietal lesions may result in the emergence of temporary left hemispatial neglect, and, in many cases patients recover from this condition after a few days. Several researchers have argued that the fundamental deficit of patients with hemineglect is the inability to utilize egocentric perceptual space distortion (Irving-Bell et al., 1999; Kerkhoff, 2000). The present study suggests that in some patients who no longer exhibit neglect on traditional neuropsychological measures continue to suffer from subtle lateralized depth perception deficits. As such, while they might perform well on measures such as the line bisection task or the clock drawing test and on tasks that tap into depth perception in the right visual field, such as the MOCA cube test. In contrast, they will perform poorly on the same exact task when it requires depth perception in the left visual filed. Method: three clinical cases with documented right parietal lesions using imaging techniques were studied. Results: In all three cases, patient exhibited a left, but not right sided depth perception deficits. Additionally, all three patients suffer from deficits in day to day activities, such as driving, that could be explained by these findings. Conclusions: The three cases appear to support the hypotheses that patients who had recovered from left hemispatial neglect continue to suffer from left sided depth perception deficits. However, large studies using the said methodology are needed to support the above conclusions.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.122
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 47Decomposition of the Trail Making Test in a Large Clinical Sample of
           Older Adults
    • Authors: Poreh A; Eskew L.
      Pages: 703 - 794
      Abstract: Objective: Previously, Poreh (2012) described the use of computer assisted software to decompose the Trail Making Test (TMT) in a sample of 271 subjects who were recruited from the general population. The present study showed that sections 3 and 4 of the TMT correlate with controlled word fluency testing semantic switching, but not clustering indices. These same sections also correlate with the Five Point Test Unique Designs index. In the present study we attempted to replicate these findings in a large clinical sample. Method: A sample of older adults (N = 100) who were referred for a neuropsychological evaluation to rule out dementia. Results: The study confirmed the previous findings and showed that the said sections of the TMT-B correlate highly with the Semantic Fluency switching but not clustering indices as well as the Saint Louis University Mental Status (SLUMS) exam total score. Conclusions: The implications of the present study are discussed in the context of the Quantified Process Approach to neuropsychological assessment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.123
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 48Examining Executive Functioning Differences in Math and Reading
           Disorders
    • Authors: Abu-Suwa H; Burley C, Lupton A, et al.
      Pages: 703 - 794
      Abstract: Objective: To compare executive functioning performance in those with math and reading learning disorders. Method: Participants were part of a de-identified neuropsychological database. A total of 320 participants were utilized, and were placed into one of three groups based on DSM-IV diagnosis (math disorder, reading disorder, no diagnosis). The math disorder group consisted of 111 individuals (Mean age = 29.28, SD = 11.83; Mean education = 13.66, SD = 1.74; Caucasian = 66; female = 76); the reading disorder group consisted of 94 individuals (Mean age = 29.68, SD = 11.08; Mean education=13.94, SD = 2.26; Caucasian = 54; female = 53), the control group consisted of 115 individuals (Mean age = 33.97, SD = 11.97; Mean education = 13.53, SD = 2.97; Caucasian = 65; female = 58). Differences in group performance on the Stroop, Trails, WCST, and Category tests were analyzed using one-way ANOVAs. Results: Results indicated significant differences between the groups on the Category number of errors t-scores (F = 5.05,p < .05) and on the WCST number of perseverative errors (F = 4.57,p < .05). Post-hoc tests revealed significant differences between the math and reading disorder groups, such that those with reading disorders had higher t-scores (M = 43.30,SD = 11.90) than those with math disorders (M = 37.41,SD = 11.93) on the Categories test, and those with math disorders had higher perseverative errors (M = 18.12,SD = 12.63) than those with reading disorders (M = 12.88,SD = 9.90). Conclusions: While the Stroop and Trails measure processing speed, selective attention, flexibility, the Category Test and WCST focus on problem solving, abstraction, and perseveration. Those with reading disorders were found to perform better on the Category Test and the WCST than those with math disorders, indicating higher impairment in problem solving, abstraction, and perseveration in those with math-based disorders. Math disorders have been associated with deficits in recognizing, representing, and manipulating quantities, all of which are incorporated in the Category Test and WCST. These results provide evidence of specific executive functioning deficits that may contribute to the development of a math disorder.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.124
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 49Comparison of Computerized Versus Oral Administration of the Digit
           Span Task
    • Authors: Beach J; Aita S, Francia A, et al.
      Pages: 703 - 794
      Abstract: Objective: This study evaluated the equivalency of a computerized digit span administration (CNS Vital Signs; CNSVS) and a traditional oral digit span administration (Wechsler Adult Intelligence Scale; WAIS-IV). Method: Participants (N = 91; M age = 19.14, SD = 1.69; 62.2% White, 30.0% African American, 3.3% Asian; 61.5% female) completed forward and backward digit spans tasks on both a computerized and oral digit span administration as part of a larger battery of neuropsychological tests. Participants were split into low, medium, and high performing groups based on their scores on the oral digit span task. Results: Pearson’s product moment correlations revealed significant associations between computerized and oral versions of digit span forward r(89) = .472,p < .001 and backward r(89) = .437,p < .001. However, paired samples t-tests found overall significant differences between WAIS-IV (M = 10.37,SD = 2.05) and CNSVS (M = 9.40,SD = 2.07) forward administration scores [t(90) = 4.40,p<.001] as well as significant differences between WAIS-IV (M = 8.65,SD = 2.13) and CNSVS (M = 7.21,SD = 2.60) backward administration scores [t(90) = 5.40,p < .001]. Furthermore, paired-samples t-tests found a significant difference between CNSVS and WAIS-IV digit span forward for the medium [t(33) = 4.58,p < .001] and high [t(26) = 5.53,p < .001] performing groups and for digit span backwards for the medium [t(38) = 2.98,p = .005] and high [t(26) = 5.70,p < .001] performing groups. Oral administrations resulted in higher scores than computerized administration. Conclusions: While both computerized and oral digit span scores were significantly correlated, the traditional oral administration resulted in higher scores than computerized administration. We believe the typing motor component of the computerized administration results in increased cognitive load that consumes executive resources that negatively affects individuals at higher spans and is not present for oral digit span administration.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.125
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 50The Relationship Between Verbal and Executive Function Measures
    • Authors: Cabrera C; Harcourt S, Golden C.
      Pages: 703 - 794
      Abstract: Objective: This study examined to what degree performance on WAIS-IV verbal subtests (Similarities, Vocabulary and Information) predicts performance on executive functioning measures (Trails Making-B(TMT-B), Category, and Wisconsin Card Sort Test (WCST).) Method: A clinical database included 325 adults(46% male,53% Caucasian,Mage = 33.5, Meducation = 13.7). Pearson correlations were made of scaled scores from Similarities, Vocabulary, and Information, and T-scores from TMT-B, Category, and WCST(raw errors). Fisher z′ was used to compare the correlations. Results: At p ≤ .01 with a CI of 95%, Similarities is moderately associated with category(r(325) = .47), WCST(r(325) = −.45), and TMT-B(r(325) = .34). Vocabulary is moderately associated with category(r(325) = .38), WCST(r(325) = −.37), and weakly associated with TMT-B(r(325) = .24). Information was weakly associated with category(r(325) = .24, WCST(r(325)=−.25) and TMT-B(r(325)=.14). These correlations were significantly different (zsim:cat = 10.4,zsim:WCST = 9.1,zsim:TMT-B = −2.3), (zvoc:cat = 8.3,zvoc:WCST = 6.9,zvoc:TMT-B = −2.4), (zinfo:cat = 5.3,zinfo:WCST = 4.4,zinfo:TMT-B = −1.6). Categories is the best predictor(z′cat:sim = 10.29 ≤ z ≤ 10.51,z′cat:voc = 8.19 ≤ z ≤ 8.41,z′cat:info = 5.19 ≤ z ≤ 5.41) while TMT-B most poorest predictor for all three verbal measures(z′TMT-B:sim = −2.41 ≤ z ≤ −2.19, z′TMT-B:voc = −2.51 ≤ z ≤ −2.29, z′TMT-B:info = −1,17 ≤ z ≤ −1.49). Conclusions: Although Similarities is a core Verbal Comprehension subtest, its correlation is significantly higher for each executive function measure by being the only verbal subtest that reflects on abstract thinking(WCST), concept formation(Category), cognitive flexibility(TMT-B) and verbal reasoning. Information’s weaker correlation is related to its main measure of recall and general knowledge found on the temporal lobe with limited use of frontal lobe. Individuals who do poorly on the Similarities may have more difficulty with executive function tasks. Also, lesions or impairments to the frontal lobe will more likely affect results on the Verbal Comprehension Index(VCI). Category and WCST are greater predictors to VCI because TMT-B requires visual attention and task switching, of which is least related to verbal subtests. Future studies should focus on the relationship between language development and gender on executive function.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.126
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 51Cognitive Inhibition Performance in Adolescents with a History of
           Child Maltreatment: A Specific Comparison of Task-Switching Versus Classic
           Inhibitory Task Measures
    • Authors: De Boer D; Mackiewicz Seghete K, LaFavor T, et al.
      Pages: 703 - 794
      Abstract: Objective: Although children and adolescents with a history of childhood maltreatment (HCM) demonstrate difficulties with inhibition, most studies have focused on response inhibition within specific inhibitory tasks and have not examined how cognitive inhibition may affect task performance on different types of tasks. Therefore, the current study examined cognitive inhibition within two tasks, a classic inhibitory task and a task-switching task (TST), in adolescents with a HCM. Method: Participants included 50 adolescents (13–18 years; M = 14.9, 79% female) with either a HCM (N = 28) or no history of trauma (N = 22), matched on IQ, age, SES, and sex. Participants completed the classic Stroop task, including incongruent and neutral trials. They also completed a TST, with half of the switch trials requiring participants to overcome a previously reinforced task set (BBA) and half requiring switching to a new task set without reinforcement (CBA). An interference score was calculated for the Stroop task. Switch cost and standardized RTs for trials were calculated for the TST. Results: The HCM group demonstrated significantly more interference on the Stroop task than the control group (p < .05). Although there was no significant group difference in overall switch cost, the HCM group demonstrated shorter RTs on previously reinforced trials compared to longer RTs on previously reinforced trials in the control group (p < .05). Conclusions: These results suggest adolescents with a HCM may demonstrate differential difficulties with cognitive inhibition dependent on whether task demands need to be internally maintained or are supported by external cues.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.127
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 52The Effects of Personality on Measures of Executive Functioning
    • Authors: Harrell M; Fadoir N, Beach J, et al.
      Pages: 703 - 794
      Abstract: Objective: This study examined the effect of broadband personality factors on the relation between subjective and objective measures of executive functioning (EF). Method: Participants were 160 college students (66.3% female; 55.6% Caucasian, 29.4% African American, 5.6% Asian; age range 17–46 years, Mage = 19.64 years, SD = 3.68; 73.3% no psychological diagnosis) who completed the Barkley Deficits in Executive Functioning Scale Long Form (BDEFS), the executive functioning module from the Neuropsychological Assessment Battery (NAB), and the 120-item IPIP Neo (NEO). Results: Performances on the BDEFS and NAB EF module were converted to z-scores and compared as an EF difference score between the BDEFS and the total score of the EF module of the NAB. This provided a quantified index of discrepancy between subjective appraisal of EF and objective EF performance in the individual. A significant positive correlation was observed between Neuroticism and the EF difference score, r(160) = .31, p < .001, a significant negative association between Conscientiousness and the EF difference score, r(160) = −.40, p < .001, and a significant negative correlation between Agreeableness and the EF score, r(160) = −.20, p < .05. A multiple regression found personality variables significantly predicted EF difference score, F(5, 154) = 7.70, p < .001, r2 = .20, with Neuroticism (β = .22, p = .012), and Conscientiousness (β = −.30, p = .002), as significant predictors. Conclusions: Higher Neuroticism predicted a larger difference between subjective and objective measures of EF while higher Conscientiousness predicted a more accurate appraisal of actual EF abilities.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.128
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 53Visual Memory and Auditory Memory Predicting Performance on the
           Trails Test
    • Authors: Horne K; Strong A, Fornalski N, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine the relationship between Visual Memory Index (VMI) and Auditory Memory Index (AMI) on the Wechsler Memory Scale-IV (WMS-IV) and performance on the Trail Making Test (TMT-A/TMT-B). Method: Data derived from de-identified database of clinical adults (n = 995, Mage = 33.2, Caucasians = 62%, Male = 46%). Participants were administered the WMS-IV and TMT. The indexes that were assessed included Visual Memory Index (VMI) and Auditory Memory Index (AMI). TMT-A and TMT-B variables were comprised of the total number of seconds it took to complete the assessment. Results: Two multiple linear regressions were calculated (p < .05) to predict performance on TMT-A and TMT-B based on the VMI and AMI. Significance was found (F(2,349) = 26.599,p < .001), with an R2 = .13, only VMI significantly predicted performance on TMT-A. Significance was found (F(2,346) = 37.946, p<.001), with an R2 = .18, VMI and AMI significantly predicted performance on TMT-B. Conclusions: This study revealed that an individual’s performance on the VMI predicts functioning on TMT-A and TMT-B. However, performance on the AMI predicts functioning only on TMT-B. Suggesting TMT-B is more demanding and requires the ability to remember orally and visually presented information in comparison to TMT-A which only requires the individual to remember visually presented information. Difficulties on the AMI and VMI together can negatively impact visual attention, mental tracking, and task switching on TMT-B. Furthermore, difficulties on the VMI can negatively impact visual perceptual abilities and attention, sequencing and motor-spatial skills on TMT-A. Resulting in a strong predictive component for measures of executive functioning impacting working memory and learning. Similar research suggests that most auditory and visual memory measures are related to performance on measures associated with executive functioning (Duff, Schnoenberg, Scott, & Adams, 2005).
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.129
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 54Agreement Between Brief Computerized Neurocognitive Assessment Tools
           and a Traditional Measure of Executive Function at Clinically Meaningful
           Performance Levels
    • Authors: Ivins B; Arrieux J, Schwab K, et al.
      Pages: 703 - 794
      Abstract: Objective: To compare clinical agreement between four computerized neurocognitive assessment tools (NCATs) and a pencil-and-paper test used to assess executive functioning. Method: Four NCATs were examined in this analysis: Automated Neuropsychological Assessment Metrics (version 4) Traumatic Brain Injury-Military (ANAM4; 7 scores); CogState, also known as CogSport or Axon Sports (4 scores); CNS Vital Signs (CNS-VS; 11 Scores); and Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT; 4 scores). Executive function was assessed with selected subtests from the Delis-Kaplan Executive Function System (D-KEFS) (7 scores). Two NCATs and the D-KEFS subtests were administered to 406 US military service members (SMs), 167 with acute concussion (≤7 days) and 239 healthy controls. We determined the percentage of SMs who had any low scores on D-KEFs and also had low scores on NCATs. The following low score cutoffs were used: 1+, 1.5+, and 2+ standard deviations (SDs) below the normative mean. Results: 59.4%, 70.7%, 77.0%, and 77.6% of SMs with one or more scores 1+ SDs below norm on D-KEFS also met the same cutoff on ImPACT, CogState, CNS-VS, and ANAM4, respectively. The percent of those with one or more scores on D-KEFS 1.5+ SDs below the norm meeting the same cutoff on ImPACT, CogState, CNS-VS, and ANAM4, respectively was 39.3%, 60.0%, 65.5%, 73.7%, and for 2+ SDs below the norm was 22.2%, 47.4%, 43.8%, and 52.2%. Conclusions: These results suggest NCATs may not lead to the same clinical conclusions about a patient as the D-KEFS, especially with lower scores (1.5+ SDs below the mean). Disclaimer: The views expressed in this manuscript are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.130
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 55Differential Contributions of Executive Control to Predict
           Intelligence
    • Authors: Kassel M; Zolliecoffer C, Kazakov D, et al.
      Pages: 703 - 794
      Abstract: Objective: This study aimed to further characterize the contributions of processing speed and executive control on fluid (Gf) and crystallized (Gc) intelligence. Method: Sixty-three college students referred for learning problems completed a neuropsychological battery that included, among other tests, measures of Gc and Gf as assessed by the Shipley-2, as well as measures of Simple, 2-Choice, and Cognitive Control reaction times for both an easier and more difficult Cognitive Control task. The more appropriate adaptive elastic-net generalized regression technique was used with a Weibull distribution model for high dimension analyses. Number of errors and parameters of ex-Gaussian distribution of reaction time for the speeded tasks were entered as predictors of Gc and Gf. Results: Gc. Adaptive elastic-net with Akaike Information Criterion-corrected (AIC-c) validation and Weibull distribution reduced the maximum likelihood regression with 15 parameters to no parameters with non-zero coefficients that were predictive of Gc (all p > .05). Gf. Adaptive elastic-net with AIC-c validation and Weibull distribution reduced the maximum likelihood regression with 15 parameters to two parameters that had confidence intervals not including zero and Variable Important greater than one. Higher Gf was associated with less error on the harder Cognitive Control task (Wald X2 = 9.86, p = .002) and less overall variability on the easier Cognitive Control task (Wald X2 = 3.90, p = .048, Generalized R2 = .27). Conclusions: Present results are consistent with the general interpretation that Gf tasks require greater executive control than Gc tasks. Furthermore, current results suggest that mental speed plays little role in the Shipley-2 task.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.131
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 56Impact of Visual Dimensions on Matrix Reasoning Performance
    • Authors: Lindberg K; Miller J, Weigel S.
      Pages: 703 - 794
      Abstract: Objective: The current study aimed to test the impact of features (physical and visual dimensions of elements within a matrix) on matrix reasoning performance. Method: Undergraduate participants (N = 193) from a Midwestern university were recruited via course requirements. Participants’ mean age was 19.487 (range = 18–29, SD = 1.84), their education ranged from GED to post-graduate, and reported a variety of health and mental health diagnoses. Participants were administered the demographics questionnaire, Symbol Series Task (SST; a reasoning task), and Experimental Inductive Matrix Reasoning Task (EIMRT). The EIMRT is 3 sets of matrix reasoning tasks designed for this study with identical informational demands (i.e., rules) while varying by feature combinations or Presentation Groups (i.e., shape/width, width/height, height/shape). Participants were excluded from data analyses if effort on the EIMRT was inadequate. Each EIMRT matrix response (81 for each participant) was scored correct or incorrect for each feature (i.e., height, shape, width). Results: EIMRT scores were submitted to a 3 x 3 mixed-model repeated measures ANCOVA. Significance was found for the Presentation Group x Feature interaction, F(4, 378) = 377.82, p < .001, main effect of Feature, F(2, 378) = 5.77, p = .003, and main effect of Presentation Group, F(2, 189) = 99.874, p = .011. Conclusions: Features have differential impacts on matrix reasoning performance, as some Features may be more efficiently solved than others. These findings have implications for test development, alternate form reliability, and clinical practice.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.132
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 57Validating Stroop Color Word Test Interference in Vascular Cognitive
           Impairment
    • Authors: Marceaux J; Fullen C, Stubbs W.
      Pages: 703 - 794
      Abstract: Objective: Processing speed is known to impact Stroop Color-Word Interference performance. Algorithms controlling for processing speed have improved assessment in Parkinson’s and multiple sclerosis. This study aimed to validate Stroop Interference algorithms for individuals with vascular cognitive impairment (VCI) due to prevalence of cerebrovascular disease among veterans and findings of impaired processing speed in VCI. Method: A diverse sample (29%bilingual) of veterans referred for neuropsychological evaluation were selected from an IRB-approved VA research database. Participants passed performance validity tests and were either diagnosed VCI (n = 118;Mage = 67.3;Medu = 12.92) or no cognitive disorder (n = 88;Mage = 58.7;Medu = 13.99). Measures included Stroop Color-Word, Wechsler Adult Intelligence Scale-4th Edition, Trail Making Test, and Wisconsin Card Sorting Test. Analyses included t-tests examining group differences; regressions, controlling for demographics, examining group as a predictor of Stoop performance; and correlations examining test validity. Results: Groups differed on most Stroop scores (word and color reading, several interference algorithms), with the exception of Difference algorithm (i.e., C-CW), t(183) = 1.88,p = .061. After controlling for demographics, diagnostic group was predictive of Difference and Relative algorithm scores but not Golden, Ratio, or Residual. All interference scores were correlated with Symbol Search (absolute rs ranged from .23 to .36), while Golden and Ratio were correlated with fewer processing speed measures and consistently correlated with executive functioning measures. Conclusions: The Difference algorithm demonstrated poor divergent validity, making it inappropriate for examining interference. Based on regressions and correlations, the Golden and Ratio score algorithms appear to be valid and accurate measures of interference in VCI as they are less likely to be confounded by deficits in processing speed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.133
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 58Neuroticism & Openness: Identifying The Associations with
           Executive Functioning in Community-Dwelling Older Adults
    • Authors: Mercuri G; Holtzer R.
