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  Subjects -> PSYCHOLOGY (Total: 880 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 2)
Acta Colombiana de Psicología     Open Access   (Followers: 4)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Psychologica     Hybrid Journal   (Followers: 23)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 2)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 5)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 23)
ADHD Report The     Full-text available via subscription   (Followers: 8)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 41)
Advances in Mental Health     Hybrid Journal   (Followers: 73)
Advances in Physiotherapy     Hybrid Journal   (Followers: 56)
Advances in Psychology     Full-text available via subscription   (Followers: 61)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 3)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 405)
Aggressive Behavior     Hybrid Journal   (Followers: 15)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 33)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 16)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 37)
American Journal of Community Psychology     Hybrid Journal   (Followers: 24)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 24)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 4)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 22)
American Psychologist     Full-text available via subscription   (Followers: 233)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analysis     Full-text available via subscription   (Followers: 4)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 68)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 28)
Annual Review of Psychology     Full-text available via subscription   (Followers: 223)
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: 24)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 14)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 69)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 33)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 20)
Applied Psychological Measurement     Hybrid Journal   (Followers: 19)
Applied Psychology     Hybrid Journal   (Followers: 171)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 49)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 20)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 26)
Archives of Scientific Psychology     Open Access   (Followers: 4)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 4)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 7)
Assessment     Hybrid Journal   (Followers: 11)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 16)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 10)
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: 7)
Australian Journal of Psychology     Hybrid Journal   (Followers: 18)
Australian Psychologist     Hybrid Journal   (Followers: 12)
Autism Research     Hybrid Journal   (Followers: 32)
Autism Research and Treatment     Open Access   (Followers: 28)
Autism's Own     Open Access   (Followers: 1)
Autism-Open Access     Open Access   (Followers: 5)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 19)
Balint Journal     Hybrid Journal   (Followers: 3)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 36)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 6)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 2)
Behavior Analyst     Hybrid Journal   (Followers: 4)
Behavior Modification     Hybrid Journal   (Followers: 10)
Behavior Research Methods     Hybrid Journal   (Followers: 18)
Behavior Therapy     Hybrid Journal   (Followers: 47)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 9)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 54)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 24)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 6)
Behaviormetrika     Hybrid Journal  
Behaviour     Hybrid Journal   (Followers: 12)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 17)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 125)
Behavioural Processes     Hybrid Journal   (Followers: 7)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 6)
BMC Psychology     Open Access   (Followers: 16)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 10)
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: 138)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 36)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 33)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 43)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 20)
British Journal of Psychology     Full-text available via subscription   (Followers: 59)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 67)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 33)
Burnout Research     Open Access   (Followers: 7)
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: 14)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 13)
Case Studies in Sport and Exercise Psychology     Hybrid Journal  
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 28)
Child Development Research     Open Access   (Followers: 16)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access  
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 10)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 10)
Clinical Psychological Science     Hybrid Journal   (Followers: 12)
Clinical Psychologist     Hybrid Journal   (Followers: 17)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 70)
Clinical Psychology and Special Education     Open Access   (Followers: 1)
Clinical Psychology Review     Hybrid Journal   (Followers: 36)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 20)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 8)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 1)
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 37)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 14)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 28)
Cognitive Psychology     Hybrid Journal   (Followers: 64)
Cognitive Research : Principles and Implications     Open Access   (Followers: 2)
Consciousness and Cognition     Hybrid Journal   (Followers: 30)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 3)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 7)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 22)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 10)
Counseling Psychologist     Hybrid Journal   (Followers: 15)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 8)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 21)
Counselling and Values     Hybrid Journal   (Followers: 2)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 10)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 5)
Creativity Research Journal     Hybrid Journal   (Followers: 20)
Creativity. Theories - Research - Applications     Open Access   (Followers: 2)
Criminal Justice Ethics     Hybrid Journal   (Followers: 7)
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: 13)
Cultural-Historical Psychology     Open Access   (Followers: 1)
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: 51)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 2)
Current Opinion in Psychology     Hybrid Journal   (Followers: 4)
Current Psychological Research     Hybrid Journal   (Followers: 13)
Current Psychology     Hybrid Journal   (Followers: 15)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 20)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 15)
Decision     Full-text available via subscription   (Followers: 3)
Depression and Anxiety     Hybrid Journal   (Followers: 16)
Depression Research and Treatment     Open Access   (Followers: 13)
Developmental Cognitive Neuroscience     Open Access   (Followers: 18)
Developmental Neuropsychology     Hybrid Journal   (Followers: 16)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 45)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 1)
Discourse     Full-text available via subscription   (Followers: 9)
Diversitas: Perspectivas en Psicologia     Open Access  
Drama Therapy Review     Hybrid Journal   (Followers: 1)
Dreaming     Full-text available via subscription   (Followers: 11)
Drogues, santé et société     Full-text available via subscription  
Dynamics of Asymmetric Conflict: Pathways toward terrorism and genocide     Hybrid Journal   (Followers: 13)
Ecopsychology     Hybrid Journal   (Followers: 6)
ECOS - Estudos Contemporâneos da Subjetividade     Open Access  
Educational Psychology Review     Hybrid Journal   (Followers: 27)
Educational Psychology: An International Journal of Experimental Educational Psychology     Hybrid Journal   (Followers: 48)
Educazione sentimentale     Full-text available via subscription  
Electronic Journal of Research in Educational Psychology     Open Access   (Followers: 7)
Elpis - Czasopismo Teologiczne Katedry Teologii Prawosławnej Uniwersytetu w Białymstoku     Open Access  
Emotion     Full-text available via subscription   (Followers: 34)
Emotion Review     Hybrid Journal   (Followers: 20)
En-Claves del pensamiento     Open Access   (Followers: 1)
Enseñanza e Investigacion en Psicologia     Open Access  
Epiphany     Open Access   (Followers: 3)
Escritos de Psicología : Psychological Writings     Open Access   (Followers: 2)

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Journal Cover Archives of Clinical Neuropsychology
  [SJR: 0.96]   [H-I: 71]   [26 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0887-6177 - ISSN (Online) 1873-5843
   Published by Oxford University Press Homepage  [370 journals]
  • PGR-1 Anti-NMDA Receptor Encephalitis: Neuropsychological Profile of
           Recovery
    • Authors: Holder C; Shay N.
      Abstract: Objective: Anti-N-methyl-D-aspartate Receptor encephalitis (NMDA-E) is an autoimmune disorder whose presentation includes seizures, delirium, and dyskinesia. Although NMDA-E responds favorably to quick immunotherapy, little information is available concerning neurocognitive outcomes, particularly in children. Method: The patient is a 13-year-old Caucasian female, presenting to the ER with numbness and tingling in her dominant hand. Two weeks later the patient was hospitalized following onset of seizures, behavioral changes and delirium. During her two-month hospitalization, she was diagnosed with NMDA-E and responded well to steroid treatment. Neuropsychological complaints for the initial evaluation included disinhibited behavior, adaptive functioning loss, and speech deficits. Results: The patient was evaluated at 9-months, 12-months, and 20-months post-onset. Although she was described as previously normal functioning, results of the first evaluation showed global impairments (cognitive, academic, memory, motor, and executive functioning (EF)) and aphasic language. On the second evaluation improvements were noted for spelling, dominant motor, and non-verbal memory. In the third evaluation, improvements were measured in verbal comprehension and visual spatial skills, along with processing speed, academic skills, non-verbal memory, and dominant fine motor. Additionally, she no longer presented as aphasic, although she continued to have anomia. Conclusions: The majority of available research on NMDA-E has been conducted with adults who return to their baseline cognitive functioning with deficits only in memory and EF. Case studies with children have noted chronic deficits in EF, motor, and memory, but primarily describe toddlers or older adolescents. This case study will provide insights for the illness in a school-aged child with significant cognitive decline.
      PubDate: 2017-09-06
       
  • PGR-2 Persistent ADHD and Executive Dysfunction in a 9-Year-Old Girl with
           Sudden-onset OCD Following Infection
    • Authors: Colvin M; Williams K.
      Abstract: Objective: Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by sudden-onset obsessive-compulsive disorder (OCD) and other behavioral disturbances following infection. Identified agents include streptococcus pyogenes, varicella, and mycoplasma pneumoniae, believed to trigger an immune reaction that selectively disrupts basal ganglia function. We report that neuropsychological evaluations can detect associated cognitive dysfunction, which may persist following acute symptoms. Method: A 9-year-old girl suddenly developed OCD symptoms at age 7. Six months after symptom onset, bloodwork revealed elevated antibodies to mycoplasma pneumoniae. Symptoms improved with selective serotonin reuptake inhibitor (SSRI) medication, gradually tapered after a year. She was asymptomatic for a period of approximately three months when OCD symptoms recurred in the context of formal diagnosis with pneumonia. She was treated with a non-steroidal anti-inflammatory medication (naprosyn) and her functioning again stabilized. Her psychiatrist (KW) referred her for neuropsychological evaluation (MC) and she was seen three months after relapse, following resolution of acute symptoms and discontinuation of medication. Results: Overall intellectual aptitude fell in the high average range for age, with even development of verbal and nonverbal skills. She had difficulties regulating attention and exhibited slow processing speed, reduced set-shifting, and poor graphomotor control. Parents endorsed residual but subclinical OCD symptoms, vulnerability to anxiety and affective dysregulation, inattention (consistent with diagnostic criteria for Attention Deficit Hyperactivity Disorder), and writing. Conclusions: PANS may be associated with selective cognitive weaknesses in attention, aspects of executive function, and graphomotor output, consistent with hypothesized immune-mediated disruption of fronto-striatal networks. Cognitive symptoms may persist following resolution of acute behavioral symptoms.
      PubDate: 2017-09-06
       
  • PGR-3 A Case of Autism Spectrum Disorder Associated with Chromosome
           17p13.3 Duplication: Implications for Pediatric Neuropsychological
           Practice
    • Authors: Portnoy J; Weiss E, Facchini R, et al.
      Abstract: Objective: Deletions at p13.3 of chromosome 17 are associated with severe neurological phenotypes such as lissencephaly in Miller-Dieker syndrome, while duplications are considerably rarer and phenotypically more subtle. Microduplications at 17p13.3 that involve the YWHAE and CRK genes have been associated with autism spectrum disorder (ASD). Method: Neuropsychological evaluation of a six-year old right-handed Caucasian female diagnosed at age two with a 397 Kb microduplication at chromosome 17p13.3. Eight gene abnormalities, including YWHAE and CRK, were identified. Results: The child presented with history of developmental delay, mild dysmorphic facial features, significant hypotonia, and hyperkinetic behavior. WISC-V FSIQ was average, but with significant disparity among indices, including impaired working memory and high average fluid reasoning. She demonstrated borderline list learning and superior story recall both immediately and following a delay. Expressive and receptive language functions were average. Auditory attention was considerably stronger than visual attention, with keen recall of spoken narrative despite distractibility. Child met criteria for hyperkinetic disorder based on extreme developmental hyperactivity. She met DSM-V criteria for ASD based on clinical presentation and parent and teacher ratings suggesting atypicality, as well as deficits in social communication, abnormal eye contact, poor situational adjustment of behavior, repetitive and impulsive motor activity, and unusual sensory interests. Conclusions: This case adds to the limited body of pediatric neuropsychological data regarding rare 17p13.3 duplications, and identifies a child with genetic abnormalities known to be associated with ASD.
      PubDate: 2017-09-06
       
  • AGR-1 Acute Myeloid Leukemia: Rare Condition, Complex Disease Course, and
           Neuropsychological Investigation
    • Authors: Loughan A; Lanoye A, Shafer D.
      Abstract: Objective: Acute Myeloid Leukemia (AML) is a rare cancer of rapidly growing abnormal white blood cells which accumulate in the bone marrow and interfere with production of normal blood cells. Age of onset is most common in geriatrics, with rapid disease progression and fatality typically occurring within weeks or months if left untreated. Method: This case reviews the medical and neuropsychological profile of an atypically young (39-year-old) male diagnosed with AML. Initial presentation included gout, dyspnea, and exhaustion. Symptomology quickly progressed into multi-system organ failure, variable consciousness, delirium, and visual hallucinations. Patient was treated in the intensive care unit for 3 months, receiving three chemotherapy cycles and a bone marrow stimulant. Perceived cognitive changes included slow processing and difficulties with word-finding, math computation, and short-term memory. He noted increased difficulty managing employment-related tasks and increased frustration with respect to altered cognitive functioning. Neuropsychological evaluations were completed post-diagnosis/treatment at multiple time-points. Results: Compared to estimated average premorbid functioning, semantic fluency (second percentile), visuospatial copying (second percentile), mathematic computation (13th percentile), divided attention (ninth percentile), and immediate recall of information (first – ninth percentile) represented cognitive weaknesses. Minimal emotional distress was noted. All other domains assessed indicated preserved functioning. Pathology and disease course in relation to the neuropsychological findings will be presented. Conclusions: Cognitive profile was more consistent with patterns following extensive stays in intensive care units rather than the normal course of treatment for AML. This distinction will be highlighted and compared to literature findings. Recommendations centered on cognitive strategies, medication management, and improved quality of life.
      PubDate: 2017-09-06
       
  • AGR-2 A Sign of the Times' A Case of Cardiopulmonary Arrest Due to
           Heroin Overdose
    • Authors: Margolis S; Drake J, Tremont G.
      Abstract: Objective: A rising opioid epidemic has led to expanded use of the opioid antidote naloxone. Unfortunately, naloxone does not reverse effects of cardiopulmonary arrest (e.g., hypoxia-ischemia). Whereas neuropsychological consequences of cardiopulmonary arrest have been described in general, no studies have specifically addressed sequelae due to opioid overdose. Method: We describe a 29-year-old male 9-months after cardiopulmonary arrest due to heroin overdose. He had no substance abuse history before being prescribed opioids for a back injury. When the prescription ended, he transitioned to heroin. He overdosed and was discovered pulseless by family, who performed CPR. EMS administered naloxone. MRI revealed symmetric hypoxic-ischemic injuries to caudate nuclei, globus pallidi, and putamina. His family reported “dramatic” reductions in goal-directed behavior and memory recall, as well as limited insight and confabulation. Results: Neuropsychological assessment revealed severely diminished memory encoding, consolidation and recall, marked executive dysfunction, and bilateral impairments in fine motor dexterity with slow but accurate psychomotor speed. Neurobehavioral symptoms were significant for apathy (i.e., paucity of ideation, diminished initiation, flat affect) and anosognosia. Global mental status, basic attention, language, and basic visuoconstruction were grossly intact. He endorsed mildly elevated depressive symptoms and anxiety. Conclusions: Given recent spikes in opioid dependency and overdoses across the US, this case sheds timely light on the neuropsychological presentation of a successfully resuscitated patient with cardiopulmonary arrest following heroin overdose. In particular, his pattern of anterograde amnesia, executive dysfunction and apathy are consistent with lesions to the basal ganglia, as well as presumed disruption of connections to/from dorsolateral, medial, and ventral pre-frontal cortex.
      PubDate: 2017-09-06
       
  • AGR-3 Early-Onset Behavioral Variant Frontotemporal Dementia and its
           Impact on the Family Unit: A Case Study
    • Authors: Kay C; Leveroni C, Eldaief M, et al.
      Abstract: Objective: Behavioral variant frontotemporal dementia (bvFTD) is characterized by significant neuropsychiatric symptoms, including prominent changes in behavior, personality, and cognition. Presentation of bvFTD before age 35 is extremely rare and its effect on the family unit is very different from that of older patients. This case study highlights the impact of early-onset bvFTD on a young family, including critical safety considerations and important challenges to symptom management. Method: A 33-year-old man presented with 1.5 years of progressive behavioral and cognitive changes. Salient symptom presentation included apathy, loss of empathy, obsessional behaviors, binge drinking, and aggression towards his wife and young children (ages 1 and 3). These symptoms caused significant familial distress and marked functional impairment, including loss of employment. He underwent a neuropsychological evaluation, neurologic examination, and neuroimaging. Brain magnetic resonance imaging showed bifrontal atrophy, and fluorodeoxyglucose positron emission tomography revealed abnormal hypometabolism within the anterior frontal lobes and cingulate gyri. Results: Neuropsychological evaluation revealed prominent deficits in executive functioning and judgment, as well as select memory and language impairments. Working memory, processing speed, and visuoconstructional skills were relatively preserved. Disease course, clinical presentation, neurocognitive performance, and neuroimaging were highly consistent with bvFTD. Detailed recommendations and resources were provided to the patient's family regarding symptom management with emphasis on plans for safety. Conclusions: This case highlights the importance of a comprehensive diagnostic approach and multi-disciplinary collaboration in suspected early-onset bvFTD and the critical role that neuropsychologists play in guiding family members’ understanding of their loved one's deficits and in providing meaningful, practical, and tailored recommendations.
      PubDate: 2017-09-06
       
  • Aging and Dementia-1 Age Moderates the Relationship Between Drug Burden
           Index and Subjective Cognitive Decline in Members of the Rhode Island
           Alzheimer Prevention Registry
    • Authors: Margolis S; Daiello L, Tremont G, et al.
      Abstract: Objective: Anticholinergic/sedative medication exposure, quantified by the Drug Burden Index (DBI), has been linked to cognitive impairment in older adults. However, relationships between the DBI and subjective cognitive decline (SCD) in cognitively healthy elders at risk for Alzheimer's disease (AD) have not been investigated. Method: This cross-sectional study first identified health conditions correlated with the DBI. After adjusting for these potential drug indications, ordinary least squares regression elucidated independent relationships between DBI scores and SCD (0 = no memory decline, 1 = decline without concern, 2 = decline with concern) at mean1 standard deviation values of age in members of the Rhode Island Alzheimer Prevention Registry. Results: Participants were 206 registry members (M age = 65 ± 9 years, AD family history = 78%). Approximately 69% endorsed SCD, 62% of whom indicated concern about their memory. Over one-third (37%) reported taking anticholinergics/sedatives. The mean DBI score for the sample was 0.33 ± 0.55 (range = 0.00–2.87). Only depression (r = .455, p < .001) and anxiety (r = .230, p = .001) were correlated with the DBI. Adjusting for depression/anxiety, moderation analysis revealed that higher DBI scores were independently associated with worse SCD at age 74 (β = .331, 95% CI = .053, .609, p = .020) but not at ages 56 or 65. Post-hoc analyses showed that this DBI*Age interaction was significant and increased linearly from ages ≥−71-years. Conclusion: Anticholinergic/sedative drug use was prevalent among participants and most common in those endorsing depression/anxiety. Controlling for these comorbidities, psychoactive drug burden was associated with greater perceived memory decline at ages ≥−71-years. Longitudinal studies are needed to determine whether the association between anticholinergics/sedatives and SCD among elders at risk for AD is a pre-clinical marker of neurodegenerative disease.
      PubDate: 2017-09-06
       
  • Aging and Dementia-2 Cognitive Reserve Moderates the Positive Relation
           Between Older Ages and Inter-connectivity of Resting State Networks
    • Authors: Lindbergh C; Lv J, Zhao Y, et al.
      Abstract: Objective: Age-related changes within the default mode network (DMN) are well documented. The interactive behavior between DMN and other resting state networks, however, has not been well-studied. In this study we focused on age and posited positive correlations with inter-network connectivity, and examined whether cognitive reserve would moderate this relationship. Method: Resting state functional magnetic resonance imaging data were acquired in 48 community-dwelling volunteers (64–86 years; mean age = 72; 100% Caucasian; 58% female) and analyzed using a validated dictionary learning and sparse coding procedure. Aggregate inter-network connectivity was calculated between DMN and nine other well-established resting state networks. The Wechsler Test of Adult Reading served as a proxy measure for cognitive reserve. Moderation was tested using regression-based analyses with age (predictor), cognitive reserve (moderator), and age × cognitive reserve (interaction term) as independent variables. Inter-network connectivity was the dependent variable. Results: Bivariate analyses yielded a significant correlation between age and inter-network connectivity (r = .31, p = .029). In the overall regression model [R2 = .21, F(3, 44) = 7.95, p = <.001], the age × cognitive reserve interaction term accounted for unique variance in inter-network connectivity (ΔR2 = .10, p = .003). Simple slopes analysis revealed that cognitive reserve had an attenuating effect; the relationship between age and inter-network connectivity was non-significant at high levels of reserve and strong at low levels (t = 3.89, p = <.001). Conclusion: Inter-network connectivity increases with age in older adults, possibly due to dedifferentiation, compensation, or some combination. Cognitive reserve moderates this relationship such that the greatest resting state network desegregation is seen in individuals with low reserve.
      PubDate: 2017-09-06
       
  • Aging and Dementia-3 Neurocognitive Function and the Aging Physician: A
           Literature Review
    • Authors: Gaudet C.
      Abstract: Objective: In 2015, the American Medical Association's Council on Medical Education released a report calling for formal competency testing policies and procedures for physicians. Neurocognitive assessments are often embedded within competency assessments and are used to inform judgments regarding a physician's capacity to practice medicine. The purpose of this review was to examine the scientific evidence for the use of neurocognitive assessments to detect impairment in physicians and assess their utility as screening measures. Data Selection: A literature review was conducted to identify studies examining neurocognitive function in physicians as part of competency assessments. Combinations of the following terms were searched in the Google Scholar database: +physician, +assessment, +competency +neurocognitive +cognitive, +neuropsychological. Data Synthesis: Five scientific studies were identified. These studies, using both computerized as well as paper and pencil measures, provided preliminary evidence for the effectiveness of neurocognitive testing in detecting impairments in physicians who have already been referred for competency evaluations; however, none of the studies provided evidence for the utility of neurocognitive testing to preemptively identify physicians at-risk of being referred for a competency assessment. Conclusion: Taken together, considerable caution is warranted relative to the use of existing neurocognitive measures to prospectively screen for impairment, or those at-risk for impairment, in non-referred physicians. Additionally, significant limitations exist regarding the evidence for the use of neurocognitive testing with physicians born outside of the United States, indicating potential bias in the interpretation of existing protocols. Lastly, issues pertaining to the reliability, validity, and experimental design of the studies warrant further consideration.
      PubDate: 2017-09-06
       
  • Aging and Dementia-4 Traumatic Brain Injury History is Associated with an
           Earlier Age of Dementia Onset in Autopsy-confirmed Alzheimer Disease
    • Authors: Schaffert J; Lobue C, White C, et al.
      Abstract: Objective: To evaluate whether a history of traumatic brain injury (TBI) with loss of consciousness (LOC) is a risk factor for earlier onset of Alzheimer disease (AD) in an autopsy-confirmed sample. It was hypothesized that AD would be expressed and diagnosed approximately 2–3 years earlier based on previous findings with non-autopsy confirmed samples. Method: Data from 2,133 subjects with neuropathologically confirmed AD (i.e., at least Braak Stages III to VI and CERAD moderate to frequent) were obtained from the National Alzheimer's Coordinating Center (NACC). Subjects were categorized by the presence or absence of self-reported remote (i.e., >1 year prior to their first Alzheimer's Disease Center visit) history of TBI with LOC (TBI+ vs. TBI−). Analyses of Covariance (ANCOVA) controlling for sex, education, and race were used to compare groups in terms of clinician-estimated age of symptom onset and age of diagnosis. Results: Average age of estimated symptom onset was 2.34 years earlier (p = 0.01) for the TBI+ group (n = 194; M = 68.03; SD = 11.58) compared to the TBI− group (n = 1900; M = 70.37; SD = 10.09). Similarly, dementia was diagnosed on average 2.83 years earlier (p = 0.002) in the TBI+ group (n = 197; M = 74.18; SD = 11.22) compared to the TBI− group (n = 1936; M = 77.01; SD = 10.00). Conclusion: History of TBI with LOC appears to be a risk factor for earlier age of AD onset. Although similar findings have been reported in samples using clinical criteria for the diagnosis of AD, this is the first investigation to utilize a neuropathologically confirmed sample, warranting further investigation as to possible underlying mechanisms of association.
      PubDate: 2017-09-06
       
  • Assessment-1 Machine Learning Predicts Temporal Lobe Epilepsy Localization
           More Accurately than Lateralization Using Neuropsychological Data
    • Authors: Frank B; Scott T, Olsen J, et al.
      Abstract: Objective: We assessed whether verbal memory, nonverbal memory, verbal fluency, and naming would classify epilepsy localization with greater accuracy than lateralization when using machine learning algorithms. In addition, we assessed whether the inclusion of norm-based standard scores, demographic and emotional functioning data would reduce cross-validated error (CVϵ). Method: This study retrospectively assessed neuropsychological data on 228 patients (125 Females and 103 Males) from New York University Medical Center Comprehensive Epilepsy Center (NYU-CEC). We employed a kernel support vector machine to predict epilepsy localization and lateralization for patients receiving a medically confirmed diagnosis (n = 218 and 226 respectively). Results: We obtained the greatest accuracy assessing localization data with the Gaussian radial basis kernel function (RBF) within Hilbert space (Support Vectors = 157, CVϵ = 0.22). There was no overlap between the localization and lateralization models, such that the poorest localization model (the hyperbolic tangent kernel function; Support Vectors = 91, CVϵ = 0.36) outperformed the strongest lateralization model (RBF; Support Vectors = 201, CVϵ = 0.39). Contrary to our second hypothesis, there was little to no change in the accuracy of the models regardless of the data included. A sigmoid function was fit onto decision values to produce receiver operating characteristic (ROC) curves for the primary analyses. Conclusion: These data suggest some clinical utility in predicting epilepsy lateralization using neuropsychological indicators, albeit with more reliable results for localizing determinations. This study adds to the existing literature by employing an analytic technique with inherent advantages in generalizability when compared to linear models.
      PubDate: 2017-09-06
       
  • Assessment-2 The Evolution of Ecological Validity within
           Neuropsychological Executive Function Measures
    • Authors: Mullen C; Hewitt K, Lyles J, et al.
      Abstract: Objective: Advances in other clinical sciences have amended the neuropsychologist's role to include both differential diagnoses of brain pathology and utilization of ecologically valid assessments that assess patient functioning. The dearth of research addressing the importance of ecological validity impacts a clinician's ability to understand and interpret test findings focused on functional applications of assessment. Current neuropsychological assessment procedures have adapted and expanded upon past research limitations and recommendations. We present a systematic review of ecologically valid neuropsychological executive function (EF) measures. Data Selection: A search was conducted using GALILEO, which encompasses PsychINFO and PubMed; and Google Scholar databases with the terms “ecological validity;” “executive function”, “functional measures;” and/or “neuropsychology,” which resulted in N = 6,906 total articles. After excluding irrelevant studies lacking executive functioning data and/or non-adult groups, N = 76 articles remained. Data Synthesis: A review of relevant studies revealed various categories for EF measures such as traditional versus novel and lab-based/constraint (LBC) versus naturalistic environment. Our analysis examined the application of LBC and naturalistic EF measures on multiple clinical populations, excluding severe mental illness. The analysis of data addresses the shift toward utilization of ecologically valid assessments to ensure accurate assessment of patient functioning outside of clinical presentation. Conclusion: This systematic review addressed limitations of the slow inclusion of ecologically based measures into neuropsychological batteries. Clinical assessment should include measures that satisfy internal, external, and ecological validity. Future research needs to expand upon naturalistic EF measures and interventions (i.e., ecologically based cognitive remediation) to improve patient functioning.
      PubDate: 2017-09-06
       
  • Assessment-3 Distress Tolerance and Symptom Severity Mediate Failure on a
           Symptom Validity Test in Iraq and Afghanistan Veterans with Posttraumatic
           Stress Disorder
    • Authors: Miskey H; Martindale S, Shura R, et al.
      Abstract: Objective: Evaluate the relationship between PTSD and outcome on performance and symptom validity tests (PVT and SVT). Hypothesis: the association between PTSD diagnosis and performance on SVTs and PVTs will be serially mediated by distress tolerance and symptom severity. Method: Iraq and Afghanistan veterans (n = 120, Mean age = 41, 91% male) completed testing. Dichotomous variables were created for PTSD diagnosis (using CAPS-5) and failure on the Medical Symptom Validity Test (MSVT), b-Test, and Structured Inventory of Malingered Symptomatology (SIMS). Continuous variables were created for SIMS subscales, distress tolerance (DTS), and symptom distress (PCL-5). Hypothesis testing applied serial mediation analysis, with DTS and PCL-5 as mediators, respectively. Results: Models predicting b-Test and MSVT failure were not significant. The specified model predicted failure on the SIMS, p < .001, B = 0.52, CI [0.20, 1.17], and SIMS subscale scores on Neurologic Impairment, p < .001, B = 0.55, CI [0.25, 1.10], Amnestic Disorders, p < .001, B = 0.64, CI [0.18, 0.92], Affective Disorders, p < .001, B = 0.61, CI [0.30, 1.15], and Low Intelligence, p = .03, B = 0.17, CI [0.00, 0.44], but not Psychosis. PTSD diagnosis only demonstrated a main effect for MSVT failure; PCL-5 demonstrated main effects for SIMS failure, and all subscales except Low Intelligence. Conclusion: Difficulty tolerating negative affect may contribute to elevated symptom distress and result in over-reporting symptoms in Veterans with PTSD. Distress tolerance and symptom burden were not associated with PVT failure, supporting the independence of PVTs and SVTs. PTSD diagnosis and symptom self-report were differentially related to PVT/SVT performance.
      PubDate: 2017-09-06
       
  • Assessment-4 Reliability and Validity of the ADHD Symptom Infrequency
           Scale
    • Authors: Courrégé S; Feder A, Skeel R.
      Abstract: Objective: The present study evaluated a new self-report measure, the ADHD Symptom Infrequency Scale (ASIS), developed to identify adults exaggerating symptoms in order to meet the criteria for Attention-Deficit/Hyperactivity Disorder (ADHD). Method: A four group comparisons model (control, ADHD-diagnosed, an undiagnosed but possible, and analogue simulators) examined differences in endorsement rates across groups. A total of 309 participants recruited online through Mechanical Turk completed questionnaires. After screening for eligibility, analyses were completed with 145 participants (66% female, 82% Caucasian, Mean age = 36, SD = 13.0). Participants completed both the Barkley Adult ADHD Rating Scale (BAARS) and the ASIS. Both the ADHD and control groups were instructed to answer honestly, and the simulator group was instructed to complete the questionnaires as if trying to convince a doctor they had ADHD. Results: Items meant to detect symptom exaggeration were endorsed at a significantly higher rate for simulators compared to the other three groups, F(3, 141) = 49.19, p < .001. The optimal cut point resulted in a positive predictive value of 84% and a negative predictive value of 74%. The inattention and hyperactivity/impulsivity scales of the ASIS were highly correlated with the inattention and hyperactivity/impulsivity scales of the BAARS (r = .80, p < .001; r = .83, p < .001, respectively). The scales of the ASIS showed Cronbach's alphas in the good to excellent range (a = .81–.92). Conclusion: This study suggests that the ADHD Symptom Infrequency Scale has potential as a reliable and valid measure of ADHD that is sensitive to malingering and exaggeration of symptom.
      PubDate: 2017-09-06
       
  • Diversity-1 Subjective Memory Complaints Among Cognitively Normal
           Caucasian and African American Older Adults Predict Future Diagnostic
           Conversion: An Examination of Racial Differences in Clinical Presentation
           at Initial Visit
    • Authors: John S; Evans S, Hanfelt J, et al.
      Abstract: Objective: Subjective memory complaints (SMC) in older adults are linked to objective declines in neuropsychological performance and with increased rates of diagnostic conversion to mild cognitive impairment (MCI) and dementia. This study evaluated the frequency of SMC in cognitively normal Caucasians and African Americans at initial visit (IV) and examined racial differences in clinical presentation and subsequent diagnostic conversion. Method: Participant data was requested from the National Alzheimer's Coordinating Center for Caucasian and African American participants with three annual visits. A race-matched sample, using age, gender, and education, was created (N = 912, 456 each race) to compare IV characteristics and rates of conversion. Conditional logistic regression evaluated the following IV predictors of third visit conversion: race, SMC, and Logical Memory Delayed score (LM). Results: The full model predicting conversion at third annual visit was significant, χ2 (3, N = 912) = 102.37, p < .001. African Americans were less likely to convert (B = −1.34, p < .001); SMC was associated with a 2-fold higher odds of conversion (B = .74, p < .01); and higher LM scores were associated with decreased odds of conversion (B = −.07, p < .01). Conclusion: Despite group differences in both cognitive performance and rates of SMC at IV, all model predictors were significant for both Caucasians and African Americans. Caucasians identified as cognitively normal at IV were more likely to receive a conversion diagnosis at Visit 3. Given that African Americans are more likely to develop AD than Caucasians, this result raises the possibility of non-equivalent clinical evaluations.
      PubDate: 2017-09-06
       
  • Diversity-2 Examining the Efficacy of the Spanish Modified Story Memory
           Technique in Multiple Sclerosis
    • Authors: Krch D; Lequerica A, Aguayo A, et al.
      Abstract: Objective: Examine efficacy of the Spanish version of the modified Story Memory Technique (SmSMT), a 10-session intervention teaching context and imagery to improve learning and memory in a Mexican sample of persons with multiple sclerosis(MS). Primary hypothesis: individuals with MS and learning deficits will demonstrate significant improvements in memory after SmSMT. Method: Patients were recruited from the Mexican Foundation for MS. 20 participants with relapsing-remitting MS who met inclusion and exclusion criteria signed informed consent, were enrolled, and randomized (double blind) into treatment (10) and control (10) groups. Groups were similar in age, gender, and disease characteristics, but differed in education (treatment 15.3 ± 2.0, control 12.9 ± 3.5). Baseline and post-treatment testing consisted of cognitive and psychosocial measures. Analyses of covariance(ANCOVA) were conducted, with baseline performance and education as covariates. Primary outcome measure was Hopkins Verbal Learning Test-Revised (HVLT-R) total learning. Exploratory ANCOVAs were conducted on everyday memory (Everyday Memory Questionnaire, EMQ), depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder-7, GAD-7), and life satisfaction (Satisfaction with Life Scale, SWLS). Results: The treatment group showed a trend toward improved learning (95% confidence interval [CI] 22.66–27.88) relative to the control group (95% CI 19.33–24.54, F(1,16) = 3.14, p = .095, demonstrating a moderate-large effect size (η2p = .16). Similar trends were noted on EMQ, PHQ-9, GAD-7, and SWLS, with moderate effect sizes. Conclusion: Findings show preliminary evidence for the efficacy of the SmSMT in improving learning and memory in MS. This is an important step in the expansion of cognitive rehabilitation treatment options for monolingual Spanish-speakers worldwide.
      PubDate: 2017-09-06
       
  • Diversity-3 Neuropsychological Assessments for Adult Spanish Speakers in
           the United States
    • Authors: Gonzalez c; Arora S, Gomez R.
      Abstract: Objective: The objective of this study is to review the use and norming of neuropsychological assessments for the adult Spanish-speaking population living in the United States. Data Selection: Using Google Scholar, the databases PsycINFO, PsycARTICLES, and PsycTESTS, we collected studies that examined neuropsychological measures used with Spanish-speaking participants. Data Synthesis: Organized by cognitive domains, a list of translated neuropsychological assessments will be described including the psychometric decryptions and norms based on Spanish-speaking participants. For each of these measures the benefits and limitations will be listed. Conclusion: 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 will be provided with a recommendation list of the best neuropsychological assessments to use based on norms and psychometric properties. Lastly, clinical future directions will be also given, including conducting further research regarding the validity and reliability of the tests available and develop norms for respective groups due to the variability within the Hispanic subgroups living in the United States.
      PubDate: 2017-09-06
       
  • Diversity-4 Where Are We in Understanding Acculturation in
           Neuropsychology: A Systematic Literature Review
    • Authors: Goette W; Schmitt A, Carballo a.
      Abstract: Objective: To identify how acculturation is defined and measured in neuropsychological research, and to determine how acculturation is conceptualized in neuropsychological assessment. Data Selection: During February 2017, PsycINFO and PubMed were searched using the terms ((neuropsych* or neurocog*) AND (assessment OR evaluation OR testing OR test OR measure) AND (accult*)). Results were limited to journal articles printed in English. Empirical studies were included if they included at least one statistical analysis of acculturation on any measure of cognition. Other articles were included if they discussed the interaction of acculturation and test performance. While 146 results were screened, 41 met inclusion criteria. Data included the type of study, how acculturation was measured, how acculturation was defined, whether the study calculated reliability of the tests or scale, and the population studied. Data Synthesis: Most studies were empirical (82.9%) and used direct measures of acculturation (82.4%). Twelve acculturation scales were used with the Acculturation Rating Scale for Mexican Americans-II being most common (17.9%). Proxy measurements included 14 different variables with length of residency in the dominant country collected most commonly (13.8%). Most definitions of acculturation were unidirectional (53.7%). Reliability for tests administered (11.8%) or measurement scale (6.7%) were rarely calculated. Hispanic/Latino and Spanish-speaking populations were the most common samples (60.5%). Conclusion: Heterogeneity in samples, tests administered, and measures of acculturation used preclude synthesis of empirical results. Neuropsychological studies tend to use bipolar, unidirectional conceptualization of acculturation not supported in acculturation psychology. Simple statistical and experimental methods in the literature limit consideration of acculturation effects in neuropsychological assessment.
      PubDate: 2017-09-06
       
  • Neurological and Neuropsychiatric Disorders-1 The Impact of
           Cholesterol-lowering Medication Use and Plasma Lipid Levels on Cognitive
           and Motor Function in Parkinson's Disease
    • Authors: Dhima K; Holder N, Cullum C, et al.
      Abstract: Objective: Existing literature alludes to a potential neuroprotective effect of cholesterol-lowering medication and abnormal lipid levels on the development of Parkinson's disease (PD). However, prognostic implications of this effect remain unclear. The current study explores how use of cholesterol lowering medication and plasma lipid levels relate to cognitive and motor function and progression in PD. Method: Subjects included 93 recently diagnosed (≤2 years) PD patients from the Parkinson's Progression Markers Initiative. Cognitive measures included Animal Fluency, Benton JoLO, SDMT, WMS-III LNS, and HVLT-R. Off-state motor function was measured with the MDS-UPDRS-III. Assessments were completed at baseline (T1) and three years (T2). Stepwise regressions were conducted to predict baseline cognitive and motor scores, as well as change scores (T2-T1). Predictors included cholesterol-lowering medication use, baseline fasting plasma lipid levels [high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides], and age. Bonferroni correction for multiple regressions was applied (a = 0.006). Results: Although no significant models emerged after correcting for multiple regressions, four models trended toward significance. At baseline, higher age predicted worse verbal retention (HVLT-R retention, p = 0.023, β = −0.241). At follow-up, higher baseline triglycerides predicted slower verbal recall decline (HVLT-R retention, p = 0.014, β = 0.282; HVLT-R delay, p = 0.047, β = 0.216), and higher baseline LDL predicted slower motor decline (MDS-UPDRS-III, p = 0.042, β = −0.242). Conclusion: Findings support the potential for a neuroprotective impact of dyslipidemia in this PD cohort. Trends suggest higher triglycerides may be associated with slower verbal memory decline, while higher LDL may be related to slower motor decline. Further exploration is warranted to understand the influence of cholesterol in PD, which could lead to novel therapeutic interventions.
      PubDate: 2017-09-06
       
  • Neurological and Neuropsychiatric Disorders-2 Aggression and Anger in
           Active Duty Service Member with Mild Traumatic Brain Injury
    • Authors: Bailie J; Ekanayaker V, Ettenhofer M, et al.
      Abstract: Objective: Anger is a common symptom after mild traumatic brain injury (mTBI). Elevations in anger may increase risk for aggression. In other disorders, anger has been identified as a key moderator of aggressive behavior. This study sought to explore the relationship between anger and aggression following mTBI. Method: Participants were 25 service members with a history of mTBI, a mean age of 33 (SD = 9.02), and an average of 12.6 (SD = 7.09) years of military service. Participants completed the State-Trait Anger Expression Inventory, Second Edition (STAXI-2), the Patient Health Questionnaire-9 (PHQ-9), the PTSD Checklist (PCL-C), and a questionnaire of self-reported aggressive behavior. Results: Participants endorsed on average eight aggressive acts (SD = 4.86), most common included agitation (69.2%), arguing (65.4%), and hitting something (61.5%). Trait Anger (T-Ang r = 0.76, p < 0.001) and Anger Expression-Out (AX-O r = 0.69, p < 0.001) had the largest correlations to aggression. Post-traumatic stress and depression also had strong relationships to anger and aggression. The relationship between anger and aggression however did not change when controlling for depression (T-Ang r = 0.66; AX-O r = 0.65) or post-traumatic stress (T-Ang r = 0.63; AX-O r = 0.57). Conclusion: Increased emotions of anger were related to aggression in military personnel with a history of mTBI. Frequency of anger problems (trait anger) and tendency to express anger outwardly were more important in understanding aggression in this population then assessment of current feelings of anger. This relationship was unique and was not related to depression or post-traumatic stress.
      PubDate: 2017-09-06
       
  • Neurological and Neuropsychiatric Disorders-3 Beyond 24hr vEEG: Relying on
           Neuropsychological Testing to Better Understand Non-epileptic Seizures
    • Authors: Shafer M; Durrett C, Burghardt T, et al.
      Abstract: Objective: The present study was designed to evaluate the complex and elusive etiological nature of psychogenic non-epileptic seizures (PNES) by more closely examining the correlation between PTSD and PNES. Method: The study is compromised of 35 subjects who completed a comprehensive neuropsychological (NPSY) evaluation in an outpatient setting. A majority of the participants were female (n = 25) who were predominantly right handed. All participants completed a 24 hr vEEG study in a hospital-based Epilepsy Monitoring Unit (EMU) and were diagnosed with PNES. Ages ranged from 18 to 67 (Mean = 39). Results: Approximately 80% of the sample reported a history of sexual assault. Cognitively, the sample largely presented with average IQ (M = 93, STD = 15.9) and reading ability (WRAT-IV M = 100, STD = 18). Only two of the sample scored in the mid 20 s on Trial 2 of the TOMM suggesting strong motivation and effort (i.e., limited malingering). Impressively, correlations on psychological instruments were strong between F scales and PTSD scales (Keane = .79, p < .001; Schlenger = .72, p < .001) while less than robust correlations were observed between F scales and scales of somatization. Conclusion: Greater emphasis on the role PTSD plays in the semiology of PNES is required to move treatment interventions for this condition forward. The present study describes the strong relationship between PTSD and PNES, an absence of malingering behaviors, and low perceptions of somatization within this population. Ultimately, future studies should aim to identify individual clinical cohorts within this population (e.g., borderline, dissociative) as a means of extending PNES treatment guidelines.
      PubDate: 2017-09-06
       
  • Neurological and Neuropsychiatric Disorders-4 Neurocognitive Variability
           Following Treatment for Autoimmune Encephalitis
    • Authors: Coulehan K; Spat J, Botvinick J, et al.
      Abstract: Objective: Autoimmune encephalopathy (AE) is a constellation of rare neuropsychiatric disorders with high morbidity and mortality. Owing to the heterogeneity of etiologies and presentations, the profile of neurocognitive strengths and weaknesses following AE is highly variable. In an effort to further add to the extant literature, this case-series compares and contrasts the neurocognitive functioning of four patients s/p AE (two anti-NMDA, one limbic encephalitis, one unknown etiology). Method: Patients were aged 16, 19, 35, and 39 at the time of assessment. Symptoms immediately prior to AE diagnosis included delusions and hallucinations (n = 2), altered mental status (n = 1) and flu-like symptoms (n = 1). Three of four patients experienced new onset seizures; only one had a normal EEG. Neuroimaging was unremarkable for three of four patients. Treatment for all patients included intravenous and oral steroids, and intravenous immunoglobulin. Comprehensive neuropsychological assessments were conducted within a year of disease onset. Results: All patients evinced executive dysfunction (set-shifting, inhibition, planning, encoding) and reduced fine motor coordination. Considerable variability across patients was observed across areas of verbal comprehension, nonverbal reasoning, visuospatial skills, processing speed, attention, and memory. Three of the four patients endorsed experiencing mild to severe psychological distress. Conclusion: Though the studied sample did not consistently exhibit memory deficits often seen in this population, our findings reflect the presence of prominent cortical and subcortical deficits often seen in patients immediately following AE treatment. To this end, this case-series underscores the considerable individual neurocognitive variability. Improved understanding of individual neurocognitive variability among patients with AE facilitates more targeted treatment interventions.
      PubDate: 2017-09-06
       
  • Pediatrics-1 Impaired Processing Speed: An Under-studied Phenomenon Across
           Neuropsychiatric Disorders in Youth
    • Authors: Braaten E; Ward A, Vuijk P, et al.
      Abstract: Objective: Impaired processing speed (PS) associates with difficulties in academic and adaptive functioning. PS has been examined extensively in attention-deficit/hyperactivity disorder (ADHD) but to a lesser degree in other conditions. We aimed to elucidate the role of diagnosis, psychiatric comorbidity and transdiagnostic psychopathology traits in the prediction of impaired PS in youth referred for neuropsychiatric evaluation. We also examined a potential mechanism by which PS impacts academic functioning. Method: Data were from 775 youth, ages 6–21, consecutively referred for evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. PS was operationalized using the Wechsler intelligence scales indices. Data were analyzed using mixed modeling, ANOVA, logistic regression and SEM, controlling for age, sex and psychotropic medication use. Results: In referred youth, PS showed greater impairment than working memory (WM; Mdifference = −1.3, p = .03) and general ability (GA: Mdifference = −9.0, p < .001). Youth with psychosis, autism spectrum disorder (ASD), mood disorders and ADHD all showed impaired PS. Controlling for comorbidity, the presence of psychosis (OR = 3.5), ASD (OR = 1.8) and ADHD (OR = 1.5) increased the risk of having slow processing speed (PSI < 85). Among dimensional psychopathology measures, only inattention (OR = 1.4) was a significant predictor of impaired PS across disorders. In models, PS had an indirect effect through both WM and GA on different domains of academic function. Conclusion: Impaired PS is relevant to neuropsychiatric conditions beyond ADHD. Our data raise the possibility that variation in inattention accounts for impaired PS across disorders. Findings also have implications for the mechanism by which PS impacts academic function.
      PubDate: 2017-09-06
       
  • Pediatrics-2 Validation of the MVP in an Epileptic Population
    • Authors: Shay N; Holder C.
      Abstract: Objective: The Memory Validity Profile (MVP) is a performance validity test (PVT) specifically designed for children, adolescents, and young adults. Standardization samples offer support for using the measure with certain clinical populations, but no information is currently available supporting the validity of the measure with epileptic populations. Method: The MVP was administered to a sample of children and adolescents at a Level IV Epilepsy Center, who all had a primary diagnosis of seizure disorder. Demographic information, along with MVP scores were analyzed relative to the standardization, invalid performance, and clinical samples provided in the MVP Professional Manual. Results: In a sample of 62, 3.2% (n = 2) of respondents had a suspected invalid profile on the MVP. This percentage is well below the acceptable base rate noted in the manual, and was similar to the total combined clinical group. It is also well below the failure rate for Intellectual Disability, Autism Spectrum Disorder, and Traumatic Brain Injury groups. Demographics of the sample group are provided in Table 1. Table two describes the percentage of the group scoring in the invalid range. Analysis also reveals all seizure diagnosis groups fell within the acceptable range. Conclusion: The MVP authors report an acceptable base rate of 5% of respondents with clinical disorders providing invalid profiles in their initial validation of the measure; however, no study has been conducted to determine if the measure is appropriate for use in an epileptic population. Our findings suggest the MVP is an appropriate PVT for use in children and adolescents with clinical seizure disorders.
      PubDate: 2017-09-06
       
  • Pediatrics-3 The Role of Teacher Warmth in Teacher Accuracy Evaluating
           Child Cognitive and Executive Functioning
    • Authors: Hennrick H; Freedman-doan C.
      Abstract: Objective: This study sought to expand current knowledge about aspects of the teacher-child relationship that may facilitate accuracy in teacher reporting on children's higher-order cognitive skills, including attention, working memory (WM), and executive functioning (EF). Method: The study included 37 teachers and their 8- to 12-year old students. Teachers completed informant report measures of children's attention, WM, and EF. The children underwent a comprehensive neuropsychological assessment, completing performance-based measures of attention, WM, and EF. Results: Teachers’ reports captured children's true neurocognitive abilities, as measured by performance-based measures; of the 35 possible correlations (7 neuropsychological tests × 7 teacher scales), 22 correlations (63%) were significant at the p < .05 level, while an additional nine correlations were marginally significant (p < .10). Greater warmth was associated with fewer reported cognitive problems, and less warmth was associated with a greater number of reported cognitive problems; 5 of seven possible correlations were significant at the p < .05 level, and an additional two were marginally significant. Hierarchical regression analyses showed that above and beyond that which was accounted for by neuropsychological measures, teacher warmth accounted for significant variance in teachers’ reports; 4 of 11 ΔR2 were significant at the p < .05 level, and an additional four were marginally significant. Lastly, moderation analyses showed that teacher warmth significantly interacted with true attention abilities to predict teachers’ reports of inattention (ߠ = −.55, p < .05); moderate warmth was predictive of the most accurate teacher reports, whereas low warmth predicted over-report of attention problems, and high warmth predicted under-report of attention problems. Conclusion: Performance-based measures of children's attention, WM, and EF were reflected in teachers’ reports of those same constructs. Performance-based measures of abilities and teacher warmth significantly predicted nearly all areas of the areas of cognitive functioning. Teacher warmth significantly moderated the relationship between performance-based neuropsychological measures of attention, and teachers’ reports of attention abilities.
      PubDate: 2017-09-06
       
  • Traumatic Brain Injury-1 Apolipoprotein E (APOE) e4 Genotype is Associated
           with Increased Psychiatric Distress in Veterans with a History of
           Mild-to-Moderate Traumatic Brian Injury
    • Authors: Merritt V; Clark A, Sorg S, et al.
      Abstract: Objective: Since few studies have examined the relationship between the APOE gene and long-term clinical outcomes following traumatic brain injury (TBI), we aimed to determine whether the e4 allele of the APOE gene influences neuropsychiatric symptoms in military Veterans with a history of mild-to-moderate TBI. Method: Participants included 140 Veterans (TBI = 83, military controls [MC] = 57) who underwent APOE genotyping (participants were blinded to APOE status) and were divided into e4+ (TBI = 19, MC = 16) and e4− (TBI = 64, MC = 41) groups. All participants underwent a comprehensive neuropsychological assessment, including completion of self-report measures assessing psychological distress. The primary outcome measures were the total score from the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and PTSD Checklist (PCL). Two-way analyses of variance were conducted to examine the effect of group (TBI vs. MC) and e4 status (e4+ vs. e4−) across symptom measures. Results: There was a significant main effect of group across all symptom measures (TBI > MC; all p-values < .001; np2 = .226–.295), no main effect of e4 genotype (p = .173–.213, np2 = .011–.014), and a significant interaction of group by e4 genotype across all measures (p = .030–.041, np2 = .030–.034). Specifically, for TBI participants, e4+ Veterans had significantly higher symptom scores than e4− Veterans (p = .008–.012, np2 = .046–.050). For MC participants, e4 status had no effect (p = .541–.621, np2 = .002–.003). Conclusion: The results suggest a potentially meaningful relationship between APOE genotype and psychiatric distress following TBI, wherein the presence of an e4 allele conveys risk for increased symptomatology in the presence of neurological insult. Although findings are preliminary, this study furthers our understanding of how genetic factors influence response to TBI.
      PubDate: 2017-09-06
       
  • Traumatic Brain Injury-2 Accuracy of Self-Reported Questions for
           Assessment of TBI History
    • Authors: Bailie J; Babakhanyan I, Jolly M, et al.
      Abstract: Objective: Often times a history of traumatic brain injury (TBI) is assessed via self-report using questionnaires. In these assessments, individuals are asked to simply report whether or not they have had a TBI in their lifetime. This relies on a lay person's understanding of what defines a medical diagnosis for a TBI. In contrast, structured clinical interviews such as the Ohio State University TBI Identification Method (OSU TBI-ID) provide clinician guided questions to determine TBI history. The objective of this study was to determine the validity of TBI questionnaires. Method: 115 active duty service members with a mean age of 26.83 (SD = 3.47) completed a self-report TBI questionnaire asking them to report if they have had a concussion or traumatic brain injury. Participants also completed the OSU TBI-ID. Results: On self-report TBI questions, 52 (45.2%) participants reported a previous TBI compared to 81 (70.4%) who had a positive TBI on the OSU-TBI ID. The TBI questionnaire had good specificity (94.12%) but poor sensitivity (61.73%). Negative predictive power was 50.79% while positive predictive power was 96.15%. Only 31.7% of participants reported an accurate number of lifetime TBI's. The majority (51.2%) with a positive TBI history under-reported their total lifetime TBI's. Conclusion: In healthy military personnel, self-reported TBI history based on questionnaires lacks sensitivity in comparison to a clinician directed structured interview. Participants fail to report having had a TBI in their lifetime, and when they do report a positive history, they tend to under-estimate the total number of injuries.
      PubDate: 2017-09-06
       