      Pages: 703 - 794
      Abstract: Objective: To investigate individual and combined associations between personality [Neuroticism, Openness] and Executive Functioning (EF) in older adults. We hypothesized that higher Neuroticism and lower Openness would be associated with worse EF. Furthermore, based on Gray’s (1981) quadrant theory of personality, we predicted that High Neuroticism-Low Openness would be associated with worse EF compared to the other three groups (Low Neuroticism-High Openness, Low Neuroticism-Low Openness, High Neuroticism-High Openness). Method: Participants were 477 English-speaking non-demented community-dwelling older adults (65+ years) living in Westchester County, NY [M(SD) age = 75.70(6.52); %female = 55.3] enrolled in the Central Control of Mobility and Aging cohort study. Participants completed a neuropsychological evaluation annually. Primary measures: EF was defined as a composite variable comprised of the Trail Making Test (A and B), Controlled Oral Word Association Test (FAS, CAT), and Digit Symbol Substitution Test. Personality (Neuroticism, Openness) was assessed with the Big-5 Inventory. Results: Linear regressions revealed that Openness (β = .153; 95% CI = .007–.026; p < .001) but not Neuroticism (β = −.044; 95% CI = −.015–.005; p = .299) was significantly associated with EF. Moreover, the High Neuroticism-Low Openness group was associated with worse EF when compared to the Low Neuroticism-High Openness (β = .115; 95% CI = .027–.349; p = .022) and High Neuroticism-High Openness (β = .121; 95% CI = .041–.392; p = .016) groups. EF differences between the High Neuroticism-Low Openness and Low Neuroticism-Low Openness groups were not significant (β = −.001; 95% CI = −.175–.171; p = .981). Analyses adjusted for age, gender, education, and medical comorbidity. Conclusions: Openness may be driving the association between personality traits and EF. Regardless of their degree of Neuroticism, individuals with lower Openness demonstrated worse EF.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.134
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 59Executive Functioning Deficits Among Juvenile Sex Offenders: A
           Systematic Literature Review
    • Authors: Ramirez A; Marrero K, Rodriguez M.
      Pages: 703 - 794
      Abstract: Objective: The aim of this review was to identify impaired executive functioning processes within juvenile male sexual offenders. Data Selection: A systematic literature search was conducted using the keywords: juvenile sex offenders, executive functions, sexual deviance, intellectual disability, neuropsychology, and adolescent. Seven databases returned 1,988 studies. Inclusion criteria: (1) peer-reviewed articles published between 2004 and 2018 (2) studies that measured executive functioning between sexual offenders and a comparison group; (3) published in English. A total of 7 studies met inclusion criteria. Data Synthesis: Four studies that used neuropsychological tests to measure executive functioning suggest that there is no significant difference between adolescent sex offenders and non-sexual delinquents in their executive function profiles. One study found a significant difference between sex offenders with high and low IQ on measures of switching attention, prospective memory, working memory, and processing speed. Another study which specifically classified sexual offenders according to the age of the victim, found that child sexual offenders significantly performed better on problem-solving, deductive reasoning, and cognitive flexibility measures. Lastly, one study revealed that sexual offenders were significantly impaired in visual conceptual and visual motor abilities. Conclusions: The results of this review suggest that findings amongst juvenile sexual offenders are inconsistent and may have multiple levels of differentiation. Some contributing factors may include: comorbid psychological diagnosis, environmental stressors, sexual interest, cognitive developmental delays, ethnic or cultural variations, and differences within subgroups of sex offenders. To better understand juvenile sexual offenses, future studies should consider using a larger sample size that comprehensively examines for these contributing factors.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.135
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 60Do Scales of Executive Function Measure the Same Things'
    • Authors: Riccio C; Lund E, Schwartz J.
      Pages: 703 - 794
      Abstract: Objective: There are numerous measures of executive function (EF), yet the multiple definitions and constructions of EF suggest that these measures may not be measuring the same construct or domains within EF. The purpose of this study was to examine the concurrent validity of the BRIEF and the CEFI parent and self-report forms with adolescents. Method: Adolescent participants, ages 12–17 years, were recruited using a snowball method with recruitment targeting individuals from under-represented groups as well as the general population. The resulting sample consisted of 52 cases with parent and/or adolescent self-report. The adolescents were predominantly female (55.77%) and white (40.38%) with a mean age of 14.56 (1.72). Results: For both parent and self-report on both the BRIEF and CEFI, mean global scores were within the average range. As expected the global parent and self-report scores on the BRIEF and CEFI were significantly correlated (Parent GEC - CEFI total r = −.86; p < .001; Self-Report GEC-CEFI total r = −.71; p < .001). Based on face validity, it was hypothesized that subscales labelled similarly would yield the highest correlations. This was the case for Inhibit-Inhibitory Control for both parent and SR (r = −.70, - = .55; p < .001) and Working Memory-Working Memory (r = −.84, −.61; p < .001). In contrast, Organize-Organization has the lowest correlation, particularly on the parent form (r = −.32; p = .02). Conclusions: While the global scores obtained for either instrument measure EF similarly, there is less consistency in how the instruments parse out and label the components of EF. Implications for practice will be discussed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.136
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 61Can a Neural Marker of Impulsivity Better Predict Interpersonal
           Problems than a Performance-Based Test'
    • Authors: Rodrigo A; Wright L, Ruocco A.
      Pages: 703 - 794
      Abstract: Objective: Impulsivity has been linked to difficulties in interpersonal functioning - a core feature of psychopathology. Little is known, however, about how different markers of impulse control may relate to measures of interpersonal problems. In this preliminary study, we investigated the association between the severity of self-reported interpersonal dysfunction and two markers of impulsivity: performance-based and neural. Specifically, these included a well-validated computerized assessment of response control, and activation in the right inferior frontal gyrus (rIFG) during a standard response control task. Method: Eighteen right-handed healthy adults completed the Inventory of Interpersonal Problems (IIP-64). Participants also completed the Connors Continuous Performance Test II (CPT-II), followed by a Go/No-go response inhibition task while levels of evoked hemodynamic oxygenation were measured in the rIFG - a region implicated in impulsivity. Associations between these markers of impulsivity and severity of interpersonal problems (i.e., total score on the IIP-64) were evaluated using regression and hierarchical regression models, respectively. Age and estimated IQ were used as covariates across analyses. Results: No association was found between commissions on the CPT-II and total score on the IIP-64 (p = .07). On the other hand, also covarying for task accuracy, a significant association was observed between total score on the IIP-64 and rIFG activity during inhibitory control (p < .001). Conclusions: These findings suggest that the recruitment of a brain region involved in impulse control may be a better predictor of self-reported severity of interpersonal dysfunction, than a performance-based marker of impulse control. These findings may have implications for optimally operationalizing impulsivity in the context of functional outcomes.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.137
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 62Associations of Normative and Maladaptive Personality Traits with
           Self-Reported Executive Functioning
    • Authors: Roye S; Castagna P, Calamia M.
      Pages: 703 - 794
      Abstract: Objective: Executive functioning (EF) is a collection of higher order processes designed to facilitate goal-oriented performance. Although commonly studied using performance-based tasks, self-report measures are also useful in assessment given their association with functional impairment. The relationship between self-reports of personality and EF is limited by the use of global EF scores and primarily measures of normative, rather than maladaptive, traits. This study sought to better understand the relationships between individual, self-reported EF domains and personality traits amongst a non-clinical sample of young adults. Participants and Method: As part of a larger study, 354 undergraduate students completed online questionnaires, including the Barkley Deficits in Executive Functioning Scale (BDEFS), International Personality Item Pool -Neo- 120 Item (IPIP-NEO-120), and the Personality Inventory for DSM-5, 100-item Short-Form (PID-5-SF). Results: Multiple regressions generally indicated stronger relationships between the normative traits than maladaptive traits and EF domains although both sets of traits provided incremental variance for several EF domains. The strongest relationships were demonstrated between Conscientiousness and all BDEFS domains, except self-regulation, which had the strongest relationship with Neuroticism (B = .66, p = .00). Similarly, significant relationships, were demonstrated between Big 5 personality traits and EF, with Disinhibition indicating the strongest relationships across all EF domains, except with self-regulation, which was better related to Antagonism (B = −.15, p = .02). Conclusions: Findings replicate prior work emphasizing the relationship of neuroticism and conscientious/disinhibition to self-reported executive functioning. Findings extend previous research by separately examining the influence of normative and maladaptive personality traits on EF deficits and highlights the utility of assessing both within a nonclinical sample.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.138
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 63The Ability of Executive Function to Predict NDRT Comprehension
           Without the Influence of VCI
    • Authors: Sattaur Z; STrong A, Diah K, et al.
      Pages: 703 - 794
      Abstract: Objective: To investigate the ability of measures of Executive Function measures to predict NDRT Comprehension. Method: Participants included 169 females and 143 males, with an average age of 32.16 (SD = 13.09) and education of 13.567 (SD = 2.42) years. Participants were 61% Caucasian. Data was derived from an ongoing de-identified database of adults with various neurological and psychological diagnoses. Assessments used to predict NDRT Comprehension included Stroop Color/Word, Trails B, and Category Test. WAIS-IV VCI and Stroop Word were included to remove influence of verbal ability on NDRT performance. Results: A stepwise regression analysis was used to analyze the predictive power of executive function on NDRT comprehension performance without influence of verbal abilities. Results were significant for the overall model F(3,309) = 67.615, R2 = .396, p < .001. After removing influence of the VCI and Stroop Word, Trails B t(311) = 5.226, p < .001 was the only executive function measure that was a significant predictor of NDRT Comprehension. Conclusions: Trails B requires that an individual switch from letters to numbers and connect the letters and numbers in sequential order, requiring cognitive shifting and attention. Speed is also measured through Trails and heavily influences scores. These results imply that after removing influence of verbal abilities, executive function plays a role in explaining the variance in NDRT comprehension, which is also related to overall intellectual ability. The results suggest that executive function, specifically Trails B, could provide a useful tool in addition to other information to predict an individual’s level of comprehension and possibly general intellectual ability. Future research should aim to explore this relationship.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.139
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 64The Influence of Emotion Dysregulation on the Wisconsin Card Sorting
           Test in Patients with Adaptive Functioning Deficits
    • Authors: Singh S; Young M.
      Pages: 703 - 794
      Abstract: Objective: Emotion regulation is defined by Gratz and Roemer (2004) as the modulation of an individual’s emotional arousal while maintaining awareness, acceptance, and understanding of his or her emotions. This study examined which aspects of emotion dysregulation significantly influence Wisconsin Card Sorting Test (WCST) performance. Method: Forty-three participants were recruited from a transitional independent living facility in Deerfield Beach, Florida. Thirty-one participants (72.1%) were male and age ranged from 18 and 43 years (mean (SD) = 22.6 (5.0)). The mean (SD) time spent at the facility at the time of assessment was 18.3 (26.8) months. Participants were administered the computerized WCST and the Difficulties in Emotion Regulation Scale (DERS). Results: A simultaneous regression was conducted to predict WCST performance from all six subscales of the DERS. Emotion regulation subscales were significantly related to WCST performance, R2 = 0.355, F(6,36) = 3.3, p < 0.05. Only the Goals scale was significantly associated with WCST performance (p < 0.01), uniquely accounting for 17.1% of the variance in WCST performance. Impulse, Awareness, Strategies, Clarity, and Nonacceptance uniquely accounted for 5.5%, 4.9%, 3.7%, 0.4%, and 0.01%, respectively, of the variance in WCST performance. Conclusions: In patients with adaptive functioning deficits, difficulties engaging in goal-directed behaviors when experiencing negative emotions significantly contributes to successful completion of the WCST. This has implications for future research determining how WCST performance may be influenced by emotional dysfunction and deficits in adaptive functioning.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.140
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 65White Noise Effects on Cognitive Performance in Those with ADHD: The
           Moderating Role of Internalizing Symptoms
    • Authors: Smith A; Roye S, Calamia M.
      Pages: 703 - 794
      Abstract: Objective: Prior research suggests that white noise played concurrently with a cognitive task may facilitate cognitive performance in those with ADHD (e.g., by reduced the need to seek out other stimulation). However, much of this work has been done only with children. Additionally, studies of white noise and ADHD have not examined the role of comorbid depressive and anxiety symptoms, which are known to effect cognitive performance in those with ADHD. We aimed to address this gap in the literature. Method: The study consisted of 34 undergraduate students with an ADHD diagnosis. Participants completed self-report measures including the Expanded Version of the Inventory of Depression and Anxiety Symptoms (IDAS-II) and also completed four computerized measures designed to assess inhibition (e.g., Antisaccade), working memory (e.g., Operation Span and Symmetry Span) and verbal list learning under both white noise and silent conditions. Results: Participant mood was compared using subscales of the IDAS-II (distress and obsession/fear). A repeated measures MANOVA indicated a non-significant effect of noise and performance, but significant interaction effects of noise and distress (λ (4,29) = 3.13, p > .05) and noise and obsessions/fears (λ (4,29) = 5.25, p < .05) on cognitive performance. Post-hoc examination of individual tests revealed that both distress and obsessions/fears were associated with differences in antisaccade performance in the context of silence vs. white noise. Conclusions: These results indicate that the effects of white noise may uniquely influence cognition amongst individuals with ADHD, depending upon the presence and severity of their internalizing symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.141
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 66Negative Priming Stroop Effect: Executive Control Added to Stroop
           Interference Effect
    • Authors: Zolliecoffer C; Kassel M, Kazakov D, et al.
      Pages: 703 - 794
      Abstract: Objective: While Stroop interference tasks have been demonstrated to activate frontal regions, whether these tasks have executive functioning properties is unclear. The present study seeks to address this gap in literature. Method: Forty-seven college students referred for learning problems completed a one-day neuropsychological battery that included, among other tests, the Conner’s Continuous Performance Test 3rd Edition, Simple Reaction Time task (RT), 2-Choice RT, Cognitive Control RT, Stroop RT, Flanker RT, 2-Back-Correct, Stop Signal Delay RT, Keep Track-Correct, and Attentional Blink- 2nd response on Lag 3 measures. Results: Color-Word Stroop. Adaptive elastic-net with Akaike Information Criteria-corrected (AIC-c) validation and a LogNormal distribution model found that ‘fat tail’ RTs on a 2-choice RT task contributed with a Variable Importance = .40 (Wald 2 = 14.21, p < .0001; Generalized R2 = .32). Negatively Primed Stroop. Adaptive elastic-net with AIC-c validation and a LogNormal distribution model found two predictors (2-back-Correct and overall variability on the Cognitive Control task) with a Variable Importance = .294 and .122 (Wald 2 = 11.19, p = .0008; Generalized R2 = .42). Negatively Primed Stroop RT was associated with poorer 2-back performance and more variability in RT on a complex cognitive control task. Conclusions: Present results find that executive Stroop components exist primarily on the basis of negatively primed items. In contrast, Stroop interference tasks built without negatively primed color-word stimuli are more related to outlier 2-choice RTs.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.142
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 67Language Deficits and Treatment Modalities in Post Stroke Aphasia
           Patients
    • Authors: Diaz-Navarro J; Rodriguez M.
      Pages: 703 - 794
      Abstract: Objective: Every year, an approximate of 795,000 people experience a stroke, of which nearly 180,000 will acquire aphasia during the critical phase of recovery (National Aphasia Association, 2017). This literature review aims to investigate effective treatment of language deficits presented by stroke patients. Data Selection: An organized search strategy was conducted using (1) Cobimet (2007–2017), (2) PubMed, (3) Psycinfo, and (4) MedLine. The following key words were used to conduct the search: (1) Aphasia, (2) Post-Stroke, (3) Language and aphasia patients, (4) Treatment options for aphasia. This review included only peer reviewed journal articles examining stroke patients with acquired aphasia over the age of 18. Articles published before 2007 and studies examining brain injury, brain tumor, and other neurological causes were excluded. After a full text review, eight articles were identified for this review. Data Synthesis: Three studies examined treatment modalities among aphasia stroke patients, which concluded that intensive speech therapy, transcranial direct current stimulation, and transcranial magnetic stimulation were significantly related to the improvement of language functioning. The remaining five studies found statistically significant differences between aphasia and control groups in language measures; which resulted in deficits of overt speech production, disrupted network connection in language brain areas, as well as, site and size of lesion having a negative correlation with rehabilitation outcomes. Conclusions: This literature review specified the nature of language deficits found among post stroke aphasia patients and offered evidence for interventions that have shown to be beneficial in this population. These findings will help inform clinicians who work with aphasic TBI patients.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.143
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 68The Effectiveness of Music Therapy on Aphasia
    • Authors: Maresco A; Rodriguez M.
      Pages: 703 - 794
      Abstract: Objective: This review examined the effectiveness of music and music therapy in the treatment of aphasia. Method: A systematic review of the literature was conducted using Academic Search Complete, Academic OneFile, Eric, Medeline, PsychINFO, and PsycARTICLES search engines. Experimental studies were included, as well as case studies, while articles that were published before 2008, literature reviews, and book reviews, were excluded. Lastly, after considering the inclusion and exclusion criteria, 6 articles met the criteria. Results: Three studies used Melodic Intonation Therapy (MIT) as a treatment modality. The remaining studies used Modified Melodic Intonation Therapy (MMIT), Rhythmic-Melodic Voice training (RMVT), and Speech-Music Therapy for Aphasia (SMTA). Findings of the studies using MIT indicated significant improvement in accuracy and the articulation of target phrases, speech outcome, and aphasia severity score in among the sample. One study revealed non-significant effects on expressive language post-intervention. The results of the remaining three studies using different treatment modalities (MMIT, RMVT, SMTA) demonstrated improvement in speech productivity, intelligibility of verbal communication, and comprehensibility following treatment. Conclusions: The findings of this review supported that music therapy, regardless of the variation used (MIT, MMIT, SMTA, or RMVT), can be an effective alternative to treating patients with aphasia. For researchers, these findings offer an assessment of current advances, which will guide future directions in research.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.144
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 69An Evaluation of the Construct Validity of the Source Memory Indices
           of the California Verbal Learning Test-Second Edition
    • Authors: Babicz M; Sheppard D, Morgan E, et al.
      Pages: 703 - 794
      Abstract: Objective: We investigated the construct validity of a simple, clinician-friendly composite of the source memory indices from the California Verbal Learning Test-Second Edition (CVLT-II) in persons with HIV disease. Method: Participants included 364 HIV+ participants, 77 of whom were diagnosed with HIV-associated neurocognitive disorder (HAND), and 203 HIV- comparison adults who completed the CVLT-II. A dichotomous CVLT-II source memory impairment variable (CVLT-II Source) was generated from normative scores on Total Across-List Intrusions and Source Recognition Discriminability (d’); participants were classified as (1) unimpaired on either source memory variable (z > −1), or (2) impaired on either or both variables. Participants completed experimental source memory tasks (Self-Ordered Pointing Task [SOPT] and Source and Item Memory Task [SIMT]) to assess convergent validity, a visuospatial task to examine divergent validity, and measures of everyday functioning to assess ecological validity. Results: CVLT-II Source impairment was associated with higher item-corrected source error scores on the SOPT (p = .020, d = .40) and SIMT (p < .001, d = .54). Individuals with HAND demonstrated greater frequency of impairment on CVLT-II Source than HAND- (OR = 2.26 [95%CI = 1.35, 3.76]) and HIV- (OR = 2.77 [95%CI = 1.61, 4.76]) individuals when controlling for education, depression, and substance use disorder (p = .008). CVLT-II Source impairment was not associated with visuospatial task performance or everyday functioning outcomes (ps > .10). Conclusions: Results demonstrate the convergent, divergent, and discriminant validity of the CVLT-II Source composite in HIV, which is associated with source memory impairment. Although the composite did not identify HIV+ persons with everyday functioning problems, future studies may examine the utility and validity of the CVLT-II Source composite in other clinical populations.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.145
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 70Memory for Neutral Memoranda: Reconsidering Salience Effects in
           Alexithymia
    • Authors: Correro A; Paitel E, Byers S, et al.
      Pages: 703 - 794
      Abstract: Objective: Alexithymia is a personality trait characterized by difficulties in identifying feelings (DIF), describing feelings (DDF), and externally oriented thinking (EOT). Alexithymia has been associated with poorer memory specifically for emotive words and other memoranda and personally salient information. Yet, there is some indication of more generalized effects on various aspects of cognition. More, the literature is limited by studies with small samples. The objective of this study was to investigate alexithymia and memory for neutral words in a large sample. Method: Young adults (n = 297, age 18–39; 214 female) studied a neutral word list, performed recognition testing 1 hr later, and completed the Toronto Alexithymia Scale-20 (TAS-20). Results: Delayed recognition memory (d’) was correlated with sex (female>male) and Externally Oriented Thinking (EOT), but not age, Difficulty Identifying Feelings (DIF) or Difficulty Describing Feelings (DDF). Hierarchical regression on d’ was significant with sex (but not age) as a predictor in Step 1 (R2 = .022, p = .04; βsex = .43); and sex, DIF and EOT as predictors in Step 2 (R2 = .064, p = .002; R2change = .042, p = .005; βsex = .38, p = .03; p, βDIF = −.51, p = .03; βEOT = −.97, p = .002). Thus, poorer delayed neutral word memory in young adults was associated with male sex and higher DIF and EOT. Conclusions: Alexithymia may contribute to memory differences using neutral memoranda, suggesting more general effects on memory in alexithymia than are apparent in previous studies. That is, contextual and personal salience effects in alexithymia may be additive rather than exclusive in memory processing and retrieval. Further study is needed to clarify the direction and nature of these complex relationships.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.146
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 71Exploring the Effect of Trait Anxiety on Working Memory
           Intra-Individual Variability: A Response Time Distributional Analysis
           Approach
    • Authors: Holcombe J; Myers M, Elliott E, et al.