  • Traumatic Brain Injury-3 Results from the Defense and Veterans Brain
           Injury Center's “Head to Head” Comparison of Four Computerized
           Neurocognitive Assessment Tools (NCATs): ANAM4, CNS-VS, CogState, and
           ImPACT
    • Authors: Cole W; Arrieux J, Arrieux J, et al.
      Abstract: Objective: In 2011, DVBIC Fort Bragg initiated a study assessing the reliability and validity of four computerized neurocognitive assessment tools (NCATs) in service members with and without acute mild traumatic brain injury (mTBI). We present the primary findings as well as new analyses from that study. Method: 215 healthy participants took one of the four NCATs (ANAM4, CNS-VS, CogState, ImPACT) on two occasions approximately 30 days apart. Reliability was assessed via intraclass correlations (ICC). 272 healthy participants and 231 with acute mTBI (≤7 days) were administered two of the four NCATs as well as a traditional battery of neuropsychological tests. Analyses included correlations between NCAT scores and traditional neuropsychological test scores, and regression analyses to investigate the unique variance group status accounted for in NCAT scores. Additional analyses included grouping by symptomatic status rather than injury status and investigating alternative metrics, like reaction time variability or classifying “poor” performance via study data versus normative data. Results: Analyses suggest less-than-desirable reliability and no clear evidence of convergent and discriminant validity. Additionally, regressions suggest NCATs have limited clinical utility, even when comparing symptomatic to asymptomatic individuals. However, alternative analytic approaches yield more promising and clinically meaningful results. Conclusion: By discussing previously reported data and incorporating new analyses, we aim to present a comprehensive overview of NCAT research. Though our results suggest the clinical utility of NCATs may be weak, standard approaches to psychometric investigations may be limiting. However, alternative metrics and novel analytic approaches may be more useful. Future directions for NCAT use and research are proposed.
      PubDate: 2017-09-06
       
  • Traumatic Brain Injury-4 Cognitive Complaints and Memory Performance in
           Elderly Veterans with TBI versus Those with TBI and PTSD
    • Authors: Munro C; Lobue C, Didehbani N, et al.
      Abstract: Objective: To determine whether the relationship between cognitive complaints and memory performance differs between elderly veterans with TBI and those with both TBI and PTSD. Method: Data were obtained from the Alzheimer's Disease Neuroimaging Initiative-DOD database. Participants were veterans aged 65+ with a lifetime diagnosis of moderate/severe TBI alone (n = 14) or a dual-diagnosis of moderate/severe TBI and PTSD (n = 16). All participants had a Clinical Dementia Rating (CDR) global score of 0–0.5, indicating some had normal cognition, mild cognitive impairment, and/or possible dementia. Subjective and informant-rated cognitive complaints were measured using the mean score for memory items on the Everyday Cognition scale. Memory performance was based upon a composite of subtests from Logical Memory recall, the ADAS-Cog, the MoCA, and the CDR. Relationships between complaint and performance variables were determined with Pearson correlations. Results: Cognitive complaints were not significantly associated with memory test performance within the TBI group. However, within the TBI/PTSD sample, informant complaints were correlated with memory performance (r = −0.66, p = 0.005) and subjective complaints showed a trend (r = −0.487, p = 0.056) (Figure 1). Conclusion: Despite varied memory performance in both groups, only the group with moderate/severe TBI and PTSD showed a relationship between cognitive complaints and memory test performance. These results suggest that individuals with an additional diagnosis of PTSD may be more aware of their own cognitive performance, or that a comorbid diagnosis increases the likelihood of symptom reporting. Future research examining the awareness of cognitive abilities in individuals with PTSD and in a larger cohort of individuals is needed.
      PubDate: 2017-09-06
       
  • A-01 First Session of Dual-Task Walking Significantly Different from
           Subsequent Examinations for Older Adults
    • Authors: Bernabe P; Niermeyer M, Neria J, et al.
      Abstract: Objective: Dual-task walking is of growing interest due to its relationship with falls (Mirelman et. al. 2012). This study examined the construct validity and internal and test-retest reliability of an obstructed walking task. Method: Thirty-four healthy older adults (Mean age = 69.5) completed an obstructed walking task under both single- and dual-task (serial subtraction) conditions during three separate sessions 5 weeks apart. The Dementia Rating Scale 2nd edition (DRS-2) measured cognitive status; selected subtests from the Delis-Kaplan Executive Function System measured EF. Results: Dual-task, but not single-task walking speed averaged across all assessments was significantly correlated with EF (r = −.376, p = .028; r = −.235, p = .181). Walking speed was internally reliable (across three trials) for both single- and dual-task conditions; Cronbach's alpha ranged from .872 to .970. Single-task speed had relatively high test-retest reliability across all sessions, (r values ranged from .721 to .815). In contrast, dual-task speed from the first session showed inadequate test-retest reliability at sessions 2 and 3 (r = .556 and .477). Interestingly, the correlation between dual-task walking speed at sessions 2 and 3 was higher (r = .842). Conclusion: Single- and dual-task walking speed assessments are internally reliable; however, test-retest reliability analyses across 5 week periods revealed the first session of dual-task assessment is only marginally related to speed at subsequent sessions. This suggests the first exposure to dual-task obstructed walking may reflect a construct somewhat distinct from subsequent exposures to the same assessment several weeks later. Further analysis is required to determine the factors accounting for this difference.
      PubDate: 2017-09-06
       
  • A-02 Global Cognitive Status Predicts Score Variability in Single- and
           Dual-Task Walking Among Older Adults
    • Authors: Bernabe P; Niermeyer M, Neria J, et al.
      Abstract: Objective: We recently proposed that first exposure to dual-task walking may assess a different construct from subsequent sessions of testing (Bernabe, 2017). This study examined whether walking speed during the first assessment was related to global cognitive status. Method: As part of a larger study, thirty-four cognitively normal older adults (mean age = 69.5) completed an obstructed walking task under both single- and dual-task (serial subtraction) conditions; the Dementia Rating Scale 2nd edition (DRS-2) was given as an index of global cognitive status. Two additional follow-up dual-task walking assessments were completed at 5 week intervals. Results: Hierarchical linear regression analyses showed that DRS-2 total scaled scores accounted for unique variance in the first assessment of dual-task walking speed beyond performance on two subsequent assessments (R2 Δ = .156, p = .006), such that lower scores were associated with slower walking during the first session (B = −2.084, p = .006). In contrast, when dual-task walking speed at the subsequent assessments was used as the outcome variable, DRS-2 scores did not account for variance above and beyond initial dual-task walking speed (R2 Δ = .038 p = .198). Conclusion: These results suggest global-cognitive status affects walking speed on an initial dual-task assessment, but not on subsequent assessments. This may reflect the impact of cognition on the ability to adjust to a novel task, suggesting that cognition only relates to dual-task walking speed in novel situations. Further studies should examine what drives this association and other variables that may influence performance.
      PubDate: 2017-09-06
       
  • A-03 Differential Encoding Strategies Following Cognitive Intervention in
           Older Adults
    • Authors: Clark E; Daley R, Sugarman M, et al.
      Abstract: Objective: A variety of cognitive interventions have been considered for addressing the needs of aging adults. Yet, the evidence for ongoing use of cognitive strategies after intervention remains limited. In a 12-week psychoeducational and skills training intervention (AgeWISE [Age Well through Interaction and Scientific Education]), older adults practiced cognitive skills. We hypothesized AgeWISE participants would demonstrate more efficient verbal encoding on the learning trials of the California Verbal Learning Test-II (CVLT-II) compared to the Control group. Method: Cognitively intact veterans, aged 62–87 were randomized to Experimental (n = 25) or Control (n = 24) groups. Experimental group participants completed AgeWISE and Control participants continued “life as usual.” All participants completed neuropsychological testing at baseline and after the group. Mixed-methods 2 (group) × 2 (time) ANOVAs evaluated overall performance and clustering strategies on the CVLT-II. Results: Both groups had comparable total scores across Trials 1–5, Short Delay, Long Delay, and Recognition (ps > .05). However, Experimental participants appeared to alter clustering strategies after training; they had a mean increase in semantic clustering of z = 0.80 (p = .028), whereas Control participants did not significantly change. Likewise, the Experimental group demonstrated less forward serial clustering, declining by z = 0.5 (p = .035) with no significant change in the Control group. Time by group interaction effects fell shy of statistical significance (ps > .08), but this null finding could be due to restricted sample size. Conclusion: Results indicate evidence to support differential encoding processing in older adults following education and cognitive training. Specifically, after training, participants were more likely to engage in semantic clustering and less likely to use serial clustering.
      PubDate: 2017-09-06
       
  • A-04 Use of the Personality Assessment Inventory's Depression Scale in
           Predicting Cognitive Impairment in Neuropsychological Assessment
    • Authors: Clark A; Goette W, Champagne T, et al.
      Abstract: Objective: High comorbidity rates of depression and dementia in elderly populations may suggest that the two disorders are not independent of one another. The current study hypothesized that the Personality Assessment Inventory's (PAI) Depression scale would significantly predict cognitive impairment and subjective cognitive impairment. Method: The PAI was administered to 46 individuals (28 females, age = 69.18. 5 years, education = 14.92.8 years) referred for dementia assessment. Assessments were conducted by graduate psychometrists with neuropsychology training. All diagnoses were made by a licensed neuropsychologist. Only those with cognitive impairment were included in these analyses. Results: No cases had significant elevations of any clinical scales on the PAI. The mean Depression raw score in non-impaired (M = 14.3, SD = 5.1), subjectively impaired (M = 16.9, SD = 8.9), and MCI (M = 19.8, SD = 8.5) individuals did not differ significantly, F(2, 40) = 2.19, p = .13. A Receiver Operating Characteristic (ROC) curve analysis was used and found that the Affective subscale distinguished non-impaired from subjective impairment (AUC = .770, p < .05) and non-impaired from Mild Cognitive Impairment (MCI) (AUC = .788, p = .004). The Depression scale distinguished non-impaired from MCI (AUC = .716, p < .05). Exploratory correlations were also calculated to determine the scales’ relationship to neuropsychological tests. Conclusion: The Depression scale was useful in detecting MCI from non-impaired individuals. The Affective subscale distinguished non-impaired from both subjective impairment and MCI. No scale was useful in separating subjective impairment from MCI. Because of the study's small sample size, future studies should consider a larger sample.
      PubDate: 2017-09-06
       
  • A-05 Memory and Executive Function Contributions to Medication Management
           Ability in Cognitively Normal Younger and Older Adults
    • Authors: Gracian E; Resch Z, Austiff M, et al.
      Abstract: Objective: Medication nonadherence influences and can be affected by physical and psychological health. Specifically, cognitive deficits can impair medication management that could contribute to unintentional medication nonadherence. Researchers have reported that executive function (EF) and memory deficits in standardized measures are significantly related to problems with medication management in clinical and aging populations. The purpose of our study, then, was to examine EF and memory contributions to medication management ability in cognitively normal younger and older adults using two computerized tasks that tap into EF and memory domains. Method: Thirty younger adults (Women n = 22; Mean Age = 21 years, SD = 2.7; Range 18–31 years) and 29 older adults (Women n = 27; Mean Age = 73 years, SD = 8.1; Range 60–88 years) completed the reversal task (RT), transverse patterning task (TPT), and Medication Management Ability Assessment (MMAA). RT is an executive function computerized task dependent on the prefrontal cortex in which contingencies are learned and then reversed. TPT, an adaptation of the rock/paper/scissors problem, is a learning and memory computerized task dependent on the hippocampus. The MMAA is a role-play activity in which participants are given instructions for taking fake medications and then asked to inform the researcher how and when they will ingest the pills. Results: Older adults had significantly lower scores on the MMAA than younger adults (p = .042). Across groups, regression analyses revealed that better performance in the TPT predicted higher scores on the MMAA (p = .009). Conversely, neither the RT (p = .863) nor age (p = .994) were related to performance on the MMAA. Conclusion: The findings suggest that learning and memory as measured by TPT is more predictive of medication management compared to age and EF as measured by RT. Although more research is warranted, the TPT could potentially be useful in detecting and predicting impairments in medication management that could ultimately affect medication adherence in aging populations.
      PubDate: 2017-09-06
       
  • A-06 Mental Health and Demographic Characteristics, But Not Parental
           History, Influence Subjective Ratings of Cognitive Functioning
    • Authors: Jackson G; Goetz M, Goldstein F, et al.
      Abstract: Objective: Past research suggests parental history of Alzheimer's disease (AD) or related memory problems influences participants’ perception of their own cognitive decline. We hypothesized that parental history and measures of psychological functioning would predict subjective ratings on the Cognitive Function Instrument (CFI). Most subjective complaints research utilizes a Caucasian-only sample. We examined predictors of CFI score in a sample of Caucasians and African Americans. Method: Older adult (Mage = 64.37, SDage = 7.99) participants (N = 3277) completed an online health history questionnaire as part of a prospective study of preclinical AD. Overall CFI score was regressed onto the following predictors in a standard multiple regression: scores from the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire depression scale (PHQ-8), ratings of overall physical (0–4) and mental health (0–4), age, race, sex, and parental history. Results: The full model explained 35.1% of the variance in CFI score, F(8, 3124) = 210.80, p < .001, with the following significant predictors: age, race, GAD-7, PHQ-8, and mental health rating. 58.7% reported no parental history of AD or related memory problems, while 41.3% endorsed parental history for at least one parent, but this did not predict CFI score (p = .221). African Americans endorsed greater subjective cognitive complaints. Conclusion: Parental history did not predict participants’ perceptions of personal cognitive decline. Minority race, older age, and greater psychological symptomatology were associated with greater CFI score. Our findings highlight salient factors that may impact self-assessment of cognitive function, including significant differences in reporting patterns by race.
      PubDate: 2017-09-06
       
  • A-07 Reported Expressive Suppression in Daily Life is Related to Lower
           Executive Functioning and Slower Action Planning Among Older Adults
    • Authors: Niermeyer M; Franchow E, Barron C, et al.
      Abstract: Objective: Experimentally-manipulated expressive suppression (i.e., effortful suppression of behavioral expressions of emotion; ES) causes subsequent short-term decrements in EF among both younger and older adults. Past work among younger adults also shows that self-reported higher-than-usual levels of naturally occurring ES are associated with both lower EF scores and slower action planning during a motor task. The current study sought to examine whether this latter finding applies to older adults. Method: 101 older adults (Mean Age = 69) completed items assessing burden of ES over the 24 hours leading up to testing, the Geriatric Depression Scale (GDS), and subtests from the Delis-Kaplan Executive Functioning System, as indicators of executive functioning (EF) and its component processes (e.g. processing speed; CP), and the Push-Turn-Taptap task for assessment of action planning. Results: Self-reported ES in the 24-hours leading up to testing accounted for variance in EF composite scores above GDS scores (R2 Δ = .08, p = .029), but not in CP composite scores (p = .239). There was a trend for a relationship between ES and action planning beyond GDS scores (R2 Δ = .05, p = .051). This latter relationship was fully accounted for by EF (i.e., ES did not account for variance in action planning beyond EF; p = .332). Conclusion: While causal findings cannot be drawn from a correlational design, these results suggest that naturally-occurring ES has a modest deleterious effect on EF (but not its component processes) among older adults that is measurable by self-report, and not fully captured in commonly used measures of depressive-symptom severity.Aging and Dementia: Alzheimer
      PubDate: 2017-09-06
       
  • A-08 Statistically Modeling Alzheimer's Disease Pathology as a Function of
           Relative Volumetric Deficits in Temporal Lobe Regions
    • Authors: Choudhury T; Fuller J, Lowe D, et al.
      Abstract: Objective: Alzheimer's disease (AD) is a progressive disease reflected by markers across several domains, including cerebral atrophy within the temporal lobe, as measured by structural magnetic resonance imaging (MRI). Specific regions within the temporal lobe have been implicated in early AD pathology and symptomatology. To our knowledge, no study has statistically modeled how relative volumetric deficits across these temporal lobe regions correspond to the spectrum of AD-related cognitive dysfunction. To do this, we implemented advanced statistical analyses within a single, self-contained AD sample. Method: We analyzed data from the Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 1041), focusing on MRI volumetric data of four temporal lobe regions implicated in AD: entorhinal cortex, hippocampus, middle temporal gyrus, and fusiform gyrus. Item Response Theory (IRT) was used to identify the continuum of decline. Then, through a process of statistical scaling, the four volumetric indicators were linked to that continuum and analyzed. Results: Volumetric deficits in the hippocampus indicated AD-related cognitive dysfunction more precisely than the other temporal lobe regions. Volumetric deficits in the middle temporal gyrus and entorhinal cortex indicated AD-related cognitive dysfunction relatively less precisely. Volumetric deficits in the fusiform gyrus indicated AD-related cognitive dysfunction least precisely. These findings were generally replicated when the four volumetric indicators were linked to global temporal lobe atrophy rather than cognitive dysfunction. Conclusion: These findings support the pattern of neuroanatomical changes typically observed in AD described in the literature. Further research is needed to cross-validate these findings within demographically heterogeneous samples and to understand the longitudinal implications of this pattern of atrophy.
      PubDate: 2017-09-06
       
  • A-09 Metamemory in Relation to Objective Episodic Memory Preclinical
           Dementia
    • Authors: Chi S; Kapoor A, Katz M, et al.
      Abstract: Objective: Metacognitive mechanisms support a self-referential process that is thought to be independent of primary cognitive abilities. In mild Alzheimer's disease, those with intact awareness of illness have demonstrated better metamemory compared to those with disordered awareness, despite comparable neuropsychological profiles. Metacognitive research in preclinical dementia is limited but may offer unique information, particularly in pre-MCI conditions such as subjective cognitive decline (SCD), where standardized neuropsychological tests lack sensitivity to detect subtle cognitive changes. Method: Participants drawn from the Einstein Aging Study (aged 70+) included groups of individuals with SCD (n = 82), MCI (n = 56), and HC (n = 120). Participants provided Judgments of Learning (JOL) prior to completing each learning trial of the Brief Visuospatial Memory Test-Revised (BVMT-R). Analysis used a 3 (group) × 3 (trials) mixed ANOVA. Bivariate correlations conducted for each group evaluated the association between JOL ratings and recall for each trial separately. Results: As expected based on group classification, HC and SCD demonstrated significantly better on BVMT-R recall compared to MCI (ps < 0.001). There was a group X trial interaction (p < 0.001) where across trial recall improvement was significantly higher for HC and SCD compared to MCI (ps < 0.001). Notably, JOLs were positively associated with BVMT-R recall for SCD only (ps < 0.05). Conclusion: SCD and HC demonstrated comparable basic recall abilities but only SCD showed an association between JOL and objective recall, suggesting SCD may be more accurate in self-assessing memory performance. Metacognitive paradigms may capture subtle transitional cognitive or behavioral changes unique to SCD along the HC to MCI continuum.
      PubDate: 2017-09-06
       
  • A-10 Cognitive Impairment Associated with APOE Biomarkers in Alzheimer's
           Disease
    • Authors: Diah K; Vitale G, Keith M, et al.
      Abstract: Objective: This study examined cognitive impairment in individuals given a presumptive diagnosis of Alzheimer's disease with associated APOE genotypes. Method: A clinical sample of 34176 adults (46.3% male; M age = 74.88; M education = 15.11; 85.9% White) from the National Alzheimer's Coordinating Center deidentified database was used. A MANOVA was used to compare individuals with the presence of apoE alleles (n = 15022; 48.2% male; 88.6% White; M age = 76.08, SD = 10.22), or absence of apoE allele (n = 18455; 46.4% male, 87.6% White, M age = 76.346, SD = 8.75), likelihood of no AD (n = 192; 57.3% male, 82.9% White, M age = 74.2, SD = 10.33), or likelihood of AD (n = 3066; 46.9% male, 88.0% White, M age = 77.04, SD = 10.39). All groups were compared to scores on the MMSE, CDRFAQ (alpha = .05). Results: Results showed significant differences in cognitive impairment based on presumptive AD diagnosis, Wilks’λ = 903, F(3,377) = 13.494, p < .001. There was no difference in cognitive impairment based on the apoE groups, Wilks’λ = .999, F(2,415) = .101, p = .959. Similarly the interaction effect between apoE genotype and AD diagnosis on the combined measures of cognitive impairment were not statistically significant, Wilks’λ = .996, F(3, 3776) = .870, p = .754. Conclusion: Cognitive impairment relative to functional ability in AD does not appear to be associated with the presence or absence of apoE genes. The apoE gene has been shown to be associated with higher rates of cognitive decline along verbal memory and abstract reasoning domains. Therefore, our results suggest that apoE may not be a global cognitive decline indicator across AD, but rather may be contained within certain cognitive domains. Thus, future studies should extensively measure the relationship between apoE alleles and different domains of cognitive decline. Determining predictors of AD onset and cognitive decline will be important in providing influential screening tools.
      PubDate: 2017-09-06
       
  • A-11 Initial Visit Predictors of Subjective Memory Complaints in Caucasian
           and African American Older Adults
    • Authors: Evans S; Loring D, Goldstein F, et al.
      Abstract: Objective: This study evaluated predictors of subjective memory complaints (SMC) in Caucasian and African American (AA) participants at their initial visit to a NIH funded Alzheimer's Disease Center. There is an increased incidence of Alzheimer's disease (AD) in African Americans as compared to Caucasians, but limited research evaluating the differences in SMC rate and predictors between races. Given previous research, we hypothesized that Caucasian participants would have a greater frequency of SMC and that SMC would be associated with lower neuropsychological test scores and higher depression scores. Method: Initial visit data were obtained from the National Alzheimer's Coordinating Center, and a sample of Caucasian and AA participants was matched on age, education, and gender (N = 912; 456 each race). Conditional logistic regression evaluated initial visit predictors of SMC (Has memory declined relative to previous abilities' yes/no), including race (Caucasian vs. AA), Geriatric Depression Scale score (GDS), Hachinski Ischemic Scale score, Mini-Mental State Exam score (MMSE), and Logical Memory Delayed Recall score (LM). Results: The full model was significant, χ2(5, N = 912) = 180.54, p < .001, with only race (p < .001) and LM (p = .02) as significant predictors. The model accounted for 18.0–23.9% of the variance in SMC. While African Americans were less likely to report SMC during initial visit, LM performance was a significant predictor in both groups. Conclusion: Race and LM predicted SMC at initial visit, with African Americans less likely than Caucasians to report SMC. This disparity warrants further evaluation to better understand the perception of AD in both races.
      PubDate: 2017-09-06
       
  • A-12 Validating the Utility of Automated Hippocampal Measurement Tools in
           Clinical Scans
    • Authors: Fung Y; Ng K, Vogrin S, et al.
      Abstract: Objective: Quantifying hippocampal volumes through expert tracing is limited in routine clinical practice due to time constraints. It is of interest to validate using automated tools for application to clinical populations. This study aims to investigate the validity of automated hippocampal volumetry against manual hippocampal segmentation on clinical MRI scans. Method: Seventy-one subjects between 40–89 (mean = 65.7) years were recruited from St Vincent's Hospital's memory clinic. T1-weighted MRI brain scans were acquired on 1.5T (n = 63) or 3T (n = 8) scanner. Hippocampus was manually segmented using Analyze v12.0 software, with a subset of scans delineated by two other raters for reliability. Automated measurements were calculated using FreeSurfer 6.0 hippocampal subfields algorithm and MILXView EADC-ADNI harmonized protocol. Results: Intra-rater (n = 5) and inter-rater (n = 30) reliabilities were high for manual segmentation, ICC = .87–.98 and ICC = .93–.99 respectively. Paired sample t-test showed that FreeSurfer total hippocampal volumes were significantly smaller than manual measurements (t = −9.995, df = 70, two-tailed p < .001, 95%CI[−657.3, −438.6]). MILXView total hippocampal volumes were also significantly smaller than manual measurements (t = −18.094, df = 70, two-tailed p < .001, 95%CI[−1266.5, −1016.6]). Automated measures correlated highly with manual measures for both FreeSurfer (rs = .90, p < .001) and MILXView (rs = .87, p < .001). Average percentage underestimations were −8.3% for FreeSurfer and −18.5% for MILXView. The Bland-Altman plots showed that these underestimations were consistent across scans for both automated modalities (Fig. 1). Conclusion: Both FreeSurfer and MILXView demonstrated robustness in relation to managing hippocampal variability seen in clinical MRI scans. There was very strong correlation as well as good agreement between manual and both automated measurement tools.
      PubDate: 2017-09-06
       
  • A-13 Examining the Validity of Automated Estimation of Entorhinal and
           Perirhinal Cortices
    • Authors: Fung Y; Vogrin S, Meade C, et al.
      Abstract: Objective: The medial temporal regions, especially entorhinal and perirhinal cortices, are of interest for detecting early Alzheimer's disease. The highly variable anatomical boundaries for entorhinal and perirhinal cortices continue to challenge automated analysis pipelines. This study examines the validity of existing automated measurement tools and introduces a novel automated analysis pipeline. Method: 3T MRI scans from twenty subjects, classified as normal, were downloaded from the Australian Imaging Biomarkers and Lifestyle flagship study of aging dataset. Entorhinal and perirhinal cortices were manually delineated using Analyze 12.0 software. Automated measurements from entorhinal and perirhinal structures were calculated from cytoarchitecturally-defined labelling, using recently revised FreeSurfer 6.0 to address earlier recognised errors. The structures were also segmented using a segmentation-registration approach based on the manual segmentations. The validation was run in a leave-one-out fashion. Results: FreeSurfer entorhinal volumes were significantly smaller than manual measurements (t = −8.108, df = 19, two-tailed p < .001, 95%CI[−625.9, −369.0]), with no significant correlation between these volume estimates (rs = −0.10, p = 0.68). FreeSurfer's total perirhinal volumes were not significantly different from manual measurements (t = 1.307, df = 19, two-tailed p = 0.21, 95%CI[−56.3, 243.28]). FreeSurfer and manual perirhinal volumes were significantly negatively correlated (rs = −.47, p = .04). Visual inspection of FreeSurfer's segmentation showed considerable overlap of entorhinal and perirhinal regions (Fig.1). Preliminary results of our landmark-based automatic segmentation showed a mean Dice similarity coefficient of 0.72 and 0.66 for entorhinal and perirhinal cortices respectively. Conclusion: FreeSurfer's current entorhinal and perirhinal segmentations appear suboptimal for estimating the volumes of these regions. Preliminary findings from our landmark-based automated pipeline offer promising results in defining the boundaries of these structures.
      PubDate: 2017-09-06
       
  • A-14 Verbal Memory Binding and Markers of Brain Pathology in Preclinical
           Autosomal-dominant Alzheimer's Disease
    • Authors: Janos A; Duncanson H, Erwin S, et al.
      Abstract: Objective: Understanding the relationship between brain pathology and cognition in preclinical Alzheimer's disease (AD) is essential for early identification of individuals at risk to develop dementia later in life. Research suggests that older individuals considered at high risk (by molecular pathology imaging) to develop AD may exhibit limited benefit from semantic cues during learning paradigms. Here we examined the relationship between verbal memory binding and markers of AD pathology in presymptomatic individuals with autosomal-dominant AD (ADAD). Method: Seven unimpaired PSEN1 mutation carriers and twelve non-carriers aged 20–55 years were included in the study. All participants completed the Memory Binding Test (MBT, previously called Memory Capacity Test or MCT), a verbal memory test that uses controlled learning and cued recall, as well as semantic interference. All participants underwent amyloid (Pittsburgh Compound B-PiB) and tau (Flortaucipir) PET imaging. Results: Groups did not differ in tau accumulation in medial temporal lobe regions and inferior temporal lobe. Compared to non-carriers, mutation carriers had elevated mean cortical β-amyloid (p = 0.016), and performed worse on the cued recall of the MBT (p = 0.04). In carriers, higher levels of tau pathology were strongly associated with worse MBT performance (r = −.92, p = 0.003). Amyloid burden was not associated with cognitive performance. Conclusion: Results support a relationship between memory binding and tau pathology (but not cortical amyloid) among carriers. Preliminary findings suggest that changes in verbal memory binding can be detected in cognitively unimpaired individuals, years before clinical onset. Future studies in larger samples are needed to substantiate these findings and better understand memory binding in preclinical AD.
      PubDate: 2017-09-06
       
  • A-15 Benefits of Receiving Cognitive Interventions in the Early Stages of
           Mild Neurocognitive Disorders Due to Alzheimer's Disease: A Systematic
           Literature Review
    • Authors: Irizarry-Anson C; Morales W.
      Abstract: Objective: There is a lack of literature examining the benefits of starting cognitive interventions early for mild neurocognitive disorders (MND) due to AD. The purpose of this review was to identify cognitive therapies that are beneficial to individuals in the early stages of MND due to AD. Data Selection: Key words used in this search included mild neurocognitive impairment, early, stages, mild, Alzheimer's disease, benefits of treatment, cognitive therapies, and cognitive restructuring. Only studies that analyzed cognitive interventions in the early stages of MND due to AD were explored. Studies published before 2007 were excluded. Seven articles met the inclusion criteria. Data Synthesis: Findings in two studies concluded that cognitive interventions were effective in helping patients maintain semantic memory, autobiographical memory, cognition, and semantic fluency for MND when compared to control groups. A five-year longitudinal case study concluded that cognitive intervention made a significant improvement in immediate recall, reading comprehension, semantic memory, general cognitive ability, and written narrative. One study found that cognitive treatment among patients with anosognosia was not beneficial. One study concluded that cognitive intervention of MND, when compared to amnestic Mild Cognitive Impairment (MCI), showed no significant benefits. A review of cognitive intervention studies identified benefits as inconclusive. One study found that intervention focused on multiple domains showed more significant improvement than those focused on one cognitive domain. Conclusion: The results of this review indicated mixed results. Benefits shown were in the areas of memory acquisition, visuospatial abilities, information retrieval, language, semantic fluency, autobiographical memory performance, and semantic personal knowledge.
      PubDate: 2017-09-06
       
  • A-16 The Predictive Validity of Cognitive Screening Tools and
           Neuropsychological Measures for Neurocognitive Disorders
    • Authors: Janos A; Duncanson H, Erwin S, et al.
      Abstract: Objective: Many screening tools are used to detect cognitive impairment, although their predictive value for severity and type of neurocognitive disorder (NCD) remains unclear. We examined the predictive validity of the MoCA, MMSE, and ACE-R for NCD and neuropsychological test performance in four cognitive domains (executive function, semantic access, immediate memory, delayed memory). Method: 92 patients (mean age: 70, mean education: 15) were administered the MoCA within one year of neuropsychological evaluation at the MGH Psychology Assessment Center. Patients were classified by severity and type (amnestic (50) and non-amnestic (25) mild NCD; amnestic (9) and non-amnestic (8) major NCD). Logistic regression assessed the relationship between screening tools and cognitive functioning. Results: The MoCA, MMSE, and ACE-R were strongly correlated with each other (p < .001). The full model evaluating performance on the screening tools and severity of neurocognitive disorder was not significant. The MMSE was the strongest predictor of amnestic presentation, beyond the MoCA (regardless of time administered) and ACE-R (p < .05). The MoCA was a significant predictor of executive function (p < .05) and the ACE-R a significant predictor of semantic access and immediate memory (p = .001). No screening tool was predictive of delayed memory. Conclusion: The MoCA, MMSE, and ACE-R were comparable in predicting NCD. The MMSE was most sensitive to NCD type (amnestic vs. non-amnestic). The ACE-R predicted semantic access problems, likely reflecting its emphasis on language. The MoCA predicted executive function problems, also likely reflecting item content. While these tools are helpful screens, it is important to recognize their limitations in terms of diagnostic sensitivity.
      PubDate: 2017-09-06
       
  • A-17 Sex Differences in Hippocampal Subfield Volume: The Impact of Amyloid
           Burden
    • Authors: Kirkland C; Berg J, Cummings J, et al.
      Abstract: Objective: To examine sex differences in impact of florbetapir-Positron Emission Tomography (PET) amyloid positivity (A+), on hippocampus subfield volume (SV). We hypothesized women with prodromal Alzheimer's disease (AD; A+ early mild cognitive impairment; eMCI), but not suspected non-AD pathophysiology (SNAP; A– eMCI) or normal cognition (NC) would show neural vulnerability in SV in the context of A+, and men would not show this pattern. Method: We examined 526 NC and eMCI participants from Alzheimer's Disease Neuroimaging Initiative (ADNI2 and ADNI-GO) with screening SV. Regression moderation models examined sex and diagnosis moderation of A+ effects on right and left SV (adjusted for total intracranial volume). Age, screening cognition, education, and apolipoprotein E epsilon 4 (APOE-4) carrier status were controlled. Results: Women with prodromal AD, but not SNAP showed smaller right cornu ammonis 4/dentate gyrus (CA4/DG; t = −3.27, p < 0.001; CI: −54.23–−13.51). No significant A+ effects were observed for NC women (t = 0.35, p = 0.72; CI: −22.95–33.02), or men with NC (t = −1.22, p = 0.22; CI: −52.98–12.47) or MCI (t = −0.67, p = 0.50 CI: −30.14–14.73). Other SV did not show sex moderating effects. Conclusion: Women with prodromal AD, but not SNAP or NC showed smaller CA4/DG volumes. There was no relationship of A+ with CA4/DG volume in men. Findings suggest sex-specific vulnerability in memory-specific brain regions in women with prodromal AD, and have implications for understanding why women show both cognitive reserve and more rapid decline in AD compared to men.
      PubDate: 2017-09-06
       
  • A-18 Exploring the Relationship Between Music and Alzheimer's Disease: A
           Systematic Literature Review
    • Authors: Otero V; Rodriguez M.
      Abstract: Objective: The relationship between music and Alzheimer's disease (AD) has been a novel topic of interest for researchers. The purpose of this systematic review was to identify the relationship between music and AD. Data Selection: The following databases were utilized: Academic Search Complete, Medline, Psycarticles, Psychology and Behavioral Sciences Collection, PsychInfo and PubMed. Key word used included: music, music therapy, Alzheimer's disease, and dementia. Peer-reviewed articles from 2007 to 2017 were selected. Articles considering other types of dementia and other forms of music therapy were excluded. Thirteen studies that met the inclusion criteria were selected. Data Synthesis: One study identified the caudal anterior cingulate and the ventral pre-supplementary motor area as brain regions that encode long-term musical memory, which is preserved in AD patients. Four studies demonstrated that self-chosen music enhanced autobiographical memories in subjects with AD. One study found that musical emotional judgment, defined as the capacity to identify mode and tempo as happy or sad, was conserved in individuals with AD. Finally, five studies concluded that music therapy implemented as a non-pharmacological treatment for patients with AD were associated with the reduction of anxiety, depression and social withdrawal. Conclusion: Results of this literature review offer an understanding of the relationship between music and AD. Therefore, music should be incorporated in the treatment of AD as a memory enhancer and as a substitute for pharmacological treatment. Future studies should research if AD patients can learn new information by incorporating music as an intervention.
      PubDate: 2017-09-06
       
  • A-19 Neuropsychological and Psychological Predictors of Conversion from
           Mild Cognitive Impairment to Alzheimer's Dementia
    • Authors: Rindge M; Moncrief G, Daniel M.
      Abstract: Objective: This study aims to determine to what extent neuropsychological measures, depression, and ratings of everyday functional status predict conversion from mild cognitive impairment (MCI) to Alzheimer's dementia (AD). Method: 210 subjects diagnosed with MCI were selected from the National Alzheimer's Coordinating Center database. Exclusion criteria included: English not primary language, health conditions, and current substance use disorder. 130 subjects (62%) converted to AD 1 to 4 years after MCI diagnosis (mean = 1.41 years, SD = 0.69). The remaining 80 subjects did not convert to AD by their last follow up 1 to 9 years after diagnosis of MCI (mean = 3.12 years, SD = 1.54). Independent variables for hierarchical logistic regression were: Logical Memory II, Trails B, Geriatric Depression Scale, Clinical Dementia Rating scale (CDR) collateral interview, Mini-Mental Status Exam, and Boston Naming Test. Results: CDR was the only significant predictor (p = .001) of conversion from MCI to AD. Subjects were 17 times more likely to convert to AD for each one-unit increase on the CDR. Conclusion: In this study, ratings of everyday functional ability were the best predictors of conversion from MCI to AD among the neuropsychological and mood measures used in this study. This is consistent with results from other studies measuring functional ability with the CDR. In contrast to our results, previous research has shown measures of verbal memory, executive function, and depression to be significant predictors of conversion to AD. Differences in neuropsychological tests used and method of assessing depression may account for these different findings.
      PubDate: 2017-09-06
       
  • A-20 Do Cardiovascular Risk Factors (CVRF) Mediate the Relationship
           Between White Matter Hyperintensities (WMHs) and Neurocognitive
           Performance'
    • Authors: Rodriguez-Flores I; Ream D, Loewenstein D, et al.
      Abstract: Objective: In this study we examined the relationship between neurocognitive performance and WMH, with and without controlling for the effect of CVRF. Method: Mild Cognitive Impairment (MCI) (n = 48), and Dementia (n = 36) groups were examined. WMH was measured by a visual ratings scale. CVRF score was calculated by summing 10 risk factors by patient history. Mean left (L)WMH scores for MCI was 1.10 (.81) and right (R)WMH was 1.09(.86) among MCI. For Dementia, mean LWMH was 1.22(1.02) and RWMH was 1.20(.97). Logical Memory-II (LM-II), Visual Reproduction I-II (VR I-II), and Digit Symbol Coding (DS-Coding) were examined. Partial correlations were conducted, one controlling for education and CVRF, and one removing CVRF as a covariate. Results: Among MCI, when controlling for CVRF, LWMH accounted for 19% [R2 = .193,p < .002] of the variance in DS-Coding, 19% [R2 = .194,p < .002] in VR-I, 17% [R2 = .170, p < .004] in VR-II, and 9% of the variance [R2 = .091, p < .044] in LM-II. RWMH accounted for 18% [R2 = .180,p < .004] of the variance in DS-Coding, and 23% [R2 = .229, p < .001] in VR-II. When CVRF was removed as a covariate, LWMH accounted for 17% of the variance [R2 = .165,p < .005] in DS-Coding, results were similar for VR-I and VR-II. No significant findings between LM-II and WMH were obtained. Among dementia, when controlling for CVRF, LWMH accounted for 12% [R2 = .123,p < .046] of the variance in VR-II and results were not significant when CVRF was removed as a covariate. Conclusion: The presence of WMH appears to impact executive function and memory primarily in prodromal stages of dementia and largely independent of the presence of CVRF, similar to the effect beta amyloid deposition.
      PubDate: 2017-09-06
       
  • A-21 Detection of MCI in African Americans Using the Montreal Cognitive
           Assessment (MoCA)
    • Authors: Smith E; Hynan L, Lacritz L, et al.
      Abstract: Objective: The Montreal Cognitive Assessment (MoCA) is a widely used cognitive screening tool. Our earlier work suggests that published cut-off scores for mild cognitive impairment (MCI) may lead to over-identification of impairment in minorities. This study aimed to develop an appropriate cut-off score to detect MCI in a community-based African American sample. Method: Consensus diagnoses of normal cognition (n = 45) or MCI (n = 90) were given to participants from a community-based cohort. Diagnoses were based on Clinical Dementia Rating score and comprehensive neuropsychological assessments; clinicians were blinded to MoCA results. Receiver operating characteristic (ROC) curve analysis was performed to determine a cut-off score to distinguish MCI from individuals with normal cognition based on optimal sensitivity and specificity, and highest diagnostic accuracy. Results: The cognitively normal group was slightly younger [M.NC = 62.33(6.76), M.MCI = 64.76(5.87); p = 0.033], more educated [M.NC = 14.36(2.51), M.MCI = 13.07(2.37); p = 0.004], and had higher MoCA scores [M.NC = 25.47(2.13), M.MCI = 21.26(3.85); p < 0.001] than the MCI group. A cut-off of 23.5 yielded optimal sensitivity (72.2%) and specificity (84.4%), with 76% accuracy in distinguishing MCI from normals (AUC = 0.826; 95%CI: 0.755–0.896; p < 0.0001). The traditional cut-off of <26 increased sensitivity (84.4%) but lowered specificity (57.8%), and demonstrated similar accuracy (75.6%). Conclusion: This study provides a cut-off score to help differentiate persons with MCI from those with normal cognition in an African American sample. Using a cut-off score of <24 reduces the likelihood of misclassifying cognitively normal individuals as impaired than previously published cut-offs. This study underscores the importance of developing community- and racially-based norms to optimize clinical utility of commonly used screening measures.
      PubDate: 2017-09-06
       
  • A-22 Neuropsychiatric Symptoms and the Diagnostic Stability of Mild
           Cognitive Impairment
    • Authors: Sugarman M; Alosco M, Steinberg E, et al.
      Abstract: Objective: Mild cognitive impairment (MCI) is conceptualized as an intermediate stage between normal cognition (NC) and dementia, most commonly due to Alzheimer's disease (AD). However, MCI is heterogeneous, and many individuals subsequently revert to NC. The current study examined whether neuropsychiatric symptoms could partially account for the temporal instability in cognitive diagnoses. Method: Data were obtained through the National Alzheimer's Coordinating Center Uniform Data Set. All participants had NC at baseline, completed at least two follow-ups, and had no recent neurological conditions (N = 6763). Generalized linear models estimated by generalized estimating equations examined the associations between symptoms on the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Geriatric Depression Scale (GDS-15) and clinical visits where participants changed cognitive diagnoses. Results: A total of 1121 participants converted to MCI; 324 subsequently reverted back to NC and 242 progressed to AD. Higher symptoms on the NPI-Q and GDS-15 increased the likelihood of converting from NC to MCI. Lower symptoms on both inventories increased the chance of reverting from MCI to NC. A decrease in the GDS-15 between visits also increased the odds of reversion. Pharmacological treatment was not significantly related to reversion. Higher symptoms on the NPI-Q (and not the GDS-15) indicated an increased risk for progressing to AD. Conclusion: The temporal instability of MCI can be partially explained by fluctuations in neuropsychiatric symptoms. Individuals with higher levels of neuropsychiatric symptoms are more likely to convert to MCI and AD and less likely to revert to NC. Efforts to identify and treat these symptoms may support cognitive functioning in older adults.
      PubDate: 2017-09-06
       
  • A-23 Bilingualism and Memory in Mild Cognitive Impairment (MCI)
    • Authors: Torres V; Arruda F, Velez-Uribe I, et al.
      Abstract: Objective: To analyze differences between bilinguals and monolingual participants with MCI in memory tests. It is well known that bilingualism offers cognitive advantages and may protect against the development of Alzheimer's disease, however, it is unclear whether the cognitive advantage of bilingualism is confined to executive functioning or may extend to memory abilities. Method: A sample of 57 participants diagnosed with MCI (39 females) comprised of 39 Spanish/English bilinguals and 18 monolinguals from the 1Florida Alzheimer's Disease Research Center. The language groups did not differ in age or education and had equivalent scores on MMSE and MoCA. Instruments: Verbal memory assessments (Logical Memory [LM-WMS-R], HVLT, and LASSI-LE) and non-verbal memory tests (Benson Figure Copy and Recall and Short-term Visual Memory Binding test [STVMBT]). Results: Univariate GLM analyses showed that the bilingual group significantly outperformed the monolingual group in LM-WMS-R immediate recall (F(1,56) = 8.3 p = .006, pŋ2 = .13), HVLT learning (F(1,56) = 11.89, p = .001, pŋ2 = .18) and LASSI-LE on two cued trials (F(1, 56) = 5.02, p = .029, pŋ2 = .082; F(1,56) = 8.68, p = .005, pŋ2 = .13) as well as one free recall trial (F(1,56) = 5.45, p = .023, pŋ2 = .09). The groups’ performance on non-verbal memory tests was equivalent. Scores on the Benson Recall (p = .43) and STVMBT color-shape (p = .85) and shape-only proportion (p = .96) were not significantly different between bilinguals and monolinguals. Conclusion: Results support the idea that bilingualism provides advantages for verbal, but not in non-verbal memory tasks. These results should be confirmed with a larger sample and longitudinally within the next 3 years.
      PubDate: 2017-09-06
       
  • A-24 Cortical Thickness Changes Associated with Failure to Recover from
           Proactive Semantic Interference as a Prognostic Factor of Mild Cognitive
           Impairment
    • Authors: Valdivia R; Zacca E, Mineo A.
      Abstract: Objective: There is increasing evidence that there are specific cognitive states that do not meet full criteria for Mild Cognitive Impairment (MCI). These cognitive states, referred to as PreMCI, confers risk for neurodegenerative disease and progression of cognitive decline over time. It is increasingly recognized that the failure to recover from proactive semantic interference (frPSI) may be an early marker of Alzheimer's disease (AD) neuropathathology, but it is unknown as to whether frPSI can differentiate persons classified as having PreMCI from those who are cognitively normal (CN). Method: We studied 49 individuals with a knowledgeable informant that, by history, had cognitive decline but cognitively normal scores on a broad array of neuropsychological measures (PreMCI-Clinical). These participants were then compared to 117 CN age equivalent elder's scores on the LASSI-L, a measure tapping into maximum storage capacity, as well as vulnerability to proactive semantic interference (PSI), frPsI and retroactive semantic interference rSI. Measures of cortical thickness (CoTH) were also evaluated. Results: PreMCI-Clinical participants evidenced greater initial learning deficits frPSI, rSI and delayed recall deficits relative to the CN group. Controlling for false discovery rate (FDR), frPSI was related to decreased CoTH in the isthmus cingulate, posterior cingulate, precuneus, fusiform, parahippocampus, superior temporal lobules, supramarginal gyrus, superior frontal, caudal middle frontal, cuneus, lingual, lateral occipital lobules and insula regions. Conclusion: Despite equivalent scores on traditional memory measures of frPSI, which has previously been shown to distinguish between PreMCI and CN elders, frPSI associated with reductions in CoTH in numerous brain regions.
      PubDate: 2017-09-06
       
  • A-25 The Relationship of BMI on Neuropsychological Outcomes in Older
           Adults with Alzheimer's Dementia
    • Authors: Vitale G; Okolichany R, Lowry B, et al.
      Abstract: Objective: The aim of this study is to determine if BMI affects decline in adults with Alzheimer's dementia. Method: The participants (N = 8399) were selected from an archival database of the National Alzheimer's Coordinating Center and were predominately male (51.9%) older adults (≥65) with a mean age of 78.73 (SD = 6.74) and mean education of 15.46 (SD = 2.76). Groups were normal weight (BMI 18.5–24.9) (n = 3559), overweight (BMI 25–29.9) (n = 3448), and obese (BMI ≥ 30) (n = 1392) and all were identified as demented with a “high probability” for Alzheimer's disease etiology. Results: A one-way between subjects ANOVA (α = .01) revealed a statistically significant effect of weight category on six of the 11 outcomes. The obese and overweight groups produced significantly better scores than normal BMI on Logical Memory (Immediate/Delayed) and Boston Naming Test. Normal BMI was more impaired than overweight group on Trail Making Test (A/B). The overweight group was more impaired on Category Fluency (Vegetables). No statistically significant effects were found on MMSE, Digit Span (Forward/Backward), Category Fluency (Animals), and WAIS-R Digit Symbol. Conclusion: The study suggests a non-linear relationship between BMI and overall cognitive functioning in Alzheimer's dementia and that specific domains may be uniquely impacted. Previous research has suggested higher BMI may selectively protect visuospatial processing speed in older age (Kuo et al., 2010). The current study supports this, but also presents a domain-specific approach to the BMI-cognitive functioning relationship. Word retrieval and delayed memory are foundations of Alzheimer's dementia, and the current study found they were the least impaired in the obese group. This may suggest BMI selectively moderates these domains and not others.Aging and Dementia: Other
      PubDate: 2017-09-06
       
  • A-26 The Functional Impact of Emotional Dysregulation in Adults with
           Frontotemporal Dementia
    • Authors: Vitale G; Capp K, Stripling A.
      Abstract: Objective: The existing literature has suggested that behavioral indicators are key in differentially diagnosing Frontotemporal Dementia (FTD) from other dementias. The present study examined which daily living domains were most affected by severity of emotional and behavioral dysregulation in patients with FTD. Method: Participants included FTD-diagnosed adults (n = 2,036) from the National Alzheimer's Coordinating Center Uniform Dataset. Participants were primarily male (64.9%) with a mean age of 64.59 years (SD = 9.67) and mean education of 15.15 years (SD = 3.11). Predictor variables were aggression, apathy, disinhibition, and irritability severity as ranked by informants close to the patient (e.g. spouse, sibling, child). The Clinical Dementia Rating (CDR) functional domain scales served as the dependent variables (a = .01). Results: Regression analyses revealed Judgment (F(4,462) = 3.62), Community Affairs (F(4,462) = 6.00), Home and Hobbies (F(4,462) = 5.318), and Behavior/Comportment/Personality (F(4,363) = 5.00) scales were significantly predicted. Specifically, apathy severity contributed to 1.77% of the variance in Community Affairs and 3.31% in Home and Hobbies. Disinhibition severity predicted Judgment (1.42%), Community Affairs (1.90%), and Behavior/Comportment/Personality (3.10%). Irritability severity accounted for 1.37% of the variance in Judgment, 1.14% in Community Affairs, and 0.96% in Home and Hobbies. CDR scales not predicted were Memory, Orientation, and Language. Aggression severity did not predict any CDR scales. Conclusion: These results indicate that not only is the presence of these behavioral indicators indicative of FTD but also that their level of severity corresponds to associated problems as measured by the CDR. Establishing severity level and progression of these behavioral indicators and their impact on specific activities of daily living would provide key diagnostic and prognostic information.
      PubDate: 2017-09-06
       
  • A-27 Working Towards a Neuropsychological Profile for the Major Sleep
           Disorders
    • Authors: Vitale G; Zachar R, Grego A, et al.
      Abstract: Objective: To identify which cognitive deficits in older adults are associated with specific sleep disorders and to compare outcomes of untreated sleep apnea with cases undergoing treatment. Method: The participants (N = 146) were selected from the National Alzheimer's Coordinating Center database. The sample was primarily female (50.7%) older adults aged 65 to 95 (M = 75.42, SD = 6.71) with a mean education of 15.49 years (SD = 2.95). Four groups were created: untreated sleep apnea (n = 34), narcolepsy (n = 19), REM sleep behavior disorder (RBD) (n = 33), and insomnia (n = 60). Dependent variables were age and education-adjusted z-scores of 11 neuropsychological outcomes. Results: Using a .01 significance level, MANOVA revealed an overall effect, Wilks’λ = .506, F(33,389.60) = 3.07, p = < .001. Univariate comparisons revealed the following: sleep apnea. Conclusion: The study suggests different sleep disorders may affect different neurocognitive domains in older age; namely, sleep apnea showed selective impairment on memory domains, the word retrieval deficit in narcolepsy was the only mean found to be more impaired than all other groups, REM sleep behavior disorder showed mostly global deficits, and insomnia mean outcomes remained largely within normal limits. This study supports neuropsychological testing to determine functional consequences in the sleep disorder population. Future research should investigate co-factors such as years with disorder, treatment techniques, average hours of sleep per night, and quality of sleep.
      PubDate: 2017-09-06
       