      Pages: 703 - 794
      Abstract: Objective: We examined whether trait anxiety, a predictor of poor working memory (WM) performance, was associated with longer response times (RT) when captured by τ in an ex-Gaussian distribution. Method: 264 (75.23% female; M age = 20.47, SD = 2.97; M education = 14.27, SD = 1.12; 77.2% White, 11.9% African American, 10.9% Other) undergraduates completed the State-Trait Anxiety Inventory (STAI) and Reading Span Task (R-Span). RTs from correct responses within 2.5 standard deviations from their mean were entered into Quantile Maximum Probability Estimator (QMPE) to estimate RT parameters (μ, σ and, τ) for each participant’s ex-Gaussian distribution to see if they were related to higher anxiety scores on the STAI. Results: Pearson correlations revealed WM was negatively related to τ, r(262) = −.198, p < .01 and a strong positive association was found between τ and Reaction Time, r(262) = .85, p < .01. A 4 x 4 multivariate analysis of variance (MANOVA) revealed the WM effect was almost significant, Wilks Lambda = .92, F(12,648) = 1.652, p = .073, ηp 2 = .03. Follow-up ANOVAs revealed the main effect for WM on τ was significant, F(3,248) = 2.76, p = .04, ηp 2 = .03. Conclusions: Working memory was negatively related to τ which, as a measure of Intra-Individual Variability (IIV), appears to predict worse cognitive performance and has utility over other measures of variability. However, no relation between increased anxiety and impaired WM performance was found, possibly due to our sample being generally emotionally healthy college students. Future studies should examine anxiety as a moderator variable in WM performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.147
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 72Health and Disability Differences Among Patients with Amnestic and
           Non-Amnestic Mild Cognitive Impairment
    • Authors: Holguin G; Wagner G, Slonim T, et al.
      Pages: 703 - 794
      Abstract: Objective: Memory, language, thinking, and judgment impairment differences among amnestic and non-amnestic mild cognitive impairment (MCI) patients have been well established. However, little research has examined neuropsychiatric symptom differences among amnestic and non-amnestic MCI patients. This study seeks to investigate baseline health and disability characteristic differences among amnestic and non-amnestic MCI patients. Method: Patients (12 males; mean age 69 ± 9.76) with amnestic (n = 11) and non-amnestic (n = 12) MCI underwent comprehensive neuropsychological testing and assessment at a community-based neurology clinic. The World Health Organization Disability Assessment Schedule 2.0 was used to assess disability characteristic differences among amnestic and non-amnestic MCI patients. Results: Compared to amnestic patients (M = 1.06, SD = 0.72), non-amnestic MCI patients (M = 2.21, SD = 1.01) reported increased difficulty functioning in life activities such as responsibilities, work, and school, t(12) = −2.23, p = .045. Non-amnestic MCI patients (M = 2.08, SD = 0.48) exhibited increased global functional impairment compared to amnestic MCI patients (M = 1.65, SD = 0.46), t(21) = −2.18, p = .041. Lastly, there was a trend such that non-amnestic MCI patients (M = 2.49, SD = 0.76) reported more cognitive difficulties with understanding and communicating compared to amnestic MCI patients (M = 1.95, SD = 0.46), t(21) = −2.06, p = .052. Conclusions: Results suggest that non-amnestic MCI patients are more aware of their school, work, and global impairment compared to amnestic MCI patients. Further research to increase our understanding of neuropsychiatric symptom variability among amnestic and non-amnestic MCI patients is recommended.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.148
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 73Eye-Tracking Gaze Patterns Are Not Related to Object Location Memory
           Performance in Healthy Older Adults and Those with Amnestic Mild Cognitive
           Impairment
    • Authors: Laing J; Rahman-Filipiak A, Hampstead B.
      Pages: 703 - 794
      Abstract: Objective: Early work has demonstrated that gaze patterns may differ across the Alzheimer’s Disease (AD) spectrum; however, few studies have examined the functional impact of these eye movement changes. We evaluated whether gaze pattern predicted performance on the Object Location Touchscreen Task (OLTT), a measure of object location memory, in healthy older adults (HOA; n = 20) and those with mild cognitive impairment (aMCI; n = 16). Method: Participants underwent eye-tracking to measure average number and duration of fixations per stimulus as well as shifts between the target and surrounding areas during encoding. After a 15-minute delay, participants were shown each object and asked to recall its location during Free Recall, Cued Recall, and Recognition conditions. Correlations between gaze pattern variables and OLTT accuracy were evaluated in the combined sample and by subgroup. Results: Independent samples t-tests demonstrated that individuals with aMCI performed more poorly than HOAs on the OLTT (all p < .005); however, the groups did not differ in terms of gaze pattern variables (all p > .05). Pearson’s r bivariate correlations revealed no significant relationships between gaze pattern variables and any OLTT outcome in either the combined sample or in either subgroup (all p > .05). Conclusions: Gross gaze pattern variables do not appear to differ in those with MCI nor to contribute to behavioral difference in object location performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.149
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 74Hippocampal Volumes Are Related to Performance on a Temporal
           Sequencing Task
    • Authors: Moll A; Reckow J, Hampstead B.
      Pages: 703 - 794
      Abstract: Objective: We previously demonstrated that temporal order memory, the ability to remember the order of events, showed some age-related decline as well as additional superimposed effects of mild cognitive impairment (MCI). Here, we evaluated the relationships between temporal order memory and standard memory tests as well as relationships between performance and frontal, medial temporal, and parietal lobe volumes. Method: Thirty-five participants (cognitively intact, n = 19; MCI, n = 16) completed the Temporal Sequencing Task (TST), which consisted of three-, four-, and five-item order sequences that were reconstructed immediately after presentation and again 10 minutes later. Participants also completed a series of other neuropsychological tests and underwent structural magnetic resonance imaging. Results: Immediate performance on the TST was significantly and positively related to Trail Making A and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Immediate Memory Index (IMI) Scores. Delayed TST performance was significantly correlated with RBANS Delay Memory Index (DMI) performance. Hippocampal volume was positively related to IMI (r = .635, p < .001) and DMI performance (r = .548, p = .001), with similar relationships observed for inferior parietal cortex. For the TST, hippocampal volume was positively related to Delay Total Score (r = .445; p = .007). Conclusions: TST performances showed concurrent validity given relationships with established tests. Delayed TST performance was solely related to hippocampal volume, which raises the possibility of more specific brain-behavioral relationships relative to typical neuropsychological tests.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.150
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 75Verbal and Visuospatial Episodic Memory: Roles of Attention and
           Executive Function in a Memory Clinic Population
    • Authors: Richey L; Bonner-Jackson A.
      Pages: 703 - 794
      Abstract: Objective: This study examined the impact of attentional and executive functioning (EF) skills on episodic memory performance in two commonly used memory measures, the Brief Visuospatial Memory Test-Revised (BVMT-R) and Hopkins Verbal Learning Test-Revised (HVLT-R). Method: 745 participants (age: M = 66.57) were assessed in the outpatient memory clinic of a large academic medical center. Data were extracted from medical records and retrospectively analyzed utilizing multiple linear regression (p < .05). Predictor variables included attention measures (Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span (DS) Forward, Total), EF measures (Delis-Kaplan Executive Function System Trail Making, Tower, Color Word Interference (CWI)), and tests of visuospatial and verbal ability (Judgment of Line Orientation (JLO), WAIS-IV Block Design, Boston Naming Test). Outcome variables included age-adjusted Total Recall scores (i.e., sum of the learning trials) of the BVMT-R and HVLT-R. Results: Models noted a sizable contribution of attention and EF to overall variance explained in the HVLT-R (R2 = .25, p < .001) and the BVMT-R (R2 = .23, p < .001). EF measures significantly predicted the BVMT-R (individual variance: R2 = .05, p < .001), whereas attention measures significantly predicted the HVLT-R (individual variance: R2 = .05, p < .001). Findings also suggest that EF may account for more variance in the BVMT-R than visuospatial ability, and attention may account for more variance in the HVLT-R than verbal ability. Conclusions: Data suggest that when selecting episodic memory measures and interpreting their findings, clinicians may want to consider the impact of attention and EF.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.151
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 76Differences in Memory Performance on Neuropsychological Measures
           Among Adults with Attention-Deficit Hyperactive Disorder
    • Authors: Rodriguez I; Rivas-Vasquez R, Rey G, et al.
      Pages: 703 - 794
      Abstract: Objective: To delineate the memory performance on neuropsychological measures of adult individuals with Attention-Deficit Hyperactive Disorder (ADHD). Method: Participants included 98 adults diagnosed with ADHD by a licensed clinical psychologist in a large neurology practice. Subjects underwent comprehensive neurological and neuropsychological examinations including a clinical interview to exclude comorbid conditions. Participants in the study had a mean age of 28.55 (SD = 9.04) and a mean education of 13.36 (SD = 1.96) and was predominantly right-handed (89.8%). In addition to this, other demographic information about the clinical sample is provided in Table-1. Raw scores were converted to t-scores using standardized normative data to account for cofounding variance of age and gender. Neuropsychological measures included Rey Auditory Verbal Learning Test (RAVLT), Wechsler Memory Scale-IV Logical Memory subtest (WMS-IV: LM I-II), and Wechsler Adult Intelligence Scale-IV-Longest Digit Span Backward (WAIS-IV-LDSB). Results: One Sample t-tests contrasting the performance of subjects were conducted, and are summarized in Table-2. These data revealed that performance on Trial-1, Total Recall, and as well as immediate recall on the RAVLT were significantly better than the immediate recall of stories on the LM-I. Similar findings were evident on delayed memory with better scores for in the recall of the RAVLT as compared to the recollection of stories in LM-II. Regarding working memory, significantly better scores were found on WAIS-IV-LDSB than on proactive interference on the RAVLT. Conclusions: Overall, data suggest that ADHD individuals perform significantly better (average) on a rote-learning list task than on episodic memory scores (low average) in immediate and delayed recall. Results indicate that individuals encode information better through repetition versus one-trial learning. Notwithstanding, working memory problems were more substantial on proactive interference than LDSB, suggesting difficulty with encoding multiple sets of information. These findings help provide clarity on the neuropsychological profile of adult ADHD individuals who report memory complaints.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.152
      Issue No: Vol. 33, No. 6 (2018)
       
  • B - 77Constructs of the WMS4 and WAIS-IV Intelligence Subscales
    • Authors: Stebbins L; Fornalski N, Harcourt S, et al.
      Pages: 703 - 794
      Abstract: Objective: To explore the factor structure underlying the WAIS-IV intelligence and WMS4 subscales. Method: Data was collected from a de-identified database in a community clinic representing psychological and neurological disorders. Participants included were 153 males and 193 females (Mage = 32.77, Medu = 13.72; 53%Caucasian). A factor analysis, with an orthogonal varimax rotation, was performed using eight WMS-4 Index subscales from the AMI and VMI indices, and WAIS-IV FSIQ subscales. Results: Results of the factor analysis model was significantly correlated (determinant = 6.840E-6). Results indicated that 4 factors were found significant with eigenvalues over 1. Secondly, the Kaiser-Meyer-Olkin measure of sampling adequacy was .87, which is above the recommended value of .6, and Bartlett’s test of sphericity was significant (χ2 (153) = 4021.71, p < .001). Conclusions: The analysis yielded four factors explaining a total of 67.25% of the variance for the entire set of variables. The first factor derived was labeled as a non-verbal visuospatial factor (i.e., designs, visual reproduction), which explained 43.99% of the variance. The second factor may represent general intellectual ability (G) (8.98%), the third factor was labeled as memory (8.64%), and the fourth factor as non-verbal intelligence (5.64%). These four patterns of constructs identified are independent of one another and compromise the primary subscale measures of both the WAIS and the WMS. Understanding the underlying constructs of the WAIS and WMS can be useful in clinical practice to help identify comparisons across the different assessments, to facilitate diagnosis and treatment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.153
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 01Cultural Differences in Baseline Concussive Symptom Reporting
    • Authors: Burley C; Bennett R, Lashley L, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine differences in pre-concussion baseline concussive symptom reporting between individuals from the United Sates, Haiti, Jamaica, Colombia, and Venezuela as determined by the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) symptom inventory. Method: Athletes with no history of concussion (n = 488) were selected from an archival database of baseline ImPACT symptom inventory scores of High-School athletes. Participants were grouped based on their home country: United States (n = 100, 50% male), Haiti (n = 96, 70.8% male), Jamaica (n = 92, 62% male), Colombia (n = 98, 63.3% male), and Venezuela (n = 102, 54.9% male). Results: Initial analyses indicated that groups differed significantly by gender (F(4,483) = 2.668, p = .032) and age (F(4,483) = 3.758, p = .005), but not by education (F(4,483) = 1.491, p = .204). Results of multiple ANCOVA analyses using age and gender as covariates revealed significant differences between groups in the following pre-test symptom scores: headache rating (F(4, 483) = 2.818, p = .025), balance problems (F(4, 483) = 3.237, p = .012), dizziness (F(4, 483) = 2.596, p = .036), trouble falling asleep (F(4, 483) = 17.425), sleeping less than usual (F(4, 483) = 3.861, p = .004), sensitivity to light (F(4, 483) = 2.573, p = .037) drowsiness, (F(4, 483) = 4.864, p = .001), nervousness (F(4, 483) = 2.341, p = .010), mental fogginess (F(4, 483) = 3.205, p = .013), difficulty concentrating (F(4, 483) = 3.317, p = .011), and difficulty remembering (F(4, 483) = 3.094, p = .016). Results also revealed differences in total pre-test symptom scores (F(4, 483) = 5.166, p<.001). Conclusions: Results revealed significant differences in symptom scores between groups at baseline ImPACT assessment. Results suggest that the home country of athletes completing ImPACT may have a significant influence on pre-test symptom reporting. As such, clinicians should carefully consider home countries and possible cultural differences when interpreting symptom scores in baseline ImPACT assessment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.154
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 02Cultural Differences in Baseline ImPACT Composite Scores
    • Authors: Burley C; Bennett R, Lashley L, et al.
      Pages: 703 - 794
      Abstract: Objective: To determine cultural differences in pre-concussion baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores between individuals from the USA, Haiti, Jamaica, Colombia, and Venezuela. Method: Athletes with no history of concussion (n = 469) with complete data were selected from an archival database of baseline ImPACT composite scores for high-school athletes. Participants were grouped based on their home country: USA (n = 98), Haiti (n = 89), Jamaica (n = 87), Colombia (n = 96), and Venezuela (n = 99). Results: Initial analyses indicated that groups differed significantly by gender (F(4,465) = 2.815, p = .025) and age (F(4,465) = 3.538, p = .007), but not by education (F(4,465) = 1.545, p = .188). Results of ANCOVA analyses using age and gender as covariates revealed significant differences between groups in visual-motor speed composite scores (F(4, 465) = 10.499, p < .001, partial η2 = .083), and reaction time composite scores (F(4, 465) = 14.908, p < .001, partial η2 = .114). Pairwise comparisons with a Bonferroni adjustment revealed the following significant differences in visual motor-speed composite scores: USA higher than Haiti (MD = 6.398, p < .001) and Jamaica (MD = 3.250, p = .019); and Haiti lower than Colombia (MD = −4.902, p < .001), Venezuela (MD = −4.345, p < .001), and Jamaica (MD = −3.148, p = .032). Results from reaction time composite score pairwise comparisons revealed that Haitian athletes scored lower than athletes from the USA (MD = 0.106, p < .001), Jamaica (MD = 0.062, p = .005), Colombia (MD = 0.109, p < .001), and Venezuela (MD = 0.111, p < .001). Conclusions: Results revealed significant differences in visual-motor speed and reaction time composite scores across groups at baseline ImPACT assessment. Results indicate that visual-motor speed and reaction time composite scores were significantly different based on the home country of athletes. As such, clinicians should carefully consider home countries when interpreting composite scores in ImPACT assessment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.155
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 03Comparing Performance on the Rey Complex Figure Test Between
           Hispanics and Non-Hispanics
    • Authors: Cook A.
      Pages: 703 - 794
      Abstract: Objective: The objective of this study is to compare performance on the Rey Complex Figure Test (ROCF) between non-Hispanics and Hispanics living in the United States. We expected to see Hispanic participants receive lower scores due to the fact that the ROCF test was developed in a Western culture, one different from their own. Method: Currently 64 participants (32 non-Hispanic and 32 Hispanic) with no history of neurocognitive disease, brain injury, or addiction were been administered the battery. Participants were recruited from the community as volunteers.The ROCF was administered as part of the EMBRACED battery: a comprehensive and domain specific computerized neuropsychological battery. In our analysis, participants from each group will be matched based on age and education, as age and education are known to be the most significant variables affecting performance on the ROCF. In our analysis, participants from each group were be matched based on age and education, as age and education are known to be the most significant variables affecting performance on the ROCF. A 2x3 ANOVA test was ran for the copy, immediate, and delayed recall trials. Results: A significant interaction was seen between culture and test score, particularly with the immediate (p = .03) and delayed recall (p = .03) trials with a 95% confidence interval. Conclusions: The ROCF is one of the most commonly administered neuropsychological tests and is often assumed to be of use when assessing diverse populations due to its nonverbal nature, yet it’s use with ethnically diverse populations has not been confirmed thus more studies are needed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.156
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 04Neuropsychological Assessments for Adult Spanish Speakers in the
           United States
    • Authors: Gonzalez Catalan M; Paulraj S, Ma F, et al.
      Pages: 703 - 794
      Abstract: Objective: The Hispanic and Latino population in the United States has reached nearly 58 million in 2016, accounting for half of the U.S. demographic growth since 2000 (U.S. Census Bureau, 2016). Different trends in cross-cultural and ethnic minority psychology have emerged to address mental health disparities present in ethnic minorities (Hartmann et al., 2013). In the field of clinical neuropsychology, professional guidelines were developed to improve the quality and accessibility of neuropsychological evaluations for Spanish-speaking individuals living in U.S. (Judd et al., 2009). However, research shows there is a significant cultural discrepancy in current neuropsychological instruments, procedures, and norms result in conceptual errors in the assessment of Spanish speakers (Puente et al., 2015). The objective of this study was to review the use and norming of neuropsychological assessments for the adult Spanish-speaking population living in the United States. Method: Using Google Scholar, the databases PsycINFO, PsycARTICLES, and PsycTESTS, we collected studies that examined neuropsychological measures used with Spanish-speaking participants. Results: Organized by cognitive domains, a list of translated neuropsychological assessments was described including the psychometric descriptions and norms based on Spanish-speaking participants. For each of these measures, the benefits and limitations were listed. Conclusions: A wide variety of the most used assessments have norms for Hispanics outside the country (particularly Spain, Mexico, and Puerto Rico) but these norms represent a small section of the diverse population living in the United States. Thus, a summary of existing translated neuropsychological measures was provided with a recommendation list of the best neuropsychological assessments to use based on norms and psychometric properties.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.157
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 05Use of the Montreal Cognitive Assessment (MoCA) in a Rural Outreach
           Program for Military Veterans
    • Authors: Hilgeman M; Boozer E, Davis L.
      Pages: 703 - 794
      Abstract: Objective: The Montreal Cognitive Assessment (MoCA) is a free, easily accessible screener ideal for use in rural areas where resources are limited. We examined administration/scoring by non-clinical, trained staff; compared positive screening rates using two cut-off scores; and examined predictors of education-adjusted scores in N = 168 rural military Veterans from the Alabama Veteran Rural Health Initiative (VCOHW). Method: Participants recruited through the VCOHW and completed baseline assessment which included the MoCA. Assessments were administered by non-clinical VA employees trained on MoCA administration and scoring by experienced clinicians. Participants ranged in age from 21 to 85 with a mean age of 55.6 years; 91.3% were men and 7.1% were women. Self-identified race/ethnicity revealed: 58.6% White/Caucasian, 40.9% Black/African American, 1% Hispanic (n = 2), and 0.5% Asian (n = 1). 53% reported formal education past high school. Baseline measures were completed through self-report or interview for illness burden, occupational and functional disability, psychiatric symptoms, stress and trauma checklists, and healthcare utilization. General demographics, military history, and legal history were also included. Results: Accuracy of administration (95%) and scoring (68%) was calculated on audited MoCAs. Higher than expected rates of positive screens were observed (40% using 24/30 cutoff) in this relatively young (M = 55 years) community-dwelling sample. Correlation analyses revealed age was negatively correlated with overall performance (−.48, p < .001). Age was also negatively correlated with five of six cognitive domains: visuospatial/executive abilities, naming, delayed recall, orientation, and attention. thinking was not significantly related to age. An ANOVA predicting the total education-adjusted MoCA score from subjective health, race, age, and education revealed a significant model [F (4, 158) = 17.48, p < .0001], such that age (t = −7.63, p < .001), race (t = −2.51, p = .01), and education (t = 3.25, p = .001) significantly predicted MoCA scores. Subjective health was not significant. Conclusions: This study advances rural practice by being the first to: 1) examine MoCA scores in a rural, Deep South U.S. sample; and 2) report fidelity administration data for non-expert outreach staff.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.158
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 06Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV)
           Short Form Accuracy in Children with Attention-Deficit/Hyperactivity
           Disorder (ADHD): Does Primary Language Matter'
    • Authors: Nuñez M; Emami A, Mayfiled A, et al.
      Pages: 703 - 794
      Abstract: Objective: Short forms of standard intelligence tests are useful in clinical and research settings where administration of a full intelligence test is impractical or not required. However, there is little research on the validity of short forms in non-English speaking populations, so the current study examined WISC-IV short forms in Spanish and English-speaking children with ADHD to determine their accuracy in estimating Full Scale IQ (FSIQ) and comparability of these estimates based on language. Method: Participants included children diagnosed with ADHD who were administered the WISC-IV Spanish (n = 165) or WISC-IV (n = 299) based on whether their primary language was Spanish or English, respectively. FSIQs were calculated using the Tellegen and Briggs procedure for three, four, and five subtest short forms. Discrepancy scores, misclassification rates, and intraclass correlation coefficients (ICCs) were used to determine accuracy of these short forms in estimating FSIQ and their comparability based on language. Results: The short forms examined demonstrated good to excellent accuracy in estimating FSIQ across Spanish- and English-speakers (ICCs ranged from .78 to .94). When a combination of discrepancy scores, misclassification rates, and ICCs were considered, the short form comprised of Block Design, Similarities, Coding, Vocabulary, and Letter-Number Sequencing subtests provided the most accurate estimation of FSIQ in both language groups. Conclusions: Short forms demonstrate similar levels of accuracy in estimating FSIQ across WISC-IV Spanish and English versions in children with ADHD. Findings suggest short forms may be useful for research and screening purposes in Spanish-speaking pediatric populations diagnosed with ADHD.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.159
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 07Assessing the Significance of Neurocognitive Sequelae in a Young
           Bilingual Adult Following an Episode of Endocarditis with Ishemic Stroke
    • Authors: Patiño Y; Torres K.