  • A-28 What Predicts Performance on Lower Extremity Motor Sequencing Task in
           Healthy Older Adults'
    • Authors: Bryant A; Clark B, Clark L, et al.
      Abstract: Objective: Aging is associated with a myriad of physiological changes that result in declines in cognitive and physical abilities. Advancing age is known to result in declines in executive functioning (EF) and motor function. Studies have demonstrated a relationship between impaired EF and impaired upper extremity motor sequencing in older adults. We sought to examine the relationship between neuropsychological performance and lower extremity motor function. This relationship is important to consider given impairments in both cognitive and physical abilities are related to fall risk. Method: Forty-four community-dwelling older adults (mean age: 79.6 (SD 5.37); 14 male) without overt neurological disease participated in this study. Participants completed neuropsychological measures, including the Repeatable Battery for the Assessment of Neurological Status-Update (RBANS), Controlled Oral Word Association (COWA), and Trail Making Test. Additionally, measures of upper extremity motor function (Purdue Pegboard Test (PPBT)) and lower extremity motor function (Four Square Step Test (FSST)) were obtained. Note: 10 individuals did not complete COWA or TMT. Results: Lower extremity motor function (FSST) was not related to general cognitive ability (RBANS Total Score r = −0.02), Immediate Memory (r = 0.02), or Delayed Memory (r = 0.16). FSST performance was correlated with PPBT for dominant and non-dominant hands (r = 0.24; r = 0.49, ps < 0.01) and was related to RBANS Coding (r = −0.33) and slower TMT A (r = 0.42, ps < 0.05). There were small effect sizes for FSST and RBANS Semantic Fluency (r = 0.20, p = 0.22), COWA (r = −0.30, p = 0.10), and TMT B (r = 0.29, p = 0.12). Note: COWA and TMT were likely underpowered due to smaller N within the sample. FSST was unrelated to RBANS Figure Copy (r = −0.03), but was related to RBANS Line Orientation (r = −0.42, p < 0.01). A regression model using all participants, with PPBT, RBANS Coding, and RBANS Line Orientation as predictors, explained 41% of the variance in FFST performance, F(3,35) = 8.08, p < 0.001. Conclusion: These data suggest performance on upper extremity motor sequencing, visuospatial orientation, and EF predict performance on lower extremity motor sequencing task. The small effect sizes between other EF measures and FSST suggest a similar relationship between EF and functional impairment noted in prior research. Future studies should include a larger sample size and additional measures of EF and fall risk.
      PubDate: 2017-09-06
       
  • A-29 Utility of the University of Pennsylvania Smell Identification Test
           as a Screening Test for Dementia
    • Authors: Carballo A; Goette W, Schmitt A, et al.
      Abstract: Objective: The current study evaluates the potential of the University of Pennsylvania Smell Identification Test (UPSIT) as a screening test for dementia. Method: The sample consisted of 62 participants (26 men) referred for dementia assessment, with a mean age of 70.3 (SD = 10.0) and mean education of 14.6 years (SD = 2.9). A Kruskal-Wallis Test and Multinomial Regression was used to determine the ability of the UPSIT raw score to discriminate between diagnostic groups. A Receiver Operator Characteristic Curve was used to identify ideal cutscores. Results: The distribution of errors made on the UPSIT across individuals without cognitive impairment was not the same across groups, H(2) = 18.423, p < .001. Post-hoc analyses revealed that the dementia group had a significantly greater mean rank (42.25) than the non-impaired group (18.87), p < .001. A Multinomial Regression model with UPSIT errors as the predictor was significant, R2(2) = 18.827, p < .001, but the regression classified no cases of MCI. Based on these findings, the MCI group was omitted from further analysis. The ROC curve analysis (AUC = .939) revealed a cutscore of 10 errors on the UPSIT, and maximized sensitivity (100%) and specificity (74.07%). Conclusion: Given the significant area under the curve found from the ROC curve and the high sensitivity/specificity of the UPSIT, it may serve as a strong screening test for dementia. These findings should be viewed cautiously given the relatively high educational level of the participants involved and due to the preponderance of Alzheimer's diagnoses in the dementia group.
      PubDate: 2017-09-06
       
  • A-30 Differences Among Unspecified and Specified Neurocognitive Disorders
           Across Spanish Speaking Hispanics Older Adults Using the Repeatable
           Battery for the Assessment of Neuropsychological Status-Update
    • Authors: Castillo L; Santos S, Barnes I, et al.
      Abstract: Objective: Studies informing diagnosis and treatment for Spanish-speaking older Hispanic adults using the Repeatable Battery for the Assessment of Neuropsychological Status-Update, Spanish Version (RBANS) are limited. The present study aims to determine whether RBANS subtest differences exist among unspecified (UNCD) and specified neurocognitive disorders (SNCD) in Spanish-speaking older Hispanic adults. Method: At an outpatient memory program, archival data of patients (N = 66) diagnosed with a neurocognitive disorder, who underwent neuropsychological testing was examined. Participants were divided into UNCD (n = 31; 71% female / 29% male) and SNCD (n = 35; 60% female / 40% male) groups; participant's age ranged from 53–87 (m = 78.70) and years of education ranged from 0 to 16 years (m = 7.89). Differences using Mini-Mental Status Exam-2 (MMSE-2) between the two groups was employed to determine diagnostic accuracy. Differences in RBANS subtest scores were then assessed using independent samples t-tests. Results: Diagnostic accuracy was indicated using the MMSE-2 as a significant mean difference (a = 0.05) among the UNCD and SNCD groups existed (t = 2.781; p = 0.007). Findings revealed differences (a = 0.05) among the two groups in RBANS List Learning (t = 3.071; p = 0.003), Picture Naming (t = 2.080; p = 0.042), and Coding (t = 2.770; p = 0.007). No significant differences were found on other measures. Conclusion: Differences were found among UNCD and SNCD on rote verbal memory, confrontational naming, and processing speed and visuomotor functioning. These results may lead to additional insights in the clinical assessment of a specific neurodegenerative process within this population. Future studies should examine these differences in the utility of the RBANS in diagnosing SNCDs within Spanish speaking older Hispanic adults.
      PubDate: 2017-09-06
       
  • A-31 Naturalistic Assessment of Everyday Functioning in Individuals with
           Parkinson's disease
    • Authors: Cunningham R; Schmitter-Edgecombe M.
      Abstract: Objective: To determine whether the Day Out Task (DOT), a naturalistic task that requires multitasking in a real-world setting, would be sensitive to cognitive impairment in individuals with Parkinson's disease (PD). Method: Participants were 31 healthy older adults (ages 65–71, M = 68, SD = 9.0), 17 adults with PD (ages 63–72, M = 68, SD = 9.5) and 14 adults with PD-associated mild cognitive impairment (PDMCI) (ages 61–70, M = 65, SD = 7.7). Participants were required to prioritize, organize, initiate and complete eight different subtasks in a campus apartment to prepare for a day out (e.g., warm up a heating pad, pack a magazine, gather correct bus money). The time it took participants to complete the task was recorded, along with task accuracy and task sequencing, a measure of task efficiency. Results: A one-way Analysis of Variance revealed that compared to both the HOA and PD groups, individuals with PDMCI required more time to complete the DOT, p < .05. Individuals with PDMCI were also less accurate, p < .05; performing more subtasks incompletely or inaccurately, and less efficient, p < .05; sequencing tasks poorly compared to both the HOA and PD groups. No significant differences emerged between the HOA and PD groups. Conclusion: Individuals with PDMCI may experience reduced functional abilities, including executing everyday activities less efficiently and accurately. In contrast, Individuals with PD without MCI performed comparably to HOAs in their ability to multi-task, organize and execute performance on a complex naturalistic everyday task.
      PubDate: 2017-09-06
       
  • A-32 Use of a Discrepancy Score for the RBANS Total Scale Score and
           Premorbid Ability in the Screening and Diagnosis of Dementia
    • Authors: Goette W; Moore J, Klueppel L, et al.
      Abstract: Objective: The objective was to evaluate the potential of a discrepancy score between the estimated IQ from the Weschler Test of Adult Reading (WTAR) and the RBANS Total Scale score for screening and diagnosing cognitive impairment. Method: The study used archival data for a sample of 62 individuals (26 men) with a mean age of 70.3 (SD = 10.0) and mean education of 14.6 years (SD = 2.9) who were referred to a memory research clinic for dementia assessment. A database of their results on a standardized neuropsychological assessment was used for this study. Results: The mean WTAR IQ and RBANS Total Scale difference was not the same across groups, F(2, 58) = 18.024, p < .001. Post-hoc analysis revealed that the non-impaired and MCI groups did not differ though both were had a mean discrepancy score significantly less than the dementia group's. Receiver operator characteristics curves revealed comparable accuracy between the discrepancy score and the RBANS Total Scale. The discrepancy score was not significantly related to demographic variables or current WAIS IQ while the RBANS Total Scale was significantly related to both education (r = .25, p < .01) and WAIS IQ (r = .55, p < .01). The WTAR was found to be a significant mediator of the relationship between education and the RBANS Total Scale, z = 2.26, p = .02, R2 = .09. Conclusion: The WTAR-RBANS discrepancy score is a comparable diagnostic score to the RBANS Total Scale; however, the discrepancy score may be more appropriate for individuals with educational attainment or WAIS FSIQs outside the average range.
      PubDate: 2017-09-06
       
  • A-33 The Effect of Demographic Variables on the Utilization of Strategic
           Completion of the Five-Point Test
    • Authors: Krivenko A; Sarah T, Poreh A.
      Abstract: Objective: Evidence from the literature points to strategy use on various assessments as being a better indicative of executive functioning than summary scores. The current study sought to explore this in the Five-Point Test (5PT) and examined strategy use on the 5PT and correlated these with The Barkley Deficits in Executive Functioning Scale (BDEFS) in 306 English speaking adults. Method: The mean age of participants was 36.89 18.08 with an average of 14.65 2.85 years of education. The majority was female (70.3%), Caucasian (76.0%), and had a primary language of English (97.7%). Results: In analyzing the scales of the BDEFS, the study found that only the unique design (rs = −.10, p = .040), addition (rs = −.13, p = .013) and strategy (rs = .10, p = .048) of the 5PT correlate significantly with the self-organization subscale of the BDEFS; only the addition (rs = −.12, p = .018) of the 5PT correlate significantly with the self-regulation subscale of the BDEFS; and only the rotation (rs = −.10, p = .045) of the 5PT correlate significantly with the total score on the BDEFS. A mediation analysis was significant such that education mediated the relationship between age and number of unique designs on the 5PT, b = .086, 95% BCa CI [.035, .138], as well as for the relationship between age and strategies used on the 5PT, b = .069, 95% BCa CI [.014, .122]. Conclusion: These findings are consistent with the literature which indicates that self-report measures of cognitive functioning rarely correlate with actual performance on neuropsychological tests. Additionally, the findings are also consistent with the literature which indicates that higher education acts neuroprotectivity against cognitive decline.
      PubDate: 2017-09-06
       
  • A-34 Neuropsychological Performance of Mild Cognitive Impairment Patients
           in a Memory Clinic in Puerto Rico
    • Authors: Melendez-Cabrero J; Otero F, Berrios Y, et al.
      Abstract: Objective: To describe and compare the neuropsychological performance of mild cognitive impairment (MCI) subgroups identified in the Alzheimer's Prevention Clinic in Puerto Rico. Method: The current study is a secondary analysis with an exploratory-descriptive design. MCI was classified in two main groups: amnesic MCI (aMCI) and non-amnesic MCI (nonMCI), which were each subdivided in single and multiple domains. None of these patients had crossed the dementia threshold in functionality assessment. The total sample consisted of 95 patients (n = 65 females and n = 30 males) seen at the Alzheimer's Prevention Clinic & Research Center in Puerto Rico. The age range was 47–85 years (M = 67.57, SD = 9.034). Selected tests were the MoCA, category fluency tests (ANT, SUP, ACT), phonemic fluency tests (Letter F, and P), CVLT total, and DRS (total, MEM, I/P). Results: A One-way ANOVA revealed significant differences in the following neuropsychological tests and subtests between groups: MOCA [F(3,72) = 11.664, p = 0.000], DRS [F(3,75) = 10.838, p = 0.000], CVLT total [F(3,54) = 16.656, p = 0.000], MOCA-DR [F(3,50) = 3.467, p < 0.023], Animal naming [F(3,83) = 4.752, p = 0.004], Supermarket naming [F(3,82) = 5.146, p = 0.003], Letter F [F(3,81) = 5.114, p = 0.003], Letter P [F(3,81) = 2.740, p = 0.049], Actions naming [F(3,80) = 4.613, p = 0.005], and DRS-MEM [F(3,77) = 2.131, p = 0.000]. Overall, the MOCA and the DRS-MEM were the only two tests that differed between all four subtypes of MCI. Conclusion: The results of this study suggest that the MCI subgroups differ significantly not only by cognitive domain but by specific tests, which would help clinicians in the differential diagnosis between them.
      PubDate: 2017-09-06
       
  • A-35 Is Level of Acculturation a Predictor of Performance on Different
           Cognitive Domains Among Older Adults' Variability Among Samples
    • Authors: Mendoza L; Irizarry C, Garcia P, et al.
      Abstract: Objective: Acculturation has been found to be significantly associated with neuropsychological functioning in various domains (Boone et al., 2007). This study is aimed to examine the effects of level of acculturation on neuropsychological functioning among older adults. Method: This study used archival data. The sample consisted of 142 Hispanic individuals. The age range was from 57–91 (M = 73.52, SD = 6.92), and education range 0–24 (M = 12.26, SD = 4.16). Mini-Mental Status Examination (MMSE), Logical Memory II (LM II), Visual Reproduction I (VR I), Visual Reproduction II (VR II), Hopkins Verbal Learning, Verbal Fluency, and Digit-Span Forward and Backward were examined. Cognitively normal (n = 70), Mild Cognitive Impairment (MCI; n = 27), and dementia (n = 45) subjects were examined. Each diagnostic category was split into groups of high and low level of acculturation according to scores from The Short Acculturation Scale for Hispanics (SAHS). Results: A series of ANCOVAs were run controlling for age and education. Among CN participants, there was a significant difference between acculturation groups in LM II [F(1,64) = 4.34, p = .044] and in Digit-Span Forward [F(1,64) = 3.94, p = .052]. There were no significant differences between acculturation groups among MCI or dementia. Conclusion: Results indicated that acculturation plays a role on cognitively normal older adults’ neuropsychological functioning, with better performance in attention, encoding, consolidation, visual spatial skills, lexical access speed, vocabulary size, inhibition ability, and cognitive flexibility. These results indicated that acculturation level may not significantly affect cognition among MCI and dementia individuals. Future studies should be conducted on larger sample sizes.
      PubDate: 2017-09-06
       
  • A-36 Comparative MoCA Performance in Elderly Community Dwelling African,
           Hispanic, and Caucasian Americans Diagnosed with Dementia
    • Authors: Norheim N; Kissinger-Knox A, Mulligan K, et al.
      Abstract: Objective: Comparative data for the Montreal Cognitive Assessment (MoCA) specific to ethnic minority groups drawn from the same population are limited (Rossetti et al., 2017). Therefore, this study was conducted to report descriptive and comparative data from patients at a single community memory clinic. Method: The MoCA was administered to 888 participants (55.7% females, 91.4% Caucasian, 5.4% African American, 3.2% Hispanic) as a cognitive screening measure prior to a neuropsychological evaluation in which they were diagnosed with dementia. The mean age was 78.56 years (SD = 6.17, range 45–85), and the average education level was 13.40 years (SD = 2.76). Results: A two-way ANOVA examined the role of race/ethnicity and sex on MoCA scores. Race had a significant main effect on MoCA score for those diagnosed with dementia (F(2,882) = 3.58, p = 0.03), while sex did not affect MoCA score (F(1,882) = 0.98, p = 0.32). Post-hoc tests revealed Caucasian MoCA scores (M = 17.62) were significantly different from African American scores (M = 16.13) (p = 0.018). There were no significant differences between Caucasian and Hispanic scores (M = 16.50) (p = 0.177) and Hispanic and African American scores (p = 0.712). There were no significant interactions. Conclusion: Interpreting scores that are not normed from a representative ethnic population may result in inaccurate diagnostic classification (Pedraza, et al., 2012). Findings suggest that previously established MoCA cutoff scores may not characterize performance accurately among ethnic minorities versus Caucasians who live in the same geographic area.
      PubDate: 2017-09-06
       
  • A-37 Clinical Features, Symptom Progression, Medical History, and
           Psychosocial Implications of Progressive Supranuclear Palsy Presenting in
           a 78-year old Female: Multidiscipline Contributions to the Diagnostic and
           Treatment Process
    • Authors: Palmer L; Wesbecher K, Thompson-Sard C, et al.
      Abstract: Objective: Progressive supranuclear palsy (PSP) a degenerative brain condition presents with progressive gait and gaze control limitations, related visual changes, difficulty with speech and swallowing, and dementia. PSP has a prevalence rate of approximately 1.39–6.4 in every 100,000 individuals. It is difficult to accurately diagnose PSP, as it is often misdiagnosed as Parkinson's disease (PD), Alzheimer's Dementia (AD) or Primary Progressive Aphasia (PPA). Symptoms present on average after age 60, but may occur earlier, with a higher rate of occurrence in men than women. (Source: http://memory.ucsf.edu/education/diseases/psp cited 3.31.17). Method/Results: This case describes as a 78-year-old non-Hispanic white woman initially referred for a neuropsychological evaluation by her partner who was concerned about changes in her mood and speech. The patient, a previously vivacious, loquacious woman living independently, had decided to close her antique shop because of progressive dysnomia and dysfluency. Symptoms emerged following cataract surgery two years prior to the referral. Across the past year, gait and balance problems emerged with an escalation of serious falls, worsening oral-motor apraxia, and nystagmus. History was remarkable for maternal early onset dementia, a childhood history of nystagmus and dyslexia. Neurological examination yielded evidence of vertical supranuclear gaze palsy and postural instability. Structural MRI findings were supportive of a diagnosis of PSP almost three years after the patient began experiencing dysnomia and dysfluency. Neuropsychological findings were notable for language and executive function impairments, with intact basic attention, cognitive ability, confrontation naming, and memory. Language impairments followed a subcortical pattern, with letter fluency < category fluency, while executive dysfunction manifested as impaired cognitive flexibility. Visuospatial deficits are better accounted for by the patient's nystagmus. Conclusion: The profile suggested frontal subcortical dysfunction, consistent with the diagnosis of PSP. Interventions included weekly psychotherapy, cognitive remediation, speech and PT. Discussion includes the implications for a thorough intake and review of a history, as well as the consequences of diagnosing AD in the absence of comprehensive neuropsychological evaluations, diagnostic workups, and imaging studies. We conclude with a review of best treatment practices & lessons learned from the privilege of working with this amazing woman.
      PubDate: 2017-09-06
       
  • A-38 Utility of Derived Difference Scores from the Trail Making Test to a
           Neuropsychological Assessment
    • Authors: Patel D; Goette W, Carballo A, et al.
      Abstract: Objective: Evaluate the clinical utility of the Trails B - Trails A difference score to a neuropsychological assessment. Method: The study used archival data for a sample of 62 individuals (26 men) referred to a memory research clinic for dementia assessment. The sample's mean age was 70.3 (SD = 10.0) and mean education was 14.6 years (SD = 2.9). A database of their results on a standardized neuropsychological assessment was used for this study. Results: Ranks analysis of covariance, with age (r = .425, p = .001) as the covariate, demonstrated that mean rank of TMT differences were not equal across non-impaired, MCI, and dementia groups, F(2, 53) = 8.076, p = .001. Post-hoc analysis demonstrated that the MCI and dementia groups did not differ significantly. Receiver operator characteristic curves were thus generated for the non-impaired and MCI groups (area under the curve = .757) and the non-impaired and dementia groups (area under the curve = .937) separately. The TMT difference was significantly correlated with RBANS Immediate Memory (r = −.300, p = .023), Visuospatial/Constructional (r = −.337, p = .011), Language (r = −.397, p = .001), Attention (r = −.527, p < .001), Delayed Memory (r = −.364, p = .004), and Total Scale score indexes (r = −.507, p < .001); Grooved Pegboard dominant (r = −.290, p = .035) and non-dominant (r = −.300, p = .028); Stroop Color-Word (r = −.447, p < .001); and the Wisconsin Card Sorting Test Perseverative Responses (r = −.385, p = .006). Conclusion: The TMT difference score may serve as a good indicator of dementia. The relationship among the derived score and neuropsychological data supports viewing it as a measure of cognitive efficiency.
      PubDate: 2017-09-06
       
  • A-39 Is Adult Attention-Deficit Hyperactive Disorder (ADHD) a Risk Factor
           for Dementia' A Closer Look from Neuropsychological Perspective
    • Authors: Rodriguez-Flores I; Capovani M, Chan A, et al.
      Abstract: Objective: The objective of this study is to examine neuropsychological features that are convergent between ADHD and Frontotemporal Dementia (FTD). Method: Testing was conducted at the University of Miami, Leonard Miller School of Medicine. Patient (Pt)-1 is a 34 year-old, Hispanic male with 12 years of education. He complained of inattentiveness since childhood and diagnosed with Adult ADHD. Pt-2 is a 67 year-old, Hispanic male with 12 years of education with memory complaints and behavioral disturbances progressing over the past year. He met diagnostic criteria for FTD. Results: Average pre-morbid levels of functioning for both patients were documented. Both performed in impaired range (<1st percentile) on Trials to Complete 1st category on Wisconsin Card Sorting Test, suggesting prominent decline in executive functioning. Learning and memory scores in both patients on delayed recall of California Verbal Learning Tests-2(CVLT-2)/WHO-UCLA, Logical Memory (LM)-II, and Brief Visouspatial Memory Test-Revised were impaired(<1st percentile). Attention and working memory were borderline-impaired in both patients (2–5th percentiles) on Digit Span. Pt-1 scored in the 2–5th percentiles on semantic fluency, immediate recall on LM-I, CVLT-2, while Pt-2 scored in the < 1st percentile on semantic fluency, immediate recall on CVLT-2, 2nd percentile on LM-I, suggesting deficits on expressive language, rote and episodic memory functioning. Psychomotor speed as measured by Coding was in the 9th percentile in both patients, while results of Trails-A was average in both, reflecting reductions but preserved processing speed. Cognitive flexibility as measured by Trails-B was in the 9th percentile for Pt-1, while Pt-2 discontinued due to significant difficulties, strongly implicating the dorsolateral prefrontal cortex. Visuoperception-construction abilities as measured by Block Design was in the 16th percentile for Pt-1 and 32nd percentile for Pt-2, representing spared functioning for both. Conclusion: Overlapping deficits and significant reductions in measures of rote, episodic, visual memory, attention, semantic ability, and executive functioning across the Adult ADHD and the FTD patients were observed. This implicates bilateral frontotemporal involvement raising the question whether Adult ADHD represents a risk factor for FTD. This relationship should be further explored longitudinally.
      PubDate: 2017-09-06
       
  • A-40 Risk Factors for Earlier Age at Onset of Dementia with Lewy Bodies
    • Authors: Schaffert J; LoBue C, Nguyen T, et al.
      Abstract: Objective: Traumatic brain injury (TBI) with loss of consciousness (LOC), along with certain demographic and psychiatric factors, have been associated with earlier onset of mild cognitive impairment, frontotemporal dementia, and Alzheimer disease, but have not been examined in dementia with Lewy bodies (DLB), which was the aim of this study. Method: Data from 976 subjects with a clinical diagnosis of DLB were obtained from the National Alzheimer's Coordinating Center (NACC). Multiple linear regression examined whether self-reported history of remote TBI with LOC (i.e., >1 year prior to the first Alzheimer's Disease Center visit), remote alcohol abuse, years of education, sex, and/or lifetime history of depression were associated with earlier DLB symptom onset. Results: Higher education (b = −.28; p = <.001), depression history (b = −1.95; p < .001), and male sex (b = −1.76; p = .003) were significant predictors of earlier DLB onset. A history of remote TBI (b = −1.38; p = .12) and alcohol abuse (b = −1.83; p = .09) were not significant predictors. Depression history, male sex, and every 6 additional years of education were each associated with an approximately 1.5 to 2 year earlier DLB onset. Conclusion: Remote TBI with LOC and alcohol abuse history did not impact DLB onset, despite being risk factors for cognitive decline in other conditions. History of greater education, depression, and male sex were associated with an earlier DLB onset, necessitating further research to better understand these relationships. Replication of these results using autopsy-confirmed DLB is needed.
      PubDate: 2017-09-06
       
  • A-41 Semantic Variant of Frontotemporal Dementia Masquerading as Primary
           Progressive Aphasia: A Meyers Neuropsychological System Case Study
    • Authors: Shah M; Greco S, Raymond M.
      Abstract: Objective: Identify distinct neuropsychological profile for Semantic Variant Frontotemporal Dementia (SvFTD) and Primary Progressive Aphasia (PPA). This case outlines physical, cognitive, and behavioral sequelae of SvFTD and PPA. Method: The patient is 78-year-old Caucasian right-handed female diagnosed with Logopenic PPA and referred for neuropsychological examination due to complaints of memory decline. Her history included: white matter changes, left hippocampal atrophy, and hypertension. Common psychometric measures were administered: intellectual, the Meyers Neuropsychological Battery (MNB), and the Independent Living Scale measure of daily adaptive functioning. Results: Pattern of findings reflected diffuse impairments in cognitive and functional domains: attention-concentration, information processing, cognitive flexibility, executive functioning (reasoning, abstraction, problem-solving), memory, primary motor, and sensory perception. Additionally, daily adaptive functioning was significantly impaired. Psychologically, mild problems with sleep, anxiety, and insight/judgment were evident. Overlays of neurological/neuropsychological groups utilizing the MNB were strongly consistent with SvFTD (cor. = 0.73; conf. = 0.63). Statistically, PPA was less consistent (cor. = 0.33; conf. = 0.51). Conclusion: SvFTD typically is misdiagnosed as PPA and/or Alzheimer's disease due to significant deficits in language abilities including word retrieval, speech rate, syntax/grammatical errors, and reduced reading/writing. Neuropsychologically, individuals with PPA exhibit intact cognitive functioning (including executive functions and memory), except for language. On the contrary, individuals with SvFTD demonstrate global cognitive deficits in conjunction with verbal impairments. The MNB, new and unique analysis approach, in its differential diagnostic conclusion was able to differentiate between the aforementioned neurological conditions along with clinical capacity ranges consistent with the ILS. The case illustrated MNB's ability to make refined discriminations among neurodegenerative processes.
      PubDate: 2017-09-06
       
  • A-42 Differentiating Parkinson's Disease and Dementia with Lewy Bodies
           
    • Authors: Shah M; Sica R.
      Abstract: Objective: This case study outlines physical, behavioral, and cognitive deficits of Vascular Parkinsonism (VP) versus Parkinson's disease (PD) and Dementia with Lewy Bodies (DLB). Method: The patient is a 68-year-old Caucasian right-handed male diagnosed with DLB and PD referred for neuropsychological examination due to complaints of memory decline and rule out aforementioned conditions. His history included: lesion in the periventricular white matter and hypertension. Common psychometric measures were administered: intellectual, the Meyers Neuropsychological Battery (MNB), selected subtests of the Halstead-Reitan Neuropsychological Battery (HRNB), and the Independent Living Scale for daily adaptive functioning. Results: Pattern of findings was consistent with diffuse and lateralized (LCH > RCH) impairments in cognitive and functional domains including: attention-concentration, information processing, cognitive flexibility, verbal reasoning, memory, primary motor, and psychomotor speed. In addition, independent living abilities were impaired considering physical (gait and balance issues) and cognitive limitations. Psychologically, mild problems with depression, fatigue, irritability, and poor sleep were evident. Overlays of neurological and neuropsychological groups utilizing the MNB for pattern analysis were strongly consistent with Vascular Disease (cor. = 0.84; conf. = 0.70) and Parkinson's disease (cor. = 0.58; conf. = 0.60). Statistically, DLB was weak (cor. = 0.21; conf. = 0.48). Conclusion: The MNB was able to differentiate diagnostically between the three neurodegenerative processes. The MNB additionally identified sleep apnea as a contributing clinical condition though it was not a requested question to be addressed. Furthermore, the MNB produced clinical capacity ranges determining the patient's daily adaptive skills. Finally, the MNB is a new and unique analysis approach in its differential diagnostic conclusions. Employing graphic overlay pattern of cognitive results, along with correlation and configuration statistics of fit, the battery is able to make refined discriminations among neurodegenerative processes.
      PubDate: 2017-09-06
       
  • A-43 Cognitive Reserve at Presentation to Adult Protective Services
    • Authors: Stanley-Olson A; Gauthier J, Lande E.
      Abstract: Objective: Cognitive reserve (CR) indicates the resiliency an individual shows in cognitive performance as their brain pathology increases, and is considered a protective factor against cognitive decline. Once CR is depleted, impairments in functioning become apparent. A possible clinical implication of this is that by the time individuals with greater CR present to social services,they may show greater relative impairment, compared to someone with lesser CR, as their disease is theorized to have greater time for progression.The current study examines this hypothesis using education as a predictor of cognitive reserve in a clinical setting. Method: Subjects were older adults without prior cognitive diagnosis (N = 90) referred to Adult Protective Services for evaluation of cognitive concerns in the context of independent living ability or dependent adult abuse. Cognitive performance was examined based on level of education (i.e., ≤12 years or >12 years). Results: T-tests indicated no significant group differences in age or education, although did evince significant group differences on safety and money management, verbal and nonverbal intelligence, list learning and recall, and visual organization measures. Controlling for age, regression analysis indicated performance on list recall was predicted to decline with increased level of education. In contrast and as expected, regression analysis controlling for age showed performance on an intelligence measure to increase with increasing level of education. Conclusion: CR as measured by level of education predicts greater decline on one measure of verbal memory at presentation toAdult Protective Services.
      PubDate: 2017-09-06
       
  • A-44 Self-report Versus Observed Mood Symptoms in Individuals with
           Dementia Referred to Adult Protective Services
    • Authors: Stanley-Olson A; Gauthier J, Henderson L, et al.
      Abstract: Objective: Dementia clients can struggle with accurately reporting mood symptoms, an essential area of evaluation for Adult Protective Services (APS) workers as they determine which support clients need to improve health and safety. Performance on a brief mood measure was examined to determine if self-reported mood symptoms would be higher among persons with mood symptoms identified by APS observations. Method: Participants wereolder adults(N = 86) with dementia evaluated regarding independent living capacity. Participants (52 women/34 men) aged 51 to 95 (M = 80.26 years) ranged in education from 2 to 20 years (M = 12.8 years). The Hospital Anxiety and Depression Scale (HADS), a 14-item self-report mood measure, was administered. Behavioral mood symptoms were observed in home by APS workers using the TRIO, an observer risk assessment tool. Results: T-tests indicated no significant group differences in age or education. Self-reported depression symptoms were significantly higher (t(84) = 2.085, p = 0.020) for the group with APS observed depression behaviors (M = 8.24, SD = 4.78) compared to those without such behaviors (M = 6.21, SD = 4.12). Self-reported anxiety symptoms were significantly higher (t(84) = 1.827, p = 0.035) among those with observed anxiety behaviors (M = 7.21, SD = 4.34) than without (M = 5.55, SD = 3.96). Conclusion: HADS self-reported mood symptoms are higher for individuals with observed mood symptoms compared to individuals without observed mood symptoms, suggesting this may be a useful tool for APS evaluations. Further research into concurrent observer and self-report of mood ratings is needed.
      PubDate: 2017-09-06
       
  • A-45 Dementia vs. Sleep Apnea: A Neuropsychological Case Study
    • Authors: Zaccheo V; Sica R.
      Abstract: Objective: This case study described how neuropsychological examination is able to determine a patient's cognitive deficits secondary to sleep apnea versus neurodegenerative process. Sleep apnea, a disorder of disrupted breathing during sleep, affects about 18 million Americans and is known to produce particular cognitive deficits to certain neurodegenerative conditions if left untreated: attention, memory, executive functioning, and motor coordination. Method: The patient is a 62-year-old Caucasian right-handed male who was referred by his neurologist to rule-out mild cognitive impairment and dementia, in light of memory, learning, and attention changes. His history was also remarkable for untreated sleep apnea. He completed a comprehensive neuropsychological examination at a private practice. Common psychometric measures were administered: intellectual, Meyers Neuropsychological Battery (MNB), subtests of the Halstead-Reitan Battery (HRB), and performance validity measures. Results: Cognitive findings revealed deficits in Verbal memory and primary motor abilities. Remaining abilities were intact. Utilizing the MNB, the patient's profile was compared with various neuropsychological samples and was strongly compatible with sleep apnea (r = 0.39, conf. = 0.67), and inconsistent with MCI, dementia, and vascular sample. Cognitive dysfunction was determined secondary to uncontrolled sleep apnea, and neurodegenerative processes were ruled-out. Recommendation for sleep study was made. Conclusion: Sleep apnea is a common disorder affecting millions of people. The pattern of deficits produced by this condition can mimic neurodegenerative processes and appropriate differentials must be considered. Neuropsychological examination, especially the MNB which provides profile analysis matching to various neuropsychological samples, is able to differentiate the diagnosis in the decision making process, coupled with clinical judgment and medical history.
      PubDate: 2017-09-06
       
  • A-46 Epileptic or Psychogenic Seizures' A Neuropsychological Case
           Study
    • Authors: Zaccheo V; Sica R, Raymond M.
      Abstract: Objective: This case study describes how neuropsychological examination is able to differentiate psychogenic vs epileptic seizures in a patient with a history of childhood trauma/abuse and abnormal EEG findings. Method: The patient is a 45-year-old Caucasian right-handed female who was referred by her neurologist due to onset of seizures in 2012 and subsequent cognitive complaints - short-term memory, word finding, and processing speed. She completed comprehensive neuropsychological examination at a private practice. Common psychometric measures were administered: intellectual, Meyers Neuropsychological Battery (MNB), subtests of the Halstead-Reitan Battery (HRB), and performance validity measures. Results: Cognitive findings revealed impaired Verbal/Nonverbal memory, with remaining abilities intact. Psychologically, she endorsed significant anxiety (including post-traumatic stress) and depression. Utilizing the MNB, the patient's profile was compared with various neuropsychological sample and was strongly compatible with individuals experiencing neurological manifestations of distress (r = 0.79), supporting cognitive dysfunction secondary to an emotional etiology. While her memory deficits were consistent with EEG findings, this was accounted for by the literature which has demonstrated that childhood trauma/abuse alters brain development, specifically the hippocampus leading to memory issues and abnormal EEG patterns. Conclusion: Being able to discern psychogenic vs. epileptic seizures can be difficult, especially in light of abnormal EEG findings. However, neuropsychological testing using the MNB (which provides profile analysis matching to various neuropsychological samples) is able to differentiate the diagnosis and aid in diagnostic clarification.
      PubDate: 2017-09-06
       
  • A-47 Neuropsychiatric, Motor, and Demographic Correlates of Apathy in
           Parkinson's Disease
    • Authors: Brown D; Barrett M, Flanigan J, et al.
      Abstract: Objective: To understand the relationship between apathy and mood, cognition, psychosis, behavioral regulation, sleep, motor functioning, and demographic factors in Parkinson's disease (PD). Method: A sample of 111 participants with PD followed in neurology clinics at a tertiary medical center were administered the Apathy Scale (AS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Montreal Cognitive Assessment (MoCA), Frontal Systems Behavior Scale (FrSBe), REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS), and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) as part of a larger prospective longitudinal investigation of neuropsychiatric symptoms in PD. Demographic information and data from formal assessment of psychosis were also collected. A one-way multivariate analysis of variance for parametric, and chi-square test for nonparametric variables were conducted to assess for significant differences between low (AS = 13) and high (AS > 13) apathy groups. Results: There were significant differences (p < .05) between low and high apathy groups for the BDI-II, BAI, MoCA, FrSBe Executive Dysfunction subscale, MDS-UPDRS Part III, and education, but not the FrSBe Disinhibition subscale, RBDSQ, ESS, current psychosis, age, sex, or disease duration (see Table 1). Mood measures yielded the largest effect sizes (BDI-II ƞ2 = .22; BAI ƞ2 = .21), followed by education (ƞ2 = .12), FrSBe Executive Dysfunction (ƞ2 = .07), MoCA (ƞ2 = .06), and MDS-UPDRS Part III (ƞ2 = .05). Conclusion: Mood, cognition, aspects of behavioral regulation, motor functioning, and education are associated with apathy in PD. These results further the understanding of neuropsychiatric, motor, and demographic correlates of apathy in this clinical population. Additional study of these constructs may help direct treatment of individuals with PD.
      PubDate: 2017-09-06
       
  • A-48 Multiple System Atrophy: A Case Study
    • Authors: Carballo A; Goette W, Schmitt A.
      Abstract: Objective: Multiple Systems Atrophy has been characterized in the literature as a progressive neurodegenerative disorder with variable parkinsonism, autonomic failure, cerebellar ataxia, and cognitive impairment (Abrahão et al. 2011). It has a prevalence rate that ranges from 1.9 to 4.9 cases per 100,000 people (Spaccavento et al. 2013). The purpose of this case study is to further illustrate the nature of impairments in these patients. Method: The case study follows a 61-year-old, right handed, Caucasian male with 16 years of education. He was diagnosed in 2014 with Multiple System Atrophy with dominant cerebellar features, and requested a neuropsychological assessment to determine his current neurocognitive status. Measures of general intellectual ability, memory, attention and concentration, executive functioning, constructional/visuospatial ability, and motor functions were included in the assessment, and were averaged to represent each domain. Results: The current set of data from these cognitive tests reveal a neurocognitive profile that is impaired for someone of his age and education. He demonstrated significant strength in tasks requiring executive functions such as inhibiting an incorrect response or flexibly shifting attentional resources (M = 58, SD = 10). However, tasks that had a timed or significant motor component (M = 21.5, SD = 10) were the weakest, and his neurocognitive profile does not support memory impairment. Conclusion: These performances are consistent with subcortical damage likely incurred as part of the progressive nature of the cerebellar dominant features of his multiple system atrophy.
      PubDate: 2017-09-06
       
  • A-49 Early Identification of Neurocognitive Deficits and Symptom
           Manifestation Associated with Juvenile Huntington's Disease (JHD) in a
           Preschooler: A Pediatric Case Study
    • Authors: Cederberg C; Espe-Pfeifer P, Nopoulos P.
      Abstract: Objective: Juvenile Huntington's Disease (JHD) is an autosomal dominant neurodegenerative disease characterized by an excessive number of trinucleotide CAG repeats that manifests by a triad of symptoms consisting of cognitive impairments, motor dysfunction, and psychiatric symptoms. Among children diagnosed with JHD, age of symptom onset has been found to be strongly associated with CAG repeat length and prevalence of seizures. Assessment results are presented to help clarify symptom presentation in a five-year-old with newly confirmed JHD. Method: The current case report presents results from a baseline assessment of neuropsychological functioning involving a preschooler with recent diagnosis of JHD as part of research protocol. The patient was referred to a JHD collaborative research study to monitor neurocognitive functioning and symptom progression. A timeline of symptoms and results of diagnostic and neuroimaging procedures are presented. Results: Evaluation of the patient revealed general intellectual abilities in the low average range, with variability observed in performance across tasks. Poor verbal reasoning skills and deficits in motor-dexterity and visual-motor integration were noted. Evidence of inattention and inefficiencies when encoding and recalling information were also observed. Behavioral changes, including aggression and hyperactivity, were also reported. Conclusion: Discussion in this case focuses on the implications of neuropsychologists identifying neurocognitive abilities, behavioral and psychiatric issues that may be more prominent in JHD populations. As this case represents an exceedingly young age of onset of JHD, baseline data from this assessment may serve to better understand the nature and progression of the disease across home and school functioning.
      PubDate: 2017-09-06
       
  • A-50 Neuropsychiatric and Behavior Complexities of Monitoring Progression
           of Juvenile Huntington's Disease Symptoms: A Case Study of Two Siblings
    • Authors: Cederberg C; Espe-Pfeifer P, Nopoulos P, et al.
      Abstract: Objective: Juvenile Huntington's Disease (JHD) is an autosomal dominant neurodegenerative disease characterized by an excessive number of trinucleotide CAG repeats that manifests by a triad of symptoms consisting of cognitive, motor, and psychiatric dysfunction. Although cognitive deficits have been studied in many of the movement disorders, little is known about the rate of progression of symptoms occurring in individuals with JHD. Annual assessments across a 2-year period for adolescent male siblings are presented to help clarify the progression of JHD symptoms, and to examine how co-existing psychiatric and behavioral problems may contribute to symptom severity. Method: The current case report presents results from two annual neuropsychological assessments involving adolescent siblings with JHD, each presenting with unique behavioral and psychiatric concerns. Symptoms and results of diagnostic procedures are compared between these siblings, with consideration for how each individual's unique behavioral, emotional, and psychiatric concerns impact level of functioning. Results: Evaluation revealed no evidence of significant cognitive decline. However, mood and behavioral concerns were identified as prominent and factors impacting day-to-day functioning. These mood and behavioral concerns manifested differently for each sibling, with aggression, impulsivity, and substance abuse reported for the eldest, and anger outbursts and poor hygiene noted for the younger brother. Conclusion: Discussion focuses on the role of neuropsychologists in monitoring symptoms associated with JHD, and in effectively communicating results to parents and children. Understanding the role comorbid psychiatric conditions have on cognitive functioning, and recommending interventions to help address these symptoms that directly impact home and school functioning will also be discussed.
      PubDate: 2017-09-06
       
  • A-51 Cognition and Affect Among Individuals with Chiari Malformation Type
           I: An Examination of Memory, Anxiety, and Depression
    • Authors: Crittenden J; Stephenson T, Harty S, et al.
      Abstract: Objective: To establish the clinical profile of memory and psychological distress in patients with Chiari malformation type 1 (CM1). There is a lack of published research on CM1's influence on neuropsychological function (Bakim et al., 2013; Koziol & Barker, 2013). Method: The study sample (N) consisted of 33 participants (28 females) with a mean age of 35.7 (standard deviation (SD) = 12.1). The study was conducted at an outpatient neurosurgery clinic and was comprised of individuals referred for neurosurgical intervention. The neuropsychological evaluation included two measures of memory (California Verbal Learning Test II; Rey Complex Figure Test) and one measure of psychological distress (Brief Symptom Inventory). Statistical analyses were conducted, exploring key demographics and CM1 features (tonsillar descent; syrinx) on the target measures. Results: Descriptive statistics revealed an atypical profile on measures of memory, anxiety, and depression. A sizeable portion of participants performed below average (≤−1.0 SD) on visual (>45%) and verbal (>30%) memory. Furthermore, over 40% of individuals endorsed above average (≥1.0 SD) psychological distress (anxiety = 50%; depression = 40.6%). Key demographics and CM1 features were not significantly associated with memory, anxiety, or depression. Conclusion: While the atypical profile of memory, anxiety, and depression suggests a possible causal influence of CM1, initial analyses indicate that the physical features of CM1 may not directly influence memory or affective function. These findings are limited by a modest sample size. Detailed understanding of relationships between CM1 and neuropsychological function will be enhanced as a function of increased sample size and future post-operative comparisons.
      PubDate: 2017-09-06
       
  • A-52 Neuropsychological Assessment of Akinetic Mutism: A Case Study
    • Authors: Dunn R.
      Abstract: Objective: Akinetic mutism (AM) is a rare disorder characterized by reduced or absent spontaneous speech and movement within the context of preserved alertness. The dearth of research on AM presents challenges for accurate diagnosis of this disorder. The present case study illustrates implications for the assessment of AM by neuropsychologists. Method: The patient is a 45-year-old male who sustained a severe traumatic brain injury (Glasgow Coma Scale of 5). Neuroimaging showed bilateral subarachnoid hemorrhages in the frontal lobes, as well as intraparenchymal hemorrhages in the right caudate. Results: The patient was initially diagnosed as being in a minimally conscious state based on his performances on the JFK Coma Recovery Scale-Revised. On further neuropsychological testing, it was found that the patient would sometimes exhibit functional communication through the writing of words and phrases if he was prompted by the examiner numerous times and was provided with ample time to respond. Other possible diagnoses, including aphasia, apraxia, delirium, locked-in syndrome, and severe depression, were ruled out. Through repeated observation and assessment, it was found that the patient's level of awareness had been significantly underestimated. For example, the patient was fully oriented (Orientation Log score of 30/30; of note, this brief 10 item measure took approximately 45 minutes to administer due to the patient's reduced initiation), and he was able to demonstrate carry-over of newly learned information across evaluations. The patient also exhibited appreciation for humor as evidenced by him making a socially-appropriate joke (via writing) during an evaluation, although affect remained flat. Results indicated that the patient met the neurobehavioral criteria for AM. The neuroanatomical location of the patient's brain injury was also consistent with a diagnosis of AM. Conclusion: Neuropsychologists should consider the possibility of AM in patients exhibiting minimal responsiveness in the context of preserved visual tracking and/or other signs of alertness. This case study highlights the importance of differential diagnosis, repeated observation/assessment, and the use of external stimuli to elicit responses when assessing for AM.
      PubDate: 2017-09-06
       
  • A-53 Limbic Encephalitis: A Neuropsychological Case Study
    • Authors: Greco S; Piccoli K.
      Abstract: Objective: This case study describes the neuropsychological consequences of Limbic Encephalitis. Limbic Encephalitis, an immunological condition, includes symptoms of temporal lobe seizures, amnesic syndrome, and mood/behavioral changes, including anxiety, depression and sleep disturbances. Cognitive functioning is typically associated with impairments in memory, executive function, working memory, and processing speed. Method: The patient is a 49-year-old, Caucasian, right-handed female who was referred by her neurologist due to significant behavioral, psychological, and cognitive changes. Her history included: Limbic Encephalitis, seizure disorder, depression, anxiety, and sleep disturbances. She completed a comprehensive neuropsychological examination in an outpatient private practice. Common psychometric measures were administered including intellectual, achievement and the Meyers Neuropsychological Battery. Performance validity measures were unremarkable. Results: Pattern of findings were consistent with diffuse and lateralized (LCH > RCH) cognitive deficits in verbal and visual memory, complex-incidental attention, verbal fluency and naming. Contrary to recent literature, problem solving, processing speed, abstraction, and working memory abilities were relatively spared. Psychologically, she endorsed severe reactive depression and anxiety in the context of a normal psychiatric history. Conclusion: Limbic Encephalitis is a complex autoimmune condition that mirrors many diagnoses, including but not limited to dementias, seizures and/or psychiatric conditions. Neuropsychological evaluation provides objective data to aid in multidisciplinary care and treatment planning. Accurate diagnosis and medical management of Limbic Encephalitis is critical, as the neurological consequences are severe if left untreated. Lastly, future research is needed from neuropsychological point of view.
      PubDate: 2017-09-06
       
  • A-54 Beta-Thalassemia Major: A Pediatric Neuropsychological Case Study
    • Authors: Greco S; Inselberg M, Klimik L, et al.
      Abstract: Objective: This case study describes the neuropsychological profile of Beta-Thalassemia Major (B-TM), a blood disorder that reduces the production of hemoglobin and depletes iron levels, resulting in severe anemia. Symptoms of B-TM may include fatigue, pale complexion, and slow growth. Cognitive symptoms include depressed IQs, difficulties with inhibition, abstract reasoning, memory, attention, visuospatial skills, language and visuomotor functioning (Duman et al., 2011; Economou et al., 2000; Monastero et al., 2000; Raafat et al., 2015). Method: The patient is an 8-year old, Caucasian, right-handed female referred by her Neurologist due to academic difficulties. She completed a comprehensive neuropsychological examination including intellectual, achievement, memory, performance validity, and the complete Halstead Reitan Battery, at an outpatient private practice. Results: Performance IQ, processing speed, executive functioning, and complex integrative motor skills were impaired. Full-scale IQ, Verbal IQ, memory, and attention were within normal limits, contrary to research findings. Behavioral measures indicated externalizing and internalizing problems (e.g. hyperactivity, depression, atypicality, and withdrawal) and delayed adaptive skills. Conclusion: Limited neuropsychological research is available regarding B-TM. Studies indicate cognitive sequelae including depressed IQs, diffuse/focal higher order cognitive abilities, and motor skill impairment. Consistent with the literature, this case study revealed impairments in diffuse cognitive abilities (abstraction), Performance IQ, and complex integrative motor skills. However, her most salient deficit was information processing. Further, this child performed better on measures of language, attention, and memory than would be expected given current research. Additional research is needed to enhance understanding of brain-behavior relationships in B-TM.
      PubDate: 2017-09-06
       
  • A-55 Alzheimer's Disease in Down Syndrome: A Neuropsychological Case Study
    • Authors: Greco S; Piccoli K.
      Abstract: Objective: This case study describes the differential diagnosis of cognitive changes secondary to early-onset Alzheimer's dementia (AD) in individuals with Down syndrome. In addition to global cognitive impairments, early-onset dementia in this population is marked by personality and behavioral changes including: irritability, oppositional behavior, apathy, and decreased social interaction. Late onset seizure disorder is also a positive indicator for Alzheimer's dementia in Down syndrome. Method: The patient is a 27-year-old, Caucasian, right-handed female who was referred by her neurologist to rule out cognitive dysfunction secondary to early-onset Alzheimer's dementia. Her history included: Down syndrome, hypothyroidism, seizure disorder, and mood disorder. Common psychometric measures were administered including intellectual, Meyers Neuropsychological Battery (MNB), and adaptive functioning. Results: Pattern of findings were consistent with global impairment in cognitive and functional domains including, attention, language, visual-spatial, intellectual functioning, memory, abstract reasoning, and adaptive skills. Behaviorally, the patient presented with increased oppositionality and acute personality changes. Overlays utilizing the MNB was most consistent with Alzheimer's dementia (Cor. = .67, Con. = .81) followed by developmental delays, thyroid, and sleep apnea. Conclusion: Integrating historical/medical information, collateral data, adaptive abilities, and the MNB results, findings were consistent with cognitive dysfunction secondary to AD along with her previous existing conditions. Consistent with the literature, personality and behavioral changes were evident, common features of early-onset dementia with this population. Future research is needed from a neuropsychological point of view regarding accurate neurocognitive assessment and identification of cognitive changes in Down syndrome.
      PubDate: 2017-09-06
       
  • A-56 Enterobacteriaceae and Parkinson's Disease: A Review
    • Authors: Grosse C; Miller K, Deragon K.
      Abstract: Objective: Gastrointestinal (GI) dysfunction is detected in approximately 80% of Parkinson's Disease (PD) patients and has gained interest as a potential etiological model of PD (Parashar & Udayabanu, 2017). The GI dysfunction has been linked to microbial imbalances in the digestive tract. In turn, the microbiome may mediate the neuroinflammation associated with PD (Dobbs, et al., 2016). This review will explore the select theories and mechanisms of the gut-brain axis in relation to PD. Specifically, this review will center on the enterobacteriaceae family of microbes. Data Selection: Data sources included PsycINFO, PsycARTICLES, PubMed, Academic Search Complete. Largely informal procedures were utilized, however, some key words and phrases were used to examine the existing data on this topic (microbiome, Parkinson's disease, gut-brain axis, gastrointestinal inflammation, microbiota, gut-bacteria). Data Synthesis: The gut-brain axis has wide ranging effects on neurophysiology. The correlation between PD and microbiota are impactful across health and the neurosciences. These studies have led to questions regarding the mechanisms involved. The Enterobacteriaceae family of microbes consistently appears in the literature as a link in the chain leading to PD. Conclusion: This field of study represents a shift in thinking across disciplines that work within the realm of health and the neurosciences. This shift translates to advances in understanding the two way communication between the brain and gut, has illuminated correlates between microbial diversity and PD, and may lead to the development of novel treatments (Dinan &Cryan, 2016; Parashar & Udayabanu, 2017). Proposals for future research will be examined.
      PubDate: 2017-09-06
       
  • A-57 Adult Woman Presenting with Foreign Accent Syndrome (FAS): A Case
           Study
    • Authors: Gurnani A; Horwitz J.
      Abstract: Objective: Foreign Accent Syndrome (FAS) is a rare disorder caused by acute neurological insult and/or psychogenic factors resulting in the patient speaking with a non-native foreign accent. The majority of documented FAS cases have a neurologic origin; psychogenic FAS is often underreported due to case complexity and ambiguity, as well as limited literature, associated with its diagnosis (Keulen et al., 2016a, 2016b). The current study provides information regarding the cognitive profile and overall presentation of psychogenic FAS based on findings from a 39-year-old white woman (“AB”) diagnosed with the condition. Method: Neuropsychological evaluation and personality assessment were conducted. All major cognitive domains were assessed. Results: Reported clinical symptoms included a chronic Ukrainian-sounding accent and daily “spells” characterized by catatonic immobility and muteness, with subsequent nonsensical speech resembling a foreign language. Neuropsychological testing revealed executive limitations and difficulties with visual encoding, but with intact language performance. Personality assessment was indicative of aberrant thought processes, a tendency to develop physical symptoms in response to stress, and over-reporting of somatic complaints particularly of a neurologic-appearing nature. Psychological functioning was further characterized by moderate anxiety and depression. Conclusion: AB's overall presentation was most suggestive of a diagnosis of functional neurological symptom disorder, consistent with her trauma history and the rule-out of a neurologic etiology based on extensive previous neurological work-up; however, cognitive limitations may have been partially attributable to aspects of her complex medical history, including left frontal venous malformation and arrhythmia with pacemaker placement. Additional research is needed to assist in differentiating psychogenic from neurologic-based FAS
      PubDate: 2017-09-06
       
  • A-58 Diagnostic Clarification and Psychological Management of Pediatric
           Unilateral Perisylvian Polymicrogyria: Contributions of Comprehensive
           Neuropsychological Assessment
    • Authors: Lewandowski A; Lewandowski C, Cole J, et al.
      Abstract: Objective: Unilateral Perisylvian Polymicrogyria (UPP) is a complex developmental malformation characterized by abnormal lamination and pathological microscopic over-folding of the cerebral cortex (Leventer et al., 1999).While the etiology remains uncertain, abnormalities are hypothesized to be the result of impairment to early cortical organization or late neuronal migration and both genetic and non-genetic indications exist (Barkovich et al., 2005). UPP is associated with a variety of neurological conditions and neuropsychological deficits that include epilepsy, impaired intellectual functioning, motor dysfunction and spasticity, speech disturbance, and global developmental delay (Leventer, et al., 2010). Method: We present a case study of a fifteen-year-old Guatemalan adolescent who was adopted at 16 months old and was initially diagnosed with global learning deficits until he suffered a seizure in class. Abnormal EEG and MR neuroimaging confirmed UPP and neuropsychological assessment was completed as part of a comprehensive neurological evaluation to redefine functional status. Results: Findings revealed low average IQ, left-hemisphere learning disabilities and deficits on measures of sensory response speed, fine motor persistence and efficiency, complex problem solving, sequencing, executive reasoning, language, attention, encoding and retrieval, and depression. Conclusion: Neuropsychological assessment provided clear evidence of lateralized dysfunction consistent with left UPP, as well as unique frontal and subcortical dysfunction not explained by other demographic, medical, or psychological factors. These neurocognitive and behavioral details allowed for more focused and individually-centered treatment planning by pediatrics, neurology, and academic caregivers, and findings provided significant diagnostic clarification of left UPP and furthered clinical understanding of this adolescent's mental status beyond structural imaging studies UPP.
      PubDate: 2017-09-06
       
  • A-59 Association of Epilepsy Severity Factors with Performance on the
           Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
           in Adults with Temporal Lobe Epilepsy
    • Authors: Maiman M; Del B, Farrell E, et al.
      Abstract: Objective: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a commonly used cognitive screener. Individuals with temporal lobe epilepsy (TLE) show widespread deficits on this measure. Understanding how markers of epilepsy severity can impact RBANS performance can be clinically informative. This study aimed to explore several markers of epilepsy severity (i.e. age of seizure onset, illness duration, number of anti-epileptic drugs; AEDs) and their role with cognition. Method: 30 L-TLE (Age: M = 43.57; SD = 15.75; IQ: M = 87.63; SD = 20.42) and 16 R-TLE (Age: M = 47.25; SD = 14.47; IQ: M = 93.06; SD = 14.47) adults were administered the RBANS. A linear regression was calculated to examine how these epilepsy severity markers predicted RBANS total performance. Results: RBANS Total score (M = 73.09, SD = 16.51) was significantly correlated with age of seizure onset (r = .44, p < .01), illness duration (r = −.40, p < .01), and number of AEDs (r = −.36, p < .01). Additionally, the overall model was significant and accounted for 24% of the variance in RBANS Total score, F (3,43) = 4.18, p < .01, R2 = .24. Still, individual markers of epilepsy severity proved to be non-significant predictors of RBANS total performance. Conclusion: Findings suggest that these epilepsy severity factors, while associated, cannot individually predict RBANS total performance in TLE. However, when these factors are combined into a single model, they can account for a significant percentage of the variance in RBANS total performance. This may indicate that epilepsy severity cannot be captured by a single factor; instead, a more comprehensive approach must be considered when trying to understand the relationship between cognitive performance and epilepsy severity.
      PubDate: 2017-09-06
       
  • A-60 Examining the Clinical Utility of the Repeatable Battery for the
           Assessment of Neuropsychological Status (RBANS) for Characterizing Seizure
           Lateralization in Adults with Temporal Lobe Epilepsy
    • Authors: Maiman M; Del B, Farrell E, et al.
      Abstract: Objective: Prior research has demonstrated that left temporal lobe epilepsy (L-TLE) patients perform worse on verbal tasks than right TLE (R-TLE) patients, while some have found the opposite to be true for visuospatial abilities. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)is a commonly used cognitive screening tool that can evaluate a range of cognitive difficulties in epilepsy. To date, no study has examined the sensitivity of the RBANS for seizure lateralization for TLE patients. Method: 30 clinically referred L-TLE adults (Age: M = 43.57; SD = 15.75; IQ: M = 87.63; SD = 20.42) and 16 R-TLE adults (Age: M = 47.25; SD = 14.47; IQ: M = 93.06; SD = 14.47) completed the RBANS. Groups did not differ for age (t = −.78, p = .44), IQ (t = −.94, p = .35), or gender (2(1, 46) = .27, p = .74). A series of t-tests were computed for each of the scales on the RBANS with the significance level set at .05. Results: A series of t-tests revealed significant left versus right TLE differences for Picture Naming (t = −2.17, df = 43.82, p = . 04, d = . 61) and Digit Span (t = −3.25 df = 44, p < .01, d = 1.05), such that individuals with left TLE exhibited poorer performance. No other significant group differences were observed. Conclusion: Consistent with prior studies, L-TLE patients had weaker performance on select language-based subtests relative to R-TLE patients. This was only seen on two subtests. Failure to find significant differences on additional RBANS language-based subtests is likely due to sample size limitations. Additionally, there were no differences between R-TLE and L-TLE patients on the RBANS visually-based subtests, which is consistent with much of the prior literature.
      PubDate: 2017-09-06
       
  • A-61 Grooved Pegboard Performance is Related to Teacher-Reported, but not
           Parent- Reported, Executive Dysfunction in Children with Epilepsy
    • Authors: Maiman M; Leaffer E, Vasserman M, et al.
      Abstract: Objective: Children with epilepsy frequently exhibit fine motor and executive functioning deficits, which are two highly inter-related constructs. Identification of fine motor impairments may indicate concomitant executive functioning deficits. This study explored whether grooved pegboard performance is related to parent and teacher ratings on the Behavior Rating Inventory of Executive Function (BRIEF) in children with epilepsy. Method: 71 children with epilepsy (M = 10.82 years; SD = 3.00) completed grooved pegboard. Parents and teachers completed the BRIEF. Multiple two-stage hierarchical regressions (a = 0.01) were conducted with BRIEF composites as the dependent variables. Stage one controlled for epilepsy severity (i.e. age of seizure onset and number of anti-epileptic medications). Grooved pegboard performance was entered at stage two. Results: Epilepsy severity variables did not contribute significantly to BRIEF composites on either the teacher version [Global Executive Composite (GEC: F (2,68) = 2.20, p = 0.12), Metacognition Index (MCI: F (2,68) = 1.37, p = 0.26), Behavior Regulation Index (BRI: F(2,68) = 1.93, p = 0.15)] or parent version [GEC: F(2,139) = 1.89, p = 0.15, MCI: F(2,139) = 3.08, p = 0.05, BRI: F(2,139) = 0.37, p = 0.70]. Adding grooved pegboard to the model did contribute significantly to GEC (F(4, 66) = 6.79, p < 0.01) and MCI (F(4,66) = 5.76, p < 0.01), but not BRI (F(4, 66) = 1.79, p = 0.14) on the teacher BRIEF. However, this addition did not contribute significantly to parent BRIEF composites [GEC: F (4,137) = 1.41, p = 0.24, MCI: F(4,137) = 2.55, p = 0.04, BRI: F (2,139) = 0.28, p = 0.89]. Conclusion: Poor performance on grooved pegboard is significantly related to teacher-reported, but not parent-reported, executive dysfunction in children with epilepsy, even after controlling for epilepsy severity.
      PubDate: 2017-09-06
       
  • A-62 Serial Neuropsychological Assessment of an Adult with Moyamoya
           Disease and Borderline Personality Disorder
    • Authors: Margolis S; Sartori A.
      Abstract: Objective: Moyamoya disease (MMD) is a rare cerebrovascular condition, which predisposes people to hypoperfusion, TIA, and stroke. Frontal-subcortical cognitive deficits are common but the rate of neuropsychiatric sequelae is unclear. Case studies have described acute onset mania and psychosis precipitating MMD diagnosis in children/adolescents; however, comorbid personality disorders have not been documented. Method: We describe a 27-year-old, right-handed, female of mixed race with angiogram-confirmed MMD. Her history includes labile moods and impulsivity since childhood, and polysubstance abuse/prostitution in adulthood. Inpatient neuropsychological evaluations were conducted during two hospitalizations: following a right MCA ischemic stroke involving frontal, temporal, and parietal areas, and then 3-months later following left hemisphere punctate infarcts. Results: Initially, she had left-sided facial droop/foot drag and right gaze preference. Speech was pressured, dysarthric and profane. Thought process was tangential. Affect was labile and interpersonal boundaries were loose. Neuropsychological testing revealed severely impaired attention and marked visuospatial/constructional deficits with pronounced left-sided neglect. Language and verbal learning/memory storage were grossly intact but with variable delayed verbal recall. Insight and judgment/decision-making were poor. At follow-up, basic attention, neglect, and insight improved. Visuospatial, memory recall, and mood/lability issues persisted. Executive dysfunction was now apparent. She did not demonstrate aphasia. Conclusion: This patient's initial presentation and persisting deficits represent classic neuropsychological sequelae of right MCA infarction. However, it is difficult to disentangle whether her borderline personality traits developed independently of MMD, were mediated by chronic hypoperfusion, or represent a neuropsychiatric prodrome of MMD induced strokes. Regardless, these behavioral abnormalities were exacerbated by stroke and further impaired her overall functioning.
      PubDate: 2017-09-06
       
  • A-63 Auditory Verbal Learning and Memory in a Clinical Sample of
           Spanish-speaking Hispanic Adults
    • Authors: Nuñez A; Emami A, San M, et al.
      Abstract: Objective: There is a paucity of empirical information concerning the verbal learning and memory performance of Spanish-speaking clinical populations. To address this disparity, this study examined the effects of various neurological conditions on verbal learning and memory, as measured by the Rey Auditory Verbal Learning Test (RAVLT), in a clinical sample of Spanish-speaking Hispanic adults. Method: The sample included 139 Spanish-speaking Hispanic adults (mean age = 42.71 years, SD = 18.48; 52.6% male) with a neurological condition (Parkinson's disease n = 19, epilepsy n = 12, traumatic brain injury n = 57, mild neurocognitive disorder n = 39, and stroke n = 12). Participants who had been administered the RAVLT were selected from a consecutive series of cases referred for neuropsychological evaluation to the Neurology Section of the University of Puerto Rico Medical School. Results: Multivariate analysis of variance showed a significant effect between neurological condition and RAVLT performance (p = .027), after adjusting for age. Results showed a general pattern in which participants with traumatic brain injury performed significantly worse than other neurological conditions in delayed recall (p = .025). Additionally, a comparison of trial scores indicated that participants with traumatic brain injury exhibited less learning compared to other neurological conditions (p = .005). All groups showed an initial learning curve from Trials I to V. Conclusion: Findings contribute to our understanding that Spanish-speaking Hispanic adults with traumatic brain injury may show decrement in verbal learning and memory performance, even after apparent initial learning. Future research in larger samples is warranted to elucidate factors influencing verbal learning and memory performance of underrepresented populations in neuropsychological research.
      PubDate: 2017-09-06
       
  • A-64 Observing Self-Reported Fatigue and Depression Before and After
           Dimethyl Fumarate Therapy in Multiple Sclerosis
    • Authors: Pandey K; Russell-Giller S, Mohn J.
      Abstract: Objective: To observe the change in depression and fatigue levels before and after Multiple Sclerosis (MS) patients begin dimethyl fumarate (DMF) therapy Method: 55 patient charts were retrospectively analyzed (61.8% female, average age 47.8 +/− 9.81, average disease duration 12.45 years +/− 8.56). Included charts were comprised of patients with a clinical diagnosis of RRMS who had received DMF treatment after January, 2013 and who had completed SymptoMScreen questionnaire as standard of care. Depression and fatigue were operationalized by the patients’ self-reported score on SymptoMScreen. Paired Samples T-Tests were performed to observe the change of depression and fatigue pre-DMF and post-DMF therapy. Results: 14 Paired Sample T-Tests were performed on the depression score and the fatigue score pre-DMF and post-DMF at 3 months, 6 months, 12 months, 18 months, 24 months, and 30 months. None of the tests displayed a significant change in depression or fatigue before and after DMF therapy. Paired sample correlations between pre and post-DMF therapy depression scores and fatigue scores were highly significant. Conclusion: Fatigue and depression play important roles in the quality of life for patients with MS. While previous studies have shown DMF treatment to improve overall health-related quality of life, our study showed that when fatigue and depression were exclusively observed, there was no significant change before and after DMF therapy. Further prospective research should be done with a greater patient population to observe the impact of DMF therapy on depression and fatigue in MS patients.
      PubDate: 2017-09-06
       
  • A-65 Post-surgical Cognitive Decline in an Epilepsy Patient Following a
           ‘Wrong Way’ Wada
    • Authors: Pasternak E; MacAllister W.
      Abstract: Objective: While language production is left-lateralized in an overwhelming majority of right handed individuals, it is right-lateralized in a small but significant percentage of left-handed individuals. Serial assessments were undertaken in a left- handed individual with right-hemisphere seizure focus, with Wada testing confirming right-hemisphere language. Method: The patient is a 29-year-old left-handed Caucasian male, with a 10-year history of poorly controlled right temporal lobe epilepsy. Presurgical neuropsychological assessment indicated preserved general intellectual functioning, with no gross impairments. Presurgical Wada testing indicated right hemisphere language representation, with poorer left hemisphere memory compared to intact right hemisphere memory. Despite Wada results, the patient underwent a partial right temporal lobectomy. At the time of re-evaluation, he continued to have about 4 seizures/month despite surgery. EEG monitoring continued to indicate right temporal hyperexcitability and diffuse right hemispheric dysfunction. Moreover, he reported post-surgical changes in word-finding and memory. Behavioral observations were significant for episodes of nonsensical speech with uncertain ictal association. Results: Re-evaluation confirmed significant post-surgical impairments in visual confrontation naming, verbal learning and memory, and nonverbal memory. Conclusion: Unfortunately, these findings are not surprising given pre-surgical Wada findings that documented right hemisphere language and stronger right hemisphere memory. Right hemisphere language dominance further complicates diagnostic considerations for the newly observed episodes of nonsensical speech, due to their uncertain ictal association and the possibility of surface negative seizures at the resection site. This tragic case clearly demonstrates the value of Wada testing in establishing risk for post-surgical cognitive decline.
      PubDate: 2017-09-06
       
  • A-66 Maternal Prenatal Medical Conditions and Their Effect on
           Neurocognitive Deficits Among Their Children
    • Authors: Perez D; Rodriguez M.
      Abstract: Objective: To review the relationship between maternal, prenatal medical conditions and neurocognitive deficits among their children. Methods: A systematic literature review was conducted using the following keywords: prenatal medical conditions, cognitive deficits, neurodevelopmental deficits, prenatal medical complications. The following databases were used: PsychARTICLES, PsychINFO, PubMed, Academic OneFile, PsychARTICLES and MedLine. Peer reviewed articles that examined the relationship between maternal prenatal medical conditions and cognitive deficits among their children were included. Articles focused on substance use and psychiatric conditions were excluded. 8 articles were included. Results: Three studies found a relationship between Maternal thyroid function in pregnancy and verbal and nonverbal cognitive function, fetal and infant head growth and attention deficit hyperactivity problems. Two studies found a relationship between decreased cognitive function and abnormalities in the blood and urine during pregnancy. One study focused on the relationship between maternal thyroid autoimmunity in pregnancy and behavior and cognitive function. One study found that Fetal Growth Restriction due to placental insufficiency was associated with compromised cognitive outcome in Very Low Gestational Age children. Another study found a positive relationship between prenatal maternal seizure and cognitive deficits. Conclusion: The literature revealed a general correlation between maternal prenatal medical conditions and child cognitive deficits. Examining the effects of medical treatment during gestations should be considered as a future direction to possibly reduce related cognitive deficits in children.
      PubDate: 2017-09-06
       
  • A-67 Cognition, Depression, and Physical Disability in Multiple Sclerosis
           as Predictors of Illness Intrusiveness
    • Authors: Portnoy J; Altaras C, Miller J, et al.
      Abstract: Objective: Multiple sclerosis (MS) is capable of causing impairment in physical, cognitive, and emotional functioning. The role that these three types of disability play in patient perception of illness is not well understood. Method: 116 patients with MS, aged 18 to 77 (M = 47.6, SD = 11.3), were recruited from a large tertiary care MS center. Patients completed the Illness Intrusiveness Ratings Scale (IIRS), Patient Heath Questionnaire (PHQ-9), Timed 25-Foot Walk (T25-FW), 9-Hole Peg Test (9-HPT), and four neuropsychological tests commonly used in evaluation of MS: the Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), California Verbal Learning Test (CVLT), and Brief Visuospatial Memory Test (BVMT). Hierarchical linear regression examined the contributions of cognitive, physical, and emotional disability to illness intrusiveness ratings. Results: In an age- and sex-adjusted model, neuropsychological test performance was associated with significant change in prediction of illness intrusiveness (ΔR2 = .104, p = .013). Physical disability (T25-FW, 9-HPT) was not significantly associated with illness intrusiveness (ΔR2 = .044, p = .059), while reported depression on the PHQ-9 was strongly associated with illness intrusiveness (ΔR2 = .234, p < .001). Conclusion: Cognitive and emotional functioning both contribute significantly to MS patients’ feeling that their disease intrudes upon their lives, with emotional distress playing an especially large role. Physical disability in MS is less likely to significantly influence perceived illness intrusiveness.
      PubDate: 2017-09-06
       
  • A-68 Emotion and Cognition in Movement Disorders: Comparing Pre-operative
           Deep Brain Stimulation Patients with Parkinson's Disease and Essential
           Tremor
    • Authors: Saad A; Harty S, Richardson R, et al.
      Abstract: Objective: To explore the relationship between emotional distress (depression and anxiety) and cognitive function in patients diagnosed with Parkinson's disease (PD) and essential tremor (ET) being evaluated for deep brain stimulation (DBS) surgery. Individuals diagnosed with PD and ET frequently report elevated symptoms of depression and anxiety (Weintraub et al., 2015; Sengul et al., 2015) and negative emotionality has been repeatedly shown to impact neuropsychological performance (Del Brutto, 2015). Exploring the relationship between emotionality and neuropsychological function is warranted as performance on neuropsychological examinations is often a measure for DBS surgery candidacy. Method: Data was collected during outpatient pre-operative workups for DBS surgery (n = 122, PD; n = 45, ET). Assessments included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Zung Self-Rating Anxiety Scale, and Center for Epidemiological Studies Depression Scale-Revised. Results: No significant differences were found in anxiety and depression between disease types. Anxiety was significantly correlated with depression in both PD (r = .421, p < .001) and ET (r = .766, p < .001) groups. Within the PD group, anxiety was significantly associated with the Immediate Memory Index and the Total Score Index (r = −.297, p = .02; r = −.219, p = .032). Conclusion: These results suggest that anxiety within PD patients presenting for DBS may negatively influence neuropsychological performance in general and in the domain of immediate memory. As such, it will be important to further explore the effect that anxiety has on cognitive performance in movement disorder patients seeking DBS surgery.
      PubDate: 2017-09-06
       
  • A-69 Comprehensive Neuropsychological Evaluation in a Child with Subdural
           Empyema Secondary to Acute Frontal Sinusitis: A Case Study
    • Authors: Sadurni C; Santiago C, Tanner W, et al.
      Abstract: Objective: Subdural empyema is an intracranial collection of purulent material between the dura/arachnoid mater. Consequent deficits are associated with affected brain areas and immediacy of treatment. Symptoms correlated with infection are fever, vomiting, impaired consciousness, and sudden focal neurologic deficits. Neurocognitive sequelae include deficits in language, attention, executive, behavior and motor functioning. Neuropsychological functioning of an 11 year-old Haitian female, 13 months post-incident, is presented with the purpose of adding to existing limited literature. Method: Patient had immediate right hemiparesis and was taken to hospital where a CT/MRI scans indicated left frontal cerebritis and concurrent paranasal sinus disease, suggestive of contiguous spread of infection. Her two-month inpatient acute hospitalization was remarkable for neurosurgeries to drain empyema, hemicraniectomy, External Ventricular Drain and Ventriculoperitoneal Shunt placement, with inpatient rehabilitation for 6 more weeks. Outpatient neuropsychological testing included intelligence, achievement, language, memory, perceptual/spatial, executive function, auditory processing, attention, motor, processing speed, and behavioral/emotional functioning. Results: Results revealed significant decline in functioning, with deficits in areas of receptive/expressive language, verbal memory, fine-motor skills, processing speed, working memory/effortful/auditory attention, and verbal executive functioning/cognitive flexibility. Overall, global language deficits, slow processing, concrete thinking, and poor motor functioning impacted performance across domains. Some disinhibition/frustration was exhibited and depressive symptomatology was endorsed. Diagnoses included Major Neurocognitive Disorder due to another medical condition, with behavioral disturbance; Adjustment Disorder, with depressed mood; and Global Aphasia. Conclusion: Neurocognitive deficits are commensurate with left brain damage to the fronto-temporal-parietal areas with some right frontal involvement while other areas of functioning were adequate.
      PubDate: 2017-09-06
       
  • A-70 Neurological and Psychological Effects with Chikungunya Infectious
           Disease: A Systematic Literature Review
    • Authors: Sosa M; Arias M.
      Abstract: Objective: The Chikungunya Virus (CHIKV) is an arthropod borne viral disease found epidemically across tropical and subtropical areas. The disease has spread to more than 60 countries worldwide from Africa, Asia, Europe to the Americas. Since 2015 over a million suspicious cases of CHIKV have been recorded in Latin America, Caribbean Islands and the U.S. This study will provide an overview on CHIKV and describe the neurological and psychological impacts we are now discovering. Data Selection: A systematic literature review was conducted using the following keywords: “Chikungunya,” “infectious disease,” “psychological,” “neurological,” “symptoms,” “sequelae,” and “United States.” Studies included for review involved articles published after 2005 and peer-reviewed articles in psychological and medical journals. Articles that only focused on the biological etiology of CHIKV and comorbid infectious diseases were excluded. Initial searches yielded a total of 120 studies of which 9 met the inclusion criteria. Data Synthesis: The literature demonstrates supporting evidence for serious neurological and psychological effects with those diagnosed with CHIKV. Longstanding disabilities include musculoskeletal disorders (i.e. arthralgia, myalgia), chronic fatigue, depression, and neurocognitive disorders across the lifespan. Long term consequences such as memory loss, sleep disorders, encephalitis, myelopathy and myeloneuropathy, osteoarthritis, and retinal hemorrhage were also found. Conclusion: Review of the data demonstrates preliminary evidence that CHIKV long-term consequences may cause significant impact in neurological and psychological function. Current challenges for professionals will be to identify and diagnose CHIKV and its clinical presentation for disease management in a multidisciplinary approach. Future studies with larger sample sizes and strong methodology are needed.
      PubDate: 2017-09-06
       
  • A-71 Cognition and Affect Among Individuals with Chiari Malformation Type
           I: An Examination of Executive Function and Psychological Distress
    • Authors: Stephenson T; Crittenden J, Harty S, et al.
      Abstract: Objective: To establish the clinical profile of executive function (EF) and psychological distress in patients with Chiari malformation type 1 (CM1). Research regarding CM1's influence on neuropsychological function is severely lacking (Bakim et al., 2013; Koziol & Barker, 2013). Method: The sample consisted of 33 patients (28 females) with mean age of 35.7 (standard deviation (SD) = 12.1). The study was conducted at an outpatient neurosurgery clinic and was comprised of individuals referred for surgical intervention. The battery included four measures of EF and one measure of psychological distress. Statistical analyses explored descriptive statistics and the relationship between CM1 features (tonsillar descent; syrinx) and EF measures. Results: Regression analyses revealed no significant associations between CM1 features and EF measures. However, descriptive statistics uncovered an atypical profile on measures of EF with two distinct groups emerging. Many CM1 patients performed below average (≤−1.0 SD) on measures of phonemic fluency (30%), cognitive flexibility (22%), and inhibition (27%). Sizable portions of patients also performed above average (≥1.0 SD) on measures of semantic fluency (>27%), and cognitive switching with a motor component (21%). Results also showed that 63% of patients endorsed above average severity levels (≥1.0 SD) of global psychological distress. Conclusion: Initial analyses suggest that CM1 features do not directly influence EF. However, the emerging pattern suggests that CM1 may have a negative influence on psychological distress and on EF performance in subsets of patients. Detailed understanding of relationships between CM1 and neuropsychological function will be enhanced with increased sample size and as post-operative comparisons are drawn.
      PubDate: 2017-09-06
       
  • A-72 Deep Brain Stimulation of the Anterior Limb of the Internal Capsule
           for Treatment of Therapy-refractory Obsessive Compulsive Disorder (OCD): A
           Case Study Highlighting Neurocognitive and Psychiatric Changes
    • Authors: Choudhury T; Davidson J, Viswanathan A, et al.
      Abstract: Objective: Obsessive compulsive disorder (OCD) is an anxiety disorder characterized by repeated, unwanted thoughts and behaviors. Individuals with this condition often experience significant emotional distress secondary to their symptoms. Additionally, impairments in attention/concentration, processing speed and executive functions are typically observed. The exact pathology of OCD remains unknown; consequently, it can be difficult to treat patients with severe symptomatology. Deep brain stimulation (DBS) may be a viable treatment option for individuals who do not respond to medication and/or cognitive behavioral therapy. Method: DBS of the anterior limb of the internal capsule was administered for a patient with severe, therapy-refractory OCD. Changes in cognitive and neuropsychiatric functioning were measured before and after the DBS procedure, including at 35 and 51 months post-operative follow-up. Results: Postoperative neuropsychological results evidenced significant improvements in cognitive domains of global mental status, processing speed, and executive functioning. The patient provided qualitative feedback to the treating psychiatrist which also consistently reflected a reduction in OCD symptoms and consequently, improved quality of life (QOL). Conclusion: As an emerging experimental therapy, DBS for severe therapy-refractory OCD has generated promising outcomes but still requires extensive evaluation in order to validate the safety and reliability of the procedure.
      PubDate: 2017-09-06
       
  • A-73 Performance on a Novel Brief Measure for Social Cognition in
           Individuals with Schizophrenia
    • Authors: Becker M; Zenisek R, Paul N, et al.
      Abstract: Objective: Social cognitive deficits in psychiatric and neurological disorders contribute to impairment in functioning. However, few neuropsychological measures are available to assess social cognition, including screening procedures. This study assessed differences in performance on a novel brief measure for social cognition in people with schizophrenia or schizoaffective (SZ) disorder. Method: Participants included 21 people with SZ recruited from a community outpatient clinic (mean age = 46, SD = 9; male = 86%) and 19 healthy controls (CN) from the community (mean age = 35, SD = 11; male = 68%). Diagnosis was confirmed with the SCID and current symptoms were assessed. The Brief Test of Social Cognitive Abilities (BTSCA) was developed for this study to assess affect recognition (AR), social perception and processing (SP), and theory of mind (ToM). It includes items selected from tests typically used in laboratory settings that are sensitive and specific to social cognitive deficits. The BTSCA was administered with other tests designed to assess additional cognitive processes. Results: Mixed model ANCOVA was used to compare groups (SZ vs CN) on the social cognitive composite scores (AR, SP, ToM) controlling for age differences between groups. ANCOVA indicated that the SZ group performed significantly worse that controls across all domains (F = 9.64, p = .004). Conclusion: These results provide preliminary support for the BTSCA as a screening measure to detect social cognitive deficits in individuals with SZ. To establish its clinical utility, sensitivity to deficits in other neurological and psychiatric populations should be determined in future research.
      PubDate: 2017-09-06
       
  • A-74 SPECT Cerebral Blood Flow Differences Between Self-Reported
           Post-Traumatic Stress Disorder and Obsessive-Compulsive Symptomatology
    • Authors: Boix-Braga M; Herman C, Lowry B, et al.
      Abstract: Objective: To compare cerebral blood flow differences, as measured by SPECT, between self-reported post-traumatic stress disorder (PTSD)and obsessive-compulsive disorder (OCD) symptomatology. Method: Using a symptom checklist, participants were determined based on their score on scales measuring self-reported OCD and PSTD symptomatology. These participants were part of a large archival de-identified database. There were a total of 3,015 participants (age: M = 38.92, SD = 14.37; 53.5% males, 68.8% Caucasian). Participants were placed on their respective groups based on whether their responses fell at or above the 75th percentile of the sum of responses of their respective scales. Measurements were analyzed in 17 areas across the brain. Results: A MANOVA was found significant at the participants’ baseline level at the = .01 level. Significant differences were found in the left frontal, right frontal, and right basal ganglia area, in which the high OCD group had higher rCBF levels in both frontal regions and lower levels of rCBF in the right Basal Ganglia region in comparison to the PTSD group. Conclusion: Results indicate that OCD-related symptomatology may result from a functional disturbance in the frontal-striatal loop system, whereas PTSD symptomatology has been found to be linked to a malfunction of the hypothalamic-pituitary-adrenal axis and in frontal-limbic connections, thereby providing further evidence that OCD and PTSD are based in separate and distinct biological phenomena. These findings provide further explanation as to why these two often-related disorders are differentiated by symptom presentation of frontal lobe-related tasks ignoring, suppressing, or neutralizing thoughts versus a more limbic-related presentation of threat detection and elaborating conditioned and unconditioned fear responses.
      PubDate: 2017-09-06
       
  • A-75 Factor Structure of the Emotional Verbal Learning Test in a
           Schizophrenia Population
    • Authors: Call E; Hussey J, Strauss G, et al.
      Abstract: Objective: The Emotional Verbal Learning Test (EVLT) is a list-learning test that assesses emotional memory from 4 emotion categories (Happiness, Sadness, Anger, & Anxiety). Reliability and validity studies suggest the EVLT has comparable psychometrics to commonly used list-learning tests. Because individuals with schizophrenia exhibit emotion processing abnormalities, the current study examined factorial validity of the EVLT in a schizophrenia sample. Method: Participants included 70 individuals diagnosed with schizophrenia (age = 42.4; education = 11.94; %male = 57.1) who were administered the EVLT. Principal component analysis with varimax rotation was used to examine factor structure. Number of factors were selected using Kaiser-Guttman criteria. Results: PCA identified six factors that accounted for 71.6% of the variance. These factors consisted of four emotion learning factors composed primarily of Trial 5, short-delay and long-delay scores for each of the four emotions. There was also a recognition factor composed of recognition scores for each of the four emotions. An encoding factor was composed of Trial 1 scores for anxiety and sadness. Conclusion: The current six-factor solution identified in this schizophrenia sample was similar to the seven-factor solution identified for controls in prior studies. The factor structure in the current sample demonstrated more cross-loadings of items across factors. This may be due to sample size considerations. The primary difference between the six- and seven-factor solutions was presence of an encoding factor of Trial 1 scores for anger and happiness in the control group. These results provide initial support for similarity of factor structure in normal and schizophrenia populations. Additional research using confirmatory factor analytic approaches are needed.
      PubDate: 2017-09-06
       
  • A-76 Belief Reasoning and Inhibition in Delusions
    • Authors: Connaughton E; Anandakumar T, Boulton K, et al.
      Abstract: Objective: Delusions occur in a number of disorders, including schizophrenia, traumatic brain injury and dementia. It has been theorised that people with delusions have a belief evaluation impairment caused by difficulty inhibiting beliefs so as to reason about them as if they may not be true (i.e., an impairment in doxastic inhibition). It is predicted that people with delusions will display greater difficulty than controls when judging the logical validity of a statement that conflicts with reality (i.e., display greater difficulty on “conflict” items of a “belief-bias” reasoning task but not on “no-conflict” items), as evaluating these statements requires inhibition of beliefs about the world. Methods: 15 people with current delusions and a diagnosis of schizophrenia or schizoaffective disorder, and 20 controls (matched on age and gender) were recruited. Participants completed a belief bias reasoning task and tasks assessing attention, working memory, and general inhibitory function. Results: Participants with delusions showed significantly greater difficulty than control participants on at least one task assessing working memory, and at least one task assessing general inhibitory function. On the belief-bias task, participants with delusions made a greater number of errors on “conflict” items than “non-conflict” items, and made more errors on “conflict” items when compared to controls. Conclusion: Consistent with a doxastic inhibition account, participants with delusions showed greatest difficulty with conditional reasoning when statements conflict with reality. Evidence for working memory and general inhibitory difficulty in participants with delusions was also found. Theoretical implications of these findings will be discussed.
      PubDate: 2017-09-06
       
  • A-77 The Effects of Cannabis and Anxiety on Neurocognitive Functioning
    • Authors: Crittenden P; Grisanzio K, Goldstein-Piekarski A, et al.
      Abstract: Objective: To examine the neurocognitive effects of cannabis use and anxiety symptoms. Method: Participants (n = 255) were adults with anxiety and/or depressive symptoms who completed the Beck Anxiety Inventory (BAI); Penn State Worry Questionnaire (PSWQ); Depression, Anxiety and Stress Scale (DASS); and Mood and Anxiety Symptom Questionnaire (MASQ). Cannabis use severity was measured by the Cannabis Use Disorder Identification Test-Revised (CUDIT-R). Neurocognitive domains were assessed using computerized testing (WebNeuro). Results: A principal component analysis of anxiety and depressive symptoms revealed two anxiety factors, “anxious arousal” and “worry,” and two additional symptom factors, “anhedonia” and “tension” that were used as control variables in a hierarchical multiple regression model. Cannabis use severity was associated with higher levels of anxious arousal, higher levels of worry, and decreased performance across all cognitive domains. The interaction between anxious arousal and cannabis use severity significantly predicted decreased cognitive performance for verbal memory (immediate recall, R2 = 0.092, F(9, 245) = 2.752, p = 0.004; learning rate, R2 = 0.116, F(9, 245) = 3.574, p < 0.001; intrusion errors, R2 = 0.092, F(9, 245) = 2.752, p = 0.004); and decreased speed for identifying facial emotions (fear, R2 = 0.203, F(9, 245) = 6.940, p < 0.001; anger R2 = 0.168, F(9, 245) = 5.481, p < 0.001; neutral R2 = 0.153, F(9, 245) = 4.928, p < 0.001). The interaction between worry and cannabis use severity significantly predicted accuracy for identifying facial emotion (R2 = 0.079, F(9, 245) = 2.330, p = 0.016). Conclusion: Findings suggest that high cannabis use may intensify the effects of anxious arousal and worry on neurocognitive performance. Further research is warranted to examine the potential anxiolytic, anxiogenic, and associated neurocognitive effects of varying levels of cannabis use.
      PubDate: 2017-09-06
       
  • A-78 Serial Position Effects of the Emotional Verbal Learning Test and
           California Verbal Learning Test-Second Edition in Individuals with
           Schizophrenia
    • Authors: Emami A; Nunez A, Favela S, et al.
      Abstract: Objective: Individuals with schizophrenia (SZ) experience learning, memory, and emotion processing deficits. Therefore, it is important to assess learning, memory, and emotion processing to identify deficits and identify changes associated with intervention. This study examined differences in serial position effects for two tests of learning and memory: the Emotional Verbal Learning Test (EVLT) and California Verbal Learning Test-Second Edition (CVLT-II). Method: Participants included individuals with SZ (n = 70; mean age = 42.4, SD age = 11.8) and controls (CN; n = 52; mean age = 32.4, SD age = 12.1). SZ participants were recruited from an outpatient community mental health clinic, and CN from the community. The EVLT is a test of emotional verbal learning and memory, and was administered with the CVLT-II to participants in a counterbalanced order. Results: A repeated-measures ANOVA was used to examine differences in serial position effects for the EVLT and CVLT. Serial position (primacy, middle, recency) and test served as repeated measures, and group as a between subjects factor. A significant group by serial position by test interaction was found. Participants had greater recall of primacy and recency words compared with words in the middle of the lists on both tests (p's < .001). The CN group recalled significantly more items than the SZ group on both tests (p's < .001). Finally, greater primacy effects were present for CVLT compared to EVLT, accounting for a three-way interaction. Conclusion: In addition to the CVLT-II, the EVLT may serve as a valuable tool in the assessment of memory and learning deficits among individuals with schizophrenia and may provide an advantage in assessing emotional learning and memory.
      PubDate: 2017-09-06
       
  • A-79 Semantic Emotional Self-report Affects Free-recall Intrusion Errors
           on the Emotional Verbal Learning Test
    • Authors: Gomez-Batista S; Lee B, Allen D.
      Abstract: Objective: People with schizophrenia have deficits in emotion processing that have real-world impact on functional outcome. Research suggests that emotional shading of semantic memory may affect emotional experience and cognition in this group. Emotionally-valenced intrusion errors on learning tasks provide a unique method of examining the impact of emotional semantic memory on learning and episodic memory. Method: Participants with schizophrenia were administered the Emotional Verbal Learning Test (EVLT): A list-learning task similar to the California Verbal Learning Test (CVLT) comprised of emotion words (e.g. joy) belonging to four emotional categories (happiness, sadness, anger, and anxiety), and were asked to self-report their overall emotional experience during the last two weeks in terms these same emotional categories (i.e. semantic memory of emotional experience). A median split of emotion rating was used to identify high-reporters vs. low-reporters of emotion in each of these categories. Analyses of variance were used to examine differences in the frequency of emotion-specific intrusion errors during list-learning as a function of emotion reporter groups within people with schizophrenia. Results: Those with schizophrenia who are high-reports of semantic anxiety had significantly fewer sadness intrusions (p < .05) and more happiness intrusion (p < .05) errors. Subjects with higher reports of anger had significantly more happiness (p < .05) intrusion errors. Conclusion: Long-term subjective reports of emotional experience thought to reflect semantic memory for emotion may affect episodic memory as assessed by a list-learning task. The seemingly paradoxical nature of this pattern is further discussed.
      PubDate: 2017-09-06
       
  • A-80 Intrusion & Repetition Errors on the Emotional Verbal Learning
           Test (EVLT) in Schizophrenia
    • Authors: Hussey J; Call E, Strong M, et al.
      Abstract: Objective: The Emotional Verbal Learning Test (EVLT) is a list-learning test assesses emotional memory from four emotion categories (Happiness, Sadness, Anger, & Anxiety). In addition to word recall, the EVLT allows comparison of intrusion and repetition errors across the emotional categories. Intrusions and repetitions may be associated with underlying emotional state or psychopathology, although this has not been directly examined in a clinical population. The present study compared intrusion and repetition errors in performance in schizophrenia (SZ) and control groups to further examine this matter. Method: Participants included 122 individuals (mean age = 42.4; controls n = 52; SZ n = 70). SZ diagnosis was confirmed with the SCID. Participants were administered the EVLT as part of a larger battery of tests. Mixed-model ANOVA was used to examine differences between groups (SZ, controls) across the four emotional categories. Results: ANOVA revealed significant between-group (p < .01; SZ and controls) and within-subjects effects for emotion (p < .01), but no significant interaction effect. Results indicate that, in general, happiness and anger intrusions occurred more frequently than sadness and anxiety, and that the SZ group had more intrusions than the control group. Post hoc analysis indicated that the SZ group had significantly more happiness and anger intrusions than the control group. The two groups did not differ on sadness or anxiety. No significant between- or within-subjects effects were found for repetition errors. Conclusion: SZ groups may offer intrusions of Happiness and Anger emotion words more often than any other EVLT semantic category. Specifically, SZ groups may have more intrusions of Happiness and Anger words than control groups.
      PubDate: 2017-09-06
       
  • A-81 Are Cognitive Inefficiencies a Predictor or Consequence of Major
           Depressive Disorder'
    • Authors: Schaefer J; Caspi A, Cook S, et al.
      Abstract: Objective: Major depressive disorder (MDD) has been linked to cognitive inefficiencies. One theory suggests that superior cognitive functioning in childhood decreases risk of later MDD. Another, however, suggests that MDD leads to persistent cognitive deficits following disorder onset. We examined (1) the temporal ordering of cognitive impairment and depressive episodes, and (2) whether impairment associated with MDD is specific or generalized across cognitive domains. Method: We used data from the Dunedin Study (N = 1037), a New Zealand-based, population-representative birth cohort followed with 96% retention. Study members were assessed repeatedly from childhood to midlife for both cognitive functioning (using Weschler IQ measures, neuropsychological tests, and self-/informant-reported cognitive problems) and psychopathology (including MDD and common comorbidities). Results: With the possible exception of a few speeded measures, we found little evidence to suggest that poor cognitive test performance is a reliable predictor or antecedent of MDD. Instead, poor performance appeared to be most closely associated with non-MDD psychiatric comorbidity. Interestingly, despite little objective evidence of cognitive decline, we found that Study members with a past history of depression tended to score higher on measures of self- and informant-reported cognitive impairment than their never-depressed peers. Conclusion: Our results suggest that, to the extent that there is a relationship between MDD and poor cognitive test performance, it seems to be largely attributable to psychiatric comorbidities rather than to depressive symptoms per se. Future research may benefit from considering cognitive deficits that occur during depressive episodes from a transdiagnostic perspective.
      PubDate: 2017-09-06
       
  • A-82 Emotion Regulation and Cognitive Control in Schizophrenia: An
           Electrophysiological Study
    • Authors: Sullivan S; Strauss G.
      Abstract: Objective: Individuals with schizophrenia (SZ) display abnormalities in emotion regulation and cognitive control that are driven by structural and functional abnormalities of the prefrontal cortex. In healthy individuals, there is evidence that effective implementation of an emotion regulation strategy has beneficial effects on a temporally proximal cognitive control task. The present study examined whether attempts to up- and down-regulate negative emotion via reappraisal have differential effects on subsequent cognitive control in SZ and healthy controls (CN). Method: Participants included 30 outpatients diagnosed with SZ and 29 demographically-matched CN recruited from the general community. All participants were trained in emotion regulation via reappraisal (up-regulation or down-regulation) before completing a combined emotion regulation and cognitive control (numerical Stroop) task. The electroencephalogram was recorded while participants performed the Stroop-Regulation task, and event related potentials (ERPs) were used to index emotion regulation effectiveness (late positive potential) and cognitive control (sustained potential). Results: Both CN and SZ evidenced comparable neurophysiological reactivity to unpleasant stimuli. Although CN demonstrated neurophysiological evidence of effective use of reappraisal to increase and decrease negative emotion, SZ were only effective in increasing negative emotion. CN displayed enhanced cognitive control following increase trials and impaired cognitive control following decrease trials, as indicated by modulation of SP amplitude. In SZ, increase instructions marginally impaired cognitive control and decrease instructions had no effect on cognitive control. Conclusion: These results may suggest that emotion regulation abnormalities may play an under-recognized role in general cognitive control deficits that occur in SZ.
      PubDate: 2017-09-06
       
  • A-83 SPECT Differences in a Measure of Depression Among Those Diagnosed
           with PTSD
    • Authors: Tirado C; Zachar R, Jiminez J, et al.
      Abstract: Objective: To examine brain areas most associated with cerebral blood flow (rCBF) differences with levels of depression in individuals who are diagnosed of PTSD. Method: Participants selected based on scores of a depression self report. Clients received SPECT scans, at rest and administration of CPT. Ages ranged from 18–86 (M = 40.46, SD = 15.86) and consisted of 41.3% females, 58.6% males. Subjects were stratified on two levels, lower and higher levels of depression (lower n = 381, higher n = 348). Results: MANOVA was significant at the .05 level, for depression at baseline Wilks’λ = .992, F(32, 2460) = 2.853, p < .001. Lower levels of depression at baseline showed significantly lower rCBF in the left cerebellum, and left temporal, while an increase in blood flow in the motor sensory area when compared to higher levels of depression. MANOVA was significant at the .05 level, at concentration Wilks’λ = .993, F(32,2460) = 3.149, p < .01. Lower levels of depression at concentration showed significantly lower blood flow in the left limbic region, left temporal and an increase in blood flow in the motor sensory area when compared to high levels of depression. Conclusion: Results indicate a relationship between traumatic events experienced and an increase in depressive symptoms. With this rise in depressive symptomology, an increase occurs in rCBF in individual's temporal areas associated with memory and emotion processing. The increase in time focused on emotion and associated depressive symptoms of the traumatic event causes this increase at times where the individual is relaxed and while trying to concentrate on a task. Focus is not fully given on the intended task but rather on the associated depressive feelings attached.
      PubDate: 2017-09-06
       
  • A-84 SPECT Differences in Cerebral Blood Perfusion with Individuals
           Diagnosed with Impulse Control Disorders and Cluster B Personality
           Disorders
    • Authors: Wutke J; Stebbins L, Okolichany R, et al.
      Abstract: Objective: To determine the differences in baseline cerebral blood perfusion in individuals diagnosed with impulse control disorders and Cluster B personality disorders. Method: Participants were selected from a de-identified database assembled by Amen Clinics and managed by the Neuropsychological Assessment Center at Nova Southeastern University. The sample (N = 444) received either a Cluster B personality disorder (PD) or impulse control disorder diagnosis (ICD) based on DSM-IV criteria. Comorbid cases were excluded from this study. The sample was predominantly male (56.4%) with a mean age of 37.04 years (SD = 14.19) The sample was predominantly Caucasians (70.2%). An independent samples t-test was conducted to determine differences in blood perfusion in the different brain regions measured by SPECT scans. An alpha level of .001 was used. Results: Results indicated significantly greater perfusion for PD in the Left/Right(L/R) Limbic Areas (t = −6.267, p < .001;t = −6.213,p < .001), L/R Basal Ganglia (t = −5.802,p < .001;t = −5.443,p < .001), L/R Sensory-Motor Areas (t = −4.029,p < .001,t = −3.294,p = .001), and Vermis (t = −3.421,p = .001). ICD had greater perfusion in the L/R Cerebellum (t = 4.785,p < .001;t = 5.242,p < .001), L/R Occipital Lobes (t = 6.757,p < .001,t = 5.790,p < .001), and Right Temporal Area (t = 5.543,p < .001). Conclusion: PD demonstrated higher activation in areas associated with dopaminergic pathways in the basal ganglia, physical sensation, and emotional control which have been associated with addiction. The lack of significant frontal activation and increased subcortical activation in PD follows Lurian theory indicating subcortical impulses override the cortical executive control. ICD demonstrated stronger activation in visual and auditory sensation, which may corroborate how ICDs like kleptomania and pyromania fixate due to increased visual sensitivity and stimulation. Further research should assess how each subtype of ICDs differ in perfusion due to the variation of subtypes.
      PubDate: 2017-09-06
       
  • A-85 SPECT Differences in Cerebral Blood Perfusion for Self-Reported
           Anxiety
    • Authors: Zachar R; Tirado C, Stebbins L, et al.
      Abstract: Objective: The current investigation focused on examining the relationship between cerebral blood flow to various cortical regions and the subjective experience of high and low levels of anxiety. Method: Participants (N = 4,374) were divided into two groups based on their level of symptom endorsement for questions relating to anxiety. These individuals were evaluated by SPECT scans at Baseline and during Concentration. The data was derived from a de-identified database of adults with a variety of psychiatric diagnoses given a baseline SPECT scan to measure rCBF and a second scan while completing the Connor's Continuous Performance Test. Results: A multivariate analysis of variance (MANOVA) indicated that individuals with higher levels of anxiety displayed elevated cerebral blood perfusion in cortical areas of the right and bilateral areas such as bilateral limbic and occipital regions as well as the right frontal lobe. There were significant differences in the left and right basal ganglia and right temporal lobe as well. Conclusion: Results indicate that individuals with high levels of anxiety will excel with the learning of new tasks but will struggle with consolidating the information into usable templates. This may lead to difficulties in workplace or classroom settings, initially having little difficulty learning new material but struggling to import that information into memory. They may also exhibit deficits in understanding details as compared with a more holistic view of tasks. Seeing the bigger picture will come easier to individuals with high levels of anxiety but breaking the gestalt down into its components will be more difficult to complete.
      PubDate: 2017-09-06
       
  • B-01 Is Sluggish Cognitive Tempo Related to Depression, Anxiety, and
           Stress'
    • Authors: Callahan L; Suhr J, Gloger E, et al.
      Abstract: Objective: The construct of Sluggish Cognitive Tempo (SCT) has gained attention recently. Originally thought of as a subset of ADHD symptoms, SCT is now being considered separate and distinct from ADHD. Although some research has identified SCT as potentially being difficult to distinguish from anxiety and depression, there is no literature on the role of noncredible reporting on presentations with SCT. The present study hypothesized that individuals high in SCT would report more depression, anxiety and stress than individuals low in SCT, controlling for noncredible reporting of symptoms. Method: Participants were undergraduate students who identified as either high or low in SCT on the basis of an online screening, and then were confirmed as high or low in SCT on the basis of the SCT subscale of the Barkley Adult ADHD Rating Scale They then completed several additional self-report measures and a brief neuropsychological battery; the measures included the Depression, Anxiety, and Stress Scale as well as a measure of noncredible self report (CAARS CII). Results: An independent samples t-test was conducted to investigate the relationship between individuals high and low in SCT and their level of depression, anxiety, and stress. All relationships were significant, with considerable differences between Hi SCT and Low SCT in depression and stress, both p's < .001, d = 1.29 for depression, d = 0.77 for stress, and moderate differences in anxiety, p = .024, d = 1.29 for anxiety. Conclusion: Results suggest that SCT may not be a unique construct given that it is related depression, anxiety, and stress. The overlap in symptoms is of concern in regard to treatment decisions. Future studies should continue to examine whether SCT is distinct from other psychological disorders.
      PubDate: 2017-09-06
       
  • B-02 Sluggish Cognitive Tempo is Related to Sleep Difficulties
    • Authors: Gloger E; Suhr J, Smith J, et al.
      Abstract: Objective: Sluggish Cognitive Tempo is sometimes seen in children, adolescents, and adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Becker and colleagues (2016) suggest SCT is more related to inattention rather than hyperactive or impulsive components. Although ADHD and SCT are related, data suggests SCT may be its own psychopathology. Individuals with ADHD experience more sleep difficulties than those without; it is possible that individuals with SCT also experience sleep difficulties. We hypothesized that SCT is related to sleep difficulties in emerging adults, after controlling for non-credible symptom report. Method: Participants were college-age students, age 18–24, who participated in pre-screening to determine their levels of SCT (high or low). Individuals high and low completed a clinical interview, measures of SCT, and sleep. For the present analyses, we used data from the Pittsburgh Sleep Quality Index (sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction) and the self-reported SCT symptoms from the Barkley Adult ADHD Rating Scale IV. Results: More males fell in the high SCT group (p = .033), but groups did not differ in age. The high SCT group had worse overall sleep quality (p = .004), more problems falling asleep (p = .018), more medication use when falling asleep (p = .006), more daytime difficulties(p < .001), and worse composite sleep score (p = .002). Groups did not differ in total hours of sleep each night, sleep efficiency, or troubles with sleep. Conclusion: Those high in SCT have poor sleep quality, more difficulty falling asleep, more medication use to fall asleep, more daytime sleepiness, and worse composite scores of sleep. Sleep difficulties should be considered when complaints of SCT are made; it is possible that SCT is due to poor sleep, which could be addressed with treatment. Future research could include a polysomnogram study to investigate actual sleep behavior and consequences.
      PubDate: 2017-09-06
       
  • B-03 Social Cognitive Deficits in Children with Attention Deficit
           Hyperactivity Disorder
    • Authors: Graves S; Parke E, Mayfield A, et al.
      Abstract: Objective: Research suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) exhibit deficits in social cognitive abilities and these deficits contribute to social dysfunction. Social cognitive abilities involve processing of social information, and include affect recognition, theory of mind (ToM), and social knowledge. However, little information is known regarding impact of ADHD symptomatology on aspects of social cognition and whether social cognitive deficits predict problem behaviors.This study investigates relationships between social cognition, ADHD symptomatology, and behavioral outcomes. Method: Participants included 25 children diagnosed with ADHD, and 25 healthy controls (HC). Children in the ADHD group were 10.6 years old and 76% male with a Full Scale IQ of 98.1. 64% were diagnosed with ADHD-Combined (n = 16) and 36% with ADHD-Inattentive (n = 9). Children in the HC group were 10.1 years old and 60% male with a Full Scale IQ of 107.4. Participants were administered a battery of tests designed to assess ADHD symptomology, behavioral disturbances, and social cognitive domains including affect recognition, ToM, and pragmatic language ability. Results: Mixed model ANOVA comparing the ADHD to HC across social cognition measures indicated that ADHD performed significantly poorer than HC on affect recognition, pragmatic language, cognitive ToM, and cognitive empathy. Largest differences between groups were present on cognitive ToM and cognitive empathy. Conclusion: Children with ADHD had more difficulty with cognitive components of social cognition (pragmatic language, cognitive ToM, and cognitive empathy), rather than the affective domains (affective ToM and empathy). Performance on facial affect recognition tests may be more related to cognitive components of social learning than initially expected.
      PubDate: 2017-09-06
       