      Pages: 703 - 794
      Abstract: Objective: The neurocognitive sequelae following acute endocarditis with associated ischemic strokes can include various focal impairments. The current research on the neuropsychology of bilingual individuals suggests testing language performance in both languages to determine discrepancies. The case presented will demonstrate the importance of assessing language in the languages that patients consider having dominance. The assessment and diagnostic and treatment considerations when working with patients at risk of not receiving appropriate assessment are discussed through this case. Method: A 21-year-old, Hispanic, bilingual male, college student underwent neuropsychological testing and MRI imaging. Cognitive complaints included short term memory, difficulties concentrating, and expressive speech difficulties, with minimal functional deficits. Symptoms onset was two years prior to presentation, in the context of endocarditis with subsequent ischemic strokes. The majority of neuropsychological tests were completed in the English language given his fluency and years of education in the U.S.; however, language measures were completed in the Spanish language to discern a discrepancy between language and verbal working memory performances. The normative data for the Spanish language tests administered were obtained from best group normative samples available. Results: Cognitive weaknesses were related to sustained attention, processing speed, visual organization, visual set shifting, and dominant manual dexterity. Fluency, and auditory working memory were also relatively weak within the context of high average to superior intellectual functioning. Subtests with verbal component were completed in English and Spanish, and performance was demonstrated to be stronger in the Spanish language. Conclusions: This case illustrates the ongoing importance of evaluating test performance in multiple languages depending on the patient’s language dominance and everyday fluency. Although the patient presented in this case study moved to the United States in his early teenage years and is attending college in the United States, there was an observed discrepancy in the neurocognitive data that warrants further discussion when providers are addressing these clinical issues.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.160
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 08Factor Structure and Measurement Invariance of a Neuropsychological
           Test Battery Designed for Assessment of Cognitive Functioning in Mexican
           Americans
    • Authors: Stypulkowski K; Gavett B, Johnson L, et al.
      Pages: 703 - 794
      Abstract: Objective: Establishing the measurement invariance of neuropsychological assessment batteries across groups is increasingly important as the U.S. population becomes more diverse. The current study sought to investigate the measurement invariance properties of a battery of commonly used neuropsychological tests in an ethnically (Hispanic vs. non-Hispanic) and linguistically (Spanish vs. English) diverse sample. Method: Participants were 736 middle-aged and older adults (MAge = 62.1, SD = 9.1) involved in the Health and Aging Brain among Latino Elders (HABLE) study, an epidemiological study of cognitive aging in Mexican Americans. Participants completed a battery of cognitive tests and the test scores were included in a series of confirmatory factor analysis models. Results: A single factor model was identified that provided the best balance between model fit and parsimony (CFI = 0.971, RMSEA = 0.065, SRMR = 0.037) and had a composite reliability of r = .92. When subjected to measurement invariance testing across three ethnicity/language groups (Hispanic/English, Hispanic/Spanish, and non-Hispanic/English), the single factor model was found to possess strict measurement invariance without a decrement in fit compared to a strong (scalar) invariance model (ΔCFI = .001, ΔRMSEA = .002; Δχ2 = 28.9 Δdf = 24, p = .23). Conclusions: These results indicate that a single factor model is suitable for estimating global cognitive functioning in Mexican Americans and non-Hispanic whites without bias by ethnicity or language.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.161
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 09The Influence of Demographic Variables on Normal Neuropsychological
           Test Performance in English Speaking Hispanic and Matched White Older
           Adults
    • Authors: Werry A; Daniel M.
      Pages: 703 - 794
      Abstract: Objective: While the impact of cultural factors on neuropsychological test performance is documented in literature, there is little data on the impact of demographic factors for older adults of different ethnic groups. The objective of the current study was to determine the impact of demographic variables on neuropsychological measures in neurologically healthy older adults of different ethnicities. Method: Subjects from the National Alzheimer’s Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 73.5/6.4; education = 14.7/3.1). Groups were formed based on self-identified ethnicity of White Non-Hispanic (n = 145) or Hispanic (n = 145) and matched for age, education, and gender. Dependent variables for a series of multiple regression analyses included raw scores on neuropsychological measures including: Mini Mental State Exam, Logical Memory Immediate and Delayed, Digit Span Forward and Backward, Trail Making Test A & B, Animal Naming, Vegetable Naming, Digit Symbol, and Boston Naming Test. Independent variables were age, years of education, and gender. Results: Age was a statistically stronger predictor of Boston Naming Test performance in the Hispanic group compared to the White group. Education was a statistically stronger predictor of Digit Span Forward performance in the White group compared to the Hispanic group. There were no other differences in demographic predictor variables for the groups. Conclusions: These results indicate that the predictive relationships of age, education, and gender on neuropsychological performance are more similar than different for English speaking Hispanic and matched White older adults.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.162
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 10Influence of Demographic Variables on Measures of Memory and
           Language for Spanish Speaking Hispanic and Matched White Older Adults
    • Authors: Werry A; Daniel M.
      Pages: 703 - 794
      Abstract: Objective: Although research suggests demographic factors are differentially correlated with performance on tests of memory and language, few studies examine this influence for older adults or consider specific ethnic groups. The objective of the current study was to determine the impact of demographic variables on memory and language in healthy older adults of different ethnicities. Method: Subjects from the National Alzheimer’s Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 74.2/6.5; education = 12.6/3.7). Groups of self-identified White Non-Hispanic (n = 161) or Hispanic (n = 161) individuals were matched for age, education, and gender. Neuropsychological tests were administered in the subjects’ primary language. Dependent variables for a series of multiple regression analyses included: Mini Mental State Exam (MMSE); Logical Memory Immediate and Delayed Recall (LMI & LMD); Boston Naming Test (BNT); Animal Naming; and Vegetable Naming. Independent variables were age, years of education, and gender. Results: Education was a stronger predictor for verbal fluency and memory measures in the White group and for BNT in the Hispanic group. Gender was a stronger predictor for verbal fluency measures in the White group, and of BNT performance in the Hispanic group. There were no statistically significant differences between the groups for age as a predictor. Conclusions: With the exception of age, demographic variables have different patterns of association with memory and language test performance for Hispanics and Whites. These findings highlight the importance of using caution interpreting scores of Hispanic individuals tested in Spanish based on dominant culture English speaking norms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.163
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 11Examining Cerebral Blood Flow Differences in Cannabis and Alcohol
           Use Disorders
    • Authors: Abu-Suwa H; Sohail S, Golden C, et al.
      Pages: 703 - 794
      Abstract: Objective: To compare cerebral blood flow (rCBF), as measured by SPECT, in those with cannabis and alcohol use disorders. Method: Participants were part of a de-identified SPECT database. Participants were chosen if diagnosed with either alcohol or cannabis use disorder, based on DSM-IV criteria. Participants were excluded if diagnosed with both substance disorders, dementia or brain trauma. The alcohol group consisted of 433 participants (mean age = 40.01,SD = 13.79;male = 282;Caucasian = 312) and the cannabis group consisted of 263 participants (mean age = 27.34,SD = 9.82;male = 209;Caucasian = 177). T-tests were used to measure rCBF differences between the groups across 17 brain areas, at baseline and while completing the CPT-II, while controlling for age and gender. Results: Results indicated significant differences in the left and right parietal lobes and motor sensory areas at concentration and baseline (p < .05), such that rCBF was higher in the cannabis group. There was also a difference in the left and right limbic areas at baseline (p < .05), such that rCBF was higher in the alcohol group. Conclusions: Little is known about the effects of cannabis use on the brain. Some evidence suggests associations between cannabis use and impairment in the frontal and limbic structures. Alcohol is known to affect various motor, sensory and frontal areas of the brain, however the results of this study suggest that impairment in motor and sensory regions is higher when using cannabis than when using alcohol, whether at rest or while completing attentional tasks. These results help elucidate the impact of cannabis on the brain, such that the effect may be similar to or exceed that of alcohol.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.164
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 12A Case of Accelerated Progression of Co-Morbid Primary Lateral
           Sclerosis and Frontotemporal Dementia
    • Authors: Arora S; Ordoñez C, Collins W, et al.
      Pages: 703 - 794
      Abstract: Objective: Primary Lateral Sclerosis (PLS) is a rare motor neuron disease with a median survival rate of 20 years. PLS has comorbidities with frontal lobe deficits- as per a meta-analysis, co-morbid Frontotemporal dementia (FTD) occurred in 3% of the patients. This study presents a cognitive and behavioral profile of a patient with co-morbid PLS and FTD, and highlight poly-etiologic factors such as depression, history of alcohol abuse, and reduced vital capacity compounding the patient’s disease progression. This case will add to sparse neuropsychological literature on PLS. Method: “Frank” is a 47-year-old Caucasian male diagnosed with PLS and FTD in 2017. Neuropsychological tests (Trails Making Test, Rey Complex Figure Test, Logical Memory I & II, Symbol Search, Coding, California Verbal Learning Test-II, Digit Span, Screening Auditory Comprehension, Verbal Fluency, Color Word Interference, and Judgement of Line Orientation), mood screeners, and clinical interviews were used to assess “Frank’s” cognitive and behavioral functioning. A process approach was used to understand his strengths and weaknesses. Results: “Frank” has mild to severe deficits in executive function, language, memory, and attention with intact visuospatial skills. His pulmonary function is declining (vital capacity 20%) and has moderate depression (Beck Depression Inventory-II = 30/63). He presents with perseverating thoughts and pseudobulbar affect. Conclusions: Frank’s cognitive deficits are consistent with past literature on PLS. Factors such as depression, reduced vital capacity, and history of alcohol abuse contributes to an accelerated deterioration of his faculties. Further research is required to study factors and their process leading to rapid progression of PLS co-morbid with FTD. References: de Vries, B. S., Rustemeijer, L. M., van der Kooi, A. J., Raaphorst, J., Schröder, C. D., Nijboer, T. C.,… & van Es, M. A. (2017). A case series of PLS patients with frontotemporal dementia and overview of the literature. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 18(7–8), 534–548. Piquard, A., Le Forestier, N., Baudoin‐Madec, V., Delgadillo, D., Salachas, F., Pradat, P. F.,… & Lacomblez, L. (2006). Neuropsychological changes in patients with primary lateral sclerosis. Amyotrophic Lateral Sclerosis, 7(3), 150–160.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.165
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 13Assessing the Appropriateness of Catatonia Rating Scales in
           Describing Motor Abnormalities in an Adult with Autism Spectrum Disorder
    • Authors: Davis K; Kennedy S, O’Grady J, et al.
      Pages: 703 - 794
      Abstract: Objective: Motor abnormalities are common in individuals with autism spectrum disorder (ASD). One such abnormality, often called “freezing,” occurs when individuals stop moving in the middle of activities. Freezing often co-occurs with behaviors such as stereotypic movements, odd posturing, and echolalia, which may suggest a catatonic-like presentation. To date, no widely used clinical assessment tools have been developed specifically for evaluating these abnormalities in individuals with ASD, and thus, these abnormalities are difficult to reliably identify and measure. We evaluated the appropriateness of existing catatonia rating scales in describing freezing and concurrent catatonic-like motor abnormalities in ASD. Method: We retrospectively analyzed 34 videos of one participant with level three ASD who had exhibited freezing behaviors during his participation in an intensive educational program. The participant was recorded in various outdoor and indoor settings. Two raters independently coded the videos using six established catatonia rating scales. Interrater reliability was calculated, and validity was assessed using DSM-5 symptom counts from Criterion A for Catatonia and clinicians’ subjective determinations of whether freezing had occurred. Results: Good to excellent interrater reliability was achieved on the Rogers Catatonia Scale, but all other rating scales showed poor reliability. The Rogers ratings significantly predicted clinicians’ determinations of freezing (p = 0.01) as well as DSM-5 symptom counts (p < 0.001), indicating high convergent validity. Conclusions: The Rogers Scale demonstrated the best psychometric properties when coding videos of this participant. Since the Rogers Scale seems to be a workable clinical measure for this participant, it may be a reliable and valid way to describe motor abnormalities in other individuals with similar neurodevelopmental profiles.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.166
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 14Worsening Fatigue Predicts Increased Cognitive Complaints and
           Declines in Cognitive Test Performance Among Individuals with Multiple
           Sclerosis
    • Authors: Domen C; Nair K, Hoyt B, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine the effect of fatigue on cognitive complaints and objective cognitive test performance among multiple sclerosis (MS) patients. Method: 109 MS patients (79% female, age = 46.8 ± 7.8 years) completed questionnaires assessing fatigue, mood, and general cognitive concerns (GCC), as well as neuropsychological testing, at baseline and one-year follow-up. Stepwise linear regression with backward elimination was performed using standardized change scores for self-report measures and cognitive domain composites. Covariates of interest included age, education, disease duration, PDDS, drug type, and mood. Models were chosen based on F-values, adjusted R2, and parsimony. Results: A model including change in fatigue and anxiety predicted change in GCC, F2, 91 = 12.742, p < 0.001, adjusted R2 = 0.202. After controlling for anxiety, worsening fatigue was associated with increased GCC, t92 = −4.332, p < 0.001. Worsening fatigue and depression also predicted slowed processing speed, F2, 90 = 4.229, p = 0.018, adjusted R2 = 0.066; however, after controlling for depression, fatigue was only weakly associated with processing speed, t91 = −1.919, p = 0.058. Worsening fatigue alone predicted declines in visual memory, F2, 91 = 6.127, p = 0.015, adjusted R2 = 0.053, and verbal fluency, F2, 91 = 6.392, p = 0.013, adjusted R2 = 0.055. GCC did not predict cognitive performance (all ps > 0.05). Conclusions: Worsening fatigue predicted increased cognitive concerns and declines in certain cognitive domains, albeit to a lesser degree and contrary to expectations. Consistent with prior findings, subjective cognitive complaints were not associated with test performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.167
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 15Psychogenic Nonepileptic Seizures: A Case Study Involving Focal
           Epilepsy and Trauma
    • Authors: Engelmann M; Nussbaum N.
      Pages: 703 - 794
      Abstract: Objective: Psychogenic Nonepileptic Seizures (PNES) is a complex disorder characterized by paroxymal events that lack the typical electrophysiological changes associated with electrically based seizures. Neurobiological evidence supporting the etiology of PNES is mixed, though a large percentage of PNES patients have adverse histories involving trauma. The present case study will address the multifactorial etiology of PNES with co-occurring Focal Epilepsy. Method: HM is a 15-year-old young woman referred for evaluation due to pharmacoresistant Focal Epilepsy. Seizures were first recognized at age 4. No family history of seizures. Psychosocial history notable for multiple traumas. HM has missed a great deal of school and has no history of therapy. Prior to evaluation, HM’s seizures occurred when leaving the house for school and on the morning scheduled for assessment. Another seizure-like event was observed during testing. Results: Neuropsychological results indicate greatly impaired functioning in motor, language, memory, and cognitive domains. Despite these challenges, HM’s adaptive functioning was rated in the low average range, along with average social functioning. Conclusions: While some of HM’s seizures follow a pattern consistent with Focal Epilepsy (e.g. occurring during sleep, drooling, electrographic activity), other events are more likely a product of stress and anxiety. In addition to focal seizures, HM’s history of adverse life events combined with cognitive, academic and psychosocial challenges have resulted in PNES. Treatment recommendations include school supports, speech-language therapy, and intensive individual cognitive behavioral therapy to address PNES with continued treatment of electrically based seizures. This case illustrates the complex etiology and treatment of PNES and electrical seizures.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.168
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 16The Relationship Between Subjective Cognitive Function and
           Neuropsychological Performance in an Urban HIV+ Population
    • Authors: Focht K; Foster E, Minniti N, et al.
      Pages: 703 - 794
      Abstract: Objective: There are discrepancies in the literature as to whether perceived cognitive difficulties correlate with observed deficits on neuropsychological measures. Individuals with human immunodeficiency virus (HIV) are at an increased risk of developing neurocognitive impairment. The main objective of this study was to explore the relationship between subjective cognitive functioning and neuropsychological performance in an urban population of HIV infected (HIV+) and HIV negative (HIV-) adults. Method: Participants from the Comprehensive NeuroAIDS Center at Temple University Hospital completed questionnaires assessing depressive symptomatology (BDI-II) and self-reported cognitive abilities in the areas of language, memory, sensorimotor, and higher-level cognition (PAOFI). Neuropsychological tests included measures that assessed five cognitive domains: attention/working memory, processing speed, fine motor speed and dexterity, verbal fluency, and executive functioning. Potential relationships between subjective cognitive dysfunction, neuropsychological performance, age, education, and depressive symptomatology, as well as CD4+ nadir for the HIV+ group, were assessed using Pearson correlations (2-tailed) and partial correlations controlling for specific variables. Results: Here, we report that perceived language abilities correlates positively with verbal fluency in the HIV+ group (r = 0.318, p = 0.013) as well as in the comparison control group (r = 0.487, p = 0.003). Age, education, depression, and CD4+ nadir were controlled for in these analyses. No significant correlations were found regarding other neuropsychological domains in the HIV+ or HIV- participants. Conclusions: Subjective cognitive functioning may not be the most accurate indicator of cognitive decline. Additional research is required to better understand patients’ abilities to accurately assess and report their cognitive status in specific domains.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.169
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 17 Case Review: Neuropsychological Evaluation of a Patient with
           Epilepsy Secondary to Temporal Lobe Encephalocele
    • Authors: Greth Z; Matusewicz M, Reno A.
      Pages: 703 - 794
      Abstract: Objective: Identification of epilepsy secondary to temporal lobe encephalocele has increased in recent years due to improvements in neuroimaging. Neuropsychological evaluation of patients with this rare disorder is important to help inform surgical planning and medical decision-making; however, neuropsychological findings associated with this population are not well-documented. This review examined neuropsychological functioning in an adult patient with intractable epilepsy due to temporal lobe encephalocele. Method: The patient was a 45-year-old, right-handed, Caucasian female with unremarkable neurodevelopmental background. Patient developed new onset seizures at age 42. Pre-surgical epilepsy work-up revealed seizure focus in the left temporal lobe. Neuroimaging was remarkable for encephaloceles in the left middle fossa and the petrous ridge. Neuropsychological evaluation and Wada testing were performed as part of the comprehensive pre-surgical work-up. Results of neuroimaging, neuropsychological, and diagnostic procedures were presented. Results: Neuropsychological testing revealed a circumscribed pattern of impairment. Performance validity testing was unremarkable. Intelligence was in the borderline range. Deficits were observed on measures of language, verbal memory, and executive functioning. Verbal memory results were consistent with a dysexecutive profile rather than an amnestic pattern of memory loss. Wada testing indicated left language dominance and bilaterally intact memory functioning. Mood screening revealed minimal depression and moderate anxiety symptoms. Conclusions: This review provided novel neuropsychological findings for a patient with epilepsy secondary to left temporal lobe encephalocele. Findings were consistent with left hemisphere dysfunction and suggestive of mesial temporal lobe sparing. Further investigation of neuropsychological status in this rare patient population will help further guide treatment decision-making and mitigate post-operative sequelae.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.170
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 18An Informal Intervention to Promote Social Engagement Using
           Communication Technologies with an Adult with Level 3 Autism Spectrum
           Disorder
    • Authors: Keller K; O’Grady J, Gordon B, et al.
      Pages: 703 - 794
      Abstract: Objective: Adults with autism spectrum disorder (ASD) often experience social isolation. There is a growing body of evidence that supports the use of electronic devices to increase attention and engagement in this population. We evaluated the use of text messaging and Facebook to promote communication skills and establish basic reciprocal social interactions with one adult with level 3 autism spectrum disorder (ASD-3). Method: We piloted the intervention on a 30-year-old man with ASD-3 who was selectively recruited through an intensive educational program. The participant was presented with the option to use iMessage and Facebook on his personal devices during speech-language therapy sessions scheduled four times each week. He was prompted to operate the applications using a chaining method, and he received support with spelling and typing. Communication frequencies and descriptions of quality and character of communications were recorded in session notes. Results: The participant’s use of communication technologies increased the frequency of positive and appropriate social communications. Conclusions: Communication technologies were effective tools in expanding and enhancing the participant’s social communications and allowing him to utilize limited language capacity in a socially typical way. The use of communication technologies eliminated aspects of the participant’s communication that typically interfere with successful face-to-face interactions, such as poor eye contact, impaired articulation, and decreased attention; the acceptable use of images and shorthand reduced demands for speech and language and created a communication platform better matched to his abilities. Further research is needed to design and test formal interventions involving communication technologies for adults with ASD.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.171
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 19Systematic Review of Psychosocial Interventions for Adults with
           Level 3 Autism Spectrum Disorder
    • Authors: Kennedy S; Dallavecchia A, Davis K, et al.