  • B-04 Understanding the Role of Sleep in the Relationship Between Atopic
           Dermatitis and Attention-Deficit/Hyperactivity Disorder
    • Authors: Leal G; Hernandez-Cardenache R.
      Abstract: Objective: This review aims to examine the relationships between Atopic Dermatitis (AD) and Attention-Deficit/Hyperactivity Disorder (ADHD) with sleep disturbance (SD) as a mediating factor. There is currently a lack of consensus regarding their relationships; therefore, understanding these associations is of utmost importance. Data Selection: A systematic literature review was conducted in December 2016 using the keywords: ADHD, eczema, atopic dermatitis, risk factor, and sleep. The search included four databases (1) EBSCOhost, (2) PubMed, (3) Medline, and (4) ScienceDirect. The search returned 255 studies. Only studies that examined the relationship between eczema, sleep and ADHD, published after 2007 were included. Following screening by inclusion and exclusion criteria, 10 studies were identified for this review. Data Synthesis: Three studies suggested a strong association between eczema and ADHD symptoms in individuals with SD. One study suggested that individuals who have AD and do not have a SD are at risk of having ADHD. The findings of four studies suggested inadequate methods when defining the presence/absence of AD and ADHD, as it was based on self-reports or medical records and were not confirmed by medical professionals. Finally, none of the studies established important temporal relationships between AD and ADHD. Conclusion: Prospective interdisciplinary studies that examine the role of SD in the association between eczema and ADHD are warranted, as well as robust studies that establish causality. Future research should strengthen diagnostic validity of atopic dermatitis and ADHD. Increasing the field's understanding on the biological underpinnings of ADHD and eczema will aid in the implementation of preventive measures in individuals at higher risk of developing ADHD.
      PubDate: 2017-09-06
       
  • B-05 Examination of Emotional Lability and Impulsivity as Distinct
           Constructs in Relation to Cognitive Inhibition
    • Authors: Lee G; Suhr J, Racine S.
      Abstract: Objective: Stroop tasks have been widely utilized to assess cognitive inhibition in attention-deficit/hyperactivity disorder (ADHD). Recent research suggests that, in addition to attention, hyperactivity, and impulsivity, emotional lability is associated with ADHD, although its relationship with impulsivity remains less understood. We attempted to delineate the unique relationships of ADHD-related emotional lability and impulsivity on cognitive inhibition. Method: 215 healthy emerging adults (average 19.13 years old) who participated in a larger study of urgency and psychopathology were administered the Conners’ Adult ADHD Rating Scale (CAARS) and the Delis-Kaplan Executive Function System Color-Word Interference Test (CWIT) as part of the study. 70% were female and 90% identified as White. The CAARS impulsivity/emotional lability scale was divided into two separate subscales of emotional lability and impulsivity. Results: Regression analyses controlling for general speed (color trial) and ADHD DSM-IV inattentive symptoms showed that emotional lability and impulsivity accounted for 5% additional variance in performance on CWIT Interference (p = .002). Emotional lability was positively linearly related to cognitive inhibition (beta = .211, p = .004), while impulsivity was negatively linearly related to cognitive inhibition (beta = −.216, p = .006). However, neither subset showed a relationship with CWIT Interference/Flexibility (emotional lability beta = −.073, p = .297; impulsivity beta = −.040, p = .594). Conclusion: Emotional lability and impulsivity were uniquely related to, and showed opposite relationships with, cognitive inhibition. Findings provide preliminary evidence for the conceptualization of emotional lability and impulsivity as two separate constructs in relation to cognitive inhibition. Follow-up studies should be conducted with clinical samples and additional measures of impulsivity and inhibition.
      PubDate: 2017-09-06
       
  • B-06 Age-based Differences in Relative rCBF in ADHD Adults: An Exploratory
           SPECT Study
    • Authors: Lowry B; Wutke J, Golden C, et al.
      Abstract: Objective: To compare age-based differences in rCBF in ADHD adults. Method: 707 ADHD adults without comorbidity were drawn from an archival de-identified database containing rCBF SPECT data. Three age based groups were formed: ages 18–30 (n = 249;79.5%male,67.1%White,Mage = 21.84,sd = 3.55), ages 31–59 (n = 360;67.2%male,69.7%White,Mage = 46.24,sd = 7.89), and ages 60–87 (n = 98;64.3%male,74.5%White,Mage = 66.19,sd = 5.88). Multiple ANCOVAs controlling for gender were conducted comparing groups during concentration with Bonferroni comparisons across the brain. Results: Results indicated significant (p < .001) differences for rCBF in 11 of 17 ROIs. Pairwise comparisons showed significantly decreased rCBF in ages 18–30 in the right limbic area, right basal ganglia, and vermis and significantly increased rCBF in bilateral frontal and parietal lobes in comparison with ages 30–59 and 60–87. Ages 30–59 showed significantly increased rCBF in the left limbic area, left basal ganglia, right frontal lobe, and bilateral motor sensory areas when compared with ages 18–30. Ages 60–87 showed significantly decreased rCBF in the left frontal lobe when compared with ages 30–59. Conclusion: Increased rCBF in the frontal and parietal lobes for younger ADHD adults may indicate increased cognitive effort to sustain attention and process stimuli. Reduced rCBF in the basal ganglia, limbic areas, and vermis may indicate reduced ability to coordinate behavioral responses and reduced emotional processing of stimuli. This may be due to younger adults developing and refining behavioral and emotional management skills as their brains mature. Decreased rCBF for older ADHD adults in the left frontal lobe suggests a reduced role for these areas, making them more dependent on posterior brain areas. Dependence on the posterior brain may cause increased attentional problems for older adults.
      PubDate: 2017-09-06
       
  • B-07 The Relation of Sluggish Cognitive Tempo (SCT) to Objective
           Indicators of Processing Speed and Working Memory
    • Authors: Smith J; Suhr J, Gloger E, et al.
      Abstract: Objective: Currently, researchers consider SCT to be related to but distinct from ADHD; though further investigation is needed to determine its status. The relationship of subjective complaints of SCT to objective indicators of impairment has only been investigated in a few studies, with mixed findings. However, none to date have controlled for noncredible reporting of SCT symptoms or noncredible responding. The objective of the present study was to compare undergraduates high and low in SCT on measures of processing speed and working memory after controlling for noncredible reporting and noncredible responding. Method: Participants were undergraduates aged 18–24. There were no differences in high and low SCT groups by age, p = .157. There were more males in the high SCT group, p = .033. Participants completed self-report measures of SCT (subtest of the Barkley Adult ADHD Rating Scale IV) and related conditions and were administered a battery of neuropsychological tests. Results: Participants were assessed for non-credible symptom reporting; no participants needed to be removed. Two participants were removed for evidence of non-credible performance on the WMT. Groups were not different in in estimated intelligence. The high SCT group actually performed better on a few measures of processing speed, psychomotor speed, and working memory than those who reported low symptoms of SCT and were otherwise not different in performance on all other measures. Specifically, the high SCT group performed significantly better on the COWA, p = .016, and on speeded word reading of the STROOP, p = .026, and were near significantly better on part B of the numbers and letters test, p = .064. All other differences were nonsignificant, although the general pattern was for the high SCT group to perform better. Conclusion: Those who self-reported high SCT symptoms did not objectively perform differently than those with low SCT symptoms on measures of processing speed, psychomotor speed, and working memory; and in a few cases, did better. This underscores the need for objective verification of symptom report, particularly when considering diagnosis or making accommodations decisions. Further research is needed to verify these findings with larger samples.
      PubDate: 2017-09-06
       
  • B-08 Long Term Impact of Magnesium Deficiency on Cognitive Functioning
    • Authors: Erhan H.
      Abstract: Objective: A 38 - year - old woman, diagnosed with Asperger's Syndrome, Major Depressive and Anxiety Disorders, and lifelong Migraine Headaches, was referred for neuropsychological assessment by her mother, due to difficulties in functioning independently. Medical records revealed a long standing history of Disorder of Magnesium Metabolism. The aim is to examine whether neuropsychological test findings match the literature with regard to the impact of magnesium deficiency on motor, learning and memory functioning. Method: Separation anxiety, expressive language difficulties, and mathematics disorder were identified in grade school. Treatment of depression, anxiety and migraine headaches occurred throughout childhood and adulthood. MRI findings revealed, “mild cerebral volume loss, incidental note of abnormal cranial cervical junction, with an acute clival axial angle measuring 120 degrees, and interest in clinical correlation for ventral brain stem compression syndrome.” Brain scan review independently by second radiologist confirmed atrophy. Results: Neuropsychological assessment revealed features of a nonverbal learning disability including: severely impaired range psychomotor speed, borderline to severely impaired range visual motor tracking, mildly to severely impaired range constructional praxis, and difficulty interpreting prosodic intonation. Mathematics Disorder was also evident. Retroactive and proactive interference were evident in unstructured list learning. Visual memory skills, for complex information, were severely impaired. Conclusion: The current clinical presentation and the neuropsychological findings appear to be consistent with reports in the neuroscience and developmental neuropsychology literature with regard to the role of magnesium levels on psychomotor speed, learning and memory.
      PubDate: 2017-09-06
       
  • B-09 Cognitive and Executive Function Profile in Children and Adolescents
           with Autism Spectrum Disorder, with and without Specific Learning Disorder
           
    • Authors: McGuinness P; Cook N, Bush H, et al.
      Abstract: Objective: Autism Spectrum Disorder (ASD) and Specific Learning Disorder (SLD) are each associated with neurocognitive weakness. However, it is unclear if having a comorbid SLD confers any additive negative effect on cognition or executive functioning for youth with ASD. To our knowledge, no study has examined this effect. Youth with ASD and comorbid SLD were hypothesized to have lower cognitive scores and elevated executive function ratings. Method: Participants were 48 youth ages 6–15 (M = 9.7, SD = 2.4, 75% male) with ASD, referred for neuropsychological evaluation. ASD youth with comorbid SLD (ASD+LD; n = 24) were individually matched to ASD only youth (n = 24) for age, sex, race, autism severity, ADHD symptoms, and comorbid psychiatric diagnosis. Differences in WISC index and BRIEF parent report scale scores were compared with paired sample t-tests. Results: The ASD+LD group had significantly lower working memory scores (M = 89.7, SD = 18.1) compared to the ASD only group (M = 97.5, SD = 13.5), [t(22) = −1.72, p = .05], medium effect size (Cohen's d = .49). Processing speed in the ASD+LD group (M = 85.9, SD = 13.2) was not statistically lower than the ASD only group (M = 93.0, SD = 15.6), [t(22) = −1.56, p = .07], however a medium effect size was observed (d = .49). Groups did not differ on the General Ability Index. The only significant difference in executive functioning ratings was in Planning/Organizing [t(22) = 2.6, p < .01], (d = .60). Conclusion: Youth with ASD+LD may be at greater risk for working memory, processing speed and planning challenges compared to youth with ASD alone. Understanding and identifying potential sources of or contributors to cognitive difficulties is critical for clinical care and supporting development.
      PubDate: 2017-09-06
       
  • B-10 The Relation Between Intraindividual Variability Among Intellectual
           Functions and Severity of Autism
    • Authors: Aita S; Beach J, Taylor S, et al.
      Abstract: Objective: This study examined the relation between intraindividual variability (IIV) of performance on objective intelligence testing and autism spectrum disorder (ASD) severity. Method: 199 children with ASD (M age = 7.95, SD = 3.27; 83.9% male; 74.37% Caucasian, 13.57% African American, 9.05% Asian, 5.03% Hispanic) from the Autism Speaks-Autism Treatment Network (ATN) registry completed the Stanford-Binet Intelligence Scales (SB) and Autism Diagnostic Observation Schedule (ADOS) as a part of a larger neuropsychological battery. SB IIV was computed by calculating the SD across the 5 primary SB composites for each individual case. IIV was categorized into 3 groups using frequency distribution-based tertile split. Pearson correlation, one-way ANOVA analyses, and post-hoc pairwise comparison tests were used to assess the associations between IIV group and ADOS severity ratings as well as SB FSIQ. Results: There was a significant relation between SB IIV and ADOS ratings (r = −.22, p < .01) such that higher SB IIV was associated with lower ADOS severity ratings. Further, SB FSIQ was significantly related with SB IIV and ADOS ratings (r = .43, p < .001; r = −.46, p < .001, respectively) where higher FSIQ was associated with greater IIV and lower ADOS severity ratings. IIV group was significantly associated with ADOS severity ratings as well as SB FSIQ (F(2,195) = 3.39, p = .036, Ƞ2 = .03; F(2,195) = 18.47, p < .001, Ƞ2 = .16, respectively). Post-hoc analysis revealed that the low SB IIV group had significantly greater ADOS ratings in addition to lower SB FSIQ compared to the high SB IIV group. Conclusion: Compared to those with lower ASD severity, performance across tasks on the SB were uniformly low (i.e., low IIV) in those with severe ASD.
      PubDate: 2017-09-06
       
  • B-11 Evaluation of the Equivalency of the Stanford-Binet-5 Comprehensive
           and Abbreviated Versions for Measuring Intelligence in Autism
    • Authors: Beach J; Aita S, Taylor S, et al.
      Abstract: Objective: This study evaluated the equivalency of the comprehensive Stanford-Binet-5 (SB5) Full Scale IQ (SB-FSIQ) and the abbreviated SB5 two-subtest estimated Full Scale IQ (SB-ABIQ) in children with autism. Method: Participants (N = 75; M age = 6.39,SD = 2.70; 78.7% White, 17.3% African American, 6.7% Asian; 12.0% female) completed the SB5 as part of a larger battery of tests included in the Autism Speaks Autism Treatment Network national database. Participants in this sample completed the full SB5 and had both a SB-FSIQ and SB-ABIQ score computed. All participants were diagnosed with autism spectrum disorder (ASD) and were assigned standardized clinical severity ratings of mild (n = 29), moderate (n = 24), or severe (n = 22) based on a tertile data split. Results: Spearman's rho correlations revealed that both SB-FSIQ r(73) = −.419, p < .01 and SB-ABIQ r(73) = −.276, p < .01 scores were significantly correlated with ASD severity ratings. Additionally, paired-samples t-tests found a significant difference between the SB-FSIQ and SB-ABIQ scores at each level of autism severity. There were significant differences at all levels of ASD severity including mild (Mean SB-FSIQ = 83.83, SB-ABIQ = 86.79)[t(28) = −2.77, p = .01], moderate (Mean SB-FSIQ = 77.83, SB-ABIQ = 82.04)[t(23) = −2.75, p = .01], and severe (Mean SB-FSIQ = 64.27, SB-ABIQ = 70.86)[t(28) = −4.20, p < .001]. Mean differences between SB-FSIQ and SB-ABIQ increased with severity rating in a linear fashion. Conclusion: Though both SB-FSIQ and SB-ABIQ were significantly correlated with autism severity, our results show that the abbreviated SB5 overestimated the comprehensive battery SB5 full scale IQ in children with autism and the effect became more pronounced as autism severity increased. Future research should explore whether other abbreviated IQ measures are similarly affected and may not be appropriate in this population.
      PubDate: 2017-09-06
       
  • B-12 Updated FAS BeST: Accurately Screens Children with Fetal Alcohol
           Syndrome
    • Authors: Colunga-Marin A; Seiders J, Mara T, et al.
      Abstract: Objective: Children with Fetal Alcohol Syndrome (FAS) are often misdiagnosed. The FAS BeST (Andrews & Robins, 2009) was designed to screen for the behavioral profile common in those with prenatal exposure to alcohol (PEA). We evaluated the accuracy of the FAS BeST in differentiating those with FAS and partial FAS (pFAS) from controls. Method: Participants were drawn from a larger participant pool (n = 417, 200 females, 216 males, 1 unreported). Participants had a confirmed diagnosis of FAS (n = 38), pFAS (n = 16), and controls (n = 31). Parents completed the FAS BeST (DeVries, Mckinney, Waller & Andrews, 2002), a 52 item inventory created to assess for behavioral profiles of children with PEA. The independent variables were the diagnoses (3) and the age groups (1 to 5 years old, 5 to 15 years old, 15 to 62 years old.). The dependent variable was the FAS BeST total score. Results: The data were analyzed using 2-way ANOVA. A main effect was found for diagnoses FAS (109.7), pFAS (95.69), and controls (35.80). A significant interaction occurred between age group and diagnosis; 5–15 had the highest scores. Conclusion: The FAS BeST accurately differentiates between those with FAS, pFAS and controls. The differentiation is the clearest in the middle age group. The FASBeST identified unique behaviors such as poor memory, requiring more supervision than others, and not knowing friend from foe that occur with those with FAS and pFAS. The FAS Best accurately identifies children with FAS and pFAS from their non-affected developmental peers. It is most effective with children ages 5–15 years.
      PubDate: 2017-09-06
       
  • B-13 Sustained Neuropsychological Deficits Observed in Youth Sport-Related
           Concussion Testing Over Multiple Concussions: A Case Study
    • Authors: Conaboy C; Santiago R, Vaughn D, et al.
      Abstract: Objective: While the majority of concussions resolve in 7–10 days (McCrory, et al., 2013), youth athletes with a history of multiple concussions may be at risk of experiencing subtle long-term effects (Schatz, Moser, Covassin, & Karpf, 2011). The present case study aims to examine changes in neuropsychological outcomes for a middle school athlete with a history of three concussions, who sustained two additional concussions over two years. Method: A 13-year-old male football player completed a two-hour baseline neuropsychological battery as part of a larger research study assessing cognitive functioning in sport-related concussion. Within one month, the subject sustained his fourth concussion and returned for post-concussion evaluation. Two years from the initial evaluation, the participant returned for a second baseline evaluation, and was re-evaluated two months later upon sustaining a fifth concussion. Results: Reliable change indices (RCI) greater than 1.96 represent statistically significant decline. This participant experienced significant declines from initial baseline in all four subtests of the Wechsler Abbreviated Scale of Intelligence, the Perceptual Reasoning Index (RCI = 3.571) and Full-Scale IQ (RCI = 2.703), as well as spatial memory (RCI = 2.415) and list learning (RCI = 3.808). Conclusion: The present results indicate that the participant experienced declines in cognitive and intellectual functioning from baseline after two concussions over two years, suggesting long-term effects of multiple concussions. This case study highlights the importance of both baseline testing in youth athletes and the need to closely monitor symptoms during a child's recovery, especially in the context of multiple concussions.
      PubDate: 2017-09-06
       
  • B-14 Neurocognitive Functioning During and Post Chemotherapy in a Child
           with Cardiofaciocutaneous Syndrome: A Case Study
    • Authors: Coulehan K; Spat J, Pritchett A, et al.
      Abstract: Objective: Cardiofaciocutaneous Syndrome (CFCS) is an extremely rare autosomal dominant disorder, classified as a RASopathy variant. This case study describes the neurocognitive functioning of a child with CFCS and acute lymphoblastic leukemia (ALL), a common comorbidity in RASopathies. CFCS, ALL, and chemotherapy/steroid treatments are all associated with shared and unique neurocognitive sequelae. Given the complexity of etiological factors, understanding developmental trajectory of children with CFCS with hematological neoplasias is crucial to guiding appropriate treatment approaches and intervention. Method: The patient underwent comprehensive neuropsychological assessments at ages four (during chemotherapy) and six years (post-chemotherapy); he received chemotherapy and steroid treatment for a 39 month interval from 15–54 months of age. Additional history is remarkable for respiratory, dermatologic, and neuro-developmental differences. Gross and fine motor milestones were mildly and severely delayed, respectively. Results: Clinically significant changes were considered to be >1 standard deviation above or below baseline performance on tasks assessing intellectual, academic, neuropsychiatric and behavioral functioning. Improved performances were observed for attention, nonverbal reasoning, working memory, and alphabet writing. Declines were noted in affect recognition, memory, and verbal fluency. Remaining areas of functioning were stable. Conclusion: Through case study, we were able to examine pre-/post-chemotherapy treatment in a child with CSFC and ALL. Our results indicated that social perception, language, and memory may be susceptible to long-term cognitive difficulties in children with CFCS and ALL. Given the strong comorbidity of these two illness, understanding the combined cognitive impact is critical to facilitating best treatment and intervention approaches.
      PubDate: 2017-09-06
       
  • B-15 Clinical Outcomes Following Proton Radiation for Pediatric Brain
           Tumors
    • Authors: Duncanson H; Grieco J, Evans C, et al.
      Abstract: Objective: Radiation therapy is integral in treatment of pediatric brain tumors. Conventional photon radiation is associated with negative long-term sequelae. Proton radiotherapy (PRT), which enables better targeting of tumors, may entail fewer sequelae. This prospective study examined intellectual (IQ), adaptive, executive, and emotional functioning in children treated with PRT. Method: 155 patients received baseline (BL) testing during PRT (age M = 8.90;sd = 5.13 years) and follow-up (FU) (interval M = 3.18;sd = 2.07 years). Diagnoses were medulloblastoma (35%), craniopharyngioma (18%), and other (47%). Two age groups: <6 years (37%) and ≥6 years (63%) by two PRT groups: craniospinal irradiation (CSI) (39%) and focal PRT (61%) were analyzed. Age-appropriate measures were administered (Bayley-II; Wechsler scales; BRIEF; BASC-2; SIB-R). Results: Mean IQ and adaptive scores were in the average range at BL and FU. Mean IQ declined from 105.37 to 103.39 (p = 0.049) for the total sample. However, only the <6 years CSI-treated group showed significant IQ decline (p = 0.003). Adaptive skills were stable across the four age-x-treatment groups. Emotional/executive functioning mean scores were in the normal range at FU, although greater rates of withdrawal, atypicality, working memory, and initiation difficulty were reported than in the general population. Younger CSI-treated children had slightly more problem behaviors at FU (p = 0.012). Conclusion: Three years after PRT, adaptive skills and intelligence remained stable across age and treatment type, with the exception of an IQ decline in the younger (<6 years) patient group treated with CSI. Emotional and executive functioning was largely in the normal range. Outcomes are encouraging; PRT shows promise as an effective treatment of pediatric brain tumors.
      PubDate: 2017-09-06
       
  • B-16 Maternal Bilingualism and Early Language Development in Children of
           Adolescent Mothers
    • Authors: Foss S; Davis A, Monk C.
      Abstract: Objective: Existing research suggests that children raised in multilingual households demonstrate delayed language development compared to children living in monolingual environments (e.g., Hoff et al., 2012). There also is evidence that children of adolescent versus adult mothers have weaker language development (e.g., Keown et al., 2001). However, minimal research exists examining language development in children of bilingual versus monolingual adolescent mothers, despite their compounded risk for language delays. While bilingual children typically “catch up” developmentally to monolingual peers by school-age (e.g., Bedore & Peñ¡¬ 2008), it is unknown what implications these differences have for early milestone assessment. This study assessed whether 14-month-old children of bilingual versus monolingual adolescent mothers demonstrated comparatively compromised language development. Method: Participants (n = 49, 56% males) were toddlers of predominantly Latina adolescent mothers enrolled in a longitudinal study about prenatal stress and infant development. Maternal age ranged from 14–20 years (M = 17.29 years). The Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley, 2005) were administered at 14 months (M = 14.11 months). All mothers were fluent in English and reported bilingual status (yes/no) at enrollment. Results: Although cognitive (p = .86) and motor (p = .36) composite scores were comparable across groups, mean language composite scores differed significantly between children of bilingual (n = 35; M = 91.00, SD = 9.26) and monolingual (n = 14; M = 99.36; SD = 11.78) mothers (p < .02), suggesting that children of bilingual versus monolingual mothers demonstrate compromised language development at 14 months. Conclusion: Exposure to multiple languages appears to influence language development by 14 months of age in children of adolescent mothers; this should be accounted for when assessing developmental milestones.
      PubDate: 2017-09-06
       
  • B-17 IQ Differences Between Children with Oppositional Defiant Disorder
           and Children with Conduct Disorder
    • Authors: Gontkovsky S.
      Abstract: Objective: Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are two of the most common psychiatric conditions of childhood, and both disorders have been associated with cognitive declines. This study compared the intellectual functioning of children with ODD to that of children with CD. Method: Participants were selected from a clinical sample of 363 children consecutively referred for outpatient psychological evaluation. Diagnoses of children were made by a licensed clinical psychologist based on the results of a clinical interview of the child, collateral interview of the child's parent/guardian, and scores from the Behavior Assessment System for Children, Third Edition and Attention Deficit Disorders Evaluation Scale-Third Edition. The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) also was administered to assess intellectual functioning and rule out mental retardation. For study inclusion, children were required to have a diagnosis of ODD or CD as well as an absence of Attention-Deficit/Hyperactivity Disorder. Based on this criteria, 23 and 85 children had CD (M age = 10.35 years) and ODD (M age = 9.54 years), respectively. Results: MANOVA revealed a significant difference in WISC-IV performance between groups F(5, 102) = 2.44, p = .039; Wilks’λ = .893, partial ƞ2 = .11. Statistically significant between-group differences were observed across all five WISC-IV primary index scores, with the CD group performing uniformly within the Borderline range and the ODD group performing within the Low Average to Average range. Conclusion: Although children with ODD and CD both display declines in intelligence, those with CD perform significantly worse than those with ODD, implying differential brain involvement in the disorders.
      PubDate: 2017-09-06
       
  • B-18 Sensitivities and Specificities of Social Communication Questionnaire
           in a Clinic-Referred Sample
    • Authors: Lee C; Esler A, Hudock R.
      Abstract: Objective: The Social Communication Questionnaire (SCQ) is a widely used checklist for autism spectrum disorder (ASD). Previous studies suggested satisfactory psychometric properties of the SCQ as a screening measure for research-referred samples. However, subsequent studies revealed low sensitivities and specificities in clinic-referred samples. Information is needed on the characteristics of children who tend to be misclassified by the SCQ to guide decision-making in research and clinical settings. Method: The sample included 164 children who completed comprehensive diagnostic evaluations with developmental testing and the Autism Diagnostic Observation Schedule (ADOS) in an ASD specialty clinic. Receiver Operating Characteristic (ROC) curves were used to determine sensitivity and specificity of the SCQ for children with best estimate diagnoses of ASD or non-spectrum disorders. Results: Using a cutoff of 15, the SCQ had lower sensitivity (0.68) and specificity (0.53) than previously reported results using samples comprised of clinic- and research-referred individuals. Children who were identified as false negatives (FN) displayed similar ASD symptom severity on the ADOS as true positives (TP), but false positives (FP) showed lower severity than TP and FN. Children classified as FP tended to display greater behavioral issues, more internalizing problems, and better adaptability than TP (ps < 0.01). Children classified as FN had fewer nonspectrum comorbid diagnoses, withdrawal, atypical behaviors, and better adaptive skills than TP (ps < 0.01). Conclusion: The findings revealed that the SCQ may be better used as a measure of the distribution of ASD symptoms across populations with and without ASD, rather than as a clinical screener or confirmatory tool.
      PubDate: 2017-09-06
       
  • B-19 Behavioral Differences Between Diagnoses: Fetal Alcohol Syndrome and
           Agenesis of the Corpus Callosum
    • Authors: Mara T; Colunga A, Seiders J, et al.
      Abstract: Objective: We investigated the efficacy of the FAS BeST to differentiate individuals diagnosed with Fetal Alcohol Syndrome (FAS) or partial FAS (pFAS) from those with Agenesis of the Corpus Callosum (cACC), Partial ACC (pACC), Hypoplasia, or DCC. Method: Participants were drawn from a larger pool (n = 417 individuals; 200 females, 216 males, 1 unreported). Each participant had a confirmed diagnoses of FAS (n = 38), pFAS (n = 16), cACC (n = 211), pACC (n = 87), Hypoplasia (n = 17), DCC (n = 10), or control (n = 31). Ages ranged from 1.5 to 62 years and were divided into 3 groups; 1.5–5, 6–15, and 16-adult. Care providers, recruited at conferences, from area clinics and listservs, completed the FAS BeST (Andrews & Robins, 2009) which consisted of 52 items on a Likert scale. The total scores was the dependent variable. The diagnoses and age groups were the independent variables. Results: A main effect occurred for age groups (p < .05). There was a main effect for diagnoses (p < .001). Controls had the lowest total scores and those with FAS or pFAS had the highest scores. There was a significant interaction between diagnoses and age groups. Children with FAS or pFAS in the 6–15 age group had the highest scores. Conclusion: The FAS BeST (Andrews & Robins, 2009) is effective in differentiating those with FAS and pFAS from those with other diagnoses. Although several characteristics are similar or overlap between all diagnoses, individuals with FAS and pFAS show a unique behavioral profile that can be screened for accurate diagnosing.
      PubDate: 2017-09-06
       
  • B-20 The Effect of Music Therapy on the Mirror Neuron System in Children
           with Autism Spectrum Disorder: A Systematic Literature Review
    • Authors: Perez T; Barnes I, Sosa M, et al.
      Abstract: Objective: Social learning domains and empathy among Autism Spectrum Disorder (ASD) have been linked with mirror neuron system (MNS) activation. The purpose of this systematic literature review was to examine the effects of music therapy on the MNS in children diagnosed with ASD. Data Selection: Databases used included: PsycARTICLES, PsychINFO, and EBSCOhost. Key words included: “autism spectrum disorder,” “music therapy,” “children,” “mirror neuron system,” and “United States.” Inclusion criteria were studies published after 2007 that were peer-reviewed. Exclusion criteria were articles from non-academic sources, case-studies, and articles about ASD and other comorbid disorders. Initial searches yielded a total of 309 studies of which six met the inclusion criteria. Data Synthesis: Articles identified an association between a dysfunctional MNS to social, language, and behavioral deficits in ASD. One article identified that making music with others engages areas of the brain which coincide with the MNS including the inferior frontal gyrus, superior temporal areas, and connectivity related to speech. Articles demonstrated preliminary evidence towards a positive effect of music therapy on emotional awareness, social skills, production of words, verbal communication and attention in children with ASD. Conclusion: Most studies reported positive outcomes, suggesting that music therapy might be a promising intervention for some children with ASD and for some specific purposes. Many of the review articles had limitations including small sample sizes, lack of control groups, and absent randomized control trials. Future studies focused on how music therapy conducted with these patients impacts the MNS with larger sample sizes and strong methodology are needed.
      PubDate: 2017-09-06
       
  • B-21 Comprehensive Neuropsychological Testing in a Child with Congenital
           Hypoplastic Pituitary Gland with Secondary Hypothyroidism: A Case Study
    • Authors: Perez D; Ball K, Hernandez L, et al.
      Abstract: Objective: Children with congenital pituitary hormone deficiency (PHD) exhibit abnormalities of pituitary hormone production leading to hypopituitarism and relatively low thyroxine concentrations at the critical phase of Central Nervous System (CNS) growth in early life. PHD is attributed to (CNS) abnormalities such as hypoplastic pituitary gland, and linked to growth hormone deficiency (GHD). Neuropsychological functioning of an atypically developing 12-year-old female with hypoplastic pituitary gland, PHD and GHD is presented. Patient's medical history includes prematurity, ventricular septal defects, right-sided congenital facial paralysis, and hypoplastic pituitary gland with secondary hypothyroidism. MRI revealed abnormality of the pituitary axis with absence of the stalk, a small cellar and ectopic posterior bright spot of the pituitary. There are limited neuropsychological studies regarding distinct cognitive profiles for children with PHD. Findings will contribute to the limited literature available regarding neuropsychological functioning secondary to PHD using updated, comprehensive neuropsychological assessments. Method: Comprehensive neuropsychological testing was conducted to determine cognitive strengths and weaknesses. Testing included updated measures of intelligence, achievement, language, memory, attention/concentration, auditory processing, perceptual/spatial, executive functioning, motor functions, processing speed and behavioral/emotional functioning. Results: Neuropsychological testing revealed primarily average functioning in verbal/visual memory and passive attention. Relative weaknesses were noted in intellectual functioning, verbal functioning, auditory processing, working memory, learning, fine motor skills, divided attention and cognitive flexibility. Conclusion: PHD, GHD, and a hypoplastic pituitary gland may be linked to impaired cognitive functioning, as evidenced by current findings. Further comprehensive neuropsychological testing of PHD patients is recommended to determine a cognitive profile and ensure appropriate early interventions.
      PubDate: 2017-09-06
       
  • B-22 Assessment of Intra-Variability in Intellectual Scores Over Repeat
           Neuropsychological Evaluation in a Pediatric Clinical Population
    • Authors: Reagan T; Uecker A, Noyes E.
      Abstract: Objective: Investigations of neurodevelopmental changes in childhood have found cellular, structural, and functional changes associated with developing neurocognitive skills occurring through childhood and adolescence. With regard to cognitive profile, studies of various developmental disorders diagnosed in childhood have been associated with variability within intellectual testing profile. The purpose of the study was to evaluate intra-variability of intellectual profile in a pediatric clinical population evaluated in repeat neuropsychological testing. Method: The sample consisted of 26 children, ages seven to 19 (mean = 11.73, SD = 2.90). Assessment data included administration using the Wechsler Intelligence Scale for Children-Fourth or Fifth Edition. Each individual had two standardized test occasions occurring at an average of 2.62 years apart, many with the same examiner. Results: The sample demonstrated profile intra-variability significantly different from one standard deviation between highest and lowest index score both at time one t(25) = 2.79, p < 0.01 (M = 1.40; SD = 0.73) and time two t(25) = 5.81, p < .001 (M = 1.85, SD = .74). Additionally, intellectual score variability was significantly higher at time two compared with time one t(49.97) = −2.19 p < 0.05. These findings occurred despite recent analysis, with the current sample, indicating stability of full scale intelligence scores upon repeat evaluation. Conclusion: Especially given technological advances that allow visualization of underlying biological processes, further examination of intra-variability of composite intellectual test information in comparison to a standardized population, as well as to one's own test performance, has potential to be prognostically informative.
      PubDate: 2017-09-06
       
  • B-23 Gender Modulates the Association Between Autistic Traits and Cortical
           Structure
    • Authors: Richard E; Peng C, Mehta E, et al.
      Abstract: Objective: There is emerging evidence for brain- and behavior-based gender differences among individuals with Autism Spectrum Disorder (ASD), though such studies are complicated by the low base rate of females diagnosed with ASD. Because traits associated with ASD can be viewed continuously and extend to the general population, we can seek to identify structural neural endophenotypes in large and relatively unconfounded (no comorbidities) subclinical samples that enable robust examination of gender influences. Data Selection: The current study included 382 (152 male) 18–22-year-old adults who completed self-ratings of autistic traits using the three-factor (Sociability, Mentalizing, Detail Orientation; Palmer et al., 2015) Autism Quotient (AQ). Participants also provided one structural magnetic resonance imaging scan. The CIVET brain-imaging pipeline (v2.0) and the SurfStat image analysis suite were used to derive vertex-level cortical thickness values and complete analyses. Data Synthesis: Strikingly, all significant gender differences were in the associations (FWE-corrected ps < .05) between AQ scores and cortical thickness were driven by males. Positive correlations between subclinical autistic traits and cortical thickness were found as follows: total AQ with the right anterior insula, Mentalizing with the right and left anterior insula, and Detail Orientation with the right ventromedial and ventrolateral prefrontal, bilateral primary motor, and left superior parietal cortices. Conclusion: These results reveal that gender modulates autistic traits-cortical structure associations in that males drive all significant associations between the two. Further work is needed to elucidate driving mechanisms (e.g. biological sex differences such as chromosomal/genetic and/or hormonal factors) and measurement issues (e.g. ASD assessment tools have been validated using predominantly male samples).
      PubDate: 2017-09-06
       
  • B-24 Overshadowing Effects of Childhood-Onset Fluency Disorder on Autism
           Spectrum Disorders
    • Authors: Robinson M; Blackwell M, Culotta V.
      Abstract: Objective: The purpose of this study was to highlight an occurrence of Childhood-Onset Fluency Disorder overshadowing more pervasive underlying neurodevelopmental disorders. This case study examined the neuropsychological profile of a youngster presenting with a severe fluency disorder presumed to be impacting social communication and reciprocity. Method: A 9-year 7-month-old female was referred for neuropsychological evaluation at an outpatient clinic secondary to a history of a fluency disorder, as well as concerns regarding peer relationships, learning, and anxiety symptoms. Assessment included medical record review, parent interview, behavioral observations, and administration of a neuropsychological test battery. Results: Results of the assessment were consistent with an Autism Spectrum Disorder (ASD), also associated with Attention-Deficit/Hyperactivity Disorder and an Anxiety Disorder, in addition to a Childhood-Onset Fluency Disorder (Stuttering). Cognitive and academic skills ranged from borderline to average. Neuropsychological weaknesses were evident on tasks requiring processing speed, sustained attention, and oral-motor skills. Significant deficits in social responsiveness and theory of mind were also apparent. Conclusion: Convergent literature reflects significant co-morbidity between ASD and language impairments; however, there is limited research regarding the co-occurrence of fluency disorders and ASD. The current case was characterized by an early diagnosis of Childhood-Onset Fluency Disorder and a late diagnosis of ASD at 9 years of age. It is suspected that the late ASD diagnosis was a function of concentrating on the severe fluency disorder rather than the deficits in social reciprocity and theory of mind. This case highlights the need to rule out more global developmental disorders during the differential diagnosis process.
      PubDate: 2017-09-06
       
  • B-25 Does the Wide Range Assessment of Memory and Learning-2nd Edition
           (WRAML-2) Lateralize in Children and Adolescents with Epilepsy'
    • Authors: Salinas L; Dalrymple J, MacAllister W.
      Abstract: Objective: The Wide Range Assessment of Memory and Learning-Second Edition (WRAML-2) is a well-established memory battery that can be used with young populations. Few studies have examined its utility in classifying hemispheric lateralization of deficits in an epilepsy population. The current study aimed to examine whether memory profiles on the WRAML-2 would differ across groups showing lateralized findings on electroencephalography (EEG) and basic magnetic resonance imaging (MRI). Method: Seventy-two youth with lateralized epilepsy received the WRAML-2 as part of their comprehensive neuropsychological evaluation. Lateralization indices were created by calculating the differences between visual and verbal index scores. Independent-samples t-tests then compared scores among those with left versus right hemisphere abnormal EEG (39 left, 33 right) and MRI lesions (31 left, 24 right). Results: No significant differences in individual WRAML-2 verbal and visual memory and recognition index scores between patients with left versus right lateralized EEG patterns and MRI lesions, p > .05. There were also no significant differences between the two groups for calculated memory and recognition lateralization indices, p > .05. Conclusion: Despite its widespread use for assessing memory, the WRAML-2 does not appear to yield specific memory profiles to lateralize seizure pathology in pediatric epilepsy patients. It is likely that current findings reflect the fact that early developmental neurological insults can lead to functional reorganization in young patients.
      PubDate: 2017-09-06
       
  • B-26 Updating the Reliability and Validity of the FAS BeST: A Measure to
           Assist in the Treatment and Diagnosis of Fetal Alcohol Syndrome
    • Authors: Seiders J; Andrews G, Mara T, et al.
      Abstract: Objective: The Fetal Alcohol Syndrome Behavioral Survey of Traits (FAS BeST) was designed to assess effects of prenatal exposure to alcohol (PEA: Andrews 7 Robins, 2009). We aimed to update the reliability and validity by increasing the sample size to assist in the differential diagnosis and treatment of those with FAS. Method: Participants (n = 417) included 200 females, 216 males, and 1 unreported. Data were gathered via mailed packets, volunteers at conferences, and care-providers at area clinics. Parents of the children completed the FAS BeST and the Achenbach Child Behavior Checklist. Participants (ages 1.5–62) had a confirmed diagnosis of FAS (n = 38), partial FAS (pFAS; n = 16), ADHD Inattentive (n = 4), ADHD Combined (n = 3), complete agenesis of the corpus callosum (ACC; n = 211), partial (pACC; n = 87), hypoplasia (n = 17), DCC (n = 10), and controls (n = 31). The FAS BeST was the dependent variable. Independent variables were gender of the child and diagnostic groups. Results: Odd-even split-half analysis tested the reliability of the FAS BeST across gender and diagnostic groups with no main effect or interaction found. Criterion validity was obtained comparing FAS BeST scores with Achenbach Externalizing scores. There was a significant correlation between the FAS BeST and Achenbach Externalizing and Internalizing scores. Conclusion: Reliability was found across genders and diagnostic groups. Validity is found with the Achenbach Externalizing score, used for gathering behavioral data on children with PEA. Andrews (2003) found children with PEA are often misdiagnosed due to impulsive behaviors rated on the Achenbach. These new results can allow confidence the tool is reliable and valid as a behavioral screener.
      PubDate: 2017-09-06
       
  • B-27 The Role of Dysgenesis of the Corpus Callosum on Neuropsychological
           Development: A Twin Case Study
    • Authors: Seitz D; Soden D, Andrews G.
      Abstract: Objective: Abnormalities in the corpus callosum hinder communication across hemispheres, resulting in delayed acquisition of developmental milestones and impaired mental processing. A developmental timeline and overall cognitive differences have not yet been identified in those younger than age 6 years. We investigated attention and social cognition in a pair of monozygotic twins with average intelligence. One twin has complete agenesis of the corpus callosum (cACC). Method: Two 4-year-old monozygotic twins completed A Developmental NEuroPSYchological Assessment (NEPSY-II). Four domains were evaluated: Attention and Executive Functioning, Visuospatial Processing, Language, Social Perception. Results: Data were presented as scaled scores/percentile ranks and compared across domains. Visuospatial Processing was depressed in the twin with cACC (37th percentile) relative to the neurotypical twin (84th percentile). Attention/Executive functioning were unremarkable. In Social Perception, the twin with cACC misattributed the emotion “fear” (11–25th percentile) more often than the neurotypical twin (51–75th percentile) and had more difficulty inhibiting voluntary body movements (e.g., eye opening) when tasked with remaining still (6–10th percentile compared to 26th-50th percentile). Within the Language domain, cACC appears to impair rapid language production and processing (9th percentile compared to 37th percentile). Conclusion: This unique case study suggests that cognitive differences begin to emerge in those with cACC in multiple areas. Visuospatial processing and rapid language expression were noted for relative deficits. Difficulties in executive control and recognizing affect were noted. Understanding these differences will inform the development of differential diagnoses and treatment plans for children with cACC.
      PubDate: 2017-09-06
       
  • B-28 Behavioral and Adaptive Functioning Differences in Children with
           Complete Agenesis of the Corpus Callosum: A Monozygotic Twin Study
    • Authors: Soden D; Seitz D, Andrews G, et al.
      Abstract: Objective: The corpus callosum is thought to be vital to emotional regulation and adaptive functioning. Past studies have recognized functional differences in adult populations with agenesis of the corpus callosum, but a developmental timeline is not established in the literature. Phenotypical differences in emotional regulation and adaptive functioning were investigated within monozygotic twins (one neurotypical, one with agenesis of the corpus callosum) in order to determine the developmental abilities of each child. Method: Biological parents of 4 year old monozygotic female twins completed the FAS BeST (Andrews, 2009) with developmental items, the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II), and the Child Behavior Checklist for ages 1–5 (CBCL, Achenbach). Both twins had at least average intelligence, one had cACC. Results: Data were reported in percentiles or v-scale scores (M of 15, SD of 3). The participants displayed similar behavioral profiles, while the twin with cACC displayed greater emotional reactivity (=50th and 84th percentile) and pervasive developmental problems ( = 50th and 69th percentile) on the CBCL. The twin with cACC was depressed in domestic daily living skills (18 and 21) and coping skills (11 and 14) with similar functioning in remaining domains. Conclusion: Within a pair of monozygotic 4 year old twins, cACC was associated with a decreased capacity to regulate mood and decreased mental flexibility, corroborating past findings (Andrews, 2011). Additionally, domestic living skill deficits may indicate a difficulty in perspective taking and understanding proper applications of social scripts. This study delineated phenotypical differences in behavior and adaptive functioning toward early intervention in areas of difficulty.
      PubDate: 2017-09-06
       
  • B-29 Differences in Social Function Among Children Diagnosed with
           Disorders of the Corpus Callosum
    • Authors: Spromberg C; Robison M, Andrews G, et al.
      Abstract: Objective: Social functioning of those with Complete agenesis of the corpus callosum (cACC) or partial ACC (pACC) was examined (ages 1 yr to 25 yrs). Our hypotheses were that children with cACC would demonstrate increased difficulty with social exchange rules than those with pACC. Second, older children/young adults would experience increased social challenges. Method: Participants included 342 children ages 1 to 25 years (M = 8.6), 227 had a diagnosis of cACC, and 115 were diagnosed with pACC. Parents completed a questionnaire including demographic items (age, diagnosis, etc.), and 35 items regarding the child's social function. The data were collected over multiple years using a listserv for families raising children with disorders of the CC. Results: A factor analysis was completed on the 35 items to identify groupings. Two strong loadings resulted: social exchange rule proficiency (positive) and social exchange rule deficiency (negative). A MANOVA indicated significance for age (p < .05). Younger participants were rated as having greater proficiency than older participants. There was no main effect for diagnosis but scores were high for negative items and low for positive items. Conclusion: Contrary to our first hypothesis, children with cACC were not rated differently than those with pACC suggesting that as the social struggles are equally challenging. Parents appear to view older children with ACC as having greater social deficits than younger children. This may be explained by increased expectations and milestones that are not met with age. These data suggest that social functioning support is indicated for both groups.
      PubDate: 2017-09-06
       
  • B-30 Neuropsychological Profile of a Child with Pyridoxine-Dependent
           Epilepsy: A Case Study
    • Authors: Stimmel M; Facchini R, Weiss E, et al.
      Abstract: Objective: Pyridoxine-dependent epilepsy (PDE) is an extremely rare, early childhood genetic disorder categorized by intractable seizures, with an estimated prevalence of 1 in 400,000 to 700,000. Intractable seizures are caused by an autosomal-recessive genetic mutation in the antiquitin gene (ALDH7A1), treated by pyridoxine (Vitamin B6). Limited research has suggested global neuropsychological impairments, while other research has highlighted specific deficits in expressive verbal ability. The case of a six-year-old girl who presented with PDE will be examined for neuropsychological findings to highlight the presentation and cognitive profile of PDE. Method: In this six-year-old girl, seizures were identified at 9 months and occurred on at least 15 occasions, lasting for as long as 15 minutes. After months of inconclusive medical treatment and continuing seizures, she was administered Vitamin B6 at which point seizures subsided. At age 3, she experienced a disruption of treatment and another seizure occurred. Treatment immediately resumed and she is currently seizure free. Genetic testing is in progress. Developmental and learning delays were noted by her physician, her teacher and her mother. The current neuropsychological evaluation examines cognitive, emotional and behavioral functioning. Results: Neuropsychological evaluation identified strong perceptual reasoning skills and weaker verbal comprehension and receptive language ability (mixed receptive-expressive language disorder). Attention was variable throughout testing; hyperactivity and inattention were present (ADHD). Academics were moderately weak. Behavioral concerns were evident. Conclusion: This six-year-old girl with rare Pyridoxine-dependent epilepsy does not evidence global impairments but demonstrates weaknesses in verbal comprehension and receptive language ability.
      PubDate: 2017-09-06
       
  • B-31 The Challenges of Neuropsychological Formulation for Children
           Diagnosed with Multiple Sclerosis (MS) due to Complex Diagnostic Factors
    • Authors: Talbot E; Williams E, Starza-Smith A.
      Abstract: Objective: With an incidence of 9.83 per million children per year, paediatric onset multiple sclerosis (MS) is rare. It does, however, present challenges for differential diagnosis alongside other demyelinating syndromes, such as Acute Disseminated Encephalomyelitis (ADEM) and various recurrent acquired demyelinating conditions, making diagnosis complex in this population. We highlight the different trajectories related to diagnosis and the impact of this on the child, family and wider healthcare and education systems surrounding them. Method: Serial neuropsychological assessment data (Delis-Kaplan Executive Function System; Wechsler Intelligence Scale for Children, Children's Memory Scale, Behavior Rating Inventory of Executive Function) is presented for two children with an initial diagnosis of ADEM; one subsequently was diagnosed with MS later altered to Myelin Oligodendrocyte Glycoprotein (MOG) antibody mediated encephalitis. Results: Case 1: presents with average IQ and memory, significant deficits in executive function, including behavioural regulation and hyperactivity. Diagnostic journey indicated as recurrent ADEM leading to diagnosis of MS at 16 years old, later changed to MOG antibody mediated encephalitis. Case 2: presents deficits in IQ and memory and executive function following ADEM diagnosis at young age. Conclusion: We consider how recent advances in medical investigation have uncovered numerous demyelinating syndromes impacting on the challenge of diagnosis of ADEM, MS and other demyelinating conditions. We question whether we are meeting the neuropsychological needs of children/adolescents with ADEM, MS and other demyelinating conditions in paediatric neuropsychology practice due to limited understanding of the complex and differential diagnoses and discuss whether ADEM and MS form a diagnostic continuum.
      PubDate: 2017-09-06
       
  • B-32 Pitt-Hopkins Syndrome: A Unique Case Study
    • Authors: Tan A; Goodspeed K, Bordes Edgar V.
      Abstract: Objective: Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder (112 documented cases as of 2012, prevalence unknown) caused by insufficient expression of the TCF4 gene. Most cases are characterized by severe intellectual disability, absent speech, motor delays, and autism spectrum disorder (ASD). Many have abnormal brain imaging (e.g., dysplastic corpus callosum), dysmorphic faces, and medical comorbidities: myopia, constipation, epilepsy, and apneic spells. The present case study expands existing understanding of this disorder by presenting a unique phenotype with higher cognitive abilities and fewer medical comorbidities. Method: Patient was a 13-year-old, Caucasian male with history of significant language delays, ASD diagnosed at age 3, and attention deficit hyperactivity disorder. He had recent diagnosis of PTHS following genetic testing after many years of seeking answers. Despite late identification of PTHS, he received early language intervention. His MRI revealed a dysmorphic corpus callosum consistent with PTHS. Results: Evaluation of intellectual, attention/executive, memory, visual-motor/fine-motor, academic, adaptive, and emotional/behavioral functioning revealed global impairment across all areas of functioning consistent with mild to moderate intellectual disability. However, he demonstrated abilities beyond what has been detailed in the literature including use of full sentences, capacity to learn and solve novel problems, basic academic functioning, and independent ambulation. Performance improved with structure, repetition and simplification of instructions, pairing visual and verbal stimuli, and behavioral reinforcement. Conclusion: Children with PTHS may demonstrate a spectrum of abilities contrary to what has been documented in the majority of PTHS cases thus far. Failure to recognize this spectrum can result in late identification of an accurate diagnosis.
      PubDate: 2017-09-06
       
  • B-33 Visuospatial Processing and Executive Functioning in Turner Syndrome
    • Authors: Vargo T; Klabunde M, Hong D, et al.
      Abstract: Objective: Turner Syndrome (TS) is a neurogenetic disorder characterized by partial or complete loss of the X-chromosome in phenotypic females. Previous studies with mixed TS groups have shown impaired visuospatial processing (VP) and executive functioning (EF), with possible genetic and hormonal influences. This study aims to elucidate genetic contributions by comparing VP and EF in children with monosomic TS, mosaic TS, and healthy controls. Method: Participants were 5–16 year-old females (40 monosomic, 13 mosaic, and 40 controls) who completed core subtests of the WISC-IV, Developmental NEuroPSYchological Assessment (NEPSY), and Wide Range Assessment of Visual Motor Abilities (WRAVMA). MANCOVAs were conducted for VP and EF separately, with Verbal IQ (VCI) as a covariate. Results: As expected, the omnibus F revealed significant differences between diagnostic groups for VP (F(12,166) = 4.34, p < .001) and EF (F(6, 192) = 5.25, p < .001). When examining main effects, we found significant differences between groups on the VP subtests NEPSY Arrows (F(2,87) = 20.86, p < .001), NEPSY Picture Puzzles (F(2,87) = 13.59, p < .001), NEPSY Visual-Motor Precision (F(2,87) = 15.16, p < .001),WRAVMA Matching (F(2,87) = 9.21, p < .001), WRAVMA Drawing (F(2,87) = 13.93, p < .001), and WISC Block Design (F(2,87) = 10.08, p < .001). We found significant differences between groups on the EF subtests WISC Digit Span (F(2,97) = 10.87, p = .001), WISC Letter-Number Sequencing (F(2,97) = 9.37, p < .001), and NEPSY Response Set (F(2,97) = 7.66, p < .001). Pairwise comparisons revealed a significant difference between monosomic and mosaic TS for only NEPSY Arrows (p = .047). Conclusion: Results indicated significant differences across diagnostic groups for VP and EF. Findings revealed differences between monosomic and mosaic TS for some VP and EF subtests, which suggests certain component skills may be differentially impacted by X-chromosome dosage. This supports separation of TS subtypes in studies of neuropsychological functioning.
      PubDate: 2017-09-06
       