      Pages: 703 - 794
      Abstract: Objective: Though adults with level 3 autism spectrum disorder (ASD-3) may benefit from a range of support services, few, if any, interventions specifically designed for this population exist. This article presents the results of a systematic review of the literature on psychosocial interventions for adults with ASD-3. Data Selection: We conducted an electronic search using PubMed and Google Scholar and hand combed references from literature reviews, books, and program reports to identify 50 peer-reviewed studies published since 1968 documenting the effects of psychosocial interventions in adults with ASD-3. Participants were adults age > 18.0 years with a primary diagnosis of ASD-3. Psychosocial interventions included behavioral (including but not limited to applied behavior analysis) programs, recreational therapies, social skills training programs, and multisensory rooms. Quantitative outcome measures included structured observations, rating scales, and standardized assessments. Primary outcomes included problematic behaviors, vocational skills, adaptive skills, leisure skills, social/communication skills, and emotional functioning/quality of life ratings. Data Synthesis: Though calculations of Hedges’ g supported the effectiveness of some behavioral skills training and recreational therapy programs, evidence was lacking for most types of interventions, and synthesis was limited by a high risk of bias, per PRISMA guidelines, across studies. Conclusions: Overall, results should be interpreted with caution as the body of literature contained a remarkable dearth of reliable evidence, and all of the studies included small sample sizes and a high risk of bias. Further research is needed on the effectiveness of psychosocial interventions for this often-overlooked clinical population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.172
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 20The Prevalence and Neuropsychological Sequelae of Hypoxic Brain
           Injury in Victims of Intimate Partner Violence
    • Authors: Meyer J; Arnett P.
      Pages: 703 - 794
      Abstract: Objective: Victims of intimate partner violence (IPV) sustain high levels of head trauma including both traumatic brain injury (TBI) and hypoxic brain injury (HBI) from strangulation. The present study aimed to elucidate the prevalence and neuropsychological sequelae of HBI in a sample of community-based IPV victims. Method: A sample of 44 female IPV victims recruited from the community completed a clinical interview assessing for TBI and HBI and a battery of neuropsychological tests and measures of emotional functioning. Memory, Processing Speed, and Executive Functioning composite scores were formed from a battery of traditional neuropsychological measures. The Memory for Intentions Screening Test (MIST) and the Behavioral Assessment of Dysexecutive Syndrome (BADS) were also administered. Results: Nearly half (49%) of all participants experienced at least one potential hypoxic event, while 27% of victims experienced at least one HBI. History of HBI was a significant predictor of performance on the Memory Composite Score (β = −0.37, p = 0.015), the BADS Zoo Maps 1 Test (β = −0.36, p = 0.031), and a marginally significant predictor of performance on the Processing Speed Composite Score (β = −0.29, p = 0.086). Participants with a history of HBI were significantly less likely to demonstrate intact performance on the MIST Delayed Prospective Memory Test (Fisher’s Exact Test, p = .008). Conclusions: Results indicate high prevalence of potential hypoxic events and HBI in IPV victims. The observed effects on neuropsychological testing have important implications for the safety of IPV victims as compromised cognitive functioning may influence a victim’s ability to seek out resources, engage in safety planning, navigate legal proceedings, and maintain employment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.173
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 21Neuropsychological Screening of Phenylketoniuria (PKU) in an
           Interdisciplinary Care Setting
    • Authors: Mission P; Kessler-Jones A, Foy A.
      Pages: 703 - 794
      Abstract: Objective: Phenylketoniuria (PKU) is metabolic condition associated with severe physical, cognitive and psychological impairment if untreated. Further research is needed to examine and monitor neuropsychological outcomes in treated populations to inform care and decision-making1. This study examines (1) results from psychological and neurocognitive screeners, and (2) their use in an interdisciplinary genetics clinic.Method: Participants included 10 individuals who have been diagnosed with PKU and treated. Phe levels were collected. Screeners included NeuroQOL (NIH Toolbox) self-report measures on depression, anxiety, and cognitive function. Surveys administered to team members assessed benefits and barriers to the use of neuropsychological screening measures in clinic. Results: Participants were ages 10–60 (mean = 31). Onset and adherence of treatment varied and SES was variable. Phe levels at the time of the screening ranged 1.1 to >20 mg/dL. Half of participants endorsed anxiety while one-third reported cognitive dysfunction and only one depression. Phe elevations moderately correlated with anxiety (r = +0.43) but not depression (r = +0.24). Cognitive dysfunction strongly and negatively correlated with anxiety (r = −0.63, p = 0.04) and depression (r = −0.62, p = 0.05). Anxiety and depression were weakly correlated (r = +0.19). Cognitive function and elevated Phe levels were negatively correlated (r = −0.42). Conclusions: PKU patients present with a high prevalence of psychological and cognitive challenges with cognition deficits associated with Phe levels and subjective levels of anxiety and depression. We emphasize a need for routine monitoring of psychosocial and cognitive symptoms even in treated populations. Such screening and methods of care have the potential to improve treatment compliance and quality of life.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.174
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 22The Relationship Between Frontal Lobe Impairment, Mood, and
           Perceived Quality of Life in Epilepsy
    • Authors: Mitchell R; Siruckova A, Walker M, et al.
      Pages: 703 - 794
      Abstract: Objective: Prior research acknowledges the adverse effects that epilepsy may have on select psychological functioning, yet the relationship between frontal lobe dysfunction, mood, and perceived quality of life in a sample with epilepsy is not fully understood. Method: To better explain the role of frontal lobe impairment in mood and perceived quality of life of individuals with epilepsy, we examined whether impairment on COWAT (FAS), Wisconsin Card Sort Test (WCST), or Ruff Figural Fluency Test (RFFT) was associated with scores on the Beck Depression Inventory, State-Trait Anxiety Inventory, or Quality of Life in Epilepsy-31 (QOLIE-31). 529 patients completed the COWAT, WCST, and RFFT as part of a comprehensive neuropsychological evaluation. Results: Impairment in COWAT total score was significantly associated with lower perceived cognitive functioning on the QOLIE-31 (p = .035) with the impaired group (mean = 42.25) scoring 7.2 points lower than the non-impaired group (mean = 49.43). COWAT impairment was also significantly associated with lower perceived social functioning (p = .009) with the impaired group (mean = 44.57) scoring 10.2 points lower than the non-impaired group (mean = 54.77). Impairment in RFFT unique designs was significantly associated with lower perceived social functioning (p = .023) with the impaired group (mean = 43.52) scoring 9.5 points lower than the non-impaired group (mean = 53.06). Impairment on the WCST was not significant (all p > 0.05). Conclusions: These results suggest that impaired frontal lobe functioning in patients with epilepsy can negatively affect their perceived quality of life but does not significantly affect depression or anxiety symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.175
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 23Pain Catastrophizing and Its Relation to Psychological Distress and
           Cognitive Performance in a Chronic Pain Sample
    • Authors: Myers M; Holcombe J, Overstreet T, et al.
      Pages: 703 - 794
      Abstract: Objective: We examined the association between pain catastrophizing, psychological distress, and overall cognitive functioning in a clinical chronic pain sample in the Mobile, Alabama area. Method: 461 individuals completed Pain Catastrophizing Scale (PCS), Psychological Distress Inventory (PDI), Trail Making Test (TMT) parts A and B, and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as part of a larger neuropsychological battery [mean age 53.25 years (SD 13.57), range 18–89 years old, mean 13.1 years of education (SD 2.66), 61.2% female, 86.7% Caucasian, 12.6% African American, .6% Other]. Results: In 461 individuals seeking treatment for chronic pain, significant negative associations were found between PCS total scores and RBANS [Immediate Memory index (r = −.16, p < .001), Visuospatial/Constructional index (r = −.13, p < .01), Language index (r = −.17, p < .001), Attention index (r = −.21, p < .001), Delayed Memory index (r = −.16, p < .01), RBANS total score (r = −.23, p < .001)] and TMT [part A (r = −.16, p < .01), part B (r = −.18, p < .001)] scores. There was a significant positive association between PCS total scores and PDI total scores (r = .51, p < .001). Conclusions: Our results suggest higher levels of pain catastrophizing are associated with higher levels of psychological distress and decreased overall cognitive functioning. The RBANS Attention index had a slightly stronger relationship with pain catastrophizing when compared to other RBANS indexes, indicating this domain may be most affected. Further investigation is needed to see if psychological distress associated with pain catastrophizing is the reason behind impaired cognitive functioning and why attention may be most impaired.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.176
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 24EEG Net Tolerance Training for an Adult with Level Three Autism
           Spectrum Disorder
    • Authors: O’Grady J; Francis J, Gordon B, et al.
      Pages: 703 - 794
      Abstract: Objective: Individuals with autism spectrum disorder (ASD) experience increased agitation compared to typically developing peers. This increased agitation, which can impair functioning, makes it difficult to study individuals with ASD using electrophysiological measures that require individuals to sit still and cooperate with testing. Since it is challenging to collect reliable electroencephalography (EEG) data from individuals with ASD, few such studies exist of individuals with ASD, particularly those considered low functioning. We present a case study in which systematic tolerance training is used to prepare one individual with level three ASD (ASD-3) for participation in electrophysiological studies. Method: We piloted an intervention on one 30-year-old participant with ASD-3, who was selectively recruited through an intensive educational program, to increase his tolerance for wearing an EEG net. The intervention consisted of social narratives, training and reinforcement of incompatible and replacement behaviors, and systematic and gradual increases in time spent wearing the net. The intervention, administered in an experiment room setting, involved video recording sessions and retrospectively measuring behavioral signs of agitation using time interval recording. These quantitative measures were analyzed in conjunction with qualitative descriptions of behavior from clinical session notes to assess intervention effects. Results: Behavioral data suggest that the net preparation intervention helps to minimize agitation associated with physical discomfort caused by the net. Conclusions: The net preparation intervention appears to be effective in preparing one individual with ASD-3 for participation in electrophysiological studies, representing an important first step in designing and evaluating scalable interventions that could improve access to this historically understudied population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.177
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 25The Impact of Reversible Factors in a Patient with Moderate to
           Severe Memory Loss
    • Authors: Ory J; Bragg T, Ruwe W.
      Pages: 703 - 794
      Abstract: Objective: Reversible factors affecting cognition can have a significant impact on functional and neurocognitive abilities. Recommendations targeting reversible factors can produce measurable improvement in an individual’s cognitive as well as emotional functioning. Method: A Caucasian male in his mid-fifties with 13 years of education was seen for neuropsychological evaluation 30 years after a motor vehicle accident with resulting loss of consciousness >48 hours. He was an excellent student before the accident, but was forced to drop out of college afterwards. He worked in retail customer service and office jobs, and currently is a payroll clerk. He reports that he is slow to complete tasks, makes frequent mistakes, and believes he would have been terminated, but his employer is his best friend. He endorsed ongoing symptoms of PTSD related to the accident, as well as significant depression and insomnia. Neuropsychological testing was completed in 2015, due to ongoing memory concerns. A CT scan did not reveal evidence of cortical or focal atrophy, and grey/white matter differentiation was preserved. His neuropsychological test results indicated low average to severe impairment across multiple domains, and he endorsed severe anxiety and depression both during the clinical interview and on the MMPI-2. A diagnosis of Major Neurocognitive Disorder was deferred while his mood and affective symptoms were addressed. After completing Cognitive Behavioral Therapy and receiving medication for his mood and affective symptoms, he was reevaluated using an identical battery two years later. Results: Measures of attention, language, executive functioning and general cognitive abilities improved significantly. Notably, despite broad significant improvements, his MoCA decreased, as did his performance on executive functioning measures. Memory remained impaired, despite some improvement. He was diagnosed with a Major Neurocognitive Disorder due to Multiple Etiologies (i.e., remote severe TBI + progressive decline in memory and executive functioning based on serial neuropsychological testing). Conclusions: Cognitive deficits related to severe depression and anxiety “masked” genuine neurocognitive impairment in this individual. Effective treatment of his mood and affective symptoms improved his cognitive performance in multiple domains. Despite these improvements, his functional independence did not improve due to progressive memory loss and executive functioning decline.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.178
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 26Combined Effects of HIV and Past Methamphetamine Use Disorder on
           Frailty, Neurocognition, and Everyday Functioning
    • Authors: Paolillo E; Saloner R, Montoya J, et al.
      Pages: 703 - 794
      Abstract: Objective: To examine persistent effects of lifetime methamphetamine use disorders (MA) on global neurocognition, everyday functioning impairment, and accumulated damage to multiple physiologic systems (conceptualized as “frailty”) among persons living with HIV (PLWH). Method: 210 participants, aged 35–65, were categorized into three groups based on HIV status and lifetime MA diagnosis (occurring >12 months ago): HIV+/MA+ (n = 43); HIV+/MA- (n = 75); and HIV-/MA- (n = 92). Participants completed a comprehensive neurocognitive battery and self-reported measure of IADL dependence. A frailty index score (representing proportion of accumulated multisystem deficits) was calculated out of 27 possible medical and psychiatric deficits. Three multiple regression models examined differences in global neurocognition, IADL dependence, and frailty across groups, covarying for demographic and neuropsychiatric characteristics that differed between groups (e.g., lifetime alcohol use disorder). Results: HIV+/MA+ participants had worse global neurocognitive functioning and greater likelihood of IADL dependence than HIV-/MA- participants (ps < .01), but not HIV+/MA- participants (ps > .05). HIV+/MA+ participants had higher frailty index scores than both HIV-/MA- (b = −0.14, p < .001) and HIV+/MA- participants (b = −0.05, p = .030). Across the entire sample, higher frailty index score was related to worse global neurocognition (r = −0.24, p < .001) and greater likelihood of IADL dependence (2 = 25.9, p < .001). Conclusions: Results demonstrated an adverse effect of HIV, but not past MA, on neurocognitive and everyday functioning. In contrast, there was a combined detrimental effect of HIV and past MA on frailty. Given evidence of potential legacy effects of MA among older (≥50) PLWH, these findings support future longitudinal research to determine whether frailty may be a preclinical marker of neurocognitive and functional decline.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.179
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 27Cognitive Performance and Depression Symptoms in Patients with
           Migraine
    • Authors: Sebrow L; Klepper J, Seng E.
      Pages: 703 - 794
      Abstract: Objective: This study examined the relationship between depression symptoms and cognitive performance in patients with migraine at a specialty headache center. Method: This was a secondary analysis of a cross-sectional study conducted at a specialty headache center. Researchers sent a letter signed by a headache center neurologist to patients who met study inclusion criteria, including having a physician diagnosis of migraine and meeting International Classification of Headache Disorders - 3rd Edition (beta) diagnostic criteria for migraine. Seventy-seven adults (M age = 45.2, SD = 7.4, 89.6% female, 88.3% White, Non- Hispanic, and 46.8% with a graduate degree) completed surveys assessing demographics and depression symptoms (PROMIS depression scale), and a battery of neuropsychological tasks. Patients reported no migraine symptoms within 24 hours of testing, increasing their likelihood of being examined during the interictal period. Pearson’s product-moment correlations and Spearman’s rank-order correlations examined relationships among depression and neuropsychological variables (The Trail Making Test [TMT], WAIS-IV Coding, Rey Auditory Verbal Learning Test [RAVLT], The Rey Complex Figure Test [RCFT], WAIS-IV Digit Span [Forward, Backward, Sequencing], Stroop Color and Word Test, F-A-S and Animal Fluency). Results: Higher scores on the PROMIS depression scale significantly associated with lower scores on WAIS-IV Coding (r = −.27, p = .020) and Animal Fluency (rs = −.26, p = .021). The PROMIS depression scale did not significantly associate with other neuropsychological variables. Conclusions: Higher depression symptoms related to lower scores on attention/processing speed and semantic fluency tasks in patients with migraine.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.180
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 28Learning Mediates the Relationship Between Executive Functions and
           Medication Management in HIV Disease
    • Authors: Sullivan K; Woods S.
      Pages: 703 - 794
      Abstract: Objective: Given the centrality of medication adherence to optimal HIV disease outcomes, it is important to understand the neurocognitive mechanisms that underlie successful medication management in this population. HIV+ individuals commonly evidence frontostriatal circuit dysfunction and demonstrate impairment in the strategic aspects of episodic memory (e.g., semantic clustering). The current study evaluated the hypothesis that HIV-associated executive dysfunction leads to impaired learning, which adversely affects medication management. Method: Participants included 195 HIV+ adults who completed a neuropsychological research battery. Sample-based composite raw z-scores were calculated for the domains of executive functions, learning, and motor skills. The Medication Management Test-Revised (MMT-R) was administered to measure each participant’s ability to dispense medications according to specific instructions. Results: Mediation analyses using 95% bootstrap confidence intervals (CIs) revealed that learning significantly mediated the relationship between executive functions and the MMT-R after controlling for education, b = .21, 95% CI [.05, .39]. Follow-up correlational analyses revealed that executive functions (ρ = .28, p < .001) and the MMT-R (ρ = .25, p < .001) were significantly associated with semantic clustering, but not serial clustering (ps>.05), on the California Verbal Learning Test-Second Edition. Evidence of the specificity of this effect was provided by data showing that motor skills did not mediate the relationship between executive functions and the MMT-R, b = .05, 95% CI [−.03, .13]. Conclusions: Executive dysfunction in HIV disease seems to disrupt the use of effective encoding strategies, which may adversely impact the acquisition of medication management skills. Future studies might examine whether remediation strategies that support the executive aspects of learning can improve medication management in HIV disease.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.181
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 29Comprehensive Neuropsychological Testing of Adult Diagnosed with
           Charles Bonnet Syndrome after a Craniopharyngioma Resection
    • Authors: Crespo K; Zacca E, Ireland S.
      Pages: 703 - 794
      Abstract: Objective: Charles Bonnet Syndrome (CBS) is a rare clinical condition that causes complex visual hallucinations in individuals with partial or severe blindness. Literature on the cognitive ability of individuals with CBS has generally been limited in completeness and quality and has primarily been focused on the elderly population. Neuropsychological functioning of a 33-year-old male with this syndrome will be presented. Findings will add to the limited literature about neuropsychological profiles and color perception deficits of an individual with CBS using updated, comprehensive neuropsychological assessment. Method: Patient is a 33-year-old male who presented with worsening headaches for several months. He was diagnosed with a craniopharyngioma and underwent a tumor resection that resulted in an intracerebral hemorrhage. After two weeks, patient started to report complex visual hallucinations. Differential diagnosis of steroid-induced psychosis, psychiatric condition, seizures, and peduncular hallucinations were ruled out. In absence of other findings, CBS was diagnosed. Patient was given neuropsychological testing of intelligence, achievement, language, memory, perceptual/spatial, executive function, attention, motor, behavior/emotional functioning, and color perception battery. Results: Testing completed two years after tumor resection revealed Low Average intelligence, which is two standard deviations below estimated pre-morbid intelligence. Weakness were found in visual and verbal memory, processing speed, motor function, and color vision. Through color perception testing, achromatopsia, color anomia, and color agnosia were ruled out. Conclusions: Results of compressive testing are commensurate with cognitive deficits associated with subcortical and visual pathway lesions after brain injury in adults.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.182
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 30A Case of Undiagnosed Wernicke’s Encephalopathy Due to Avoidant
           Restrictive Food Intake Disorder in a Patient with Persistent Complex
           Bereavement Disorder
    • Authors: Crespo K; Barton J, Ireland S.
      Pages: 703 - 794
      Abstract: Objective: Wernicke’s encephalopathy (WE) is an acute neuropsychiatric disorder caused by thiamine deficiency that is characterized by mental status changes, ophthalmoplegia, and ataxia. Its prognosis depends on immediate supplementation of thiamine. Unfortunately, WE is often misidentified as conversion disorder leading to long-term deficits. Method: Patient is a 26-year-old right handed African American cisgender female that developed persistent complex bereavement disorder after the death of her boyfriend and avoidant restrictive food intake disorder due to sensory-based avoidance. She presented from another hospital with progressive LE weakness, dysphagia, memory deficits, reduced vision and minimal speech. No alcohol or drug use was indicated, and there was no premorbid eating disorder. She underwent a comprehensive neuropsychological evaluation 6 months after treatment, 11 months after symptom development. Results: Testing revealed persistent cognitive impairment in immediate and delayed episodic memory with intrusions, visual spatial skills, processing speed, and expressive and receptive language skills. Conclusions: Cognitive deficits from Wernicke’s Encephalopathy can persist even after intensive treatment if not diagnosed early.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.183
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 31SPECT Cerebral Blood Flow Differences Between Self-Reported Low and
           High Feelings of Hopelessness
    • Authors: Bennett R; Trinidad B, Datoc A, et al.
      Pages: 703 - 794
      Abstract: Objective: To assess which brain areas, as measured by SPECT, are related to self-reported feelings of hopelessness and suicide. Method: Using a symptom checklist, participants were determined based on their self-reported feelings of hopelessness and suicide. Participants were part of a large archival de-identified database comprised of 19,385 individuals that received SPECT scans. A total of 6,798 individuals were categorized into a low (N = 3,401) and high hopelessness group (N = 3,397) who were primarily male (60.9%) with a mean age of 40.14 (SD = 15.75). Participants were categorized based on whether their responses fell at or below the 25th percentile or at or above the 75th percentile of the sum of responses that indicated having problems related to hopelessness. The two groups were then compared with the 17 brain areas at baseline. Results: Results from an Independent samples t-test showed hypo-perfusion in the high hopelessness group within the right Limbic t(6796) = 3.129, p < .002 and Basal Ganglia t (6796) = 3.382, p < .001 areas. Furthermore, results showed hyper-perfusion in the high hopelessness group within Cerebellum right t(6796) = −2.675, p < .007, and left t(6796) = −3.169, p < .002. Conclusions: Results indicate that individuals who report high levels of hopelessness activate structures in the right limbic region, and may experience symptoms congruent with more activation of the cerebellum. Over activation in these subcortical structures provides support for feelings of hopelessness and suicide being related to more primitive rather than higher cortical areas. With current advancements in the relationship between neuroimaging and psychopathology, future research should try to target populations who are at higher risk for hopelessness and suicidal feelings.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.184
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 32A SPECT Exploratory Analysis of Differentiating Psychotic
           Symptomatology Severity
    • Authors: Bennett R; Bennett R, Golden C.
      Pages: 703 - 794
      Abstract: Objective: To assess which brain areas, as measured by SPECT, were related to severity of psychotic symptomatology. Method: Using a symptom checklist, participants were determined based on their self-reported scores on a measure of psychotic symptomatology. Participants were part of a large de-identified database that received SPECT scans of various brain regions. Participants consisted of 60.3% males, 39.5% females. Quartiles were based on upper 25th (n = 3,622) with a mean age of 43.36 (SD = 15.993), middle 50th (n = 2,971) with a mean age of 41.02 (SD = 14.871), and lower 75th percentiles (n = 5,105) with a mean age of 35.05 (SD = 15.466). Between group differences in blood flow were examined for various brain regions at baseline. Results: A MANOVA was conducted at .001, providing significant differences between upper and lower quartiles of those with psychotic symptoms, Wilks’ λ = .986; F(32, 23,360) = 5.205, p < .001. Subjects in the upper quartile yielded significantly lower blood flow relative to the lower quartile in the following areas: bilateral basal ganglia (p < .001), limbic (p < .001), frontal (p < .001), and vermis (p < .001). Conclusions: Self-reported psychotic symptomatology appears to be related to lower levels of blood perfusion in various subcortical regions. Hypo-perfusion may reflect poor emotional regulation and cognitive function. Furthermore, hypo-perfusion in the frontal region and basal ganglia may suggest lower functioning regarding one’s judgment and motivation. All in all, the dysregulation of emotional and cognitive abilities, as signified by reduced cerebral blood flow, are congruent with increased psychotic symptomatology. Future research should investigate if abnormalities in brain perfusion are a prodromal factor in developing psychotic illness.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.185
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 33Psychometric Properties of the NeuroQoL v2.0 Cognitive
           Function-Short Form in Veterans with Posttraumatic Stress Disorder
    • Authors: Clark E; Terrry D, Iverson G.
      Pages: 703 - 794
      Abstract: Objective: The NeuroQoL Item Bank 2.0-Cognitive Function-Short Form (NeuroQoL 2.0-Cognition-SF) is an 8-item self-report questionnaire designed to assess perceived cognitive problems. This study evaluates the psychometric properties of the NeuroQoL 2.0-Cognition-SF in a veteran sample with posttraumatic stress disorder (PTSD). Method: A sample of 240 participants (age M = 40.2, SD = 9.2; 80.4% men) completed the NeuroQoL 2.0-Cognition-SF on the first day of treatment within the Intensive Clinical Program at Home Base, a two-week multidisciplinary treatment program. A subset of 205 participants completed the Neurobehavioral Symptom Inventory (NSI) during treatment. The total score and subscales (NSI-Cognitive, NSI-Vestibular, NSI-Somatic, NSI-Affective) were analyzed. Results: The NeuroQoL 2.0-Cognition-SF had minimal ceiling and floor effects (lowest possible score: 0.8%; highest possible score: 0%). The mean raw score was 19.6 (SD = 6.2; T = 34.4, SD = 6.8), which is significantly lower than the standardization sample (t = −35.4 p < .001). A large portion of the sample reported clinically significant cognitive problems (82.4% scored T < 40; 63.9% scored T < 35). Internal consistency of the scale was high (Cronbach’s alpha = 0.89). Scores on the NeuroQoL 2.0-Cognition-SF had a large correlation with the NSI-Cognitive subscale (r = −.61, p < .001), and somewhat lower correlations with the NSI-Vestibular (r = −.48, p < .001), NSI-Somatic (r = −.34, p < .001), and NSI-Affective subscales (r = −.41, p<.001). Conclusions: The internal consistency reliability of the NeuroQoL 2.0-Cognition-SF was high, there was medium-high convergent validity with the NSI-Cognitive, and medium correlations with the NSI Vestibular, Somatic, and Affective subscales. Patients with PTSD reported high rates of perceived cognitive impairment based on normative sample comparisons. These data suggest the NeuroQoL 2.0-Cognition-SF has clinical utility in assessing self-reported cognition in mental health settings.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.186
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 34Montreal Cognitive Assessment: Clinical Utility in Public Psychiatry
    • Authors: Gorman K; Pinto K, Giuliano A.
      Pages: 703 - 794
      Abstract: Objective: Cognitive screening with the Montreal Cognitive Assessment (MoCA) was recently made a standard of care at our public psychiatric hospital. We examined the MoCA’s criterion validity. Method: MoCA and other neuropsychological test data was analyzed from 102 adult inpatients (age M = 38.95, SD = 15.65; education M = 11.58, SD = 2.65, range 1–18 years) with diagnoses of schizophrenia spectrum and mood disorders and multiple comorbidities. Criterion validity was assessed by comparing MoCA z scores with standardized composite scores from neuropsychological test batteries, Global Axis of Functioning (GAF) and Allen Cognitive Level Screen (ACLS) scores, and lifetime psychiatric hospitalizations. Results: MoCA z scores were predictive of composite battery z scores (R2 = 0.31, F(1, 67) = 30.16, p < 0.001) and moderately correlated with composite z scores of the Brief Assessment of Cognition in Schizophrenia (Pearson’s r = 0.66, p < 0.01), Repeatable Battery for the Assessment of Neuropsychological Status (r = 0.52, p < 0.05), Wechsler Adult Intelligence Scale-IV (r = 0.56, p < 0.001), and a composite battery including measures of intelligence, executive functioning, and verbal learning and memory (r = 0.60, p < 0.05). MoCA z scores were significantly correlated with admission GAF (r = 0.26, p < 0.05) and moderately correlated with ACLS scores (r = 0.38, p < 0.005), but were not associated with lifetime psychiatric hospitalizations. Conclusions: The MoCA generally demonstrates adequate convergent validity with more comprehensive neuropsychological measures in a public sector inpatient psychiatry population. Additional research is needed to clarify the MoCA’s relationship to functional outcomes.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.187
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 35The Predictive Value of the KMSK and PRISM in Determining the
           Neuropyschological Effects of Opioid Dependence in a Diverse Population
    • Authors: Morris E; Rivera Mindt M, Tureson K, et al.
      Pages: 703 - 794
      Abstract: Objective: Despite the growing opioid epidemic, there is little research comparing the measurement of specific aspects of opioid use that hold salience for neuropsychological (NP) function in diverse populations. The current study aimed to better understand how well a measure of lifetime heroin use compared to DSM-based diagnoses of opioid dependence in predicting NP functioning in a diverse sample. Method: Participants with self-reported histories of opioid use in this within-subjects pilot study (n = 20; 90% ethnic minority; 45% male) completed the Psychiatric Research Interview for Substance and Mental Disorders (PRISM), the Kreek-McHugh-Schluger-Kellogg scale (KMSK), and a well-validated NP battery. NP T-scores were generated using demographically-corrected norms. The PRISM provided DSM-IV diagnoses of past opiate dependence and KMSK provided heroin lifetime exposure scores (0–13, higher scores = greater exposure). Results: Hierarchical regressions revealed that the PRISM significantly predicted global NP, memory, processing speed, motor, and verbal scores (R2 = 0.22–0.31, all p’s < .05), such that those with past opioid dependence showed worse NP functioning. Adding the KMSK in the second step did not improve the prediction of any cognitive domains (all p’s > .10). Conclusions: This study shows that DSM-diagnosis of past opioid dependence, rather than lifetime heroin exposure, is a robust predictor of NP functioning in a small but diverse sample. These results are consistent with findings that heroin dependence impairs memory, fluency, and global NP functioning. Increasing the precision of opioid use measurement is essential to future studies of the cognitive consequences of the current epidemic and to inform culturally responsive interventions for this particularly vulnerable population.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.188
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 36The Role of Approach Motivation in Social Anhedonia, Affect
           Recognition, and Schizotypy
    • Authors: Selvanathan J; Grimes K, Zakzanis K.
      Pages: 703 - 794
      Abstract: Objective: Schizotypal traits may exist on a continuum, and may increase the risk of developing a first episode psychosis. Social anhedonia is often present in schizophrenia, and has been found in individuals with elevated schizotypal traits. It follows that social anhedonia is related to motivation. Recent research suggests that affect recognition may be related to reduced motivation to approach pleasurable experiences. Thus, affect recognition may be explained by social anhedonia and motivation transdiagnostically, rather than specific to schizophrenia spectrum disorders. We hypothesized the following: (1) deficits in approach motivation would mediate the relationship between social anhedonia and affect recognition, and (2) this model would account for more variance than an alternative model, whereby approach motivation would mediate the relationship between schizotypal traits and affect recognition. Method: Undergraduate students (N = 155) were administered the following self-report questionnaires online via Survey Monkey: Schizotypal Personality Questionnaire-Brief, Reading the Minds in the Eyes Test, Revised Social Anhedonia Scale, and the Behavioural Inhibition System/Behavioural Activation System Scales. Results: Neither social anhedonia nor schizotypal traits were significantly correlated with affect recognition. Approach motivation was not significantly correlated with any of the variables. Conclusions: These findings suggest that social anhedonia and affect recognition may be explained by distinct cognitive mechanisms. It should be noted, however, that no relationship was found between schizotypal traits and affect recognition, which is a well-established finding in clinical samples. Thus, future research should use objective, rather than self-report, measures of social anhedonia and approach motivation. Additionally, future research should examine these mediation models in a clinical sample.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.189
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 37SPECT Cerebral Blood Flow Differences Between Self-Reported Low and
           High Levels of Shyness and Self-Esteem
    • Authors: Trinidad B; Bennett R, Golden C, et al.
      Pages: 703 - 794
      Abstract: Objective: To assess which brain areas, measured by SPECT, relate to self-reported levels of shyness and self-esteem. Method: Participants (N = 6,897) were selected based on self-reported scores of shyness and self-esteem. The participants were extracted from an archival database. Two groups were categorized into low levels of shyness and high levels of self-esteem group (N = 3,350) and high levels of shyness and low levels of self-esteem group (N = 3,547) primarily males (61.3%) with a mean age of 39.91. Groups responses fell at or below the 25th and above 75th percentile which were then compared in 17 brain areas. Results: Results from an Independent samples t-test (p < .005) showed hypo-perfusion in the high levels of shyness and low levels of self-esteem group within Limbic left t(6,895) = −5.193 and right t(6,895) = −3.567 and Basal Ganglia left t(6,895) = −3.949 and right t(6,895) = −2.951. Hyper-perfusion was seen within Occipital left t(6,895) = 3.472 and right t(6,895) = 2.961 right Motor Sensory t(6796) = 3.244 and Temporal t(6796) = 3.487. Conclusions: The increase in blood flow in bilateral occipital lobe and right temporal lobe may amplify hypervigilance of visual and auditory stimuli. The brain becomes hyper-aware of environment, scanning for potential harm, and anticipating potential threat. The interpretations of surroundings may therefore be exaggerated, avoiding any possible threat. Avoidance may then increase anxious symptoms, reinforcing the tendency to be shy. Self-esteem may then decrease due to alienation, reduced ability to function in social settings, and inexplicable worries. The combination of these tendencies may lead toward depression and anxiety. Future research should investigate potential mediators between physical and psychological depressive symptoms targeting the occipital lobe.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.190
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 38Cross-Validation of the Word Memory Test (WMT) Genuine Memory
           Impairment Profile for Detecting Noncredible Test Performance Among
           Cognitively Impaired Veterans
    • Authors: Alverson W; O’Rourke J, Soble J.
      Pages: 703 - 794
      Abstract: Objective: The WMT is a memory-based performance validity test (PVT) with adjusted interpretive criteria (Genuine Memory Impairment Profile; GMIP) proposed for those with cognitive impairment (CI). The GMIP has been criticized for poor discriminability and unvalidated diagnostic utility. This study sought to validate the GMIP in a mixed clinical sample and demonstrate it would enhance detection of invalid neuropsychological test performance while minimizing false positives. Method: Data included 112 Veterans who completed the WMT and three criterion PVTs during clinical evaluation. This diverse sample was 38.4% valid-CI, 37.5% valid-cognitively intact, and 24.1% invalid per criterion PVTs. Group differences in WMT performance and diagnostic accuracy statistics were assessed. Results: WMT performance significantly differed between validity groups (Wilk’s Λ = .44, F[6, 105] = 22.05, p < .001, ηp2 = .56) with invalid participants scoring significantly lower across all WMT indices, with larger effect sizes for the easier/primary effort subtests (ηp2 = [.40–.51]) than harder/primary memory subtests (ηp2 = [.13–.26]). CI also had a significant effect on WMT performance (Wilk’s Λ = .74, F[6, 78] = 4.64, p < .001, ηp2 = .26). Those with CI scored lower across all indices, with larger effect sizes for harder subtests (ηp2 = .22) relative to easier effort subtests (ηp2 = [.12–.13]). Standard WMT pass/fail criteria had good sensitivity (.96), but unacceptable specificity (.64). When considering GMIP, sensitivity (.93)/specificity (.88) were acceptable, and yielded a diagnostic odds ratio of 93.75. Conclusions: Study results suggest WMT indices are more significantly affected by performance validity than memory. However, with CI, using GMIP criteria is essential to improve diagnostic accuracy and reduce false positive errors in identifying invalid performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.191
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 39Are Any of the TOMM Trials Related to Neurocognitive Ability in
           Validly Performing Outpatients'
    • Authors: Boettcher A; Ernst N, Schroeder R, et al.
      Pages: 703 - 794
      Abstract: Objective: Many studies have examined specificity rates associated with Test of Memory Malingering (TOMM) cutoffs, but fewer studies have analyzed associations between TOMM performance and genuine cognitive dysfunction. This study examined the relationships between the three TOMM trials and neuropsychological test performance in validly performing neuropsychological outpatients. Method: Archival data were culled from 54 adult outpatients seen in a clinical, medically-referred context and diagnosed with cognitive and/or psychiatric disorders. Patients were excluded if they had external incentives or they failed other performance validity tests. Patients completed the TOMM and tests from the Wechsler Adult Intelligence Scale-4 (WAIS-IV), Wechsler Memory Scale-4 (WMS-IV), and Delis-Kaplan Executive Function System (D-KEFS). Spearman’s rho correlations examined the relationship between TOMM trials and cognitive test scores. Results: All participants performed above proposed TOMM cutoffs with the exception of one patient on the Retention Trial. Significant positive correlations were seen between TOMM Trial 1 and WAIS-IV Full Scale IQ score; D-KEFS Trail Making Test, Number-Letter Switching scaled score; and WMS-IV Logical Memory I and II scaled scores. There were no significant correlations between TOMM Trial 2 and any of the cognitive tests. There was a significant positive correlation between TOMM Retention Trial and WMS-IV Logical Memory II scaled score but not any of the remaining tests. Conclusions: TOMM Trial 2 and Retention appear to be relatively resistant to cognitive dysfunction. While there is a correlation between cognitive functioning and TOMM Trial 1, no individual scored below cutoff, indicating that cognitive dysfunction did not impact scores to such a degree that false positive rates increased.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.192
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 40Comparing Embedded Performance Validity Indicators on the California
           Verbal Learning Test-II
    • Authors: Davis J; Rolin S.
      Pages: 703 - 794
      Abstract: Objective: Several California Verbal Learning Test-II (CVLT-II) variables function as embedded performance validity tests (PVTs). This study compared CVLT-II validity indicators in a rehabilitation sample grouped by criterion PVTs. Method: Participants (N = 326) were 35% female and 88% Caucasian with average age and education of 42.8 (SD = 13.5) and 13.7 (SD = 2.4) years, respectively. Participants completed the CVLT-II and 2–8 separate PVTs (M = 5.5, SD = 1.0), and were categorized by criterion PVTs into PASS (n = 278; 85%) and FAIL (n = 48, 15%) groups. Logistic regression models were fitted predicting PVT status using four CVLT-II indicators: Forced Choice Recognition (FC), Total Recognition Discriminability (D-PRIM), Critical Item Analysis (CRIT), and a previously reported logistic model (MDL). Results: PASS and FAIL groups significantly differed on CVLT-II recall trials (p < .0001). Logistic regression models showed the following overall classification rates (OCR) and areas under the curve (AUC): FC (OCR = 88%; AUC = .78); D-PRIM (89%; .82); CRIT (89%; .73); and MDL (86%; .69). Published cutoffs on FCR (<15), D-PRIM (<2.6), and MDL (>.61) showed the following sensitivity and specificity (sensitivity/specificity) values: FC (.46/.96); D-PRIM (.77/.65); and MDL (.29/.92). Adjusting the D-PRIM cutoff (<1.7) improved specificity to .92 with sensitivity of .56. A CRIT cutoff (>1) demonstrated sensitivity and specificity of .38 and .98, respectively. Conclusions: D-PRIM demonstrated the strongest AUC; a previously reported cutoff showed unacceptable specificity and required adjustment. FC, MDL, and CRIT cutoffs showed adequate specificity and sensitivity consistent with other embedded PVTs. CVLT-II indicators warrant cross-validation in other samples.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.193
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 41Cross-Validation of Multivariable Validity Indicators on the Rey
           Complex Figure Test
    • Authors: Davis J; Rolin S.
      Pages: 703 - 794
      Abstract: Objective: Combinations of Rey Complex Figure Test (RCFT) variables have been proposed as performance validity tests (PVTs). This study compared an older combination score with a recently derived logistic regression model in a rehabilitation sample. Method: Participants (N = 276) were 33% female and 86% Caucasian with average age and education of 42.5 (SD = 13.3) and 13.7 (SD = 2.3) years, respectively. Participants completed the RCFT and 4–8 separate PVTs, and were categorized by criterion PVTs into PASS (n = 237; 86%) and FAIL (≥2; n = 39; 14%) groups. Two RCFT multivariable validity indicators were calculated: RCFT-1 included Copy raw scores and atypical false positive errors; RCFT-2 used Copy raw and Recognition T scores. Multivariable RCFT indicators were examined in relation to criterion PVT status. Results: PASS and FAIL groups significantly differed on all RCFT variables (p < .01). RCFT-1 demonstrated overall classification accuracy (COR) of 87% and area under the ROC curve (AUC) of .75. RCFT-2 demonstrated COR of 86% and AUC of .73. Published RCFT-1 (.425) cutoffs showed the following classification accuracy (sensitivity/specificity): RCFT-1 (.33/.94); RCFT-2 (.18/.96). Increasing the RCFT-1 cutoff (<49) improved sensitivity (.38) while maintaining adequate specificity (.91); a lower RCFT-2 cutoff (>.30) increased sensitivity (.36) while maintaining adequate specificity (.90). Conclusions: Previously reported RCFT multivariable validity indicators demonstrated comparable COR and AUC in cross-validation. Previously reported cutoffs required adjustment to optimize sensitivity while maintaining specificity. The decision to use one measure over the other may depend on available data and available time for score calculation.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.194
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 42Performance on Three Validity Measures in a Post-Acute
           Rehabilitation Population
    • Authors: DiCarlo G; Ernst W, Kneavel M, et al.
      Pages: 703 - 794
      Abstract: Objective: The current study examined the performance of individuals with acquired brain injury in post-acute rehabilitation settings on three commonly-used measures of performance validity: the Dot Counting Test (DCT), the Test of Memory Malingering (TOMM), and Reliable Digit Span (RDS). It was hypothesized that the majority of participants would obtain passing scores based on well-established cut scores. Method: Scores for the TOMM, DCT, and RDS were obtained for 48 participants who were part of a larger data collection for a doctoral dissertation validating a new performance validity test (PVT). All participants were collected from two post-acute brain injury rehabilitation programs with mixed neurological diagnoses (primarily TBI). Participants were age 18–60, received inpatient or outpatient rehabilitation services, were 2 years post-injury, and were not involved in litigation related to their brain injury. PVTs and a demographic questionnaire were counterbalanced and administered to all participants. Results: Using well-established cut scores, 54.2% of the sample failed at least one PVT, 29.2% failed two PVTs, and 4.2% failed all three PVTs. Test-specific pass-rates were 79.2% for the TOMM, 54.2% for the DCT, and 79.2% for RDS. Conclusions: Rates of suboptimal effort were much higher than would be expected in a non-litigating clinical sample. These results suggest a need for caution with the use of a single measure of performance validity in post-acute rehabilitation settings due to high false positive rates.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.195
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 43Analysis of Five Empirically-Derived Methods of Utilizing the Test
           of Memory Malingering (TOMM) Relative to Three Other Performance Validity
           Measures
    • Authors: Farmer S; Lynch J, McCaffrey R.
      Pages: 703 - 794
      Abstract: Objective: The sensitivity (SN) and specificity (SP) of the original and four alternative TOMM methods/cutoffs, as well as other performance validity measures, were examined in a mild traumatic brain injury (mTBI) litigating sample. Data Selection: Archival data on 60 mTBI administered the following the TOMM, Victoria Symptom Validity Test (VSVT), Word Memory Test (WMT) and Reliable Digit Span (RDS) as part of an extensive battery. Five TOMM methods were examined: (1) TOMM Trial 2 & Retention (original cutoff), (2) TOMM Trial 1 < 45, (3) TOMM Trial 1 < 41, (4) items 1 −10 of Trial I (TOMM10e), (5) TOMM Trial 2 - no errors. Performance invalidity was failure on two or more performance validity measures. Data Synthesis: The WMT had the highest SN (.92) followed by the VSVT (.76), TOMM Trial 1 < 45 (.71), TOMM Trial 1 < 41 (.60), TOMM10e (.55), RDS (.55), TOMM Trial 2 zero errors (.54), and TOMM original cutoff on Trial 2 and/or retention (.51). Original TOMM scoring produced the highest SP (.96), followed by TOMM Trial 2 zero errors (.81), TOMM Trial 1 < 41 (.80), RDS (.78), TOMM10e (.67), VSVT (.65), TOMM Trial 1 < 45 (.56), and WMT (.45). Conclusions: TOMM Trial 1 < 45 had the highest SN to performance invalidity and was comparable to the VSVT and WMT. Minimal differences in SN were found across the other four TOMM methods. The SP of the TOMM methods was variable, with the original TOMM format having highest SP.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.196
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 44Performance Validity and Processing Speed in Psychoeducational
           Assessments of College Students
    • Authors: Harrison A; Stewart M.