  • B-34 A Review of Phonological Processing and Rapid Naming in Children with
           High-Functioning Autism Spectrum Disorder
    • Authors: Wexler D; Fine J.
      Abstract: Objective: The reading profiles of children with high-functioning autism spectrum disorder (HFASD) are often described as adequate/superior decoding with poor comprehension. Whether underlying neuropsychological subprocesses critical to reading are different for HFASD and typical groups is unknown. The purpose of this review is to critically examine the literature on reading subprocesses in children with HFASD. Data Selection: Search terms included autism, high-functioning autism, rapid naming, phonological awareness, phonemic awareness, neuropsychology, and reading. Yielded were eight studies published after 2006 on children ages 3 to 19 with measurement of phonological processing (PA) and/or rapid naming (RAN). Hyperlexia only studies were excluded. Data Synthesis: Two studies indicated no differences between children with HFASD and neurotypical children (Asberg & Sandberg, 2012; Jacobs & Richdale, 2013). Five found HFASD groups performing more poorly on PA and RAN (Cardoso-Martins & Ribeiro da Silva, 2010; Gabig, 2010; Hooper, Poon, Marcus, & Fine, 2007; Newman et al., 2007; White et al., 2006). Three showed that PA and RAN predicted word reading for children with HFASD and neurotypical children similarly (Jacobs & Richdale, 2013; Nash & Arciuli, 2016; White et al., 2006). Methods, including inclusion criteria and control of intellectual ability/language, may have contributed to differences in findings. Conclusion: Wide variation in underlying neuropsychological reading subprocesses in children with HFASD was found. Yet, PA and RAN were found to predict word reading similarly to typically developing children. Thus, similar reading instruction and interventions may be appropriate. Mixed findings indicate a need for longitudinal designs, consistently controlled variables across studies, and intervention response studies.
      PubDate: 2017-09-06
       
  • B-35 Prolonged Gestational Exposure to Terbutaline and Developmental
           Cognitive Impairments
    • Authors: Perna R; Harik L, McGee J.
      Abstract: Objective: Preterm labor and delivery have been shown to be among the most significant predictors of perinatal morbidity and mortality. Terbutaline, an adrenergic receptor agonist has been utilized to effectively delay preterm labor. Though preterm labor may be associated with various risk factors, research suggests that prolonged tocolytic terbutaline therapy potentially carries significant risks and is associated with subsequent developmental disorders. Method: Two fifteen year old children were exposed to terbutaline in utero to treat pre-term labor for approximately eight weeks and birth was full-term. They were referred for assessment due to academic and behavioral issues. Personal and family histories appeared noncontributory. Both children were referred for neuropsychological evaluations due to academic and/or behavioral concerns. Results: Patient A demonstrated relative weaknesses in the domains of phonological decoding as well as weaknesses in verbal comprehension and information processing speed. Patient B demonstrated relative weaknesses in the domains of auditory attention, cognitive efficiency, and mental flexibility. Conclusion: Published cases and these data may not suggest some protypical cognitive profile of prolonged gestational terbutaline exposure. However the cases suggest that exposure to terbutaline may be associated with risk for cognitive and academic difficulties. These data contribute to a growing body of literature suggesting that a prolonged in utero terbutaline exposure-neurocognitive sequelae relationship may exist. Developmental clinicians and expectant parents should be aware of potential risks associated with this type of exposure and greater public awareness of these risks may be beneficial.
      PubDate: 2017-09-06
       
  • B-36 Bone Cancer (Mylodysplastic Syndrome), Short-term Memory, and
           Rehabilitation: A Case Study
    • Authors: Perna R; McGee J.
      Abstract: Objective: Myelodysplastic syndrome is a cancer of the bone marrow that reduces blood cell formation. This can reduce bloods oxygen carrying capacity and thus brain functioning. Method: Mr. T, age 60, was diagnosed with Myelodysplastic syndrome and related refractory cytopenia (reduction in blood cell formation). He underwent 12 cycles of chemotherapy and had become transfusion dependent and neurtropenic (low WBC/neutrophils), anemic, and developed altered mental status. An allogenic (bone marrow) transplant improved his neutropenia and blood disorders, but cognitive problems persisted. A brain MRI was normal except for a small right cerebellar hyperintensity. Results: More than one year after his transplant, he began transdisciplinary brain injury/cognitive rehabilitation and significantly increased physical activities. Initial assessments (RBANS) showed 1st percentile immediate memory and delayed recall. Five months later immediate memory (75th percentile) and delayed recall (75th percentile) were significantly improved. His learning curve improved from 4-4-4-5 to 7-8-8-8 across four learning trials of a 10 word list (List Learning). Delayed recall improved from 1 to 7 words. Moreover he reported improved activity and functioning at home. Conclusion: Mr. T exhibited significantly improved memory test scores and dramatically improved in all aspects of his life after outpatient rehabilitation. Etiology of cognitive dysfunction was thought to be the anemia though it persisted long after the anemia improved. His significant improvement was likely resultant to his increase in physical and cognitive activities and intensive memory rehabilitation.
      PubDate: 2017-09-06
       
  • B-37 Group Logotherapy Following Traumatic Brain Injury: Pilot Study
           Findings
    • Authors: Fedio A; Cummings S, Buonopane V, et al.
      Abstract: Objective: The present study examined benefits to individuals with traumatic brain injury (TBI) who completed a 12-week course of group therapy based on Viktor Frankl's principles for living life with meaning (logotherapy). Method: Group therapy included topics of physical, cognitive, and emotional functioning post TBI, values and core principles, and formulation of current and future goals. Two adult females (age 60; post-injury 8 yrs) completed measures before and after the treatment program. Outcome measures included the Outcome Rating Scale, State Shame and Guilt Scale, Creative Domain Questionnaire-Revised, Ruff Neurobehavioral Inventory Spirituality Scale, and an experimental measure of satisfaction with recovery. Results: Mean z-scores are reported from pre- to post-therapy for measures on which both clients improved. The total ORS (−0.9 to 0.9) and ratings on each of its subscales (individual, interpersonal, social, overall) improved. Shame (2.2 to −0.1) and guilt (0.7 to −0.6) decreased, while authentic pride increased (−1.7 to −1.1). Creativity improved (−2.9 to −2.3), as did spirituality and a sense of meaningfulness. Both participants selected and accomplished a specific concrete goal during the course of therapy. Satisfaction with recovery remained low. Participants rated all sessions as being highly (70%–100%) useful. Conclusion: Findings suggest benefits associated with a group logotherapeutic approach for individuals with TBI in improving personal/interpersonal outlook and a healthy pattern of self-conscious emotions. Increased pre- to post-treatment self-rated creativity across domains reflects improved interest and engagement in meaningful activities and hobbies. It is not surprising that ratings of recovery did not improve during the 12 weeks as participants were several years post injury. Future study with larger samples of individuals with brain injury is needed.
      PubDate: 2017-09-06
       
  • B-38 Ecologically Oriented Neurorehabilitation Outcome: Impact of
           Compliance and Comprehension
    • Authors: Mullen C; Bove J, Ndukwe N, et al.
      Abstract: Objective: The current study examines the impact of patients’ comprehension of strategies and compliance with assignments on the outcome of the Ecologically Oriented Neurorehabilitation (EON) Programs. Method: Participants (n = 57) were adult neurological patients (e.g., traumatic brain injury, mild cognitive impairment; age M = 49.61, SD = 16.74; males = 20). Participants were trained in strategies for improving attention, memory, and problem solving using the manualized EON programs. In each session, therapists rated understanding of strategies and participation on a 5-point scale ranging from “Very Poor” to “Excellent.” Homework compliance was calculated by dividing assignments completed by assignments given. EON outcome was measured with alternate form, pre and post-treatment simulations of everyday attention, memory, and problem solving tasks and questionnaires assessing strategy knowledge and self-rating of everyday cognition. An average of 11.91 EON sessions was completed. Results: Strategy knowledge post intervention was significantly correlated with participation (r = .758, p < 0.01), understanding of strategies within session (r = .592, p < 0.01), and homework compliance (r = .77, p < 0.01). Understanding of strategies was significantly correlated with post-treatment simulations of memory (r = .33, p = 0.04), and several cognitive self-ratings (e.g., r = −.724, p = 0.02; r = −.781, p < 0.01). Session participation was significantly correlated with everyday memory simulations (e.g., r = −.788, p = 0.02; r = .808, p = 0.02) as well as cognitive self-ratings (e.g., r = −.708, p = 0.01; r = −.739, p < 0.01). Regression analyses revealed older patients’ participation level significantly predicted performance on several everyday memory simulations (e.g., t(6) = 3.14, p = 02; t(6) = 3.36, p = .02). Conclusion: Patients’ session participation and strategy understanding were significantly correlated with post-treatment outcomes. Future studies should explore the effectiveness of enhancing participation and strategy understanding in maximizing patient benefit.
      PubDate: 2017-09-06
       
  • B-39 Predicting Cognitive Functioning, Activities of Daily Living, and
           Participation Six Months After Mild to Moderate Stroke
    • Authors: Bertolin M; Van P, Greif T, et al.
      Abstract: Objective: Predicting neurocognitive and functional outcomes in stroke is an important clinical task, especially in rehabilitation settings. We assessed acute predictors of cognitive and functional outcomes six months after mild to moderate stroke. Method: We conducted a retrospective analysis of acute clinical data and six-month follow-up telephone interviews for 498 mild to moderate stroke patients (mean age = 64.50, SD = 14.54; mean education = 12.87, SD = 2.70; 49.0% female). Predictors were sociodemographic variables, the National Institute of Health Stroke Scale (NIHSS), basic physical measures, the Mesulam Cancellation Test, the Short Blessed Test (SBT), Trails A/B, and the Boston Naming Test. The outcome variables were the Communication, Memory and Thinking (M/T), ADL/IADL, and Participation subscales from the Stroke Impact Scale. We conducted four hierarchical multiple regression analyses with demographic variables and the NIHSS score entered into the first step, followed by physical variables in the second step, and neuropsychological variables in the final step. Results: Physical variables explained more variance in ADL/IADLs and Participation outcomes than in Communication and M/T outcomes, while cognitive predictors exhibited the opposite trend. The SBT was the only significant independent predictor of Communication and M/T (p's < .001), while the NIHSS was the only measure that significantly predicted ADL/IADLs (p < .001) and Participation (p = .002). Poorer performance on the screening measures predicted worse cognitive/functional outcomes six months post-stroke. Conclusion: These results support the clinical utility of administering brief screening instruments (the SBT and NIHSS) during acute recovery from mild to moderate stroke. Neuropsychologists should prioritize performance on such measures when making recommendations for rehabilitation interventions in stroke patients.
      PubDate: 2017-09-06
       
  • B-40 Left Gaze Bias with Visual Hallucinations in a Patient with Left
           Sensory Neglect: A Right Hemisphere MCA Stroke Case Study
    • Authors: DeVore B; Campbell R, Harrison D.
      Abstract: Objective: Through neuropsychological case study analysis, including multi-disciplinary reports, to determine the presence of visual hallucinations occurring in the left hemispace for a patient with acute Cebrebrovascular Accident (CVA) in the right Middle Cerebral Artery (MCA) resulting in left spatial neglect. Method: As part of routine rehabilitation treatment, an African American female patient seen at a major medical center, was assessed using various neuropsychological methods, including administration of neuropsychological assessments, neurobehavioral syndrome analysis, and general neuropsychological evaluation. Results: Evidence provided by the attending neuropsychologist and the medical centers’ multidisciplinary team supported the implications of left spatial neglect with an intentional/volitional visual bias and preoccupation to the left hemispace. Spatial neglect symptoms included discontinuation of written tasks into left spatial orientation, forgetting parts of the left side of the body, and difficulty finding objects on the left side. Despite these reported deficits, the patient was observed having a tendency to move her gaze into her left field of vision. The patient reported experiencing left sided visual and auditory hallucinations, including a deceased friend from church and “spooky faces”. Conclusion: The neuropsychological evaluation provided evidence for left hemineglect syndrome in the presence of an intentional or volitional gaze bias to the left hemifield/hemispace secondary to hallucinated content or formesthesias. This presentation supports the extant literature on the distribution and the mass effect of an infarct in the right MCA on the right parietal and right occipital regions as suggestive of anosognosia, left-hemispatial neglect, and distressing formesthesias in the left visual field as a right brain disorder.
      PubDate: 2017-09-06
       
  • B-41 Stroke Symptom Acuity and Race: Ethnic Variances in DRS Total Scores
           for Stroke Patients
    • Authors: DeVore B; Valdespino A, Campbell R, et al.
      Abstract: Objective: To explore potential racial factors contributing to differences in overall stroke acuity, a preliminary analysis of symptom severity, as recorded by the Dementia Rating Scale (DRS), was performed. Method: 551 patients, receiving treatment for cerebrovascular accident (CVA) in a rehabilitation unit at a major medical centers, were administered the DRS as part of a standard neuropsychological evaluation. The administering clinician determined ethnic identification with patients placed in one of five ethnic categories (1 = Caucasion, 2 = African American, 3 = Asian, 4 = Latino, 5 = Other/Unknown). All patient information was deidentified, with total DRS scores recorded and ethnicity coded for analysis. A one-way ANOVA of total DRS score by ethnicity was completed using R statistical software. Results: Results from the AVOVA indicated statistical significance at the 0.05 level for total DRS score by race (F(3, 547) = 3.54, p = 0.0145). A secondary t-test pairwise comparison was completed to determine significance between ethnic categories. Resulting analyses demonstrated significance between patients identified as Caucasian versus “Other or Unknown”; with Caucasian symptom scores being significantly lower then scores within the “Other/Unknown” category (t(463) = −3.06, p = 0.0025). No other comparisons were significant. Conclusion: The results from this preliminary study on the potential racial differences of symptom severity resulting from a cerebrovascular accident indicate that while racial differences may exist, a large degree of further research is still needed. Given that overall DRS scores were only significantly different when Caucasian's were compared to patients placed in the “Other/Unknown” category, more specific analysis is needed to determine potential differences.
      PubDate: 2017-09-06
       
  • B-42 Neuropsychological Performance in Patients with a Left Ventricular
           Assist Device (LVAD): A Preliminary Study Evaluating Mechanical
           Circulatory Enhancement Effects on Cognitive Functioning
    • Authors: Jandak J; Pimental P.
      Abstract: Objective: The effects of cardiovascular dysfunction and heart failure on cognition often herald poor health outcomes (Cameron et al., 2010). Mechanical circulatory devices like the LVAD have prolonged life (Park et al., 2005). It is suggested that LVADs improve cognition due to increased perfusion and oxygen saturation (Aggarwal et al., 2013). This study evaluated the effects of LVAD placement on cognitive functioning. Method: Twenty-five participants (18 males, 7 females; age 23–76 years), were recruited from a major medical center Advanced Heart Failure program utilizing strict exclusionary criteria. Study protocol included pre-LVAD and post-LVAD neuropsychological testing, utilizing a brief bedside battery with a preponderance of frontal lobe measures. Results: Statistically significant differences in pre-LVAD testing versus post-LVAD testing were demonstrated for Trail Making Test Part B (TMT-B) (p = .04), and the Stroop Color subtest (p = .02). Patients showed improvement in post-LVAD scores on both measures. There were no statistically significant differences in pre-LVAD testing versus post-LVAD testing for TMT-A, Stroop Word, Stroop Color-Word and WAIS-IV Digit Span (forward, backward, sequencing). Conclusion: Results demonstrated that LVAD implantation may lead to improved performance on selected neuropsychological measures associated with either frontal lobe or other brain structures. This may be related to increased perfusion and oxygen saturation, however, it is premature to conclude that a definitive relationship exists, since the sample size was small due to morbidity and mortality rates. As this is a preliminary investigation, it is suggested that a follow-up study be completed with a larger cohort of participants and corresponding circulatory data such as perfusion and oxygen saturation.
      PubDate: 2017-09-06
       
  • B-43 Cerebral Perfusion Among Older Adults with Cardiovascular Disease
           Differs by Gender
    • Authors: Makwana B; Tart-Zelvin A, Xu X, et al.
      Abstract: Objective: Cerebral perfusion (CP) is important in the aging process as declines in cerebral blood flow are observed. Past literature suggests gender differences across the lifespan (Parkes et.al, 2004), but without a focus on older adults or without consideration of cardiovascular disease (CVD) status. This study examined whether CP among older adults, with and without CVD, differed by gender. Method: The 59 participants (Mage = 66.68 years 9.63; 25 males) were recruited via community advertisements and an outpatient cardiology clinic. We excluded individuals who endorsed a contraindication for a magnetic resonance imaging (MRI), who reported neurological deficit(s), a history of substance abuse with hospitalization, and a psychiatric illness diagnosis. The three sessions included batteries that assessed medical history, CVD, demographics, and cognitive function as well as an echocardiogram and an MRI. Participants were compensated $150. Results: Females had higher perfusion (M = 51.46 6.50) than males (M = 46.94 6.59); t(57) = −2.63, p = .011. This significant difference was observed for those with CVD, t(18) = , −2.412, p = .027, but not for healthy controls, t(37) = −1.51, p = .867. Conclusion: Consistent with prior studies, females have higher CP than males. Further, disease status is a notable factor. As CP decline is associated with negative outcomes, it is important to develop interventions to identify, prevent, mitigate, or even reverse these declines. Findings suggest that this issue is especially relevant to males with CVD, and future research and treatment should take gender differences into account.
      PubDate: 2017-09-06
       
  • B-44 MRI White Matter Hyper-intensities and Neuropsychological Performance
           in a Clinical Sample
    • Authors: Thieme B; Daniel M, Andersen P, et al.
      Abstract: Objective: White-matter hyperintensities (WMH) on magnetic resonance imaging (MRI) are frequently found in non-demented, middle-age and geriatric populations, and are presumed to be markers of white matter structural pathology. There is a growing body of research showing that WMH can be associated with neuropsychological deficits, however; much of this literature has examined the cognitive profiles of individuals with WMH in community samples, using research protocols. The aim of this study was to examine the relationship of WMH and neuropsychological test performance in a clinical sample. Method: Subjects were 149 outpatients seen in a neurology / neuropsychology clinic who had MRI data available prior to neuropsychological evaluation. These subjects were divided into groups based on whether the interpreting radiologist described WMH (n = 55; Age: M = 57.76, SD = 11.79; Education: M = 13.69, SD = 2.64) or not (n = 94; Age: M = 48.65, SD = 14.22; Education; M = 14.18, SD = 2.55) in the MRI report. Analyses of variance (ANOVA) were used to compare group performance on a wide range of commonly used neuropsychological tests. Results: The WMH group performed significantly worse (p < 0.5) on measures of processing speed, set-shifting, visual/spatial construction, memory, and abstract reasoning. However, scores for both groups were within the average range on almost all neuropsychological measures and statistically significant differences between the groups were not clinically meaningful for the most part. Conclusion: These findings support the idea that certain domains of cognitive functioning, including processing speed, executive functioning, and memory, may be differentially sensitive to decreased white matter integrity represented by WMH on MRI.
      PubDate: 2017-09-06
       
  • B-45 Brief Screening for Depression in Polytrauma Patients: Preliminary
           Findings
    • Authors: Biehn T; Palmer G, Olson S.
      Abstract: Objective: The Neurobehavioral Symptom Inventory (NSI) is a commonly used measure to evaluate traumatic brain injury (TBI) in the Department of Veterans Affairs health care system. However, little research has been done on the clinical utility of the mental health items on the NSI. The purpose of the study is to determine the clinical utility of an item on the NSI that assesses depressed mood to predict depression as measured by the Beck Depression Inventory-II (BDI-II) utilizing receiver operating curve (ROC) analyses using a sample of veterans evaluated at a Level 3 polytrauma clinic (N = 381). Method: Retrospective data collected from veteran patients of a polytrauma outpatient clinic from 4/2009–10/2015 were used in the analyses. The measures analyzed in this study included the NSI and BDI-II. ROC analyses were conducted to determine if item 20 on the NSI assessing depressed mood predicted the presence of depression as measured by a cut-off score greater than 14 on the BDI-II. Results: There were 271 subjects who tested positive for depression based on a cut-off score of 14 on the BDI-II. The ROC analysis was significant (AOC = .875, p < .001; 95% CI = .841–.910). A cut off of 1 on item 20 of the NSI yielded a sensitivity rate of .937 and a specificity rate of rate of .459. Conclusion: These results indicate that item 20 of the NSI is predictive of a positive screen for depression with scores of 1 or greater indicating that further assessment of depression is warranted.
      PubDate: 2017-09-06
       
  • B-46 Using Postconcussive Symptoms as a Grouping Variable to Compare
           Performance on one of Four Computerized Neurocognitive Assessment Tools
           (NCAT) in Soldiers with and without Mild Traumatic Brain Injury (mTBI)
    • Authors: Cole W.
      Abstract: Objective: Postconcussive symptoms as a grouping variable, versus comparing controls to mild traumatic brain injury (mTBI), may yield more promising and clinically relevant results for the validity of computerized neurocognitive assessment tools (NCATs). Method: Healthy service members and those within 7 days of mTBI were administered two of four NCATs: ANAM4, CNS-Vital Signs, CogState, and ImPACT. Participants also completed the Neurobehavioral Symptom Inventory (NSI) and an IQ (FSIQ) estimate. Applying NSI ratings to DSM-IV Postconcussional Disorder criteria, we grouped participants into 1) control asymptomatic (n = 228), 2) mTBI asymptomatic (n = 106), and 3) mTBI symptomatic (n = 126). Three regression analyses were run for each NCAT, expecting symptomatic mTBI participants to have worse NCAT performance: 1) symptom status only, 2) symptom status and demographics (including FSIQ), 3) and only demographics and FSIQ. Comparing models 2 and 3 isolated the unique variance accounted for by symptom status. Results: Symptom status was significant for 93% of the four NCAT's scores (p < .05), though with small effects (R2 range = .004 to .122). After isolating the unique variance of symptom status, all NCAT scores had “no effect” (R 2 Change range = .000 to 0.039) except ImPACT Verbal Memory (R2 Change = .046, recommended minimum practical effect). Conclusion: Postconcussion symptoms did not predict performance on any of the four NCATs. Similar to past results comparing controls to mTBI, demographics and FSIQ were better predictors. Further research is needed to clarify if NCATs and/ or self-reported postconcussion symptoms are inadequate measures of injury impact, or if NCATs and symptom measures are assessing different constructs.
      PubDate: 2017-09-06
       
  • B-47 Acute Symptom Reporting Following Concussion Among Adolescents with
           Attention-Deficit/Hyperactivity Disorder
    • Authors: Cook N; Wojtowicz M, Silverberg N, et al.
      Abstract: Objective: Youth with ADHD report more pre-injury concussion-like symptoms compared to youth without ADHD. We examined if their acute post-concussion symptom profiles are also different. Method: Of 708 high school athletes who completed baseline testing and were subsequently assessed within 3 days of a suspected concussion, 40 self-reported having ADHD. Participants with ADHD were individually matched to 40 injured youth without ADHD (controls) based on age, sex, concussion history, and sport (N = 80; mean age = 16.2, SD = 1.2, Range = 13–18 at post-injury assessment). Between-group differences in baseline and post-injury symptom severity from the Post-Concussion Scale were examined with Mann-Whitney U tests and differences in the proportion of adolescents endorsing each individual symptom (i.e., symptom severity rating of 1 or greater) were examined with chi-square tests. Results: Youth with ADHD endorsed greater symptom severity (Mdn = 8) compared to controls (Mdn = 2) at pre-injury baseline (U = 488.5, p < .01) and post-injury (ADHD Mdn = 19.5; controls Mdn = 10.5; U = 522.5, p < .01). Compared to controls, youth with ADHD reported greater rates of certain symptoms like fatigue and difficulty concentrating both before and after injury. A small number of symptoms did not show clear differences between groups before injury, but were different after injury. Compared to controls, significantly more youth with ADHD endorsed headache (95% vs. 77.5%), feeling slowed down (65% vs. 42.5%), being mentally foggy (65% vs. 40%), and having difficulty remembering (55% vs. 25%) acutely following concussion (χ2test ps < .05). Conclusion: Adolescents with ADHD report more symptoms before and acutely following concussion. They might be somewhat more vulnerable to experience headache and cognitive symptoms within 3 days of injury.
      PubDate: 2017-09-06
       
  • B-48 Return to School and Sports Following Concussion in Student Athletes
           with Attention-Deficit/Hyperactivity Disorder
    • Authors: Cook N; Terry D, Maxwell B, et al.
      Abstract: Objective: To examine whether student athletes with Attention-Deficit/Hyperactivity Disorder (ADHD) have worse functional recovery from sport-related concussion. Method: Participants were 479 high school and college athletes (44% female) who sustained a concussion; 25 (5.2%) athletes reported having ADHD. Athletic trainers used a web-based injury surveillance system to record information related to concussion recovery. Nonparametric Mann-Whitney U tests (U) were conducted to compare days to return to school/athletics due to non-normal distributions. Chi-square tests examined the proportion of athletes who had not returned to athletics/academics at 7-, 10-, 14-, and 21-days post-injury depending on ADHD status. Results: Those with ADHD took a median of 5 days to return to school (M = 10.0, SD = 13.5) and 12 days to return to sports (M = 18.6, SD = 16.8). Athletes without ADHD took a median of 4 days to return to school (M = 6.9, SD = 9.5) and 14 days (M = 19.3, SD = 18.5) to return to sports. These rates did not significantly differ between groups (U and ps χ2 > .05). However, although not statistically significant, visual inspection of the recovery curves and calculation of effect sizes suggest that a subgroup of youth with ADHD may be at risk for prolonged academic return at 10-days (28% vs. 18%; OR = 1.84, medium effect), 14-days (20% vs. 12%; 1.80, medium effect), and 21-days following injury (12% vs 5%; 2.54, large effect). There were no statistically significant group differences in recovery rates when examining return to athletics. Conclusion: A subgroup of high school and collegiate athletes with ADHD may be at risk for longer return to school but not to sports following concussion.
      PubDate: 2017-09-06
       
  • B-49 “Post-Concussive” Symptoms Present at Baseline in Youth
           Athletes
    • Authors: Crossland M; Peterson R, Mason D, et al.
      Abstract: Objective: Clinical management of concussion in youth athletes depends in part on self-reported symptoms. In adults and older adolescents, such symptoms are known to be non-specific, occurring often in uninjured individuals. Little research has investigated base rates and correlates of baseline symptoms in child athletes. This study aimed to help fill this gap in the literature. Method: 337 competitive youth soccer players (146 males; mean age = 11.94 years; age range = 8 to 17) participated. Before the season, youth completed the Health and Behavior Inventory to evaluate “post-concussive” symptoms. Their parents completed a background questionnaire. Results: Most youth (65.9%) endorsed three or more symptoms to some degree, including at least one physical symptom and one cognitive symptom. Factors associated with higher symptom reporting included neurodevelopmental disorder (p = 0.025), psychiatric disorder (p = 0.005), and non-Caucasian race (p = 0.026). There was a trend for higher symptoms among youth with a previous concussion history (p = 0.052). Gender was unrelated to baseline symptoms (p > 0.05). Conclusion: Many youth athletes endorsed “post-concussive” symptoms at baseline, particularly those who had previous developmental or emotional difficulties or who were non-Caucasian. When making clinical management decisions for concussed youth, professionals should recognize that some level of symptomatology is normal and consider non-injury factors associated with symptom reporting.
      PubDate: 2017-09-06
       
  • B-50 Sensitivity and Specificity of the Trail Making Test (TMT) to
           Traumatic Brain Injury (TBI) in Spanish Speaking Individuals
    • Authors: Greenberg L; Arnett P.
      Abstract: Objective: The sensitivity of the TMT to brain damage is well-established, making it one of the most commonly used tests in clinical neuropsychological evaluations with English and Spanish speaking individuals. However, important validity questions are raised when English based norms are used to interpret test scores with Hispanic populations. The current study examined the validity of TMT scores in a sample of Spanish speakers with TBI using different English based norms to interpret their scores. Method: Participants included 126 adults (mean age = 39.9, sd = 18.8, 52.1% females), 83 with sustained TBI and 43 normal controls, of Puerto Rican decent. The TMT was administered in Spanish to all participants as part of a larger neuropsychological battery for individuals referred to a department of neurology for further evaluation. Results: Raw scores were converted to standard scores using the Heaton and Tombaugh norms. Receiver operator characteristic analysis was then used to examine sensitivity, specificity, positive and negative predictive value of the TMT Part A and Part B related to TBI. Results indicated that for the Heaton norms, area under the curve (AUC) was 0.77 for TMT Part A and 0.78 for TMT Part B. Comparable AUC's for the Tombaugh norms were 0.80 and 0.76, respectively. Conclusion: Differences were present between the normative systems. The Heaton norms produced scores that had the highest classification accuracy for TMT part B, while the Tombaugh norms had better classification accuracy for part A. Results are discussed in the context of problems associated with using norms based on English speakers with Spanish speaking clinical populations.
      PubDate: 2017-09-06
       
  • B-51 Sports Concussion and Headache: Symptom Duration
    • Authors: Greenberg L; Arnett P.
      Abstract: Objective: In the US alone, there are one to two million reported cases of mild traumatic brain injury (mTBI; e.g. sports concussion) annually (CDC, 2007). mTBI is associated with a wide range of symptoms, of which headache has been shown to be frequently the most severe (Merritt, Rabinowitz, & Arnett, 2015) and the most commonly reported post-concussion symptom, at a rate of up to more than 90% of athletes (Seifert, 2016). Headache appears to be consistently among the last symptoms to resolve in other populations (Condini, 2012), and was hypothesized to do so in this study of university athletes. To the authors’ knowledge, this is the first study to examine headache duration and other symptoms post-concussion in a college-aged sports concussion setting. Method: Self-report from a semi-structured interview (i.e. The Post-Concussion Interview; PCI) was used to determine symptom duration of 89 college athletes (76% male: 23% female). Participants suffered a sports-related concussion and were interviewed at the time of referral, within two months of sustaining the injury. Results: Seventy-four percent of participants (n = 89) reported headache as their longest lasting symptom. Symptoms “feeling in a fog” and “attention problems” followed in occurrence at 37% and 33%, respectively. Conclusion: Headache was endorsed by a large majority of participants as the last post-concussion symptom to resolve. Because motivation to return-to-play (Bailey, Echemendia, & Arnett 2006) and failure to diagnose concussion can lead to additional concussions and accumulated injury (Talvage, et.al., 2014), understanding symptom duration and resolution may have practical implications for concussion management.
      PubDate: 2017-09-06
       
  • B-52 Examining a New Automated Neuropsychological Assessment Metrics
           (version 4) Composite Score in Soldiers with and without mTBI
    • Authors: Ivins B; Silverberg N, Cole W, et al.
      Abstract: Objective: The Automated Neuropsychological Assessment Metrics (Version 4) Traumatic Brain Injury Military (ANAM4 TBI-MIL) battery is a widely used computerized cognitive test battery in the United States military. The purpose of this study is to compare overall ANAM4 TBI-MIL performance of soldiers with and without mild traumatic brain injury (mTBI) using a new low score composite (LSC). Method: The LSC uses the mean of norm referenced negative z-scores to quantify the number of low scores and how far those scores are below the norm. The LSC is zero when someone has no scores below the normative mean. Lower LSC values indicate worse overall performance. We compared data from a control group of 733 soldiers and 56 soldiers with mTBI (median days since injury = 11.0, IQR = 5.0–30.8, M = 23.3, SD = 36.1, range = 0–245). We used t-tests with Cohen's d to compare the LSC's of the two groups and ROC analysis to determine how well the LSC classified them. Results: The mTBI group had worse overall ANAM performance than the control group [(LSC = −0.87 vs. −0.31), 95% CI of mean difference: 0.34–0.79, p < 0.001] reflecting a large effect (Cohen's d = 1.44). The area under the ROC curve was 0.712 (95%CI = 0.633–0.792, p < 0.001), reflecting fair ability of the LSC to distinguish between the groups. Conclusion: The LSC appears to be a useful composite measure for characterizing overall poor ANAM performance and distinguishing between those with mTBI from controls.
      PubDate: 2017-09-06
       
  • B-53 Differences in Self- and Parent-Report of Executive Function Among
           Depressed and Non-Depressed Adolescents Following Mild Traumatic Brain
           Injury
    • Authors: Lace J; Zane K, Grant A, et al.
      Abstract: Objective: Previous research has linked adolescent concussion and depression (Chrisman & Richardson, 2013). Other investigations have found complex relationships between depression and cognitive performance (McClintock, Husain, Greer, & Cullum, 2010). The present study examined cognitive performance and reports of executive dysfunction among depressed- and non-depressed adolescents with concussion. Method: Archival data from a Midwestern medical center was used to examine cognitive and behavioral variables in 72 adolescents (53% female; M age = 14.99) with concussion. Primary measures included: Patient Health Questionnaire-9-Adolescent; Behavior Rating Inventory of Executive Function (BRIEF; Self and Parent); Woodcock-Johnson Tests of Achievement IV'” 4; Conners’ Continuous Performance Test - 3; Auditory Consonant Trigrams; Hopkins Verbal Learning Test; and California Verbal Learning Test - Children. Participants were grouped based severity of depression (i.e., none, mild, moderate/severe). Multivariate analyses and Pearson correlations were performed. Results: A significant multivariate analysis of variance was revealed, Wilks’λ = .56, F(16, 124) = 2.61, p = .002, partial ƞ2 = .25. Tukey's post-hoc tests indicated that adolescents with moderate-to-severe depression reported significantly higher BRIEF scores than mildly- and non-depressed adolescents. Moreover, parent-reported BRIEF scores were significantly higher among adolescents with moderate-to-severe depression compared to non-depressed adolescents. No significant differences were found for the neuropsychological measures. Conclusion: The current findings suggest that some aspects of cognition are preserved in adolescents with concussion. However, ecologically relevant tasks requiring cognitive flexibility and higher-level executive skills may be vulnerable to dysfunction in the presence of depressive symptoms. Further research examining executive functions in adolescents with concussion and depression is warranted.
      PubDate: 2017-09-06
       
  • B-54 The Role of Depression In Post-Concussive Symptoms Among Adolescents
    • Authors: Lace J; Zane K, Grant A, et al.
      Abstract: Objective: Outcomes related to adolescent concussion are controversial (McKinlay, 2009). Previous research has focused on using performance-based tests of cognitive abilities or broad-based ratings of behavior. However, few studies have examined post-concussive symptoms as they relate to mental health. The present study examined the associations of post-concussive and depressive symptomatology in adolescents with concussion. Method: Archival data from a Midwestern medical center was used to examine emotional and behavioral measures in 101 adolescents with sport-related or non-sport-related concussion. Sample demographics were as follows: 51% female; 63% Caucasian; Mean age = 14.90. Primary measures included: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT); Post-Concussion Symptom Scale (PCSS); Behavior Rating Inventory of Executive Function; and Patient Health Questionnaire-9-Adolescent (PHQ-9-A). Pearson correlations and a multiple regression were performed. Results: BRIEF and ImPACT scores were not significantly correlated with the PCSS. For the multiple regression, participants’ sex, age, and mechanism of injury (i.e., sport- or non-sport-related) were entered in the first step, and PHQ-9-A scores were entered in the second step. The final model was statistically significant, F(4, 96) = 22.89, p < .001, R2 = .49. Age and mechanism of injury accounted for 27% of the variance in PCSS. Participants’ PHQ-9-A scores accounted for an additional 22% of the variance in PCSS. Conclusion: These findings suggest that depressive symptomatology is associated significantly with post-concussive symptoms in adolescents with concussion. Together, age, mechanism of injury, and depression accounted for nearly half of the variance in the PCSS. Further research examining depression in post-concussive syndrome is recommended in adolescents with concussion.
      PubDate: 2017-09-06
       
  • B-55 The Relationship Between Plasma Tau and Neurocognition Following Mild
           Traumatic Brain Injury: A Longitudinal Analysis
    • Authors: Lange R; Lippa S, Brickell T, et al.
      Abstract: Objective: Plasma tau has previously been associated with neurobehavioral symptom reporting following traumatic brain injury (TBI). However, it is unclear whether plasma tau is related to objective neurocognitive performance. This study aimed to examine the relation between levels of tau and neurocognitive functioning in participants following mild TBI. Method: Participants were 40 U.S. military service members who had sustained a mild TBI and passed performance validity tests. Participants completed a baseline assessment that included 22 neurocognitive measures and a blood draw 3–12 months post-injury (M = 7.1, SD = 3.7). Twenty-two participants also completed a follow-up evaluation an average of 24.1 months post-injury (SD = 12.1). Tau levels were obtained using an ultra-sensitive immune-assay. Results: At baseline, higher tau levels were significantly predictive of better processing speed, executive functioning, and visuospatial composite scores (all ps < .03), but only 4/22 individual neurocognitive measures (all ps < .05). As tau increased, so too did performance on Trails-A, WMS-IV Visual Reproduction-II, and WAIS-IV Similarities and Visual Puzzles. However, the percent variance accounted for was very small (R2 = .100–.181). In the longitudinal sub-group (n = 22), higher baseline tau was not significantly predictive of the vast majority of individual and composite neurocognitive measures at follow-up, with the exception of higher attention and executive functioning composite scores. However, once again, the percent variance accounted for was very small (R2 = .250 and R2 = .194, respectively). Conclusion: There may be some association between tau levels and neurocognitive performance following mild TBI. However, unexpectedly, higher tau was associated with better cognitive performance. A larger sample size is needed to establish the strength and clinical meaningfulness of this association.
      PubDate: 2017-09-06
       
  • B-56 Traumatic Brain Injury, Apathy, and Depression
    • Authors: Lengenfelder J; Trotto G, Smith A, et al.
      Abstract: Objective: To examine the differences in depression in individuals with Traumatic Brain Injury (TBI) with and without apathy. Method: Fifty individuals with moderate-severe TBI were evaluated for apathy using the Apathy Subscale of the Frontal Systems Behavior Scale (FrSBe). Depression was measured using the Chicago Multiscale Depression Inventory (CMDI). Results: Apathy was present in 58% and depression was present in 36% of the total sample. Individuals were divided into two groups based on the presence of apathy on the FrSBe. There were no differences between apathy and non-apathy groups in age, education, gender, time since injury, or premorbid IQ. There was a significant difference between the apathy and non-apathy groups on the CMDI Mood (p = .001), Vegetative (p = .000), and Other (p = .004) subscales as well as the Total (p = .000) but not the Evaluative subscale. In examining the overlap between apathy and depression, 24% met criteria for apathy only, 2% for depression only, and 34% demonstrated both apathy and depression. Conclusion: Individuals with TBI with and without apathy demonstrated significant differences in depressive symptoms. However, consistent with work in other populations a subset of individuals who report symptoms of apathy without the presence of depression exist. Other apathy research demonstrates while depression can co-occur with apathy, the opposite does not appear to be the case, that is, apathy may not co-occur with depression. Our results support such work indicating that apathy can occur independent of depression. It is thus likely that treatments for apathy, rather than depression, would be more effective in this subset of individuals with TBI.
      PubDate: 2017-09-06
       
  • B-57 A Comparison of the Orientation Log (O-Log) and the Galveston
           Orientation Amnesia Test (GOAT) as Measures of Overall Mental Status in
           Rehabilitation Inpatients Following Traumatic Brain Injury
    • Authors: Leon A; Kitaigorodsky M, Coronado D, et al.
      Abstract: Objective: Traumatic brain injuries (TBI) result in a significant economic burden for society. A TBI is typically followed by post-traumatic amnesia (PTA), a transient state of disorientation that is correlated with long-term cognitive outcomes (Dewler et al., 2000). Given the relationship between orientation, functional status, and cognitive gains, obtaining a valid measure of PTA during inpatient rehabilitation is crucial. The purpose of this investigation was to compare MMSE-2 performance to that on two PTA measures to determine which best reflects overall mental status. Method: Participants were 23 inpatients who completed the O-Log, GOAT, and MMSE-2 upon admission to rehabilitation services following TBI. The Galveston Orientation Amnesia Test (GOAT) is a 10-item scale that predicts PTA duration (Levin et al.,1979). The Orientation Log (O-Log) is a 30-point scale that measures recovery from PTA and provides cueing (Jackson et al., 1998). The Mini-Mental Status Examination (MMSE-2) measures overall cognitive functioning (Spreen & Strauss, 1998). Results: A correlation between TBI severity, age, and total scores on the three outcome measures found that TBI severity was significantly correlated with scores on the O-Log (r = −0.39, p = 0.03), GOAT (r = −0.49, p = 0.008), and MMSE-2 (r = −0.45, p = 0.016). A linear regression was conducted with TBI severity, the O-Log, and the GOAT entered as predictors of the MMSE-2. The O-Log was the best predictor of MMSE-2 performance in this model (β = 0.68; p < .005). Conclusion: Findings suggest that although the O-Log and the GOAT perform similarly as measures of PTA, the O-Log is a more valid measure of overall mental status in this population.
      PubDate: 2017-09-06
       
  • B-58 The Relationship Between Self-Reported Cognitive Recovery Following
           Injury and Neuropsychological Test Results
    • Authors: Lippa S; Lange R, Brickell T, et al.
      Abstract: Objective: Patients attributing cognitive concerns to remote mild traumatic brain injury (mTBI) may negatively impact recovery. The current study examines the relationship between self-reported cognitive recovery and neuropsychological outcome following mTBI. Method: Participants were 36 military personnel diagnosed with mTBI prospectively enrolled in a nation-wide 15-year longitudinal study. Participants were grouped by self-reported cognitive recovery: (1) Full Recovery (n = 11), (2) Moderate Recovery (n = 14), (3) Low Recovery (n = 11). Participants completed a 5–6 hour neuropsychological battery at least 3 months (M = 24.0, SD = 36.6) post-injury. Results: Performance validity test (PVT) failure rates were similar between groups (9–15%); however, 9.1% of the Full Recovery group, 7.1% of the Moderate Recovery group, and 36.3% of the Low Recovery group failed MMPI-2-RF validity scales (χ2 = 4.442, p = .109). After excluding those with invalid symptom reporting, omnibus testing revealed significant differences in MMPI-2-RF Demoralization (d = .63–1.63), Somatic Complaints (.63–1.26), and Cognitive Complaints (d = .42–2.00), as well as PCL-C Total Score (d = 1.42–2.15), NSI Total Score (d = .48–1.64), and TBI-QOL Fatigue (d = 1.48–1.68). The Full Recovery group generally reported fewer symptoms than both other groups. After excluding those who failed PVTs, 30.0% of the Full Recovery group, 63.6% of the Moderate Recovery group, and 60.0% of the Low Recovery group met criteria for mild neurocognitive disorder (χ2 = 2.8, p = .248). Immediate memory (d = .65–1.43), delayed memory (d = .73–.95), processing speed (d = .57–.62), and executive functioning (d = .78–.96) generally improved as reported recovery increased. Conclusion: Reported cognitive recovery was significantly related to reported psychological and neurobehavioral symptoms, as well as objective cognitive performance. Research is needed to determine causal relationships between symptom attribution and neuropsychological performance.
      PubDate: 2017-09-06
       
  • B-59 The Relationship Between White Matter Hyperintensities,
           Neurocognitive Performance, and White Matter Integrity Following Mild
           Traumatic Brain Injury
    • Authors: Lippa S; Chaplin A, French L, et al.
      Abstract: Objective: To examine how the presence of white matter hyperintensities (WMH) relates to neurocognitive performance and white matter integrity following mild traumatic brain injury (mTBI). Method: Participants were 36 U.S. military service members with uncomplicated mTBI prospectively enrolled in a nation-wide 15-year longitudinal study. Participants were divided into two groups based on the presence (i.e., 1 or more) or absence (i.e., none) of WMHs: (1) WMH-Absent (n = 17), (2) WMH-Present (n = 19). Participants completed a 5–6 hour neuropsychological battery and Diffusion Tensor Imaging of the whole brain, at least three months post-injury (M = 38.1, SD = 38.5). Six neurocognitive domain summary scores, as well as DTI fractional anisotropy (FA) and mean diffusivity (MD) across 18 regions of interest (ROIs), were calculated and compared across groups. Results: After excluding those who failed PVTs (n = 4), there were no statistically significant differences between groups on any neurocognitive summary scores. Medium effect sizes were found for visual spatial functioning, however. The WMH-Absent group performed better than the WMH-Present group on this measure. When examining FA and MD in 18 ROIs individually and excluding females, only statistically significant difference was found (MD of right corticospinal tract, p = .038, d = .81). Small-medium effect sizes for MD were found in 6 additional ROIs, all of which were higher in the WMH-Absent group (d = .41–.71). Small-medium effect sizes for FA were found for four ROIs, with FA values higher in the WMH-Present group than the WMH-Absent group (d = .40–.65). Conclusion: WMHs were not reliably related to neurocognitive performance or reduced white matter integrity following mTBI.
      PubDate: 2017-09-06
       
  • B-60 Health-Related Quality of Life Following Youth Soccer-Related
           Concussion
    • Authors: Mason D; Crossland M, Simpson T, et al.
      Abstract: Objective: Little research has examined health-related quality of life (HRQOL) following mild traumatic brain injury (mTBI) in children. This study aimed to investigate the trajectory of HRQOL following mTBI in young athletes. Method: Participants were competitive youth soccer players (n = 32; aged 8–17) and their primary caregivers. Three groups were prospectively enrolled: soccer-related mTBI, minor orthopedic injury (OI), and uninjured matched controls. The PedsQL was completed by the primary caregiver within 48 hours of injury to retrospectively assess pre-injury HRQOL; it was also completed at post-injury days 7, 30, and 90 to evaluate current HRQOL. Results: At 7 days post-injury, both the mTBI and OI groups had significantly poorer HRQOL compared to uninjured matched controls (p = 0.008) as well as to their own baseline (p = 0.001, p = 0.02). The two injured groups did not differ significantly from each other on overall PedsQL score on day 7, but the mTBI group had more difficulties within the psychosocial subdomain (p = 0.03). By day 30, HRQOL had returned to baseline for both injured groups, and it remained stable until day 90. Conclusion: Consistent with previous sport-related concussion research demonstrating relatively rapid recovery in post-concussion symptoms following mTBI, HRQOL in young competitive athletes appears to improve at a similar pace. Interestingly, the mTBI group demonstrated more psychosocial difficulties at 7 days post-injury than the OI group. Thus, concussed youth athletes may benefit from additional educational and emotional support in the initial period following the injury.
      PubDate: 2017-09-06
       
  • B-61 Is There a Cumulative Effect of Risk Factors on Pediatric
           Postconcussive Syndrome'
    • Authors: Painter K; Dodd J.
      Abstract: Objective: Research has identified numerous risk factors for postconcussive syndrome (PCS), including premorbid psychiatric, developmental, and migraine disorders, as well as family history. This study examines whether there is a cumulative effect of risk factors on PCS symptom severity. Method: Participants were 96 children, ages 6–18 (Mean age = 14.6; 59% female; 72% Caucasian), who had sustained concussion within the last year and were consequently referred to an outpatient neuropsychology concussion clinic in an urban academic hospital. Exclusion criteria included, Glasgow Coma Scale (GCS) < 13, FSIQ < 80, and performance validity test failure. The criterion variable was self-reported symptoms on the Postconcussive Symptom Scale (PCSS). Risk factors included history of ADHD/LD, migraines, or psychiatric problems and family history of migraines or psychiatric problems. Additional predictive variables were current Anxiety and Depression scales of the Behavior Assessment Scale for Children (BASC-SRP). Multiple regression was used to test our directional hypothesis that a greater number of risk factors predicted higher PCSS elevations. Results: The Multiple regression was not significant (R2 = .07, F (5, 90) = 1.32, p = .27). However, in a model adding BASC Anxiety and Depression to the initial five risk factors, the total of seven predictors explained 29.2% of the variance (R2 = .29, F(7,74) = 4.369, p < .01), with depression significantly predicting PCSS elevations over all other variables (β = .29, p < .05). Conclusion: The current study does not support our hypothesis that the number of risk factors confers increased PCS symptoms. Rather, evidence suggests that current depression best predicts PCS severity, consistent with prior research.
      PubDate: 2017-09-06
       
  • B-62 Clinical Utility of the Neurobehavioral Symptom Inventory for Anxiety
           in Polytrauma Patients: Preliminary Findings
    • Authors: Palmer G; Biehn T, Olson S.
      Abstract: Objective: The Neurobehavioral Symptom Inventory (NSI) is a screening tool used to evaluate symptoms secondary to traumatic brain injury (TBI) in the Department of Veterans Affairs health care system. However, little research has been done on the clinical utility of mental health items on the NSI. The purpose of the study is to determine the clinical utility of an item on the NSI that assesses anxiety to predict symptoms as measured by the Beck Anxiety Inventory (BAI) in a sample of veterans evaluated at a Level 3 polytrauma clinic (N = 381). Method: Retrospective data collected from veteran patients of a polytrauma outpatient clinic from 4/2009–10/2015 were used in the analyses. The measures analyzed in this study included the NSI and BAI. Receiver operating Curve (ROC) analysis was conducted to determine if item 19 on the NSI assessing anxiety predicted the presence of anxiety as measured by a cut-off score greater than 5 on the BAI. Results: There were 195 subjects who tested positive for anxiety based on a cut-off score of 5 on the BAI. The ROC analysis was significant (AOC = .878, p < .001; 95% CI = .830–.926). A cut off of 1 on item 19 of the NSI yielded a sensitivity rate of .973 and a specificity rate of rate of .522. Conclusion: These results indicate that item 19 of the NSI is predictive of a positive screen for anxiety in polytrauma samples with scores of 1 or greater indicating that further assessment of anxiety is warranted.
      PubDate: 2017-09-06
       
  • B-63 Do Pre-existing Psychological or Neurodevelopmental Problems Predict
           Long-term Functioning in Children and Adolescents with Prior
           Concussions'
    • Authors: Plourde V; Low T, Jadavji Z, et al.
      Abstract: Objective: Although most children and adolescents typically recover swiftly following a concussion, a minority will take longer than 3 months. Pre-injury functioning, such as psychological and neurodevelopmental conditions, have been shown to be important predictors of concussion outcomes in youth. However, no known studies have investigated predictors of functioning in children and adolescents years after the last concussion. The aim was to investigate potential predictors of long-term post-concussion functioning in youth. Method: Children and adolescents (N = 74, mean age = 14.2 years old; 51% girls) with one prior concussion (n = 24), multiple prior concussions (n = 24), or a prior orthopedic injury and no concussion (n = 26) were seen on average 2.8 years after their last injury. Long-term functioning was assessed using the self-report versions of the Post-Concussion Symptom Inventory and the Strengths and Difficulties Questionnaire. Parents reported on pre-existing conditions (attention and learning difficulties, anxiety and depression symptoms, and migraines) using a checklist. Predictors of long-term functioning were: age at testing; sex; time between last injury and testing; number of concussions; and all pre-existing conditions reported by parents. Results: Pre-existing attention problems predicted long-term post-concussive symptoms, attention/behavioural difficulties, and overall difficulties, while pre-existing mood issues predicted post-concussive symptoms and overall difficulties. The number of prior concussions was also a significant predictor of post-concussive symptoms only. Conclusion: The results suggest that pre-existing conditions are predictive of long-term outcomes in children and adolescents with concussion. Therefore, pre-injury factors should be considered in clinical settings to prevent and treat long-term problems after concussion.
      PubDate: 2017-09-06
       
  • B-64 Mechanism of Traumatic Brain Injury Among Minority Adults
    • Authors: Ramirez-Aubone C; Ireland S, Alvarez-Jimenez A, et al.
      Abstract: Objective: The literature examining causes of traumatic brain injuries in minority populations is limited. Minorities account for nearly half of post-brain injury hospitalizations and are three times as likely to suffer TBI by intentional means. Identifying different etiological mechanisms of injury among various racial/ethnic groups is important for understanding subsequent treatment and outcome dissimilarities. To assist, we present information on the principal mechanisms of injury associated with TBI across various racial/ethnic minority groups. Method: Retrospective medical chart review identified 185 adults (148 male, 37 female), ages 18 to 95 years, admitted to Jackson Memorial Hospital with TBIs between 2013 and 2014. Racial/ethnic groups were classified by patient self-identification in medical records and included Caucasians (N = 42; 23%), Hispanics (N = 92; 50%), African Americans (N = 36; 19%), and Other (i.e., Asian, Pacific Islander, Haitian) (N = 15; 8%). Significant differences between groups with regard to mechanism of injury were determined using chi-square analyses. Results: Mechanism of injury included falls (N = 71), assaults (N = 30), motor-vehicle-accidents (N = 28), motorcycle accidents (N = 17), hit by car (pedestrians and bicycles) (N = 22), gunshot wounds (N = 4), and other (N = 13). There were significant differences in mechanism of injury across racial/ethnic groups (p. = .07). Follow-up analyses showed falls were the most common mechanism of injury among Caucasians (52%) and Hispanics (40%), but were less common among African Americans (22%) and Others (26%). Assaults were the most common mechanism of injury in African Americans, and motor vehicle accidents were most common among Others. Conclusion: Mechanism of traumatic brain injury differs across racial/ethnic groups. These differences must be considered when making treatment decisions and predicting outcome.
      PubDate: 2017-09-06
       
  • B-65 The Intraclass Correlation Reliability of the Texas Functional Living
           Scale
    • Authors: Rigney N; Hough D, Paddock B, et al.
      Abstract: Objective: Measures of functional ability that emphasize instrumental activities in daily living (IADL) can be a critical component of neuropsychological evaluations. The Texas Functional Living Scale (TFLS), a brief measure, with nationally representative norms, is a reliable tool for measuring functional abilities. However, test-retest reliability of the TFLS in individuals with severe brain injuries (TBI) is limited, and has generally been based on individuals with Mild Cognitive Impairment (MCI), Mild TBI, and dementia. Further, there has been no research evaluating the internal consistency of the TFLS among TBI groups. Method: The present study assessed test-retest reliability of accuracy of IADL completion in the TFLS. The TFLS was administered to a sample of adults (N = 23) mean age 47.3, 17 men and 6 women, with severe TBI over a 1-year interval. Severe TBI occurs when an individual enters a prolonged unconscious state following the injury, Results: For IADL accuracy, the Pearson correlation and intraclass correlation coefficient for relative consistency was robust (r = .947 and .900). The TFLS Memory subscale (t (22) = .884., p = < .001) and Time subscale t (22) = .734, p = < .001) were found to be significant. Additionally, the Money and Calculation subscale (t (22) = .930, p = < .001) as well as the Communication subscale (t (22) = .847, p = < .001) were found to be statistically significant. Conclusion: The TFLS can reliably be utilized as a clinical assessment in studies measuring IADL performance ability in severe TBI. Overall the TFLS possesses robust and relative test-retest reliability for measuring experimental and clinical use.
      PubDate: 2017-09-06
       
  • B-66 The Effect of Brain Injury Terminology on Cognitive Outcome
    • Authors: Sekely A; Bagby M, Zakzanis K.
      Abstract: Objective: To determine the influence of diagnostic terminology (i.e., mild traumatic brain injury (mTBI) versus concussion) on neuropsychological test performance. It was hypothesized that a diagnosis of mTBI would be perceived more negatively than concussion and would therefore result in worse cognitive outcomes. Method: 91 undergraduate students were randomly assigned to one of two vignette conditions. Vignettes portrayed a motor vehicle accident-related head injury, followed by a diagnosis of either mTBI (n = 45) or concussion (n = 46). After reading the vignette, participants were asked to simulate the neuropsychological aftermath of the diagnosis on various subtests of the Neuropsychological Assessment Battery Screening Module. Results: There were no significant differences between mTBI and concussion groups on attention t(89) = .118, p = .91, d = 0.02; language t(89) = .20, p = .84, d = 0.04; memory t(89) = .91, p = .36, d = 0.19; spatial t(89) = 1.30, p = .20, d = 0.27; or executive functioning t(89) = 0.72, p = .47, d = 0.15 domains. Conclusion: Perceptions of diagnostic terminology do not appear to influence cognitive outcome. Though there is debate as to whether the diagnostic terms mTBI and concussion should be used interchangeably, this study suggests that varying terminology will not contribute to cognitive outcomes following mTBI.
      PubDate: 2017-09-06
       
  • B-67 Neuropsychologists’ Likelihood to Consider Post-Concussion
           Syndrome: Implications for Practice
    • Authors: Shean M; Cottingham M.
      Abstract: Objective: Mild Traumatic Brain Injury (mTBI) is an exploding area of research in neuropsychology, mired in controversy. This study investigated whether individual differences (i.e., gender, athletic identity) among neuropsychologists were related to one's likelihood to diagnose Post-Concussion Syndrome (PCS) in athletes with sports-related mTBI. Method: An online survey was sent via various neuropsychology listservs and posted to the Facebook pages of neuropsychological societies. Respondents were required to be licensed psychologists currently practicing neuropsychology. Participants responded to items assessing demographics and athletic identity (as measured by the Athletic Identity Measurement Scale; Brewer et al., 1970), and reported how likely they were to consider the diagnosis of PCS on two vignettes. Answers ranged from 0, “I would not consider PCS at all,” to 100, “I would definitely consider PCS.” Of the 248 individuals who responded to the survey, 191 provided valid data for gender (70.2% female, 29.8% male), and 148 for athletic identity. The majority of the respondents had been in practice less than 5 years (42.5%). Results: A one-way ANOVA for gender was performed, and revealed that women were more likely to consider a PCS diagnosis than men, F(1, 189) = 7.53, p = 0.007; however; the effect size was small (partial eta squared = 0.03). Results of a separate one-way ANOVA for athletic identity were nonsignificant F(1, 152) = 0.30, p = 0.59. Conclusion: Neuropsychologists’ likelihood to consider a diagnosis of PCS differed by gender but not by athletic identity. These findings suggest that specific demographic characteristics may subtly influence neuropsychologists’ thinking regarding PCS.
      PubDate: 2017-09-06
       
  • B-68 The Role of Cognitive Reserve in Recovery from Traumatic Brain Injury
    • Authors: Steward K; Kennedy R, Novack T, et al.
      Abstract: Objective: To examine whether cognitive reserve (CR) attenuates the initial impact of traumatic brain injury (TBI) on cognitive performance (neural reserve theory) and results in faster cognitive recovery rates in the first year post-injury (neural compensation theory), and whether the advantage of CR differs based on the severity of TBI. Method: Adults with mild TBI (mTBI; n = 28), complicated mild TBI (cmTBI; n = 24), and moderate-to-severe TBI (msevTBI; n = 57), and demographically-matched controls (n = 66) were recruited from inpatient/outpatient clinics at an academic medical center and assessed at 1-, 6-, and 12-months post-injury. Outcomes were 3 cognitive domains: processing speed/executive function, verbal fluency, and memory. Premorbid IQ, estimated with the Wechsler Test of Adult Reading, served as the CR proxy. Results: Longitudinal mixed effects models were used to examine the main effects and interaction between injury severity and CR on the initial status and rate of change over time for each of the 3 cognitive domains. Higher premorbid IQ was associated with better performance on all domains at one-month post-injury (p < .05), and the effect did not differ by injury severity. Cognitive recovery rate was moderated only by TBI severity (p < .05); those with more severe TBI had faster recovery in the first year. Conclusion: Results support only the neural reserve theory of CR within a TBI population and indicate that CR is neuroprotective regardless of the degree of TBI. However, higher premorbid CR does not allow for more rapid adaptation and recovery from injury. Thus, early intervention and cognitive rehabilitation efforts should be equally targeted regardless of estimated IQ.
      PubDate: 2017-09-06
       
  • B-69 Acute Rest and Activity Expectations in the Week Following Simulated
           Mild TBI: What do People Plan to Change'
    • Authors: Sullivan K; Cox R.
      Abstract: Objective: Rest is often recommended acutely after mild traumatic brain injury (mTBI). This study investigated the rest plans of injury-simulators. Method: 165 volunteers with no (or no recent) history of mTBI were randomly allocated to a vignette condition. The vignette described a mTBI due to a motor vehicle- (MVA, n = 76) or sport-accident (SPORT, n = 89) and the volunteers responded as if they had been injured. The volunteers selected from a list of 39 ‘everyday’ behaviours (physical, cognitive, restful) those that they would change in the week following the injury. Compared to a cut-score of ‘no change’, on average, and in both conditions, there was a significant (p = <.001) planned decrease in the physical and cognitive behaviours that were relevant to at least 75% of the individuals in each group [MVAphysical t(53) = 7.373; SPORTphysical t(41) = 9.281; MVAcognitive t(41) = 9.367; SPORTcognitive t(51) = −3.521] and a significant planned increase of restful behaviours [MVArestful t(72) = 10.006; SPORTrestful t(86) = 9.566]. At the item-level the planned changes were typically largest for selected physical activities (such as weight training). Conclusion: The acute rest-activity plans of injury-simulators are behaviour-specific. Neither an expectation for blanket-rest nor active-recovery was observed, but the data were indicative of an overall plan to rest. The advice issued to patients - whether to rest or undertake graded activity - may need to such plans into account.
      PubDate: 2017-09-06
       
  • B-70 Persistent Post-concussive Symptoms in Youth Following Motor Vehicle
           Accident Versus Sports Injury
    • Authors: Tarkenton T; Wilmoth K, Didehbani N, et al.
      Abstract: Objective: Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are often comorbid conditions with significant overlap in symptomatology, which obscures diagnosis and treatment. Because mTBIs sustained in motor vehicle accidents (MVAs) occur in the context of a traumatic, potentially life-threating event, this study compares persistent post-concussive symptoms (PPCS) in individuals sustaining mTBIs during a MVA to those from a non-traumatic event (i.e. sports). Method: Participants (aged 7–22) presented with symptoms to one of four outpatient concussion clinics participating in the North Texas Concussion Registry (ConTex) 30 to 163 days following a concussion sustained in the context of either a MVA (n = 21) or sports-related event (n = 66). Measures included a Concussion Symptom Log, the General Anxiety Disorder-7 Item Scale (GAD-7), and the Patient Health Questionnaire-9 Items for Depression (PHQ-9). Independent t-tests examined symptom differences between the MVA and sports-related groups. Results: Groups did not differ significantly on demographics. Concussion Symptom Log total score significantly differed (p = .006), with greater symptom load reported by the MVA group (M = 47.80, SD = 29.56) than the sports-related group (M = 29.00, SD = 24.61). Emotional (p = .004) and cognitive symptoms clusters (p=.003), rather than physical and sleep (ps > .05), were significantly higher in the MVA group. However, groups were not significantly different on the GAD-7 and PHQ-9. Conclusion: Compared to sports-related injuries, youth sustaining a mTBI during a MVA endorsed significantly greater PPCS, particularly emotional and cognitive symptoms, although this difference does not appear in conjunction with ongoing depression/anxiety. Results may indicate a relationship with youths’ experience of symptoms in the context of trauma, although further exploration of symptomatology following traumatic versus non-traumatic events is needed before firm conclusions can be drawn.
      PubDate: 2017-09-06
       
  • B-71 Effect of Pre-Injury Migraine History on Return to School and Sports
           Following Sport-Related Concussion
    • Authors: Terry D; Cook N, Seifert T, et al.
      Abstract: Objective: The extent to which a pre-existing migraine disorder moderates recovery from a sport-related concussion is not well understood. We examined whether having a migraine history was associated with a prolonged return to school and sport following injury. Method: Athletic trainers monitored 479 high school and college athletes (44% female) who sustained a concussion using a web-based surveillance system that collected information about their concussion recovery. Nonparametric Mann-Whitney U tests (MW) were used to compare days to return to school/athletics across groups due to non-normal distributions. Chi-square tests examined the proportion of players who had not returned to athletics/academics at 7- and 14-days post-injury stratified by migraine history. Results: 37 athletes (7.7%) reported a pre-injury migraine history. Migraineurs took a median of 5 days to return to academics (M = 9.0, SD = 10.4) and 14 days to return to athletics (M = 21.7, SD = 19.5). Controls took a median 4 days to return to academics (M = 6.9, SD = 9.9) and 14 days to return to athletics (M = 19.1, SD = 18.3). There were no statistically significant differences in days to return to school or athletics between the groups (MW ps > .05). Stratifying analyses by gender and setting (high school vs. college) did not alter results. However, a greater percentage of migraineurs had not returned to school after 7 days (43% vs. 28%, χ2 = 3.864, p = .049) and 14 days post-injury (27% vs. 11%, χ2 = 7.615, p = .006). There were no group differences in recovery rates when examining return to athletics. Conclusion: Athletes with a pre-injury migraine history may be at modestly elevated risk for a protracted return to school after concussion.
      PubDate: 2017-09-06
       
  • B-72 Predicting Acute Post-Concussion Symptoms and Cognition from
           Pre-Injury Mental Health Treatment
    • Authors: Travers L; Terry D, Maxwell B, et al.
      Abstract: Objective: Greater acute symptoms are associated with increased risk for slower recovery from sport-related concussion. We examined whether a history of pre-injury psychiatric treatment was associated with worse acute symptom reporting or cognitive test performance following concussion. Method: Between 2009 and 2014, a cohort of 38,905 of adolescent student-athletes between the ages of 13 and 18 completed baseline preseason testing with ImPACT®, a computerized program that includes a health history questionnaire, measures of cognitive functioning, and a 22-item symptom inventory. A subgroup of 1,331(3.4%) were evaluated acutely for a possible concussion. Their average age was 15.3 years (SD = 1.2). Post-concussion ImPACT® testing occurred 1–14 days (M = 4.97, SD = 3.68, IQR = 2–7) following injury. Using linear regression, we assessed the unique predictive value of previous psychiatric treatment on post-injury cognitive functioning and symptom reporting after controlling for baseline, preseason scores. Results: 84 (6.3%) adolescents reported a history of psychiatric treatment during baseline testing. Pre-injury psychiatric treatment predicted worse post-injury cognition in 3 of 4 ImPACT® cognitive domains (i.e., verbal memory, visual memory, and visual motor speed) after covarying for baseline ImPACT® scores. Pre-injury psychiatric treatment was not predictive of the total post-injury symptom score, but did predict more self-reported sleep disturbance, mental fogginess, and difficulty concentrating, after covarying for baseline symptoms. Conclusion: Pre-existing psychiatric treatment predicted statistically worse cognitive functioning and some specific self-reported symptoms following injury, although effect sizes were small. Pre-injury mental health problems might manifest as a risk factor for persistent symptoms acutely following injury in some adolescents.
      PubDate: 2017-09-06
       
  • B-73 Symptom Resolution and Cognitive Performance in Adolescent
           Sports-related Concussion
    • Authors: Wadsworth H; Didehbani N, Vargas B, et al.
      Abstract: Objective: To examine differences in initial cognitive function and symptom reporting in adolescent athletes who have shorter recovery (SR) versus longer recovery (LR) times post-concussion. Method: Subjects were recruited as a part of ConTex, a North Texas concussion registry. Of the 214 subjects who completed post-concussion ImPACT testing, 137 had self-reported total symptom resolution within 30 days ([SR] 45% Female; 73% Caucasian; MAge=14.43, SD = 2.36; MEdu = 8.64, SD = 2.03), and 77 subjects had self-reported symptom resolution after 30 days ([LR] 56% Female; 74% Caucasian; MAge = 14.64, SD = 2.37; MEdu = 8.58, SD = 2.11). ImPACT cognitive composites and symptom clusters were compared between SR and LR to determine if there were differences in these scores at initial presentation. Results: The SR and LR groups were similar in terms of gender, age, race, and education. The LR group performed worse on verbal memory (F(1,211) = 11.68; p < .001) and visual motor speed (F(1,212) = 10.95; p < .001) and reported significantly more symptoms in all clusters, including migraine, cognitive, sleep, and neuropsychiatric. Conclusion: The LR group reported more symptoms and obtained lower scores on visual motor speed and verbal memory tasks at initial presentation. These findings highlight the importance of assessing cognition as well as symptoms after concussion as potential prognostic indicators of recovery. Future research is needed to replicate this result and to determine which cognitive variables and symptoms best predict those with longer recovery times following concussion.
      PubDate: 2017-09-06
       
  • B-74 SPECT Baseline Scans Suggest Cerebral Blood Perfusion Differences
           Between NFL and Non-NFL Normals
    • Authors: Zachar R; Tirado C, Golden C, et al.
      Abstract: Objective: The purpose of the current investigation is to determine differences in cerebral blood perfusion between NFL normals versus non-NFL normals via SPECT scan. Method: Subjects (N = 88) were derived from an ongoing de-identified database of adults with a variety of psychiatric diagnoses. They were given a baseline SPECT scan to measure rCBF. For the purposes of the current investigation, all individuals with psychiatric or neurological diagnoses were excluded to include only healthy normals. Two groups of NFL subjects (N = 55) and non-NFL subjects (N = 33) were utilized. Results: Due to the exploratory nature of the current investigation, several independent samples t-tests were conducted. To account for inflation, alpha level was set at .01 for significance. Results showed that NFL normals exhibited higher rCBF in the right cerebellum (t = −6.683, p < .001) and the right frontal lobe (t = −3.741, p = .001). No other significant differences were observed. Conclusion: Results indicate that normals who were a part of the NFL showed significant differences in cerebral blood flow in the right cerebellum and frontal lobe at Baseline. These results suggest that there may be some cortical and cognitive differences between individuals in the NFL and non-NFL individuals. NFL players may generally have better balance than individuals not playing a professional sport. They may also exhibit better procedural memory which is needed to complete their plays and drills accurately. NFL players may have better organization and planning abilities in order to understand plays and the specific organization of each player. Overall, these individuals may have cortical differences that aid them in being better candidates for professional athletics as compared with individuals without these cortical differences.
      PubDate: 2017-09-06
       
  • B-75 Changes in Learning and Memory over the First Year Post Pediatric
           Traumatic Brain Injury (TBI)
    • Authors: Arango-Lasprilla J; Ramos U, Valdivia T, et al.
      Abstract: Objective: To examine learning and memory in children during the first year post-Traumatic Brain Injury (TBI). Method: 30 children with mild-to-severe TBI and 30 age-matched healthy controls from Guadalajara, Mexico completed the Rey Auditory Verbal Learning Test (RAVLT) and the Rey-Osterrieth complex figure (ROCF) at 3, 6, and 12 months post-injury. Verbal learning was measured using RAVLT total score (on the five trials), verbal memory via RAVLT 30-minute delayed recall total score and visual memory using ROCF 3-minute delayed total score. Results: The 2 × 3 repeated-measures ANOVA showed a main effect for group (p < .001) and time (p < .05) and Group x Time interaction (p < .001) on RAVLT total score, with children with TBI scoring significantly lower than controls at each time point (p's < .001), and those with TBI showing an improvement for all time point comparisons (p's < .05) while controls improved from 3–12 and 6–12 months only (p's < .05). There was a main effect for group (p < .001) on RAVLT 30-minute delayed recall total, with children with TBI scoring significantly lower than controls. There was a main effect group (p < .001) and time (p < .001) on ROCF delayed total score, such that children with scored significantly lower than controls and scores significantly increased from 3–6, 3–12, and 6–12 months (p's < .001). Conclusion: Children with TBI have worse verbal learning, and verbal and visual memory than their peers in the year after injury even though both groups demonstrate improvements in verbal learning and visual memory. Neuropsychological rehabilitation during the first year post-TBI may be useful to improve cognitive functioning, and learning and memory in particular.
      PubDate: 2017-09-06
       
  • B-76 Changes in Intelligence Scores over the First Year Post Pediatric
           Traumatic Brain Injury (TBI)
    • Authors: Arango-Lasprilla J; Ramos U, Valdivia T, et al.
      Abstract: Objective: To examine changes in intelligence scores of children during the first year post-TBI. Method: 30 children with mild-to-severe TBI and 30 age-matched healthy controls from Guadalajara, Mexico were administered the Wechsler Intelligence Scale for Children (WISC-III) at 3, 6, and 12 months post-injury. Groups were similar in gender and education (p's > .05). Results: The 2 × 3 repeated-measures ANOVA showed a main effect for group (p < .001) and a Group x Time interaction (p < .01) on the Verbal Comprehension Index with children with TBI scoring significantly lower than controls at each time point (p's < .001) and improving from 3–12 and 6–12 months (p's < .01). There was a main effect for group (p < .001) and time (p < .01) on the Perceptual Reasoning Index with children with TBI scoring significantly lower than controls and improving from 3–6 and 3–12 month (p's < .05). There was a main effect for group (p < .001) and a Group × Time interaction (p < .01) on Working Memory Index with children with TBI scoring significantly lower than controls at each time point (p's < .001) and improving from 6–12 months (p < .01). There was a main effect for group (p < .001), time (p < .001), and a Group × Time interaction (p < .05) on Processing Speed Index with children with TBI scoring significantly lower than controls at each time point (p's < .001) and only the control group improving from 3–6, 3–12, and 6–12 months (p's < .01). Conclusion: Although children with TBI improve on all WISC indices except processing speed during the first year after injury, their performance is always worse than their peers on all indices. Neurorehabilitation may improve performance of these children.
      PubDate: 2017-09-06
       
  • B-77 Social Determinants of Cognitive, Academic and Mental Health Status
           in Children from a Diverse, Low-Income Community-Based Clinic
    • Authors: Grieco J; Capel L, Lyons-Hunter M, et al.
      Abstract: Objective: Neuropsychological practice in community-based settings requires appreciation of environmental factors and diversity of the population. This study examined children at a newly established neuropsychology practice in an urban, low income outpatient clinic to characterize their demographic, intelligence, academic and mental health profiles to inform service/treatment needs. Method: Intelligence and academic skills were assessed (WPPSI-IV; WISC-V; WIAT-III; GORT-5) in 85 children (65% male) ages 3–16 (mean = 8.74;sd = 3.99). Mental health status was assessed with rating scales (BASC-3; BYI-2), clinical interviews, and structured observation (ADOS-2, when indicated). Diagnoses were compared to DSM-5 prevalence rates. Demographic variables were compared to the U.S. Census Bureau. This study was approved by the hospital IRB. Results: Median family income was $19,000 below the state median. Twice as many families were living below the poverty line (20%); 3 times as many parents were of foreign origin (44%); and crime density per square mile was 15 times higher compared with national averages. Mean overall intelligence (FSIQ = 80.95,s.d. = 16.04), Index scores, and math skills (SS = 83.95;sd = 16.92) were low average; mean reading skills were very low (SS = 72.52;sd = 18.67). DSM-5 diagnoses (anxiety, depression, autism, ADHD, PTSD) were identified 3–26 times higher prevalence. Mean age of newly diagnosed autism was 5–6 years later than reported in the literature (mean=8.87;sd=4.56). Conclusion: Preliminary results suggest that children in this and similar communities are at high-risk for reading disability, academic underachievement, and mental health problems. Neuropsychology in diverse, community-based settings requires greater appreciation of demographic factors that impact learning and quality of life. Timely detection and proactive intervention are critical to support academic progress and improve mental health.
      PubDate: 2017-09-06
       
  • B-78 Effects of Native Language on ImPACT Baseline Scores
    • Authors: Hussey J; Becker M, Call E, et al.
      Abstract: Objective: The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) assesses cognitive abilities before and after traumatic brain injury. Research shows that Spanish-speaking individuals perform more poorly on Spanish versions than on English versions of the ImPACT. The current study explores this hypothesis in a state-wide sample. Method: Participants included 166 (mean age = 16.3) individuals who were selected from a consecutive series of 9,000 cases that were assessed to measure baseline functioning before sport participation. Of these, 59 were Spanish-speakers (SS) who were administered the ImPACT in Spanish. Random selection was used to develop comparable groups of Spanish-speakers administered the ImPACT in English (n = 52; SE), and English-speakers administered the ImPACT in English (n = 55; EE). No significant differences were present between groups on age, education, or sex. ImPACT composite scores were compared using mixed-model ANOVA. Results: Results indicated that the SS group performed significantly worse than the SE and EE groups on the Visual Memory (p < .01) and Visual Motor Processing Speed Composites (p < .01). SE and EE groups did not differ from each other on these two composites. No differences between groups were seen for Verbal Memory, Reaction Time, or Impulse Control Composites. Conclusion: Results provide preliminary evidence that performance of Spanish-speakers is similar across Verbal Memory, Reaction Time, and Impulse Control Composites regardless of administration language. If native Spanish-speakers choose to take ImPACT in Spanish, interpretation of Verbal Memory, Reaction Time, and Impulse Control composites may yield a more precise estimate of performance.
      PubDate: 2017-09-06
       
  • B-79 Trail Makin Test: Normative Data for Pediatric Population in Ten
           Spanish-speaking Countries
    • Authors: Ramos U; Lara V, Rodríguez I, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Trail Makin Test (TMT) from Spanish-speaking pediatric population. Method: 3594 healthy children from nine countries in Latin-America and Spain were evaluated. Inclusion criteria were: IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), and score of < 19 on the Children Depression Inventory. 50.9% were girls, and the average age was 11.4 ± 3.3 (range 6–17) years. TMT-A and B total times were normed using multiple linear regressions. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the models by country. Results: The final models showed main effects for age on TMT-A in all countries, except Puerto-Rico, so that time decreased linearly as a function of age (p's < 0.05). Also, age2 had a significant effect in Chile, Mexico, Peru, and Spain (p's < 0.05). TMT-A total time for Mexico, Paraguay, and Puerto-Rico decreased for children with MLPE > 12 (p's < 0.05). In Chile, Cuba, Guatemala, and Mexico TMT-A total time increased for girls (p's < 0.05). The final models for the TMT-B total time showed main effects for age in all countries, except Cuba and Puerto-Rico. Age2 had a significant effect in all countries, except Guatemala. TMT-B total time for Mexico, Paraguay, and Spain decreased for children with MLPE > 12 (p's < 0.05). Sex affected TMT-B for Paraguay, such that the total time increased for boys (p's < 0.05). Conclusion: This is the largest multi-national Spanish speaking pediatric normative study in the world that will allow neuropsychologists on these countries to have a more accurate way to interpret the TMT when used to assess attention and executive functions in pediatric-populations.
      PubDate: 2017-09-06
       
  • B-80 Newly Developed Learning and Verbal Memory Test (TAMVI): Normative
           Data for Pediatric Population in Ten Spanish-speaking Countries
    • Authors: Ramos U; Rivera D, Romero G, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Learning and Verbal Memory Test (TAMVI) from Spanish-speaking pediatric population. Method: 3594 healthy children from nine countries in Latin-America and Spain were evaluated. Inclusion criteria were: IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), and score of <19 on the Children Depression Inventory. 50.9% were girls, and the average age was 11.4 ± 3.3 (range 6–17) years. Total-recall, Delayed-recall, and Recognition scores were normed using multiple linear regressions. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the models by country. Results: The final models showed main effects for age on Total-recall, Delayed-recall, and Recognition in all countries, so that scores increased linearly as a function of age (p's < 0.001). Total-recall, Delayed-recall, and Recognition scores were affected by age2 for all countries, except Cuba (only in Recognition), Guatemala (only in Total-recall and Delayed-recall), Paraguay (only in Total-recall and Recognition) and Puerto-Rico (only in Total-recall). Total-recall and Delayed-recall scores in Chile, Mexico, Paraguay, Puerto-Rico, and Spain increased for children with MLPE > 12 (p's < 0.05). Sex affected Total-recall for Cuba, Guatemala, Mexico and Spain, Delayed-recall for all countries except Chile, Paraguay and Puerto-Rico, and Recognition for Mexico, Peru, and Spain with girls scoring higher than boys (p's < 0.05). The amount of variance explained in TAMVI ranged from 6.1%–38%. Conclusion: This newly developed test will be a useful tool to assess learning and verbal memory in Spanish-speaking pediatric populations from these ten countries. Clinical neuropsychologists are encouraged to include the TAMVI as part of their comprehensive evaluation protocols used with these children.
      PubDate: 2017-09-06
       
  • B-81 Peabody Picture Vocabulary Test: Normative Data for Pediatric
           Population in Ten Spanish-speaking Countries
    • Authors: Ramos U; Romero G, García de la C, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Peabody Picture Vocabulary Test (PPVT) from Spanish-speaking pediatric population. Method: 3594 healthy children from nine countries in Latin-America (Chile, Cuba, Ecuador, Guatemala, Honduras, Mexico, Paraguay, Peru and Puerto Rico) and Spain were evaluated. Inclusion criteria were: IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), and score of <19 on the Children Depression Inventory. 50.9% were girls, and the average age was 11.4 ± 3.3 (range 6–17) years. PPVT total scores were normed using multiple linear regressions. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the models by country. The non-significant variables (p > 0.05) were removed and the model was run again. Results: Ten final MLR models showed main effects for age on PPVT total scores in all countries, so that scores increased linearly as a function of age (p's < 0.001). The PPVT total scores were affected by age2 for all countries except Guatemala and Puerto-Rico (p's < 0.01). The PPVT total scores increased for children of Chile, Mexico, Paraguay, Guatemala and Spain with MLPE > 12 (p's < 0.05). Sex affected the PPVT total scores for Chile, Guatemala, Mexico and Spain, so that boys had higher scores than girls (p's < 0.05). The amount of variance explained in the PPVT ranged from 40.9% to 72.1%. Conclusion: This is the largest multi-national Spanish speaking pediatric normative study in the world that will allow neuropsychologists on these countries to have a more accurate way to interpret the Peabody Picture Vocabulary Test when used to assess vocabulary in pediatric populations.
      PubDate: 2017-09-06
       
  • B-82 Multi-Factorial Cultural Challenges in Paediatric Neuropsychology
           Assessment and Formulation
    • Authors: Starza-Smith A; Williams E.
      Abstract: Objective: In the UK, linguistic and cultural diversity is rapidly evolving, incorporating complexities from European and world-wide migration. While interpreters can bridge the gap in understanding between healthcare professionals and patients from diverse backgrounds, implications of cultural differences go beyond language barriers. We highlight and contrast challenges concerning specific linguistic and cultural identity that impact upon neuropsychological assessment, formulation and intervention. Method: We present the cases of a Central European migrant with traumatic birth injury and a Central African migrant with post traumatic brain injury (TBI). Neuropsychological assessments (Wechsler Intelligence Scale for Children, Children's Memory Scale, Rey-Osterrieth Complex Figure Test, Delis-Kaplan Executive Function System and Wechsler Non-Verbal Scale of Ability) presented untypical profiles. When possible, tests were administered in the child's native language. Results: Both children showed impairment on measures of intelligence, memory and executive function. European child showed severe difficulties with language on tests delivered in his native language and English. For African child, disentangling effects of pre-existing developmental concerns and psychological trauma pre-migration from effects of the TBI was complex. Conclusion: We highlight that cultural challenges to neuropsychological assessment, formulation and intervention vary depending on the multi-factorial aspects of the child's background. European challenges surrounded test validity, competence and cost of translation. Worldwide challenges surrounded ethical considerations, core beliefs and differential diagnosis. In each case, cultural differences had a powerful influence on how each child and their family responded to stress, disability and illness, and this impacted upon the assessment protocols and delivery of rehabilitation. Clinical recommendations are made.
      PubDate: 2017-09-06
       
  • C-01 The Practice of Neuropsychology in Puerto Rico: Results of a National
           Survey
    • Authors: Arango-Lasprilla J; Rodríguez-Irizarry W, Oliveras-Rentas R, et al.
      Abstract: Objective: The purpose of this study was to analyze characteristics of individuals working in the profession of neuropsychology in Puerto Rico in order to understand their background, professional training, current work situation, assessment and diagnostic procedures used, rehabilitation techniques employed, population targeted, teaching responsibilities, and research activities. Method: 25 self-identified professionals in the field of neuropsychology from Puerto Rico completed an online survey between June 2 and 29 of 2015. Respondents had an average age of 39 years and 76% were women. Results: The majority 76% of professionals working in neuropsychology in Puerto Rico have a background in psychology. 80% indicated having obtained their training in neuropsychology in a postgraduate program (master or doctoral degree) and 44% during postdoctoral training. The majority works with individuals with learning difficulties (82%), attention and hyperactivity disorder (67%) and dementia (59%). 90% works in evaluation and diagnosis, 52% in research, 42% in teaching, and 40% in rehabilitation. Some of the most common problems with the instruments were the lack of normative data (94%) and lack of cultural adaptation (77%). The most common barriers for the development of neuropsychology in Puerto Rico were the lack of training (76%) and clinical (64%) programs. Conclusion: Even though in PR there are professionals with adequate preparation and training in the field of neuropsychology. However, there is a need to increase regulation, improve graduate curriculums, enhance existing clinical training, develop professional certification programs, validate existing neuropsychological tests, and create new, culturally-relevant instruments.
      PubDate: 2017-09-06
       
  • C-02 Rey-Osterrieth Complex Figure: Normative Data for an Illiterate Adult
           Population from 5 Latin American Countries
    • Authors: Morlett P; Calderón C, Aguayo A, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Rey-Osterrieth Complex Figure (RCF) for illiterate Latin American adults. Method: The sample consisted of 214 healthy adults living in 5 Latin American countries (Bolivia, Colombia, Honduras, Mexico, and Salvador). Participants were illiterate (not able to read or write), had a Mini-Mental State Examination score of ≥23, a Patient Health Questionnaire-9 (depression) score of ≤4, and a Barthel Index of ≥90. The majority of the participants were women (57.9%) with an average age of 59.5 ± 17.8 years (range 18–89). Copy and immediate-recall ROCF scores were normed using multiple linear regressions and standard deviation of residual values. Age, age2, and sex were included as predictors in the analyses. The non-significant variables (p > 0.05) were removed and the model was run again. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated with separate norms for based on age and sex. Results: Two final multivariate linear regression models yielded main effects for age in copy (B = −0.139; p < 0.001) and immediate-recall scores (B = −0.099; p < 0.001), with scores decreasing linearly as a function of age. In addition, both models showed that men obtained higher scores than women (B's > 2.016; p's < 0.05). The amount of variance explained in ROCF scores was about 10%. Conclusion: To date, this is the first study to develop norms for the ROCF that include appropriate age-adjustments for the illiterate population in Latin America and allow clinicians to more accurately interpret their performance.
      PubDate: 2017-09-06
       
  • C-03 Symbol Digit Modalities Test: Normative Data for an Illiterate Adult
           Population from 5 Latin American Countries
    • Authors: Morlett P; Rabago B, De los Reyes A, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Symbol Digit Modalities Test (SDMT) for illiterate Latin America adults. Method: The sample consisted of 214 healthy adults living in 5 Latin American countries (Bolivia, Colombia, Honduras, Mexico, and Salvador). Participants were illiterate (not able to read or write), had a Mini-Mental State Examination score of ≥23, a Patient Health Questionnaire-9 (depression) score of ≤4, and a Barthel Index of ≥90. The majority of the participants were women (57.9%) with an average age of 59.5 ± 17.8 years (range 18–89). SDMT total score was normed using multiple linear regressions and standard deviation of residual values. Age, age2, and sex were included as predictors in the analyses. The non-significant variables (p > 0.05) were removed and the model was run again. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: The final multivariate linear regression model yielded main effect for age in SDMT total score, with scores decreasing linearly as a function of age (B = −0.097; p < 0.01). In addition, age2 have a significant effect in SDMT total score (B = 0.003; p = 0.05). Sex did not affect any of the outcome measures, and the amount of variance explained for the SDMT total score was 13.0%. Conclusion: To date, this is the first study to develop norms for the SDMT that include appropriate age-adjustments for the illiterate population in Latin America and allow clinicians to more accurately interpret their performance.
      PubDate: 2017-09-06
       
  • C-04 Brief Test of Attention: Normative Data for an Illiterate Adult
           Population from 5 Latin American Countries
    • Authors: Morlett P; De los Reyes A, Calderón C, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Brief Test of Attention (BTA) for illiterate Latin America adults. Method: The sample consisted of 214 healthy adults living in 5 Latin American countries (Bolivia, Colombia, Honduras, Mexico, and Salvador). Participants were illiterate (not able to read or write), had a Mini-Mental State Examination score of ≥23, a Patient Health Questionnaire-9 (depression) score of ≤4, and a Barthel Index of ≥90. The majority of the participants were women (57.9%) with an average age of 59.5 ± 17.8 years (range 18–89). The BTA total score was normed using multiple linear regressions and standard deviation of residual values. Age, age2, and sex were included as predictors in the analyses. The non-significant variables (p>0.05) were removed and the model was run again. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: The final multivariante linear regression model yielded main effect for age in BTA total score, with scores decreasing linearly as a function of age (B = −0.030; p < 0.01). Sex and age2 did not affect any of the outcome measure, and the amount of variance explained in BTA total score was 5.1%. Conclusion: To date, this is the first study to develop norms for the BTA that include appropriate age-adjustments for the illiterate population in Latin America and allow clinicians to more accurately interpret their performance.
      PubDate: 2017-09-06
       
  • C-05 Letter Verbal Fluency Test: Normative Data for Basque People
    • Authors: Olabarrieta-Landa L; Rivera D, Benito S, et al.
      Abstract: Objective: To develop age, education and sex adjusted norms for the Letter Verbal Fluency Test (LVFT) in a group of Basque people. Method: The sample consisted of 139 adults from Basque country and Navarre, Spain. All participants were fluent in Basque and Spanish, between 18 and 75 years old who completed primary school. Additional inclusion criteria included: a score of ≥27 on the Mini-Mental State Examination and a score of 4 on Patient Health Questionnaire-9. Sixty percent were women, the average age was 45.57 ± 18.9 years, and the average education was 13.7 ± 13.6 years. Participants completed the LVFT (letters A, E, and B) in Basque. Results: The regression models included age, age2, education, and sex as predictor variables, and the score of each of the letters of LVFT as single dependent variable in each model. Three linear regressions showed significant effects for education on A (b = 3.146; p < .001; R2 = .117), E (b = 2.803; p < .001; R2 = .103), and B (b = 2.667; p < .001; R2 = .102). Neither age, age2 nor sex were significant in any LVFT letter models. The assumption of homogeneity, and normality was satisfied in all models. To generate adjusted norms, 1) the predictive value was obtained using b-values of each regression model, 2) the residual value was obtained, 3) the residual value was standardized, and 4) tables of percentiles were calculated. Conclusion: To date, this is the first study to develop norms for the LVFT in Basque population. These data can be used to advance the accurate neuropsychological assessment of those who speak Basque.
      PubDate: 2017-09-06
       
  • C-08 The Bilingual Effect on Naming Performance in French-speaking
           Canadians
    • Authors: Savoie J; Root K, Goldsmith K, et al.
      Abstract: Objective: A bilingual effect on naming ability has been shown previously in English-Spanish and English-French bilinguals when tested in English. The purpose of this study was to examine if the same effect occurred in French-English Canadians when assessing naming performance in French. Method: One hundred and nineteen (n = 119) French-speaking, community dwelling, Canadians completed the Boston Naming Test (BNT) in French as part of a larger study. A subset of participants whose self-reported use and preference of language grouped them into French-speaking bilinguals (FS-BI) (n = 27; M = 43.81 years of age, M = 15.60 years of education) and French-speaking unilinguals (FS-UNI) (n = 38; M = 43.89 years of age, M = 12.76 years of education) were included in the analyses. Whereas differences in education were noted, there were no group differences in gender, age, or total self-reported French Proficiency. Results: An ANCOVA with education as a covariate revealed significant differences in total BNT scores between the two groups when adjusting for number of years of education (F(1, 68) = 4.799, p = .032). In keeping with previous studies, French speaking unilinguals (FS-UNI) (M = 43.70, SD = 8.03) had higher scores than French-speaking bilinguals (FS-BI) (M = 40.78, SD = 5.96). Conclusion: Total scores on the BNT were in keeping with expected differences with unilinguals outperforming bilinguals on the French administration of the BNT. This finding further highlights the importance of degrees of bilingualism and its impact on naming performance consistent with other studies.
      PubDate: 2017-09-06
       
  • C-09 Differences in Clinical Classification Using Combined Ethnic and
           Ethnic Specific Norms in Older Adults
    • Authors: Werry A; Daniel M, Bergström B.
      Abstract: Objective: Although researchers have documented that cultural factors influence performance on neuropsychological tests, few studies have examined the impact of ethnic specific norms on clinical classification of test scores. The objective of this study was to determine the percentage of neuropsychological test scores that moved above or below an impairment cutoff when using combined ethnic norms compared to ethnic specific norms. Method: Subjects from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 75.26/6.98; education = 15.70/2.91). Groups were formed based on self-identified ethnicity of White (n = 5311) or Black (n = 1098). All subjects were evaluated with neuropsychological testing 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. Scores that fell below or above the 10th percentile with ethnicity combined norms but not ethnicity specific norms were classified as false positives or false negatives, respectively. Results: Across various neuropsychological tests, an average of 49.71 (28.21–74.13) percent of scores that were originally below the 10th percentile for the Black group were false positives and an average of 2.96 (0.76–7.10) percent of scores that were originally above the 10th percentile from the White group were false negatives. Conclusion: These results emphasize the importance of considering ethnicity when developing, norming, and interpreting neuropsychological tests in order to reduce the risk of interpreting some Black individual's scores as impaired when they likely are not.
      PubDate: 2017-09-06
       
  • C-10 Normal Neuropsychological Test Performance for English Speaking
           Hispanic and Matched White Older Adults
    • Authors: Werry A; Daniel M.
      Abstract: Objective: The impact of cultural factors on neuropsychological test performance is documented in literature with little data on the clinical distribution of test performance in different ethnic groups. The objective of this study was to determine if there are ethnic group differences in the distribution of neuropsychological test scores across clinical ranges. Method: Subjects from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 73.45/6.37; education = 14.71/3.08). Groups were formed based on self-identified ethnicity of White Non-Hispanic (n = 145) or Hispanic (n = 145) and matched for age, education, and sex. All subjects were evaluated with neuropsychological testing 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. Chi-square analyses were used to determine if the groups’ scores were distributed proportionally across clinical performance ranges: Below-average, Low-average, Average, High-average, Superior. Results: All analyses except category fluency and Logical Memory produced a significant χ2value (χ2 (4) = 9.71–25.69, p < .05), indicating the proportion of scores across clinical performance ranges depended on ethnicity. The Hispanic members’ scores were overrepresented in the Below average and Low-average categories and the White group's scores were overrepresented in the High-average and Superior categories. Conclusion: These findings highlight the skewed distribution of neuropsychological test scores when using combined ethnic group norms and the risk of interpreting some Hispanic individual's scores as below average when they likely are not.
      PubDate: 2017-09-06
       
  • C-11 Normal Neuropsychological Test Performance for Spanish Speaking
           Hispanic and Matched White Older Adults
    • Authors: Werry A; Daniel M.
      Abstract: Objective: The impact of cultural factors on neuropsychological test performance is documented in literature with little data on the clinical distribution of test performance in different ethnic groups. The objective of this study was to determine if there are ethnic group differences in the distribution of neuropsychological test scores across clinical ranges. Method: Subjects from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (mean/SD: age = 74.15/6.51; education = 12.61/3.71). Groups of self-identified White Non-Hispanic (n = 161) or Hispanic (n = 161) individuals were matched for age, education, and sex. Neuropsychological tests were administered in Spanish for the Hispanic subjects and English for Whites, including: Mini Mental State Exam (MMSE), Logical Memory Immediate (LMI) and Delayed, Digit Span Forward and Backward, Trail Making Test A & B, Animal Naming, Vegetable Naming, Digit Symbol, and Boston Naming Test. Chi-square analyses were used to determine if the groups’ scores were distributed proportionally across clinical ranges: Below-average, Low-average, Average, High-average, Superior. Results: All analyses except MMSE and LMI produced a significant χ2value (χ2 (4) = 12.02–83.68, p < .001), indicating the proportion of scores across clinical performance ranges depended on ethnicity. The Hispanic group's scores disproportionately fell in the Below-average and Low-average categories and the White group's scores disproportionately fell in the High-average and Superior categories. Conclusion: These findings highlight the skewed distribution of neuropsychological test scores when using ethnic combined norms and the risk of interpreting scores of Hispanic individuals tested in Spanish as below average when they likely are not.
      PubDate: 2017-09-06
       
  • C-12 Parental Stress Moderates Agreement Between Parent-reported and
           Performance-based Measures of Attention in Pediatric Leukemia Survivors
    • Authors: Clem M; Lampson E, Holland A.
      Abstract: Objective: Research on agreement between parent-reported neurocognitive functioning and measured performance for pediatric leukemia survivors is limited, and the effects of stress on parental ratings remain unclear. For parents of children with attention disorders, greater parental distress has been associated with higher perceived severity of child neurobehavioral symptoms, irrespective of actual severity. Among parents of leukemia survivors in the current study, it was theorized that higher stress would be associated with greater reported child attention issues than were apparent on performance-based measures. Method: 97 pediatric Acute Lymphoblastic Leukemia (ALL) survivors ages 8–18 (M = 12.7), at least 6 months post-treatment completion (M = 4.83 years; SD = 3.6 years), completed the Conners Continuous Auditory Test of Attention (CATA). Parents completed the following measures: Behavior Assessment System for Children-Second Edition (BASC-2); Parenting Stress Index-Fourth Edition/Stress Index for Parents of Adolescents; Perceived Stress Scale. Results: Moderation analyses showed that for parents with either mild or moderate stress, BASC-2 ratings were associated with CATA indices (p's < .05), but not for parents with no/low stress. ALL survivors’ attentional functioning largely fell within expectations across modalities, and parents generally reported low levels of stress relative to norms. BASC-2 attention scales were most associated with CATA indices for response speed consistency, detectability, perseverative errors, and omission errors (p's < .05; r's = .21 to .43). Conclusion: The more stressed parents were, the more their child attention ratings agreed with performance-based attention. Higher stress levels may result in greater attunement to child functioning. Overall, parents reported unusually low stress levels, and most survivors’ attention functioning appeared relatively preserved. Clinical and research implications will be presented.
      PubDate: 2017-09-06
       
  • C-13 Relationship Between WAIS Digit Span and Brief Test of Attention
    • Authors: Conder L.
      Abstract: Objective: This study investigated the relationship between the three components of WAIS-IV Digit Span subtest: Digit Span Forward (DSF), Digit Span Backward (DSB), and Digit Span Sequencing (DSS) and external measures of working memory such as the Brief Test of Attention, as addition of DSS represents a major revision to a well validated working memory measure. Since all three components are needed to obtain a raw score for the Digit Span subtest, this study will examine the relationship between components of the DS subtest to external measures of working memory to evaluate whether or not components measure a unitary working memory construct. Method: 47 patients referred to a general neuropsychological private practice were administered WAIS-IV Digit Span (DS) as part of a larger neuropsychological battery. Participants ranged in age from 16 to 64 (27 males, 20 females). Z-scores were calculated by transforming component raw scores based on WAIS-IV age norms and norms on the Brief Test of Attention (BTA). Results: Results based on 47 participants in a clinical sample indicated a moderate, positive correlation between Digit Span Forward and Digit Span Backward (r = .49). There was a weak, positive correlation between Digit Span Forward and Digit Span Sequencing (r = .10). There was a weak, positive correlation between Digit Span Backward and Digit Span Sequencing (r = .25). All correlations were calculated with a 99% confidence interval. There was a moderate, significant correlation between Digit Forward score and BTA (r = .42, p < .05). Digit Span Backward and BTA score were not significantly correlated (r = .117, p = .43). Digit Span Sequencing and BTA were not significantly correlated (r = .16, p = .28). Conclusion: Weak correlations between DSS-DSF and DSS-DSB call into question whether the revised Digit Span subtest measures a unitary working memory construct. Additionally, by comparing these measures to the Brief Test of Attention, the lack of a significant relationship between DSBand DSS and the BTA suggest that different working memory constructs could occur. Further studies are needed to ascertain exactly what DSS measures and how it correlates with well-validated working memory measures.
      PubDate: 2017-09-06
       
  • C-14 Frequency of Atypical CPT-II Scales are Associated with Specific
           Profiles of WRAML-2 Impairment
    • Authors: Grego A; Trinidad B, Lupton A, et al.
      Abstract: Objective: Compared WRAML-2 scaled scores between pediatric groups sorted by number of elevated scales on CPT-II. Method: Data were collected from an archival database. Participants (n = 269) included mixed diagnoses, sorted into groups based upon CPT-II profiles having 0, 1, or 2+ elevations (T-scores > 70): no elevated scales (n=188, mean age 10.56 years), 1 elevation (n = 37; mean age 10.24 years), 2+ elevations (n = 44, mean age 8.59 years). Results: A MANCOVA yielded a significant age covariate, F(12, 250) = 1.82, p = .049. The CPT-II group effect was statistically significant, F(24, 500) = 1.65, p = .028. Groups differed on Story Memory, Story Recognition, Verbal Learning Recall, Verbal Learning Recognition, and Finger Windows only. Bonferroni-adjusted pairwise comparisons indicated significant differences between 0 and 2+ elevations groups only, with lower scores in the 2+ group. On Story Recognition and Verbal Learning Recognition, all groups significantly differed from each other; the groups with more elevations yielded poorer scores. Conclusion: Whereas children with two or more atypical CPT-II scores produced reliable differences on measures of visual and verbal memory, children with a single atypical CPT-II score exhibited specific deficits in verbal recognition tasks. Unlike free recall, recognition subtests contain multiple stimuli to choose from. Thus, a single CPT-II elevation may be indicative of difficulties with distraction and interference, whereas children with multiple CPT-II elevations exhibited broader deficits in encoding and retrieval across stimulus modalities. Verbal Learning (immediate recall), Design Memory, Picture Memory, and Number-Letter subtests were unaffected by CPT-II performance, suggesting that these subtests were more engaging for children and therefore, less sensitive to attentional impairment.
      PubDate: 2017-09-06
       
  • C-15 Frequency of Atypical CPT-II Scales are Associated with Specific
           Profiles of WMS-4 Impairment
    • Authors: Grego A; Strong A, Burley C, et al.
      Abstract: Objective: To determine which WMS-4 scaled scores are most sensitive to attentional impairment as measured by CPT-II among an adult sample. Method: Data were collected from an archival database. Participants (n = 321) included mixed diagnoses, sorted into groups based upon CPT-II profiles having 0, 1, or 2+ elevations, (elevations defined as T-scores > 70): no elevated scales (n = 214), 1 elevation (n = 47), 2+ elevations (n = 60). Groups did not significantly differ by age. Results: A MANCOVA yielded a significant covariate of WAIS-IV Full-Scale IQ, F(8, 310) = 36.74, p < .001. The CPT-II group effect was statistically significant, F(16, 620) = 2.27, p = .003. Groups differed on Logical Memory I, Logical Memory II, and Visual Reproduction II subtests from the WMS-IV. The 0 and 1 elevation groups did not significantly differ, while the 2+ groups scored lower than 0 and 1 groups, by approximately 1 scaled score point. Conclusion: Adults with a single elevated CPT-II score were not likelier than adults without elevated scores to exhibit memory deficits. Since individuals with multiple CPT-II elevations demonstrated impairment predominantly for tests involving contextual verbal stimuli and delayed recall, clinicians may want to place less emphasis on such subtests when estimating overall memory function among individuals with significant attentional difficulties. Results indicated that memory performance can be differentiated by number of elevated scales regardless of content, though future research should examine which CPT-II scales contributed most as predictors of memory performance. WMS-4 subtests which were unaffected by CPT-II performance might be interpreted as more engaging than other subtests, even in the presence of clinically significant attentional impairment.
      PubDate: 2017-09-06
       
  • C-16 SPECT Cerebral Blood Flow Differences Between Reported High and Low
           Levels of Distractibility Symptomatology in Children
    • Authors: Herman C; Boix-Braga M, Trinidad B, et al.
      Abstract: Objective: To compare cerebral blood flow differences between reported high levels of distractibility and low levels of distractibility symptomatology in children. Method: Participants were part of a large archival de-identified database. There were 1,029 children with high levels of distractibility (age M = 11.52, SD = 3.680; 65.3% male, 48.1% Caucasian) and 1,349 with low levels of distractibility (age M = 12.53, SD = 3.46; 74.3% male, 50.3% Caucasian). Results: A MANOVA was found significant at the participants’ baseline level at the =.01 level. Significant differences were found in 12 of the 17 areas. The high symptomatology group had higher rCBF in the left and right limbic, left and right basal ganglia, left motor-sensory and vermis areas, while the low symptomatology group had higher rCBF in the right frontal, left and right cerebellum, left and right occipital, and right temporal areas. Conclusion: Results indicate that although the symptomatology reported might be expected to differ in areas of the brain relative to distractibility, other systems may be equally as involved in determining levels of distraction among children. While pathways previously associated with sustained and selective attention include the fronto-parietal connections, it appears that distractibility, or being pulled from attention, may be associated in a dysfunction in that pathway, as frontal lobes differed between the groups, but parietal lobes did not. Indications of higher rCBF in the limbic system basal ganglia in those with high distractibility is also consistent with previous research indicating lack of distractibility in damaged limbic systems. As the majority of the brain regions were significantly different, there is indication that numerous pathways are active in influencing levels of distraction in children.
      PubDate: 2017-09-06
       