      Pages: 703 - 794
      Abstract: Objective: Accurate information about an individual’s neurocognitive status is crucial for correct diagnosis. Level of test-taking effort and motivation must be evaluated objectively during neuropsychological assessments. Recently, investigators have suggested using embedded measures of processing speed as a tool for assessing effortful performance on psychological assessments. A known groups design was utilized to investigate the influence of noncredible performance on various measures of processing speed and whether those who fail one stand-alone performance validity test (PVT) more closely resemble compliant (no fails) or clearly noncompliant subjects (e.g., those who fail two or more PVTs). Method: Psychoeducational assessment data from 1,986 individuals aged 17–57 (mean = 22.6 years, SD = 6.5; 56% female) was examined, evaluating the score differences on a number of measures of processing speed (WAIS IV Processing Speed, Woodcock-Johnson IV Letter-Pattern Matching, WJ III Visual Match and Processing Speed) between subjects who demonstrated full effort (passed all PVTs; n = 1608), failed one PVT (n = 329), or failed two or more (n = 87). Results: Subjects who failed two or more PVTs scored significantly worse on all processing speed measures than subjects who passed all PVTs (p < 0.005). Further, those subjects who failed only one PVT were not distinguishable from credible subjects. Conclusions: These results stress the importance of employing PVTs in Psychoeducational assessments; clearly noncredible subjects scored significantly lower on all processing speed measures than did credible ones. Findings also stress that failure on only one PVT is not sufficiently sensitive to noncredible performance, at least on measures of processing speed.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.197
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 45Severe Impairment Profile vs Outright Failure on PVTs: Patterns of
           Performance in a Postsecondary Sample
    • Authors: Harrison A; Stewart M.
      Pages: 703 - 794
      Abstract: Objective: Use of a severe impairment profile (SIP) on a performance validity test (PVT) should theoretically reduce false-positive rate when identifying noncredible performance by removing individuals who are truly impaired. The present study investigated how many subjects in a postsecondary sample produce a SIP profile as opposed to an outright failure on the Word Memory or the Medical Symptom Validity Tests (WMT and MSVT). If the SIP indicates severe neurocognitive impairment, one would assume not only that the SIP college students would function significantly worse than credible performers, but also that their scores on other neurocognitive tests would be lower even than those who failed PVTs. Method: Assessment data from 1919 postsecondary students (mean age 23.1, SD 7.2; 62% female) seeking disability documentation was reviewed to determine prevalence of outright failure (OF) as opposed to SIP. Data from IQ, achievement and memory tests was compared between those who obtained pass scores on WMT/MSVT, those who failed one of the first three subtests, and those who produced a SIP. Results: Credible students (n = 1761) performed significantly better than SIP students (n = 48) and WMT/MSVT failures (n = 110) on all IQ indices (p < 0.01) and all memory tests (p < 0.01). While SIP students returned the lowest mean scores across these variables, they were significantly lower than the OF group only on FSIQ, WMS-IV auditory memory, and WMS-IV immediate and delayed memory. By contrast, no significant difference was found between OF and SIP groups on measures of academic fluency. Conclusions: SIP students generally demonstrate more impaired performance across measures of intelligence and memory.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.198
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 46Questionable Divergent Validity for the Memory Validity Profile in a
           Multicultural Clinical Sample
    • Authors: Kaufman N; Davis A, Martinez V, et al.
      Pages: 703 - 794
      Abstract: Objective: The Memory Validity Profile (MVP) is a validity test for examinees ages 5 through 21 years (Sherman & Brooks, 2015). Research by the test authors involving normal youngsters (e.g., WISC-IV FSIQ M = 105.4, SD = 14.2) yielded lower correlations between MVP scores and WISC-IV composites (e.g., MVP total-WISC-IV FSIQ r = .26, p < .01), which the authors use as evidence of “strong divergent validity for the MVP” (p. 29). Our objective was to compare MVP scores with WISC-V subtests, rather than composites, to identify hidden relationships. Method: The research design was correlational and involved de-identified data (N = 51) from a neuropsychological practice. Most of the sample was male (N = 34) and Hispanic (N = 28), the average age in years was 10.65 (SD = 3.08), and the average WISC-V full-scale IQ was 80.55 (SD = 12.31, Min = 52; Max = 109). Results: Correlations between MVP scores and WISC-V subtests did not diverge on some subtests (e.g., MVP verbal-Digit Span r = .587, p < .001; MVP Total-Picture Span r = .350, p = .012; MVP Visual-Symbol Search r = .422, p = .002; MVP verbal-Matrix Reasoning r = .375, p = .007). Conclusions: Fluid intelligence may drive MVP scores-at least among children with neurodevelopmental disorders-more than the MVP manual asserts, raising questions about across-the-board claims of divergent validity. References: Sherman, E. M., & Brooks, B. L. (2015). Memory Validity Profile Professional Manual. Lutz, FL: PAR.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.199
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 47Performance Validity Testing in Veterans with Post-Traumatic Stress
           Disorder and/or Mild Traumatic Brain Injury
    • Authors: McBride W; Smith A, Cottingham M.
      Pages: 703 - 794
      Abstract: Objective: The current study evaluated the sensitivity and specificity of two embedded performance validity tests (PVTs) in a sample of veterans presenting with a history of Post-Traumatic Stress Disorder (PTSD) and/or mild Traumatic Brain Injury (mTBI). Method: California Verbal Learning Test-II (CVLT-II) Forced Choice (FC) and Reliable Digit Span (RDS) from the Wechsler Adult Intelligence Scale, Third or Fourth Edition (WAIS-III/WAIS-IV) scores were compared in credible [n = 82; M-age = 46.06(14.28); M-education = 13.10(2.27); 90.2% Male] and non-credible [n = 42; M-age = 40.76(11.48); M-education = 13.07(1.69); 97.6% Male] patients presenting for a clinical neuropsychological evaluation at a southeastern Veterans Affairs hospital. Patients were deemed credible vs. non-credible based on their performance on the Test of Memory Malingering (TOMM). Results: A cut-off of <15 on CVLT-II FC had adequate specificity (91%) with a corresponding sensitivity of 64%. However, a cut-off of <7 on RDS was associated with 89% specificity and only 17% sensitivity in this sample of patients with PTSD and/or mTBI. Conclusions: Results highlight the importance of using multiple embedded PVTs throughout an evaluation, as some have better sensitivity than others. In particular, CVLT-II FC was better at identifying individuals exhibiting a non-credible performance than was the RDS, in a sample of veterans presenting with PTSD and/or mTBI. These findings may be due to a propensity for individuals presenting with these types of diagnoses to be more likely to feign memory symptoms than attention symptoms.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.200
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 48Base Rate of WMT and RDS Failure in ADHD
    • Authors: McKinstry A; Costin C, Korinek D, et al.
      Pages: 703 - 794
      Abstract: Objective: Accurate base rates of failure on measures of performance validity in specific populations helps inform clinical practice and protects against base rate neglect. Base rates are better estimated with multiple samples across practice types and geographic locations. Our study was informed by previous research (Suhr, et. al., 2008) which found a 31% Word Memory Test (WMT) failure rate in young adults in a university clinic setting referred for Attention Deficit Hyperactivity Disorder (ADHD). Our study provides additional base rate information on the WMT as well as novel base rate information regarding failure on the Reliable Digit Span (RDS) in adults referred for assessment of possible ADHD. Additionally, our data extends findings to an outpatient private practice setting which differ from previous settings published in the literature. Method: A convenience sample of 71 adults referred for neuropsychological assessment regarding a possible diagnosis of ADHD was collected. The sample was composed of 56% males and 43% females. Demographic characteristics of the sample include 64% Caucasian, 14% African American, 4% Hispanic, 7% Asian, 6% other, 6% unknown or undisclosed. Mean age was 31 (SD = 10.58) and mean educational attainment was 15 (SD = 2.5). Results: 27% of adults failed the WMT, 13% failed the RDS, and 7% failed both. Conclusions: The findings indicate the base rate for WMT failure in adults referred for ADHD in an outpatient private practice setting is 26% and is 13% on the RDS.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.201
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 49The Relationship Between Performance Validity Measures and Health
           Factors that Influence Overall Effort in Veterans During
           Neuropsychological Evaluations
    • Authors: Mills C; Costanzo M, Reinhard M.
      Pages: 703 - 794
      Abstract: Objective: This study seeks to understand the occurrence of suboptimal effort in a Veteran sample by examining factors that may impact performance (depression, anxiety, post-traumatic stress disorder, total hours of sleep, and pain) during a neuropsychological evaluation. Method: Cognitive functioning was assessed in a sample of 48 Veterans with complex medical histories at a VA Medical Center as part of a comprehensive medical evaluation. The neuropsychological evaluation included five stand-alone and embedded measures of performance validity, Green’s Word Memory Test, Dot Counting Test, Repeatable Battery for the Assessment of Neuropsychological Status Effort Index, Rey Fifteen-Item Memory Test, and Wechsler Adult Intelligence Scale-IV Reliable Digit Span. An independent-samples t-test was conducted to compare the mean scores of the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory, PTSD Checklist for DSM-5, Wong-Baker FACES Pain Rating Scale, and self-reported total of hours slept the night before the evaluation between the two comparison patient groups (valid versus invalid). Results: The comparison groups did not differ in terms of age (t (46) = −.789, p = .434) or education (t (46) = −.843, p = .404). A significant difference was observed in estimated premorbid cognitive abilities (t (44) = −2.287, p = .027). Results revealed a significant difference in BDI-II scores (t (46) = 2.148, p = .037) and pain (t (45) = 2.019, p = .049), with Veterans categorized as invalid reporting higher levels of depression and pain. Conclusions: These findings highlight the importance of assessing effort in our Veteran population and suggest that a multitude of factors may impact neurocognitive test performance.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.202
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 50Investigation of Embedded Performance Validity Tests in the
           Delis-Kaplan Executive Function System Trail Making Subtest
    • Authors: Olsen D; Schroeder R, Heinrichs R, et al.
      Pages: 703 - 794
      Abstract: Objective: The D-KEFS is the third most frequently used measure of executive functioning, and yet, to date, there is no published research investigating it for embedded performance validity tests (PVTs). The present study extrapolates from previous research on embedded PVTs within the Halstead-Reitan Neuropsychological Battery Trail Making Test and investigates the D-KEFS Trail Making subtest for indicators of invalid performance. Method: Archival data was utilized and included a diagnostically heterogeneous sample of 292 participants (mean age = 47.78; mean education = 14.32 years) referred for standard and forensic neuropsychological evaluation. Approximately 44% of participants had known or suspected external incentive. Participants were classified as valid performers (failed 0 criterion PVTs; n = 227) and invalid performers (failed >2 criterion PVTs; n = 65). Results: Mann-Whitney U Tests indicated there were significant group differences across all D-KEFS Trail Making scaled scores (p < .01). Area Under the Curve statistics found all variables had at least “adequate” ability to discriminate valid from invalid performers (AUC > 0.70). Receiver Operating Characteristics revealed that using a scaled score cutoff of 5 yielded the following psychometric properties: Visual Scanning = 29% Sensitivity, 96% specificity; Number Sequencing = 26% Sensitivity, 91% Specificity; Letter Sequencing = 29% Sensitivity, 94% Specificity; Number-Letter Switching = 41% Sensitivity, 94% Specificity; Motor Speed = 9% Sensitivity, 98% Specificity; and Combined Number + Letter Sequencing = 29% Sensitivity, 93% Specificity. Conclusions: These results provide initial support for the use of the Trail Making subtest within the D-KEFS as an embedded PVT. However additional research should be conducted in order to evaluate the relationship between these variables and cognitive functioning in order to reduce false-positive errors in low functioning individuals.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.203
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 51Specificity of Reliable Digit Span in Dementia Evaluations
    • Authors: Olsen D; Schroeder R, Boettcher A, et al.
      Pages: 703 - 794
      Abstract: Objective: Reliable Digit Span (RDS) is the most commonly used embedded performance validity test. The present study investigated the specificity of RDS in an older adult outpatient sample referred for dementia evaluation across three levels of cognitive impairment severity. Method: Archival data from 117 patients was utilized (mean age = 73.52; mean education = 13.45 years). Patients were clinically diagnosed with either mild cognitive impairment (MCI; n = 42) or dementia (n = 75). Montreal Cognitive Assessment performance was used to classify participants with dementia as either mild (n = 55) or moderate (n = 20) severity via a cutoff of 14. Mean Repeatable Battery for the Assessment of Neuropsychological Status Total Scale scores for MCI, mild dementia, and moderate dementia groups were 86.24, 71.65, and 57.75, respectively. Results: Using a cutoff of <6, specificity rates were 90%, 83.6%, and 60% for the MCI, mild dementia, and moderate dementia groups, respectively. To maintain specificity of at least 90% in the mild dementia group, a cutoff of <5 was necessary. To maintain 90% specificity in the moderate dementia group, a cutoff of <3 was required. Conclusions: Specificity findings within the mild dementia sample of heterogeneous etiology and MCI correspond with those published by Loring et al. (2016) within early AD and MCI samples, respectively. The current findings provide further evidence that a cutoff of <6 is appropriate in patients with MCI, and indicate that a more conservative cutoff is required in patients with mild dementia regardless of etiology. RDS is not useful in patients suspected of moderate dementia given the need for a substantially lowered cutoff score.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.204
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 52Early Cutoff Criteria for Strong Performers on the Test of Memory
           Malingering
    • Authors: Polsinelli A; Cerhan J.
      Pages: 703 - 794
      Abstract: Objective: The Test of Memory Malingering (TOMM) is widely used to assess performance validity. In an attempt to improve efficiency when effort is strong, we investigated whether excellent performance on the first 25 items of Trial 1 (T1 1–25) predicts overall performance sufficiently to justify very-abbreviated administration in select cases. Method: We examined TOMM scores for 147 consecutive adult patients (Age: mean = 54, range = 19–77; 49% female). In our clinic, T1 of ≥49 is considered a “strong pass,” and T2 is not administered. We examined whether a perfect score on T1 1–25 predicts strong passers and overall strong effort (i.e., ≥49 on Trial 2 [T2]) using multiple regression, frequencies, and ROC curve analysis. Results: T1 1–25 score predicted T1 26–50 score, β = .885, p < .001, 95% CI [.947, 1.125], and this did not change when adjusted for demographic and diagnostic variables. 71 patients scored a perfect 25 on T1 1–25. Of these, sixty-five (92%) strong-passed (≥49) on T1 and 100% of the remaining patients (n = 6) obtained ≥49 on T2. Using ROC analysis a cut score of 23 on the first 25 items of T1 had high specificity (.91) and sensitivity (.90) and excellent AUC (.95; 95% CI [.92, .99]) for identifying strong effort (i.e., ≥49 on T1 or T2). Conclusions: A perfect score on the first 25 items of the TOMM predicted overall very strong performance 100% of the time, supporting abbreviated administration and thus improved efficiency in select cases.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.205
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 53Distinguishing TBI Malingering and Mild Fatigue Using Event-Related
           Potentials
    • Authors: Robinson L; McFadden S.
      Pages: 703 - 794
      Abstract: Objective: Our main objective was to determine if TBI malingering and fatigue can be distinguished on the basis of event-related potentials (ERPs). Secondarily, we determined if history of mild TBI is associated with differences in ERPs, fatigue, or performance on a short-term memory task. Method: Eighty undergraduates completed surveys for demographics, mental fatigue, and TBI history, then completed a computerized match-mismatch task while ERPs were recorded. Reaction times (RT), accuracy, N200 amplitudes, and P300 amplitudes were compared across Motivational Conditions (Normal, Malinger, Fatigue), Trial Type (Match, Mismatch), and TBI Status (mild TBI, n = 32; no TBI, n = 48) using mixed Condition X Group X Trial Type ANOVAs. Significant interactions and main effects were examined further, as appropriate. Results: Participants with mild TBI tended to report greater fatigue than healthy controls (M = 10.66, SEM = 1.15 vs. M = 8.22, SEM = .60; n.s). Participants reported mild fatigue on a manipulation check (group differences: n.s.). No significant relationships were found between TBI status, fatigue, and any behavioral or ERP measures. Malingering was distinguished from other conditions by significantly lower accuracy (η2 = .75), longer RTs (η2 = .56), and reduced amplitudes of P300 (η2 = .14). Differences between match and mismatch trials were consistent with previous literature. Conclusions: Behavioral and ERP measures were sensitive to TBI malingering, but not to history of mild TBI or mild fatigue. The results support the use of behavioral and ERP measures to identify individuals who are malingering, without concern over confounding effects of mild fatigue.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.206
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 54Utility of the Response Bias Scale of the Minnesota Multiphasic
           Personality Inventory-2-Restructured Form in Detecting Cognitive
           Malingering
    • Authors: Suh J; Kim S, Birath J.
      Pages: 703 - 794
      Abstract: Objective: The Response Bias Scale (RBS) of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) was developed to detect cognitive response bias, specifically contexts of secondary gain (Gervais et al., 2007). The literature suggests that the RBS may be effective in detecting cognitive response bias in diagnostically diverse clinical samples, including patients with mild traumatic brain injury, neurological, and psychiatric conditions (Schroeder et al., 2012; Sullivan et al., 2012). However, more evidence is needed for its utility in clinical settings. This study explored the ability of the RBS to detect noncredible cognitive responding in a diagnostically and demographically diverse clinical sample. Method: Participants (N = 109) were inpatient and outpatient clinical referrals in a public academic medical center that underwent neuropsychological evaluation. They were sorted into credible (n = 89) and noncredible (n = 20) groups for comparison, the latter group meeting criteria for probable malingered neurocognitive dysfunction (Slick et al., 1999). Cutoffs for optimal sensitivity and specificity were explored with receive operating characteristic curves. Results: The original RBS recommended cutoff (T = 100) generated 30% sensitivity and 98% specificity. However, lowering the cutoff to T = 90 increased sensitivity to 40% while maintaining acceptable specificity at 90%. Conclusions: The findings are consistent with Gervais et al.’s (2007) article and other studies that presented similar sensitivity and specificity rates for a cutoff T-score > 90 (Schroeder et al., 2012; Sullivan et al., 2012; Wygant et al., 2010). These results suggest that the RBS is useful in detecting cognitive response bias in a diagnostically diverse clinical sample.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.207
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 55Base Rates of Failed Performance Validity Tests in a Chronic Pain
           Sample
    • Authors: Taylor S; Aita S, Beach J, et al.
      Pages: 703 - 794
      Abstract: Objective: This study evaluated the base rates of Word Memory Test (WMT), Dot Counting Test (DCT), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Performance Validity Index (PVI) failure in a chronic pain sample. The effect of increasing number of failed performance validity test (PVT) on Wechsler Abbreviated Scale of Intelligence (WASI) FSIQ and pain catastrophizing was also examined. Method: 459 subjects (M age = 53.32, SD = 13.55; M education = 13.10, SD = 2.66; 61% female; 81% White, 12% African American, .6% Other) presenting for a pre-surgical evaluation at a Southeastern pain clinic completed the WMT, DCT, RBANS, WASI, and the Pain Catastrophizing Scale (PCS) as part of a larger neuropsychological battery. Results: 67.3% of subjects passed all PVTs, 19.2% of subjects failed one PVT, 9.2% of subjects failed two PVTs, and 4.4% of subjects failed all three PVTs. One-Way Analyses of variance were used to analyze the differentiation of means for the WASI FSIQ and PCS total score by number of PVTs failed. Both ANOVA models were significant (FFISQ(3, 455) = 6.18, p = <.001; FPCS(3, 455) = 55.89, p = <.001). Tukey HSD Post-Hoc Analyses were used to perform pair-wise comparisons across group means. Conclusions: As the number of PVTs failed increase, general trends showed increased pain catastrophizing and decreased FSIQ. This finding is consistent with recent literature describing performance validity as a continuous rather than categorical variable. Future research should further evaluate the continuous nature of performance validity in addition to base rates of PVT failure in both clinical and non-clinical populations.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.208
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 56MMPI-2 and MMPI-2-RF Scales Associated with Chronically Poor,
           Consistently Good, and Declining Performance Validity Across Multiple
           Evaluations: A Pilot Study
    • Authors: Williamson E; Arentsen T, Lewin R, et al.
      Pages: 703 - 794
      Abstract: Objective: During single evaluations, performance/symptom validity test (PVT/SVT) failure correlates with overreported emotional, somatic, and neurocognitive complaints on the MMPI-2-RF (Gervais et al., 2011). We explore differences in personality and test-taking approach among patients who, upon re-evaluation, demonstrate chronically poor, consistently good, or variable performance validity. Method: The MMPI-2 and ≥2 PVTs were administered to 61 participants referred for neuropsychological evaluation/re-evaluation at a large VA medical center. Participants were aged 23–75 years and 95% male. Failure of ≥2 PVTs defined performance invalidity at both evaluations, resulting in chronically poor (CPV; n = 14), consistently good (CGV; n = 21), and declining (DV; n = 26) validity groups. All MMPI-2s were valid based on CNS, VRIN, and TRIN scores. MMPI-2 data were converted to MMPI-2-RF. Results: ANOVA revealed significant differences across groups on the MMPI-2-RF F(p) scale (F = 5.25, p = .008); such differences were driven by higher F(p) scores for CPV relative to CGV groups (p = .006; η2 = .15). For participants with acceptable MMPI-2 content-based validity (CPV n = 7; CGV n = 17; DV n = 17), ANOVA revealed differences on RC2 (F = 3.71, p = .034), ANP (F = 3.32, p = .047), and trends for ACT (F = 2.85, p = .070), NEGE (F = 2.90, p = .067) and INTR (F = 2.60, p = .087), with CPV showing higher scores than DV for RC2 (p = .027; η2 = .16). Differences across groups were mixed for ANP, ACT, NEGE, and INTR, possibly due to small sample sizes. Conclusions: Veterans with chronically invalid performance overreport psychiatric symptoms more than those with consistently valid performance. Additionally, those with chronically invalid performance have lower positive emotions and, possibly, lower externalizing behaviors than those with declining performance validity. No MMPI-2 scales distinguished consistently valid from declining performance validity.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.209
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 57Demographic Factors of Invalid Baselines on ImPACT
    • Authors: Kuwabara H; Sheikh R, Ng W, et al.
      Pages: 703 - 794
      Abstract: Objective: The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized assessment that evaluates cognitive abilities before and after sports concussions. Baseline scores can be used determine premorbid cognitive functioning for injured athletes, but this becomes difficult when invalid baselines are produced. The current study examined the rates of invalid baselines among various demographic variables on the ImPACT, among athletes in Nevada. Method: Participants included 32,800 athletes (Mage = 15.26; Meducation = 9.05; 40.90% female) from across Nevada who were assessed pre- or post-concussion from 2008–2012. Test validity was determined by the standard output available from the ImPACT report. Chi square analysis and independent-samples t-tests were conducted to examine between-group differences in valid and invalid baselines on demographic variables including age, education, sex, and sport. Results: Overall, 6.3% of athletes produced invalid profiles. Males produced a significantly greater proportion of invalid baselines (6.5%) than females (5.9%; χ2 = 6.193, p < .05). Football had a higher proportion of invalid baselines (7.6%) than tennis (4%), and all other sports were relatively equal (4.3%–7.2%, excluding football and tennis; χ2 = 44.89, p < .01). There were no significant differences in age (t = 1.53, p > .05); however, education was significantly different (t = −2.8, p > .05), with younger athletes having more invalid baselines. Conclusions: Results from the current study demonstrate that rates of invalid baselines can vary based on demographics. Further research should address potential predictors of invalid baselines among athletes to help in identifying effective strategies to reduce the prevalence of invalid baselines in the future.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.210
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 58Validation of the Emotional Verbal Learning Test-Spanish (EVLT-S)
    • Authors: Kuwabara H; Gomez S, Strong M, et al.
      Pages: 703 - 794
      Abstract: Objective: The Emotional Verbal Learning Test (EVLT) assesses emotional learning and memory. Its structure is comparable to tests such as the California Verbal Learning Test, but includes emotion words from specific categories (Happiness, Sadness, Anger, and Anxiety). The current study compares a Spanish adaptation of the Emotional Verbal Learning Test (EVLT-S) with the EVLT. Method: Participants (N = 71) were recruited from the University of Nevada, Las Vegas for the piloting phase of the EVLT-S. They were administered a comprehensive battery of tests, including the EVLT and a non-emotional list learning test (LLT) in either English or Spanish. The sample consisted of 29 participants in the English group (ENG; Mage = 21.86, SD = 4.69) and 42 participants in the Spanish group (SPN; Mage = 20.17, SD = 2.79). Repeated measures ANOVAs were conducted with the five learning trials in the EVLT and LLT, between groups. Results: Results indicated a significant main effect across EVLT and LLT trials (F = 167.84, p < .01; F = 130.05, p < .01). In the EVLT, SPN performed significantly worse than ENG, across all the learning trials (f = 21.89, p < .01). There was no main effect of test language in the LLT (F = 0.007, p = .934). Conclusions: The Spanish group performed significantly worse than the English group in EVLT, but not in LLT. Possible explanations include limitations in the current translations of the original EVLT words due to language differences or the cultural meaning of the emotion words. Further analysis will be conducted to identify emotion words that may be more equivalent.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.211
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 59Differences in Specific Emotion Categories in the Emotional Verbal
           Learning Test-Spanish
    • Authors: Kuwabara H; Juarez N, Rodriguez A, et al.
      Pages: 703 - 794
      Abstract: Objective: The Emotional Verbal Learning Test (ELVT) is a neuropsychological measure that assesses emotional learning and memory. The current study compared a Spanish (SPN) adaptation of the Emotional Verbal Learning Test (EVLT-S) with the original EVLT. Specifically, the number of words recalled in the learning trials in the four specific emotion categories (Happiness, Sadness, Anger, and Anxiety) were investigated to assess item equivalence. Method: Participants (N = 71) were recruited from the University of Nevada, Las Vegas for the piloting phase of the EVLT-S. Participants were administered a comprehensive battery of tests, including the EVLT, in either English (ENG) or SPN. The final sample consisted of 29 participants in the ENG group (Mage = 21.86, SD = 4.69) and 42 participants in the SPN group (Mage = 20.17, SD = 2.79). A repeated measures ANOVA was conducted with the total recall of the four emotion categories across learning trials in each group. Results: The results indicated a significant main effect across the emotion categories (F = 19.73, p < .01). Participants in the SPN group performed significantly worse than the ENG group, across all the emotion categories (F = 21.67, p < .01). Conclusions: While the SPN group performed significantly worse than the ENG group across all emotion categories, Anger and Anxiety, had the largest differences. When examining subsequent portions of the EVLT, such as cued recall, some of the words used in specific categories are ones that are often miscategorized. Thus, the specific words of these categories should be reconsidered in the Spanish adaptation.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.212
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 60The Convergent and Discriminant Validity of the Cognitive Healthy
           Questionnaire in a Healthy College Sample
    • Authors: Aita S; Taylor S, Beach J, et al.
      Pages: 703 - 794
      Abstract: Objective: Construct validity of the Cognitive Health Questionnaire (CHQ) was examined in this study. Method: 202 healthy participants (M age = 19.54, SD = 3.35; M education = 12.41, SD = 0.76; 66.3% female; 53.0% White, 34.2% African American, 4.5% Asian) completed the CHQ, 120-item International Personality Item Pool Representation of the NEO-PI-R (IPIP-NEO), and Need for Cognition Scale (NFCS) as a part of a larger battery. After excluding four items due poor loading, exploratory factor analysis (EFA) using principle axis factoring and direct oblimin rotation on the CHQ resulted in a five-factor solution: social/intellectual activities (factor 1), nutrition (factor 2), substance use (factor 3), exercise (factor 4), and eating habits (factor 5). These factors were extracted and used as latent variables for successive analyses. Pearson correlation analyses were performed across CHQ factors, IPIP-NEO, and NFCS to examine construct validity of the CHQ. Results: Significant correlations were observed between Big-Five IPIP-NEO personality factors and CHQ factors. Strongest relations observed were between neuroticism and factors 1 and 4 (r = −.24 and −.23), extroversion and factors 1, 2, and 4 (r = .29, −.20, and .26), openness and factor 2 (r = −.20), agreeableness and factors 1 and 3 (r = .21 and −.23), as well as conscientiousness and factors 1, 3, and 5 (r = .25, −.24, and −.21). NFCS was significantly correlated with factors 1, 2, 4, and 5 (r = .32, −.20, .20, and −.20). Conclusions: This study found a different factor structure than Randolph et al. (2014) for the CHQ. Big Five personality traits, particularly conscientiousness and Need For Cognition was significantly predictive of multiple aspects of cognitive health.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.213
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 61Exploratory, Confirmatory, and Multigroup Factor Analyses of the
           Neuropsychological Assessment Battery in a Dementia Population
    • Authors: Brickell E; Luo D, Sawicki R, et al.
      Pages: 703 - 794
      Abstract: Objective: The factor structure of the Neuropsychological Assessment Battery (NAB) has not yet been examined in a clinical sample. Knowledge of the NAB’s psychometric structure and performance among different clinical groups is crucial to improving clinicians’ abilities to identify and treat dementia patients and improve long-term outcomes. The current study examined the factor structure of the NAB in a dementia population using exploratory (EFA), confirmatory (CFA), and multigroup confirmatory (MGCFA) factor analyses. Method: Archival data from a hospital-affiliated outpatient neuropsychological clinic was used to examine the factor structure of the NAB in a population of 217 community dwelling older adults diagnosed with either Alzheimer’s disease (AD, N = 118) or a vascular/subcortical dementia (NonAD, N = 99). EFA results were used to create a new model (Model 4). CFA was used to compare Model 4 to three other models from the NAB Psychometric and Technical Manual1. Finally, the model fit for AD and NonAD groups were compared on Model 4 using MGCFA. Results: EFA results suggested a four-factor model for both groups. CFAs comparing models from the Technical Manual1 confirmed that model fit improved with the addition of a sixth processing speed factor, consistent with NAB normative analyses. Model 4 demonstrated similar CFA model fit to the NAB six-factor model. MGCFA results indicated differences between groups in the covariance structure at the intercept level. Conclusions: Results largely confirmed the factor structure reported for the normative sample, and support the construct validity of the NAB in dementia samples. A multigroup moderation analysis indicated that while the two groups vary in mean subtest scores, they give rise to similar covariance structures. 1White, T., & Stern, R. A. (2003). Neuropsychological Assessment Battery Psychometric and Technical Manual. Lutz, FL: Psychological Assessment Resources.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.214
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 62Contributing Towards a Cultural Neuropsychology Assessment
           Decision-Making Framework: Comparison of WAIS-IV Norms from Colombia,
           Chile, Mexico, Spain, United States, and Canada
    • Authors: Duggan E; Loaiza C, Awakon L, et al.
      Pages: 703 - 794
      Abstract: Objective: Test and normative data selection in cross-cultural neuropsychology remain a complex issue. Despite growing awareness, more studies and instruments are needed for assessments to adequately address the impact of cultural factors, such as quantity and quality of education. In this study, we examine the interpretive effects of applying six different relevant WAIS-IV norms to a Colombian sample. Method: A sample of 305 highly educated Colombian corporate executives completed the WAIS-IV. Data were scored using norms from Colombia, Chile, Mexico, Spain, United States, and Canada and scores were compared using ANOVA. Additionally, a comparative sociodemographic framework was established to contextualize our sample to the standardization samples and populations of the six countries. Results: Colombian and Chilean norms yielded systematically similar FSIQ/Index scores (mean range = 117–121), while incrementally lower scores were found with norms from Mexico (−3–9 points), Spain (−3–11 points), USA (−8–13 points), and Canada (−11–18 points). The Verbal Comprehension Index (VCI) was the only with a different pattern: highest scores were obtained with Mexican and Spanish norms, followed by Colombian, Chilean, American, and Canadian norms. Conclusions: Although the Chilean norms are more frequently used in Colombia, the recently developed Colombian norms appear optimal for our sample; the scores do not have meaningful differences with those obtained with Chilean norms and offer fidelity to local population representation. Mexican, Spanish, American, and Canadian norms all underestimate WAIS-IV scores and distort the sample’s score distribution. Finally, notably different VCI score patterns suggest the verbal comprehension WAIS-IV construct may have some cultural nuances likely associated with education system differences.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.215
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 63Immediate Post-Concussion and Cognitive Testing (ImPACT): A Ceiling
           Effect on the Verbal Memory Composite'
    • Authors: Gaudet C; McNally A.
      Pages: 703 - 794
      Abstract: Objective: The present study aims to examine the Verbal Memory Composite (VMC) of Immediate Post-Concussion and Cognitive Testing (ImPACT) for the presence of a ceiling effect and consider its implications for the interpretation of serial assessments. Method: Repeat baseline testing scores from 130 adolescents were analyzed. ImPACT baseline tests were administered across one- to three-year intervals. For the VMC, test-retest reliability was calculated and score distribution analyses were undertaken. Results: The Pearson product-moment correlation (r) for the VMC was 0.36. Score distribution analyses revealed that 15.4% (time 1) and 16.9% (time 2) of adolescents obtained scores within three points of the maximum possible score (100) on the VMC. Conclusions: Ceiling effects may degrade the clinical utility of ImPACT’s VMC. Approximately one in six adolescents obtained scores at, or near, the maximum possible score resulting in a restricted range of scores. Consequently, the test-retest reliability of the VMC was reduced. Given ImPACT’s use as a serial neurocognitive measure, this finding should be considered in the appraisal of cognitive change. Poor test-retest reliability decreases the sensitivity of reliable change methodologies (e.g., standardized regression-based method, reliable change indices). Moreover, the probability of detecting subtle cognitive change in individuals obtaining scores at, or near, the ceiling on baseline testing may be compromised as the observed scores potentially underestimate their true abilities. Corrective procedures, such as administering alternative measures of verbal memory, may be indicated when individuals obtain a score at, or approaching, the maximum possible score on the VMC on baseline testing.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.216
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 64A Meta-Analytic Confirmatory Factor Analysis of the RBANS: Evidence
           for a Bifactor Model with Two Subfactors
    • Authors: Goette W.
      Pages: 703 - 794
      Abstract: Objective: Summarize and extend factor analytic studies of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) using meta-analytic structural equation modeling methods (MASEM). Data Selection: Primary study identification search PsycINFO using (“RBANS” AND (“factor analy*” OR “principal component”)) in January of 2018. Additional studies were identified through review of references. Studies were included if sufficient information was provided to reconstruct a partial or complete intercorrelation matrix. The MASEM utilized 11 studies and 19 samples (N = 4,028), including the RBANS standardization samples. Two-stage MASEM methods were used to fit confirmatory factor analysis models to the pooled correlation matrix. Data Synthesis: A bifactor model adapted from Torrence et al. (2016) produced the best model fit (CFI = .99; RMSEA = .03; SRMR = .02; BIC = −172.13). The manual-proposed model structure did not fit well (CFI = .93; RMSEA = .07; SRMR = .11; BIC = 720.28). The bifactor model was reliable (ωt = .90), though the general factor is not ideal for interpretation as a unitary score (ωh = .65; ECV = .67). The visual (ωvis = .80) and verbal (ωver = .90) subfactor scores appear also to be reliable. Conclusions: Consistent with prior research, the RBANS was best represented by a two-factor solution. A bifactor model produced better fit than simple two- or three-factor models. While a latent general ability scale appears to be defined, the RBANS may not be sufficiently unidimensional to interpret as recommended in the manual, and the data suggest an interpretable verbal subfactor.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.217
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 65Evaluating MMPI-2-RF Infrequent Somatic Responses (Fs) Item
           Endorsement Rates Across Ethnic, Gender, and Age Groups with a Forensic
           Inpatient Sample
    • Authors: Gutierrez R; Peck K, Burchett D, et al.
      Pages: 703 - 794
      Abstract: Objective: The 16-item Minnesota Multiphasic Personality-2 Restructured Form (MMPI-2-RF) Somatic Complaints (Fs) overreporting validity scale includes somatic items endorsed by < 25% of general medical and chronic pain patients. We examined item endorsement rates in a forensic inpatient sample with no known incentive to overreport but, living with severe mental illnesses such as schizophrenia or bipolar disorder, are at elevated risk for genuine medical symptoms. We hypothesized all Fs items would be rarely endorsed, but most frequently endorsed by older patients.Method: Fs results were examined for N = 437 forensic inpatients adjudicated not guilty by reason of insanity with no malingering V code and with non-content-based valid MMPI protocols. We examined overall and subgroup Fs item endorsement rates (by age, gender, and ethnicity). Results: Nearly every item exhibited overall and subgroup endorsement rates below 25%. Women had a 25.8% endorsement rate of an item related to smelling strange odors. An item related to convulsion history was endorsed by over 25% of every subgroup. Few items had age-related endorsement patterns, except one item about hearing loss. Conclusions: Fs was designed to be a scale comprised of somatic items rarely endorsed by individuals experiencing genuine medical symptoms, such that endorsement of several items suggests somatic overreporting. This study demonstrates that in a forensic setting, self-reported convulsion history may be relatively common and not necessarily a sign of overreporting. Future research should examine Fs endorsement rates in psychiatric inpatients with confirmed medical diagnoses. Clinicians should consider documented medical history and item-level endorsements when interpreting modest Fs elevations.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.218
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 66Patient and Parent Satisfaction with Pediatric
           Tele-Neuropsychological Assessment
    • Authors: Hague C; Hernandez A, McCreary M, et al.
      Pages: 703 - 794
      Abstract: Objective: Telehealth is a promising mechanism for providing services to patients. Research has established that tele-neuropsychology is feasible, valid, and satisfactory for evaluating adults. Emerging evidence on pediatric tele-neuropsychology is similar. However, research has not closely examined patient and parent satisfaction. This study examined participant and parent satisfaction with tele-neuropsychological assessment and explored demographic and clinical variables’ impact on satisfaction. Method: Pediatric patients (N = 44) from a demyelinating diseases clinic completed the same assessment battery across two evaluation sessions: face-to-face and remote videoconference. Following completion of the final assessment, children and their parents completed a questionnaire regarding their experience. Covariates analyzed included the age of the participant, miles from clinic, Brief Fatigue Inventory (BFI), WISC-V/WAIS-IV Vocabulary, and self- and parent-reported PedsQL Multidimensional Fatigue Scale (PedsQL MFS) Total. Results: The majority of patients and parents endorsed overall satisfaction with tele-assessment (88.7% and 94.7%). Most endorsed feeling comfortable with equipment (90.9% and 93.2%, respectively) and agreed that video testing was as acceptable as in-person (86.3% and 92.1%). Examination of demographic and clinical variables showed that PedsQL MFS self-report was associated with a decrease in a patient’s comfortability with videoconferencing equipment (p = 0.02). Conclusions: These results reveal that tele-neuropsychological assessment is generally satisfactory to patients and caregivers. However, clinicians should be aware that factors, such as fatigue, may impact an individual’s experience. Future research should further explore the factors underlying patient and parent experience of tele-neuropsychological assessment.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.219
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 67Preliminary Normative Data Analysis on the Denver Attention Test
           (DAT)
    • Authors: Richardson A; Reilly K.
      Pages: 703 - 794
      Abstract: Objective: To evaluate the DAT, a brief computerized performance validity test currently in development. Method: The DAT was initially administered to a control group of 30 randomly selected healthy adult volunteer subjects ages 18–65 from the general community. These subjects were first instructed to give full effort when completing the test (Good Effort in the attached graph). They were then provided with a background scenario prompting them to simulate mild cognitive impairments without having the test detect simulation (Malingered). A second normative group of 30 subjects were provided with the same background scenario and took the test with simulated impairments (Malingered II). Results: The attached graph displays Total Correct and Total Time for all subjects. The data indicated a cutoff Total Correct score of ≤39 (100% specificity and 88% sensitivity) and a Total Time cutoff score of ≥97 (100% specificity and 83% sensitivity) for negative response bias. Using a decision formula considering cutoffs for Total Correct or Total Time, the data demonstrate 98% sensitivity and 100% specificity in determining negative response bias. This decision formula accurately detected negative response bias in 59 out of 60 subjects in the normative groups. Conclusions: The test accurately detected negative response bias in 98% of testing subjects in the normative sample. This preliminary analysis indicates that the DAT is an effective measure of performance validity. Additional research on clinical subjects is indicated to support diagnostic utility in psychological assessments.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.220
      Issue No: Vol. 33, No. 6 (2018)
       
  • C - 68Homicide Injury Severity: An Exploratory Analysis of Relevant
           Cognitive, Demographic, and Criminologic Factors
    • Authors: Mazurek C; Brook M, Hanlon R.
      Pages: 703 - 794
      Abstract: Objective: To examine cognitive performance of homicide offenders in relation to homicide injury severity (HoIS), while exploring the influences of criminal history and relevant demographic and criminologic variables on this relationship. It was hypothesized that HoIS will be negatively associated with executive functioning and intelligence. Method: Participants were 101 offenders charged and/or convicted of first degree murder in Illinois, referred for forensic neuropsychological evaluations. The Homicide Injury Scale (HIS) was used to quantify HoIS. Cognition was measured using standardized neuropsychological tests, spanning domains: IQ, attention, executive function, memory, and language. Criminal history was quantified as number of prior convictions, obtained from the Illinois Department of Corrections. Demographic and criminologic variables were obtained from clinical interviews. Results: Analyses revealed significant negative associations between HIS and memory (rs = −.284, p < .001), remaining significant after accounting for correlates. Education moderated this relationship. In those with >12 years of education the relationship remained significant (rs = −.424, p < .001), but not for those with <12 years (rs = −.088, p > .05). Total number of prior convictions was positively associated with HIS (rs = .254, p < .05), but not memory (rs = −.086, p > .05). The regression model significantly predicted HoIS, F(6,65) = 4.576, p < .001), adj. R2 = .23. Conclusions: This study has identified demographic, criminologic, and cognitive variables that are associated with injury severity during the commission of homicide. Current findings highlight the importance of cognitive ability in predicting relevant criminologic outcomes, especially in individuals with a higher education.
      PubDate: Wed, 17 Oct 2018 00:00:00 GMT
      DOI: 10.1093/arclin/acy061.221
      Issue No: Vol. 33, No. 6 (2018)
       
 
 
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