  • C-17 Expanding the Measurement of Abstract Reasoning on the D-KEFS 20
           Questions Test
    • Authors: Ashendorf L.
      Abstract: Objective: The 20 Questions Test (20Q) from the Delis-Kaplan Executive Function System (D-KEFS) was designed to assess abstract reasoning and concept formation. The primary variables generated from the test-Weighted Achievement (WAch), Initial ion (Abs), and Total Questions (TQ)-describe the efficiency with which an individual approaches the test, but may still be suboptimal. It was hypothesized that the better measure of abstract reasoning on this test would be to examine the degree to which every question reflects an abstract plan. Method: A fixed protocol assessing a broad range of neuropsychological constructs was administered to 113 veterans referred for Polytrauma/TBI evaluation who passed performance validity testing. A Total ion Score (TABS) was calculated for all participants. Intercorrelations among 20Q variables were calculated. Linear regression, with an executive domain score (mean T-score of Trail Making Test B, Digit Span backward, and Verbal Fluency) as the dependent variable, was conducted to compare the relative variance contributed by Abs and WA with that contributed by TABS. Results: TABS correlated significantly but not completely with Abs, r = .61; WA, r = .54; and TQ, r = −.54, all p < .001. In a linear regression, TABS, p = .036, was a stronger predictor of executive functioning performance than Abs, p = .524; F(2,110) = 5.21, R2 = .09, p = .007. Likewise, TABS, p = .044, contributed a greater proportion of variance than WA, p = .244; F(2,110) = 5.73, R2 = .09, p = .004. Conclusion: TABS, an expanded measure of abstract reasoning on the D-KEFS 20 Questions Test, is uniquely related to external measures of executive functioning.
      PubDate: 2017-09-06
       
  • C-18 Impact of Asthma on Working Memory, Visual Attention, and Executive
           Functioning in Young Adults
    • Authors: Balbuena S; Washington L, Williams T, et al.
      Abstract: Objective: Asthma is a pulmonary disease that affects arterial oxygen saturation levels and causes cognitive deficits in certain populations (Irani et al, 2017). It is unclear if well controlled asthma impacts cognition in young adults. This study examined asthma's effect on working memory, sustained visual attention, and executive functioning in a college sample. Method: Participants were 68 college students, 31 of whom self-identified with asthma and 37 did not. All participants completed the University of Pennsylvania's Computerized Neurocognitive Battery (CNB, Gur et al, 2009), from which measures of working memory (letter n-back), visual attention (Short Penn CPT), and executive functioning (Penn Conditional Exclusion Task) were used. Data were analyzed using SPSS version 24, and our measure of significance was any p-value lower than .05. Group differences were examined using independent sample t-tests and chi-squares. Results: Mean age of participants was 19 (SD = .21) and education levels had a mean of 12 years (SD = 0.96). There were 37 females and 31 males in the sample. The mean Asthma Control Test score for those with asthma was 22 (SD = 2.80), which indicates well-controlled asthma. There were no group differences for the demographic variables (age, gender, handedness) or cognitive measures (correct responses, median response time) with p ≥ .05 Conclusion: Results indicated that college-age students with well-controlled asthma do not show deficits in working memory, visual attention, or executive function. This is consistent with past studies that have found cognitive deficits primarily in those with severe, poorly-controlled asthma. Future directions will be outlined.
      PubDate: 2017-09-06
       
  • C-19 The Effect of Sexual Abuse on Psychiatric Inpatient Children's IQ and
           Executive Functioning
    • Authors: Beatty A; Gervasio M, McCurdy K.
      Abstract: Objective and Method: Prior research highlighted the negative effects trauma can have on an individual's IQ and executive functioning; however, the effects of sexual abuse on IQ and executive functioning have not been explored within child inpatient populations. This study analyzed the effect of sexual abuse on the scores of the WASI-II Full Scale IQ (FSIQ), Performance IQ (PIQ), Stroop Color-Word, and Trail-Making Test Part B in 111 children aged 5–12 admitted to a psychiatric inpatient unit and referred for neuropsychological evaluation. Results: Multivariate results show sexual abuse had a significant effect on the Trail Test F(4,67) = 19.25, p < .05, the Stroop TestF(4,67) = 6.6, p < .05, the FSIQ, F(4,67) = 10.2, p < .05 and the PIQ F(4,67) = 9.37,p < .05. At .05 significance, sexual abuse predicts lower Trail, Stroop, FSIQ, and PIQ scores. Moreover, the mean scores on the Trail (patients with sexual abuse = −2.24, patients without sexual abuse = −.29), Stroop (with = 30.43, without = 39.69), FSIQ (with = 84.36, without = 95.33), and PIQ (with = 82.71, without = 93.10) tests were lower for children who experienced sexual abuse, compared to children who had not. There was a significant negative correlation between sexual abuse and FSIQ scores, r = −.224, p = .020 and PIQ scores, r = −.233, p = .015 and a significant negative correlation between sexual abuse and Stroop Color-Word scores, r = −.250, p = .019 and Trail-Making Test Part B scores, r = −.356, p = .001. Conclusion: Results demonstrate the negative effect of sexual abuse on children's IQ and executive functioning.
      PubDate: 2017-09-06
       
  • C-20 Initiation and Perseveration Deficits following Left Hemisphere
           Strokes
    • Authors: Campbell R; Valdespino A, DeVore B, et al.
      Abstract: Objective: The purpose of this study was to determine whether left hemisphere stroke patients, particularly those with left anterior communicating artery strokes, exhibited significantly greater initiation and perseveration deficits than those with localized right hemisphere strokes. Method: Our sample included 551 inpatients in an acute rehabilitation setting referred for neuropsychological evaluation. Patients were classified according to the side of stroke and arterial branch involved. Each underwent a standardized assessment that included the administration of the Dementia Rating Scale-2 (DRS-2). The Initiation/Perseveration 1 and 2 subscales of the DRS-2 were analyzed to determine whether there were significant performance differences on individual subscales across stroke and artery. Results: Primary analyses (two-way analysis of variance) found a main effect of stroke for both I/P1 (verbal tasks; F(3,525) = 2.62, p = .049) and I/P2 (motor tasks; F(3,525) = 3.01, p = .029). Follow-up analyses found that patient performance on I/P1 was significant (T = −2.14, df = 207.9, p = .033) such that those with left hemisphere stroke performed worse relative to those with a right hemisphere stroke. No main effects were found for arterial branch or an interaction between artery and side of stroke. Conclusion: Our results found that patients with left hemisphere strokes exhibited greater deficits on a subtest of verbal initiation/perseveration when compared to patients with right hemisphere strokes. Furthermore, left hemisphere strokes were not associated with lower scores on a measure of visuo-motor perseveration. These results support the literature on left hemisphere, particularly left frontal lobe, dysfunction, and language and verbal initiation deficits.
      PubDate: 2017-09-06
       
  • C-21 Executive Functions are Associated with Increased Intake of Added
           Sugars and Nutritional Information Utilization in Obesity
    • Authors: Catak P; Saules K, Al Darweesh H.
      Abstract: Objective: The purpose of the current study was to expand the research on executive functions in obesity to address the relationship between poor dietary choices and planning, decision making, and impulsivity. Method: 96 college students (82% female, 15% male, 69% White, 16% Black) with a BMI of 25 or above (M = 26.07, SD = 6.44) and no history of brain injury completed self-report measures of dietary intake and nutritional label utilization, computerized Tower of London Task (TOL) measuring decision making, and a modified computerized Stroop task for food items measuring response inhibition and response accuracy. Results: Significant negative relationships between added sugar intake and response accuracy for unhealthy food items (r = −0.438, p = 0.000), as well as healthy food items (r = −0.363, p=0.000) on the Stroop were found. Decision making and planning as measured by the TOL were not associated with sugar intake. Response accuracy on the Stroop was significantly associated with front-of-the-package nutritional label reading (r = 0.217, p = 0.034) and back-of-the-package label reading (r = 0.256, p = 0.012). Faster response times on the TOL were negatively associated only with front-of-the-package nutritional label reading (r = −0.267, p = 0.009). Conclusion: The relationship found between response accuracy on a response inhibition task and added sugar intake constitutes a novel finding by showing a direct association between executive functioning and dietary preferences in obesity. The lack of association between decision making and added sugar intake contrasts the previous studies which had implicated decision making deficits in obesity. Further, current results point to the possible role of processing accuracy and decisional impulsivity in the utilization of the nutritional information presented in food packaging.
      PubDate: 2017-09-06
       
  • C-22 Utility of the Iowa Gambling Task in the Neuropsychological
           Assessment of Community-Dwelling Elders Referred for Dementia Evaluation
    • Authors: Champagne P; Goette W, Hagan A, et al.
      Abstract: Objective: The objective was to evaluate the utility of the Iowa Gambling Task (IGT) in the neuropsychological assessment of dementia. Method: The study used archival data for a sample of 62 individuals (26 males) with a mean age of 70.3 (SD = 10.0) and mean education of 14.6 years (SD = 2.9) who were referred to a memory research clinic for dementia assessment. A database of their results on a standardized neuropsychological assessment was used for this study. Results: The IGT Total Net score was significantly correlated with sex (r = .256, p = .05), Trail Making Test Part B (r = .326, p = .01), Stroop Color (r = .277, p = .03) and Color-Word (r = .304, p = .02), Wisconsin Card Sorting Test Perseverations (r = .353, p = .02) and Errors (r = .284, p = .04), and the Smell Identification Test (r = .285, p = .04). While average IGT Total Net scores differed between groups, F(2, 56) = 2.48, p = .09, post hoc analysis showed that the MCI and dementia groups did not differ while both had significantly lower scores than the non-impaired group. The MCI and dementia groups were collapsed to a single impairment group. Receiver operator characteristic curve analysis found that the IGT Total Net was not a strong indicator of cognitive impairment (area under the curve = .671). Conclusion: Taken together, the IGT Total Net score is not likely an effective in detecting dementia-related cognitive impairment.
      PubDate: 2017-09-06
       
  • C-23 Gendered Differences of Alcohol Use and Neuropsychological
           Functioning of Incarcerated Individuals
    • Authors: Craun E; Stephanie K, Jonathan G, et al.
      Abstract: Objective: Incarcerated inmates have higher rates of alcohol use disorder than the general public. Neuropsychological deficits have been associated with alcoholism, with some studies reporting gender effects. Previous research has indicated that inmates demonstrated poorer performance on neuropsychological assessments than their non-offending counterparts. The purpose of this study was to assess the relationship between alcohol consumption and neuropsychological functioning among male and female inmates. Method: One hundred randomly selected inmates (50% female, ages 18–71) completed diagnostic screening interviews and a brief neuropsychological battery. Sixty-three inmates met criteria for alcohol dependence. For the present study, the MINI International Neuropsychiatric Interview, the Trail Making Test (TMT), and the Wisconsin Card Sorting Task (WCST) were used to assess alcohol consumption, alcohol use disorder and neuropsychological functioning. Results: A one-way MANOVA was conducted to compare neuropsychological functioning of inmates who met criteria for alcohol dependence and those who did not. The IV was alcohol dependence status and the DVs used were performance on the Letter-Number Sequencing of the TMT and Perseverative Errors of the WCST. Alcohol status significantly predicted neuropsychological deficits for men (Wilks’λ=0.77, F(4, 92) = 3.21, p < .05), with alcohol dependent inmates consistently performed worse than inmates without alcohol dependence. Alcohol dependence did not predict neuropsychological performance for women (Wilks’λ = 0.981, F(4, 92) = 0.21, p = 0.93). Conclusion: Male inmates who met criteria for alcohol dependence demonstrated neuropsychological deficits in the realms of cognitive flexibility. More research is needed to better understand this relationship, as cognitive deficits have been associated with both increased alcohol use and aspects of criminal behavior.
      PubDate: 2017-09-06
       
  • C-24 The Association Between Neurocognitive Functioning of Inmates and the
           Frequency of Criminal Behavior
    • Authors: Craun E; Kaplan S, Goode J, et al.
      Abstract: Objective: Incarcerated individuals display cognitive deficits relative to their non-offending counterparts. New research with inmates has demonstrated that deficits in cognitive flexibility are associated with frequency of criminal behavior. The purpose of this study was to replicate and expand upon these results by assessing neurocognitive functioning of inmates and its relationship to frequency of crime. Method: One hundred randomly selected jail inmates (50% female, ages 18–71) completed diagnostic screening interviews and a brief neurocognitive battery. For the present study cognitive flexibility was measured using the Wisconsin Card Sorting Test (WCST) and the Trail Making Test (TMT) and the Color-Word Interference (CWI) subtests of the Delis-Kaplan Executive Functioning System. Specifically, the contrast score of the CWI comparing inhibition/switching to inhibition subtest was used (leaving a measure of cognitive flexibility). Frequency of convicted felonies was confirmed using the state repository system. Results: Linear regression models revealed that perseverative errors in WCST predicted convicted felonies (b = −0.24 (0.07), p < 0.005), where greater perseverative errors were associated with more convicted felonies. However, letter-number sequencing subtest scores of the TMT (b = −0.09 (0.28), p = 0.73) and contrast score of CWI (b = −0.09 (0.12), p = 0.46) did not predict convicted felonies. Conclusion: These results diverge from previous findings that have found associations between cognitive flexibility and criminal behavior. Problem-solving and concept formation abilities measured by WCST may be a more important predictor of criminal behavior than cognitive flexibility measured by TMT and CWI. Implications of these findings on the development and treatment of criminal behavior will be discussed.
      PubDate: 2017-09-06
       
  • C-25 Relationship Between Concept Formation and Mental Flexibility
    • Authors: Diah K; Ethridge K, Sattaur Z, et al.
      Abstract: Objective: This study examined the relationship between the WAIS-IV Similarities subtest and performance on the WCST in a clinical adult population. Method: A sample of 607 normal adults (43% male; Mage = 28.94; Meducation = 15.36; 63.8% White) from a deidentified database was used. WAIS-IV similarities subtest standard score was compared to all WCST variables using Pearson correlations (alpha=.005). Results: After controlling for global IQ, WAIS-IV Similarities subtest significantly correlated with WCST variables Total-Administered (r = −.30,p < .001), Trials to Complete First Category ((r = −.20,p = .003), and % Correct (r = .27,p < .001). Although significant, no strong correlations were found. All other WCST to WAIS-IV Similarities correlations were weak (r < .2). Conclusion: The visual-verbal learning paradigm involves a complex process that relies on an integration of cortical activity of mental flexibility, perceptual organization and response modalities. Results revealed significant inverse and direct relationships between WAIS-IV Similarities subtest, a verbal measure of concept formation and WCST variables, a visual measure of concept formation. There was a direct relationship between similarities and % Correct on the WCST. The weak to moderate correlations found suggest that similarities subtest cannot independently predict a measure of cognitive flexibility given the intricate interplay of cognitive structures, but the correlation of these measures suggest that an individual's scaled scores on an intelligence tests has meaning beyond global IQ measure. The relationship between a single measure that has predictive value in determining the performance on other measures of cognitive flexibility is important in determining academic and functional outcomes. Future studies should examine the relationship between visual-verbal measures of cognitive mastery to determine learning behaviors and academic achievement.
      PubDate: 2017-09-06
       
  • C-26 A Comparative Evaluation in Executive Function Assessment: A Closer
           Look at the Monitoring Indices of the BRIEF and CEFI within a Mixed
           Clinical Population
    • Authors: Greer R; Gutierrez H, Maricle D, et al.
      Abstract: Objective: The purpose of this study was to evaluate the relationship between the monitoring indices of the Behavior Rating Inventory of Executive Function (BRIEF) and the Comprehensive Executive Function Inventory (CEFI) among a mixed pediatric clinical sample. Method: A non-experimental design investigated potential differences in executive function assessment measures between self-monitoring indices of the CEFI and BRIEF. This study utilized archival data from the KIDS, Inc. School Neuropsychology Post-Graduate Certification Program. Data was extracted from clinical case studies across the United States between 2004–2015. Comparisons were made between the self-monitoring indices to evaluate for differences in participant or rater gender. A two-way between-subjects MANOVA was performed on two dependent variables: BRIEF Monitoring and CEFI Monitoring. The independent variables were the participant gender (male, female) and the rater (self, parent). Results: Both main effects of gender, λ = .93, F(2, 90) = 3.37, ƞ2= .07, p < .05 and rater, λ = .91, F(2, 90) = 4.59, ƞ2 = .09, p < .05 were statistically significant. Furthermore, the multivariate interaction effect of participant Gender X Rater was not significantly significant, F (2,90) = 1.063, ƞ2 = .02, p = .35, indicating that the unique joint effect of these two variables did not account for a significant portion of the variance. Conclusion: Individuals demonstrating neuropsychological deficits in self-monitoring would benefit from the utilization of these measures to better understand their executive dysfunction as measured by both parent and self-forms. The results demonstrate how these are comparable instruments in self-monitoring assessment across rater and gender within a clinical population.
      PubDate: 2017-09-06
       
  • C-27 Comparison of Performance-based and Subjective Reports of Executive
           Function in the Context of Weight Management
    • Authors: Henry S; Gowey M, Neumeier W, et al.
      Abstract: Objective: Executive functions (EF) play a significant role in weight management. However, performance-based EF testing can be costly and time-consuming relative to self-report ratings. Prior studies have reported inconsistent relationships between the two. Moreover, no data are available on comparisons of performance-based and self-reported EF in those who have previously achieved clinically significant weight loss. The present study examined the relationship between performance-based and self-report EF measures in the context of weight management. Method: The Behavior Rating Inventory for Adults (BRIEF-A), Iowa Gambling Task (IGT), and Delis-Kaplan Executive Function System (DKEFS) Tower Test were administered to 92 adults who previously completed behavioral weight loss treatment. Pearson correlation coefficients were calculated to estimate the associations between the BRIEF-A Global Executive Composite (GEC) T-score, IGT Net Total T-score, and DKEFS Tower Total Achievement Score. Results: Participants were aged 32 to 84 (Mean = 63.9 years; SD = 11.6). The sample was racially balanced (51.1% African American; 49.9% non-Hispanic Caucasian). The majority were female (79.3%) and overweight/obese (Mean BMI: 33.5 kg/m2; SD = 4.5). There was a weak, non-significant association between the BRIEF-A GEC and the IGT (r = −0.137, p = 0.195). Similarly, there was a weak, non-significant association between the BRIEF-A GEC and the DKEFS Tower Test (r = −0.022, p = 0.836). Conclusion: Findings extend previous studies in other settings by demonstrating poor agreement between the self-report BRIEF-A and performance-based EF measures among participants of weight management programs. Results suggest that evaluation of EF in the context of weight management should incorporate both performance-based and self-report measures when possible as they appear to capture distinct EF constructs.
      PubDate: 2017-09-06
       
  • C-28 Trait Anxiety and its Relation to Self-Reported Executive Dysfunction
    • Authors: Holcombe J; Taylor S, Beach J, et al.
      Abstract: Objective: The objective of the present study was to explore the relationship between Trait Anxiety, a personality construct similar to neuroticism and self-reported executive dysfunction. Method: One hundred seventy-four (74% female; mean age = 20.44) healthy participants completed the State-Trait Anxiety Inventory (STAI) and Barkley Deficits in Executive Function Scale (BDEFS) as part of a larger test battery. Raw scores were used for total scores and subscale scores. Results: Pearson correlations revealed a significant positive correlation between the STAI-Trait and BDEFS total and subscales, r (173) = 0.61, p < .001. BDEFS subscales were then entered into a multiple regression model predicting STAI-Trait anxiety. This model accounted for 42% of the variance in Trait anxiety, R2= 0.42, F(5, 168) = 24.59, p < .001, 95% CI [−.026, 6.46]. The BDEFS subscale Self-Regulation of Emotion was the greatest predictor of trait anxiety followed by Self-Organization & Problem Solving and Self-Motivation, β = .381, p < .001. Conclusions: Trait anxiety was significantly related to all BDEFS domains. Higher trait anxiety was positively associated with greater self-reported executive dysfunction with the domain of Self-Regulation of Emotion being the strongest predictor of trait anxiety. Implications for self-reported cognitive abilities are discussed.
      PubDate: 2017-09-06
       
  • C-29 Executive and Adaptive Functioning in Adults with Congenital Heart
           Disease
    • Authors: Kazakov D; Loman M, Swanson S, et al.
      Abstract: Objective: Individuals with congenital heart disease (CHD) have a variety of heart abnormalities that can result in hypoxia. This population is at greater risk for intellectual disability, learning disorders, and cognitive dysfunction (e.g., executive functioning deficits). The vast majority of CHD research is conducted in pediatric populations, but medical advancements allow more CHD patients to survive into adulthood. Research on adaptive and cognitive functioning in adult CHD is minimal to non-existent. This study examines cognitive and adaptive functioning in an adult CHD cohort. We hypothesized that our sample would have lower IQ, executive functioning, and adaptive functioning compared to normative samples. Method: A referred sample of 23 patients with CHD (56.5% male; 73.9% Caucasian; 65% with cyanotic heart conditions; means for age and education are 33.48 and 11.96 years, respectively) underwent comprehensive neuropsychological assessment. Cognitive functioning was measured using the WAIS-IV and executive functioning was evaluated using DKEFS Letter Fluency, Tower, and Trails-Switching. Adaptive functioning was evaluated using the Adaptive Behavior Assessment System-3. Results: One-sample t-tests were performed comparing patient standard scores to respective normative samples. FSIQ was 11.5 points below and index scores were 7.3–13 points below normative means (all p < .05). Executive measures were 8.9–12.2 points below the mean (all p < .05). Adaptive functioning composite scores were 18.4–22.4 points below the mean (all p < .05). Conclusion: Our results indicate that adults with CHD perform significantly below the mean on IQ and executive functioning tests. There was also report of significantly lower adaptive functioning. Further research is necessary to better understand long-term functional outcomes in this population.
      PubDate: 2017-09-06
       
  • C-30 Investigating Ecological Validity of the DRS-2 as a Predictor of
           Daily Functioning: Why Outcome Variables Matter
    • Authors: Lopez S; Ziemnik R.
      Abstract: Objective: It is often claimed that neuropsychological tests have poor ecological validity. When establishing ecological validity, the quality of the outcome variable is important. Outcome variables are often imperfect approximations of real-world behaviors. We investigated the impact of the quality of the outcome variable on conclusions about a test's ecological validity. Method: Community-dwelling older adults (n = 33, age 60–85) were administered the DRS-2 (a measure of global cognitive status) as a predictor of daily functioning. Outcome variables were (a) timed instrumental activities of daily living (TIADLS) as an office-based approximation of daily functioning, (b) medication management over the course of 1 week (MM-1) as a sample of real-world behavior, and (c) medication management over 8 weeks (MM-8) as a presumed “actual” daily functioning. To assess MM, participants’ pills were counted weekly for eight weeks. Extra and missing pills were documented as MM errors. Results: Linear regressions with TIADLs, MM-1, and MM-8 as separate criterion variables were conducted. Controlling for age, DRS-2 did not significantly predict TIADLs (p = .073) or MM-1 (p = .056), but did significantly predict MM-8 (p = .015). DRS-2 accounted for 14% of variance of MM-8 beyond age (p = .015). Conclusion: These findings demonstrate that the DRS-2 yields better ecological validity when the outcome variable most closely reflects actual daily functioning. It was less successful at predicting a “snapshot” of daily functioning, or performance on an office-based measure of IADLs that has high face validity. Thus, tests’ ecological validity cannot be established when using office-based assessments as approximations of everyday functioning, even if such assessments have high verisimilitude.
      PubDate: 2017-09-06
       
  • C-31 The Relationship of Urgency to Impulsive Decision-Making During
           Heightened Affective States in Problem Drinkers
    • Authors: Morgan B; Suhr J, Jones S.
      Abstract: Objective: Problematic alcohol use continues to be a major societal concern. Researchers have identified several risk factors for problematic alcohol use including the personality trait impulsivity. The impulsivity facet urgency, the tendency to engage in rash action/impulsive decision-making during heightened emotion states, is related to problematic alcohol use, although findings for negative urgency are more consistent than those for positive urgency. Few studies have examined the relationship of urgency to actual impulsive action with behavioral measures of impulsivity, such as the Iowa Gambling Task (IGT); those that have examined the relationship without manipulation of mood and without controlling for the relationship of urgency with neuroticism. The present study examined the relationship between urgency and IGT risky decision-making when in a manipulated mood state. Method: Participants were 63 undergraduate students (mean age 19.08, 50 female) who endorsed hazardous alcohol use on the Alcohol Use Disorder Identification Test (AUDIT; average score 17.13) as part of a larger ongoing study. Participants completed demographic and self-report measures including the AUDIT, NEO Five-Factor Inventory-3; Neuroticism Scale (NEO-FFI-3), and the UPPS-P Impulsive Behavior Scale (UPPS-P). Participants viewed 30 images selected from the International Affective Picture System (IAPS) depending on assigned mood condition (positive, negative, or neutral). IAPS pictures continued to be displayed as participants completed the IGT. Results: Consistent with prior research, negative and positive urgency were highly related, r = 0.72. In the positive mood condition, more risky IGT performance was associated with higher positive urgency, r = 0.53, and negative urgency, r = 0.37, after controlling for Neuroticism. In the negative mood condition, relationships were not significant, but suggested more risky IGT performance was associated with lower positive urgency, r = −0.27, controlling for Neuroticism. Conclusion: Results suggest that, although positive and negative urgency are related to one another, they show differential relationships to IGT performance in different mood manipulations, after controlling for Neuroticism. Given the strong overlap of negative urgency with Neuroticism, future studies should continue to control for this variable.
      PubDate: 2017-09-06
       
  • C-32 Does Executive Functioning Predict Financial Capacity in College
           Students Beyond Inancial Literacy, Mathematical Ability, and Estimated
           IQ'
    • Authors: Szczepkowski K; Demakis G.
      Abstract: Objective: Financial capacity (FC) is of growing concern for college students with increasing student loan debt (Fry, 2014), and literature on FC in young adults is relatively sparse. Studies on FC in older adults have found a significant relationship between executive functioning (EF) and FC (Bell-McGinty et al., 2002; Baird et al., 2001; Mackin & Areán, 2009). Solesbee (2014) found that financial literacy (FL), mathematical ability, and estimated IQ predicted Independent Living Scales - Money Management (ILS-MM) scores in college students. Method: 103 healthy students (M age = 21.60; M education = 13.68, SD = 1.42; 51.1% female; 66% Caucasian, 15.2% African American, 12.4% Hispanic/Latino; 4.8% Asian, 4.9% other) completed a neuropsychological battery in exchange for course credit. Hierarchical regression was conducted to test the hypothesis that measures of EF (Trail Making Test - B and Wisconsin Card Sorting Test) would predict ILS-MM beyond FL (Markow & Bagnaschi, 2005), Wide Range Achievement Test-4 Math Computation, and Wechsler Test of Adult Reading estimated IQ. Results: EF did not account for significant variance in ILS-MM beyond FL, mathematical ability, and estimated IQ (ΔR2 = .018, p = .295). FL (β = .254, p = .009) and mathematical ability (β = .370, p = <.001) were significant predictors of ILS-MM. Conclusion: Contrary to findings of studies on FC in older adults, EF did not predict ILS-MM in college students. Future research should consider a more comprehensive neuropsychological battery to measure EF and may consider using ILS-Full Scale as well as ILS-Problem Solving and Performance/Information factor scores.
      PubDate: 2017-09-06
       
  • C-33 Using Executive Functioning and Reward Sensitivity to Predict Alcohol
           Use in Students that Varied as a Function of Parental Alcohol Misuse
    • Authors: Williams C; Montoya B, Craun E, et al.
      Abstract: Objective: Reward sensitivity and certain executive functions contribute unique risks for problematic alcohol use in college students. This study explored the interaction between three executive abilities and reward sensitivity across groups of students that varied as a function of parental drinking behavior. Students with a family history of alcohol problems were expected to have more deleterious alcohol consumption if they had low neuropsychological performance and high reward sensitivity. Method: Students were recruited from a college campus in the western United States. They completed the BIS/BAS Scales, the D-KEFS Color Word Interference Subtest, the Wisconsin Card Sorting Test, and the Operation Span. Students also reported their drinking habits and consequences experienced in the past six months. Results: A multi-group, latent factor interaction was modeled using structural equation modeling in MPlus. After removing the Wisconsin Card Sorting Test from the executive functioning factor, the model was determined to be a good fit to the data. When controlling for the effects of age, sex, ethnicity, and social desirability, executive functioning significantly predicted the maladaptive alcohol use (β = 2.33, t = 2.20, p = .027) in control subjects only. However, the latent interaction between executive functioning and reward sensitivity bordered on statistical significance (β = 1.29, t = 1.90, p = .057) for targets only. All other paths failed to reach statistical significance. Conclusion: This study is the first to model problematic drinking outcomes via an interaction between executive functioning and reward sensitivity within the context of parental alcohol misuse. Limitations and clinical applications will be discussed.
      PubDate: 2017-09-06
       
  • C-34 Expressive Suppression as Predictors of Medication Management in
           Healthy Older Adults
    • Authors: Ziemnik R; Niermeyer M, Nilssen R, et al.
      Abstract: Objective: Over-reliance on expressive suppression (ES) to regulate emotion is associated with poor psychological health, and spikes in ES are associated with compromised cognition and potentially also daily functioning. We investigated whether a retrospective self-report questionnaire of expressive suppression over the lifetime (ES-L) and over the past week (ES-W) would significantly predict medication management (MM; a complex daily task reliant on cognitive resources) during that same week. Method: Community-dwelling older adults (n = 33, age 60–85) completed the Dementia Rating Scale-2 (DRS-2), the Geriatric Depression Scale (GDS), and the Burden of State Emotion Regulation (BSERQ) for ES-L at a baseline visit. At eight weekly visits, participants completed the BSERQ for ES-W, and their MM was monitored via weekly pill counts. Extra and missing pills were documented as MM errors. Their MM at each week (MM-W) and an average across weeks (MM-8) was recorded. Results: Linear regression indicated that ES-W was significantly related to the corresponding MM-W after controlling for age, DRS-2 scaled score, GDS, and ES-L (β = −.26, p = .003). ES-W did not predict MM-W when ES-L was removed from the model (p = .71). ES-L trended to predict MM-8 after controlling for age, DRS-2, and GDS scores, but did not reach criteria for significance (p = .058). Conclusion: ES-W is only predictive of MM-W when stable, trait-like tendency to use ES is accounted for. This suggests that ES burden that is higher than usual is associated with decrements in ability to complete complex daily health behaviors.
      PubDate: 2017-09-06
       
  • C-35 Specific Verbal and Nonverbal Intellectual and Linguistic Components
           Mediate Visual-Spatial Perceptual Information Processing
    • Authors: Aaron H; Forrester R, Moses J, et al.
      Abstract: Objective: We investigated factorial interrelationships among verbal and nonverbal intelligence, spoken language and visual spatial perception to understand their interactive roles. Method: The sample consisted of 106 ambulatory American Veteran patients. All participants completed the WAIS-III, Judgment of Line Orientation (JLO), and Multilingual Aphasia Examination (MAE). There were no demographic or diagnostic exclusion criteria. Mean age of sample was 49.09 (SD = 13.75) and mean education level was 13.20 (SD = 2.55) Results: Principal component analysis of the 30 JLO items produced a two-factor solution (JLO-1: items 1–12 and JLO-2: items 13–30). Principal component analysis of the MAE Visual Naming (VN), Sentence Repetition (SR), Verbal Fluency (VF) and Auditory Comprehension (AC) subtest measures with the four WAIS-III factors produced a new four-factor solution: VN with Verbal Comprehension (VC); SR with Working Memory (WM); VF with Processing Speed (PS); AC with Perceptual Organization (PO). Factor scales were computed for these computed variables. JLO-1 and JLO-2 were refactored with the four linguistic/intellectual factors. A three factor solution was obtained. JLO-1 grouped with AC_PO, and JLO-2 grouped with VN_VC. The WM_SR variable alone was the third factorial component. The VF_PS factor did not load on any of the other components. Conclusion: Visual spatial perceptual ability appears to be multifactorial, with specific components that are verbally and nonverbally mediated. JLO-1 was associated with AC_PO, which suggests a verbal/nonverbal feedback loop in basic visual spatial processing, while JLO-2 was associated with VN, which suggests a verbal concept formation process that mediates processing of more difficult visual-spatial items.
      PubDate: 2017-09-06
       
  • C-36 Eye Movements When Reading in Two Orthographic Systems: English and
           Spanish
    • Authors: Conniff J; Lang M, Torres V, et al.
      Abstract: Objective: To analyze eye movements while reading in two orthographic systems: Spanish (regular) and English (irregular). Method: Twenty-one Spanish/English bilingual and twenty-seven English monolingual subjects between the ages of 18 and 40 were selected. Participants completed questionnaires of language acquisition, bilingualism, and basic information. Data was acquired with Tobii T60XL Eye-tracker hardware and Tobii Studio Pro software. Four paragraphs were presented to bilinguals and two to monolinguals. One paragraph (about 170 words) corresponded to elementary level reading, the other paragraph (about 250 words) to more complex literary narratives. Upon completion of reading the two (monolingual condition) or four (bilingual condition) paragraphs, participants answered comprehension questions. The total number of fixations and fixation duration mean were recorded. Results: In the bilingual group, the number of fixations and the fixation duration mean were significantly larger in Spanish than in English. This suggests when participants read in Spanish they scanned smaller written segments than when they read in English. Performance in English was similar in monolinguals and bilinguals. Conclusion: Considering Spanish is a strongly “syllable-timed” language and English is considered a “stress-timed” language, it could be proposed that reading in Spanish favors syllabic reading and English favors morphemic reading. This difference in reading strategy can suggest a different cognitive interpretation and processing of written language.
      PubDate: 2017-09-06
       
  • C-37 Gender Differences in Stroop Performance Among Individuals with
           Specific Learning Disorder with Impairment in Reading
    • Authors: Okolichany R; Vitale G, Garcia J, et al.
      Abstract: Objective: This study compared performance on the Stroop Color Word test between males and females with specific learning disorder in reading (SLD-R) and normal controls. Method: The data were derived from a de-identified clinical database that included 209 adult participants. The participants were primarily Caucasian and female. The participants were divided into three groups: SLDR-Female (n = 53), SLDR-Male (n = 41), and No Diagnosis (n = 115). A one-way between subjects ANOVA was used to compare T-Scores on Stroop Word, Color, Color/Word, and Interference. Criteria for significance was set at p < .05. Results: Results indicated significant differences on Stroop Word T-Scores (F(2, 173) = 6.530) and Stroop Interference T-scores (F(2, 163) = 4.335). Bonferroni post-hoc comparisons revealed that SLDR-Males obtained significantly lower T-Scores on Stroop Word than the No Diagnosis group, but no significant differences were found between SLDR-Females and the No Diagnosis group. Post-hoc comparisons also revealed that SLDR-Females obtained significantly higher T-scores on Stroop Interference than both SLDR-Males and the No Diagnosis group. Conclusion: Impaired performance on Stroop Word and normal performance on Stroop Color can indicate the likelihood of a reading disorder and highlight the need for further testing. Previous research has noted that individuals with SLD-R demonstrate impaired performance on Stroop Word. However, females with LD have also been shown to outperform males with LD on reading tasks. Thus, impaired performance on the Stroop test may not apply for females with reading LD and may not adequately screen for reading disorders in this population.
      PubDate: 2017-09-06
       
  • C-38 Examination of Ototoxicity and Language-Based Neurocognitive Outcomes
           in Patients Diagnosed with Pediatric Medulloblastoma
    • Authors: Olivier T; Bass J, Ashford J, et al.
      Abstract: Objective: Sensorineural hearing loss (SNHL) is associated with changes in intellectual and academic outcomes in patients with pediatric medulloblastoma, with reading ability appearing particularly vulnerable. The present study aims to identify underlying neurocognitive processes that may result in language difficulties in children with treatment-related ototoxicity/SNHL. Method: Serial neuropsychological and audiology evaluation data for 260 children/young adults (ages 3–21 years) enrolled on a multi-site medulloblastoma research/treatment protocol that included surgery, craniospinal irradiation, and chemotherapy were analyzed using a random coefficient model. Patients were assessed at baseline and up to five years post-diagnosis. Included were 116 children without SNHL (Chang grade 0); 80 with mild/moderate SNHL (Chang grades 1a, 1b, 2a); and 64 with severe SNHL (Chang grade > 2b). Seven Woodcock-Johnson Third Edition Tests of Achievement and Cognition variables were analyzed (Letter-Word Identification, Reading Fluency, Passage Comprehension, Sound Awareness, Phonemic Awareness, Processing Speed, Working Memory); data ranged from 180–257 patients based on measure. Results: Patients with severe SNHL performed significantly worse on all variables in comparison to those without SNHL (p < .05). When comparing patients without SNHL to those with mild/moderate SNHL, one significant result emerged, suggesting a significant decrease in Sound Awareness scores that persisted over time (p = < .01). Most findings remained significant after accounting for age at diagnosis. Conclusion: Children with SNHL exhibit greater deficits in language skills as hearing loss increases. Results suggest that disruption in phonological awareness may be one of the first language-based impairments to emerge, which may eventually lead to difficulties with higher-level language skills, including reading.
      PubDate: 2017-09-06
       
  • C-39 Is Non-Verbal Problem Solving Dependent on Language'
    • Authors: Tang R; Silva L, Chmielewski M.
      Abstract: Objective: Language plays a key role in flexible thinking in human cognition. Current study examines the specific role of language on several non-verbal problem-solving tests among patients in an adult outpatient neuropsychology clinic. Method: 71 monolingual English speaking patients (49% females) with primary memory difficulties are examined. Patients reported an average age of 49.20 (SD = 15.54) years and average 12.82 (SD = 2.78) years of education. Dependent variables include Trail Making Part B, perseverative responses/errors and failure to maintain the set on Wisconsin Card Sorting Test (WCST), and total and switching score on Delis-Kaplan Executive Function System, Design Fluency subtest. Results: Independent t-tests revealed no significant gender difference on cognitive performances. For the combined sample in multiple regression, years-of-education is entered in step 1, Symbol Digit Modalities Test (SDMT, Oral) as information processing in step 2, and WASI-II Vocabulary as verbal skills in step 3 as predictors. SDMT Oral score was shown to be a significant predictor of performances on Design Fluency and Trail Making Part B. Vocabulary was a significant predictor for almost all tests, with WCST performances approaching significance. Conclusion: These findings are consistent with the literature that verbal skills significantly influence non-verbal problem solving skills, over and above education and information processing.
      PubDate: 2017-09-06
       
  • C-40 The Relationship Between Intelligence and Memory in a Clinical Sample
    • Authors: Beene K; Daniel M, Andersen P, et al.
      Abstract: Objective: Clinicians frequently make inferences regarding memory test scores by examining IQ-memory score differences. Although the relationship between IQ and memory scores is well established in normal populations, there is little research investigating this relationship in clinical populations. The purpose of the present study was to investigate the relationship between “intelligence” and memory in patients with known or suspected neurologic or cognitive impairment. Method: Participants were 291 patients referred for neuropsychological evaluation to an outpatient neurology/neuropsychology clinic (gender: 43% male; mean/SD: age = 48.23/ 13.19; education = 14.19/ 2.53). Memory performance was compared for three Wechsler Adult Intelligence Scale IQ/ability groups: (a) below average (M = 81.38, SD = 8.35), (b) average (M = 100.89, SD = 5.25) and (c) above average (M = 123.09, SD = 9.02). Memory tests analyzed included: California Verbal Learning Test- Second Edition; Rey-Osterrieth Complex Figure Test; and Logical Memory and Visual Reproduction subtests of the Wechsler Memory Scale. Results: One-way MANOVA revealed a statistically significant difference between ability levels on the combined dependent variables, (F(16,562) = 10.351, p < .001; Wilk's Λ = .60; partial ƞ2 = .23). Follow up ANOVAs and post hoc analyses showed significant differences in performance for all groups on all memory measures (for all analyses: p < .001). Effect sizes were medium to large (partial ƞ2 = .20–.28; d = .67–1.72). Conclusion: Results indicate memory scores increase as IQ scores increase, although memory scores and intelligence scores are not comparable at every level. Specifically, memory scores are frequently considerably lower than IQ for those with above average intelligence.
      PubDate: 2017-09-06
       
  • C-41 Specific Spoken Language Components Mediate Each Stage of Rote
           Auditory Learning
    • Authors: Davis B; Moses J, Aaron H.
      Abstract: Objective: We investigated the relationship between factorial components of spoken language (fluency, repetition, naming, auditory comprehension) to factorial components of stage wise trial learning on Benton's Serial Digit Learning Test (SDL9). We identified specific verbal mediation process at each stage of the rote auditory verbal learning process. Method: Archival data of 296 Veterans from the Palo Alto Veterans’ Affairs Medical Center were analyzed using exploratory factor analyses. A three-factor solution of SDL9 was analyzed with the summary scale factors of naming, fluency, repetition, and auditory comprehension subtests of the Multilingual Aphasia Exam (MAE). Results: The solution explained 67.85% of the variance between the MAE components and the SDL9 factors. The model showed that the early SDL9 factor loaded with repetition, the middle SDL9 factor loaded with fluency and the late SDL9 factor loaded with fluency, auditory comprehension and naming. Conclusion: The early trials of SDL9 are mediated through verbal repetition, while the middle trials of SDL9 are mediated by verbal fluency. The late trials of SDL9 are mediated by a combination of verbal fluency, auditory comprehension and naming. Overall, the model suggests that as one learns the SDL9 task, verbal mediation becomes more generalized and spoken language changes its role as a mediator as one progresses through the learning sequence of SDL9. These findings provide support for a model that connects independent components of SDL9 to the four components of spoken language.
      PubDate: 2017-09-06
       
  • C-42 Demographic and Cognitive Predictors of Auditory-Verbal Memory Test
           Performance in a Clinical Sample
    • Authors: Prince C; Daniel M, Andersen P.
      Abstract: Objective: The purpose of this study was to investigate the influence of non-memory cognitive abilities and demographic variables on auditory-verbal memory test performance in a clinical sample. Method: Participants were 105 patients [54.3% female; age = 46.83 (14.38), education = 13.83 (2.36)] who completed neuropsychological evaluation at a neurology/neuropsychology clinic. Stepwise regression analyses were conducted to determine the extent to which non-memory neuropsychological test scores and demographic factors accounted for variance in performance on the California Verbal Learning Test-II (CVLT-II) and the Logical Memory (LM I and LM II) subtests of the Wechsler Memory Scale, 4th edition (WMS-IV). Results: Delis-Kaplan Executive Function System Trails Switching accounted for 22–33% of the variance in the Total and Free Recall trials of the CVLT-II, while age accounted for 4–7% and gender accounted for 3–7% of the variance in CVLT-II trials. Wechsler Adult Intelligence Scale, Fourth Edition Matrix Reasoning subtest accounted for 11–12% of the variance in LM I and LM II of the WMS-IV. None of the demographic variables (age, gender, education) accounted for significant unique variance in WMS-IV LM I and II performance. Conclusion: Non-memory cognitive abilities have a stronger influence on auditory-verbal memory test performance than demographic factors. In particular, executive functions are most strongly associated with auditory-verbal memory performance. When interpreting auditory-verbal memory test performance, it is important to be cognizant of these non-memory cognitive influences
      PubDate: 2017-09-06
       
  • C-43 Relationship Between Vocabulary And Verbal / Visual Memory For
           Baseline Use Of Memory Impairment
    • Authors: Ryu K; Kim Y, Chung Y, et al.
      Abstract: Objective: The objective of this study is to test the relationship between basic cognitive ability (vocabulary) and verbal/visual memories. Method: Twenty-eight healthy Korean adults (15 females, 13 males), aged from 19 to 41 years (M = 30.04, SD = 6.61) participated in the study. Their years of education ranged from 12 to 18 years (M = 15.57, SD = 1.78). Only those who heard the explanation of the study and agreed to participate were included and subjects with previous illness that might affect cognitive function were excluded. The vocabulary subtest of Korean Wechsler Adult Intelligence ScaleIV (K-WAIS-IV), Seoul Verbal Learning Test (SVLT), and Rey Complex Figure Test (RCFT) for visual memory test were used. Results: Correlation test showed that vocabulary was highly correlated with verbal memory (SVLT immediate recall: r = .43, p < .05, SVLT delayed recall: r = .59, p < .05, SVLT recognition score: r = .47, p < .05) but not with visual memory (RCFT immediate recall: r = .−.07, n.s., RCFT delayed recall r = .−.08, n.s., RCFT recognition score: .05, n.s.) Conclusion: The results that the vocabulary is correlated only to verbal memory not to visual memory shows that vocabulary subtest can only be used as a baseline for verbal memory of the individual, not for visual memory. It also means even though the vocabulary is considered as a representative subtest that measures the global intelligence that the cognitive function of the human is very material specific. Therefore, the baseline of visual cognitive function needs to be selected from another test, and further research is needed to explore it.
      PubDate: 2017-09-06
       
  • C-44 Neuropsychological Case Studies of Functional Amnesias and the
           Differentiating Characteristics from an Organic Memory Disorder
    • Authors: Saheen C.
      Abstract: Objective: To describe the neuropsychological profiles for functional amnesia, including global and selective retrograde amnesia for episodic-autobiographical information, using two validated, standardized batteries, the Halstead-Reitan Battery (HRB) and Meyers Neuropsychological Battery (MNB). Method: Case #1 is a Caucasian female 35–45 years-old with global memory impairment for 10 years, loss of personal identity, and impaired recall for family/friends. Procedural memory and work performance were intact. Medical and psychiatric histories indicated PTSD, anxiety, and depression. The HRB with intellectual, academic, performance validity (PVMs), and psychological measures was administered. Case #2 is a Caucasian female 75–85 years-old with selective retrograde amnesia. Medical and psychiatric histories revealed alcohol abuse, full remission for 10 years, and anxiety. The MNB and psychological assessment measures were administered. Results: Findings revealed both neurocognitive profiles within normal limits. In fact, both patients demonstrated above-average and superior-range performances in executive functioning and subtypes of memory. Case #1 exhibited exceptional complex integrative memory and learning, whereas Verbal delayed memory was impaired. Case #2 demonstrated superior-range Visual memory, with average-range scores on remaining memory measures. Focal and diffuse indicators were normal, as were PVMs. Psychological measures revealed avoidance, dissociation, and marked anxiety for both. Conclusion: The current case study presents the neuropsychological profiles of two patients with functional amnesia using validated, standardized neuropsychological batteries, whereas prior literature has only utilized flexible-approach batteries. Clinically, functional amnesias exemplify the necessity for objective neuropsychological data to comprehensively assess the patient's reported memory deficits. This study provides support for the use of fixed neuropsychological batteries for differential diagnosis and diagnostic clarification of functional amnesias.
      PubDate: 2017-09-06
       
  • C-45 Specific Attention Span, Working Memory and Spoken Language
           Components Mediate Rote Auditory Learning and Recall Ability
    • Authors: Seo B; Aaron H, Moses J.
      Abstract: Objective: We investigated the relationship of factorial components of visual naming (VN) and sentence repetition (SR) subtests of the Multilingual Aphasia Examination to WAIS-III subtest measures of auditory attention span and working memory. We created factor scale measures and refactored them with three factorial components of the eight-digit Serial Digit Learning Test (SDL8) to demonstrate the effects of learning strategy during each phase of SDL8 learning. Method: The sample consisted of 120 ambulatory American Veteran patients (111 men) with diverse mood, posttraumatic, psychotic, substance abuse and mixed diagnoses. All participants completed the VN and SR, SDL8, and the Digit Span-Forward (DSP-F) and Letter Number Sequencing (LNS) subtests of the WAIS-III. There were no demographic or diagnostic exclusion criteria. Mean age of the sample was 50.10 years (SD = 14.30). Mean educational level was 13.12 years (SD = 2.46). Results. The two components of VN and SR were factored together to produce two joint VN-SR components. Those components were refactored with DSP-F and LNS. VN1_SR2_LNS (working memory) and VN2_SR1_DSP-F (attention span) components were computed. These components were refactored with early, middle, and late trial components of SDL8. SDL8_Early_Trials loaded uniquely with the VN2_SR1_DSP-F attention span component. SDL8_Late_Trials loaded strongly with the VN1_SR2_LNS working memory component and moderately with the SDL8_Middle_Trials component. Conclusion: Initial performance on SDL8_Early_Trials depends on rote attention span, basic repetition and basic naming skills. SDL8 learning (middle) and mastery (late) trial performance depends on working memory and more complex naming and repetition skills.
      PubDate: 2017-09-06
       
  • C-46 WMS-IV Index Scores in Relation to Total Driving Adverse Events on a
           Driving Simulator
    • Authors: Strong A; Ethridge K, Grodner K, et al.
      Abstract: Objective: This study examines the relationship between all Wechsler Memory Scale-IV (WMS-IV) index scores and performance on a driving simulator. Method: Data were derived from an ongoing de-identified database of normal adults. Participants were administered the WMS-IV and completed a driving simulation. Index scores included Auditory Memory Index (AMI) (Mage = 28.15,n = 197), Visual Memory Index (VMI) (Mage = 27.62,n = 248), Visual Working Memory Index (VWMI) (Mage = 28.91,n = 134), Immediate Memory Index (IMI) (Mage = 28.66,n = 203), and Delayed Memory Index (DMI) (Mage = 28.65,n = 209). Scores were coded into a low or high group with the low group comprised of the bottom 25%, and the high group comprised of the upper 25%. The total driving adverse events variable was composed of the total number of collisions and tickets received during the simulation. Results: Five independent samples t-tests were conducted at the .05 level. Significant differences were found between the low and high groups for AMI (t(190) = 2.63,p = 0.009, d = 0.38), VWMI (t(129) = 2.19,p = 0.03,d = 0.38), IMI (t(194) = 3.252,p = 0.001,d = 0.47), and for the DMI (t(202) = 4.145, p < 0.001,d = 0.58). Conclusion: For all of the index scores, except for the visual memory index, individuals who performed in the bottom 25% had significantly more driving errors compared to individuals in the top 25%. These results suggest that both a verbal and a visual component are significant when assessing driving ability. These results could also be a consequence of poor attention and concentration. This could also be a result of an individual's ability to consolidate, store and manipulate information. Individuals who are able to consolidate, manipulate, and attend to information may be less likely to make driving errors.
      PubDate: 2017-09-06
       
  • C-47 Forward to the Past: Revisiting the Role of Immediate Recognition in
           Assessing Episodic Memory
    • Authors: Venkatesan U; Margolis S, Heller B, et al.
      Abstract: Objective: In assessing episodic memory, inferences about encoding are often based on effortful retrieval through immediate recall (IR). However, immediate recognition may provide unique insights into fronto-temporal interactions supporting memory formation. We examined the contribution of immediate recognition discriminability (IRD), measured in the original Hopkins Verbal Learning Test (HVLT-O), by characterizing its relationship to other memory and cognitive indices. Method: A within-subjects design was employed using a heterogeneous sample of outpatients referred to a hospital-based neuropsychology clinic for suspected dementia (N = 28, age = 757.6 years, edu = 143.5 years, 14F). Participants were administered the revised HVLT (HVLT-R), and later in the battery, the HVLT-O. Correlational and cluster analyses elucidated relationships between HVLT-O and HVLT-R measures. Hierarchical and stepwise linear regressions evaluated contributions of IR and IRD to delayed recognition discriminability (DRD), and of all 3 measures to other neurocognitive performances. Results: As expected, HVLT-O and HVLT-R were strongly interrelated. IR, IRD, and DRD were significantly associated with language scores. Regression results revealed independent contributions of IR (β = .39, p = .021) and IRD (β = .48, p = .005) to DRD, which was the strongest predictor of Boston Naming Test performance (β = .63, p < .001). A similar pattern emerged when HVLT-R IR and DRD were replaced with analogous measures from the Brief Visuospatial Memory Test-Revised. Conclusion: IRD and IR appear to tap distinct, modality-general functions possibly mediated by differential aspects of the frontal-hippocampal circuitry underlying episodic memory. Observed relationships among delayed memory and other cognitive domains may reflect component processes that are not fully captured by contemporary assessment procedures, but have potential diagnostic utility in dementia.
      PubDate: 2017-09-06
       
  • C-48 Comparison of Multiple Applications of the Individual-Standard for
           Deficit Inference in a Case Study with High Premorbid Ability
    • Authors: Goette W; Carballo A, Schmitt A.
      Abstract: Objective: Mild impairment, especially in high achieving individuals, can be difficult to infer using a normative standard. Frequently underrepresented in normative samples are individuals of very high or very low education, achievement, and intelligence. The purpose of this case study was thus to evaluate the performance of an individual-standard for inferring deficit in a high achieving client with mild impairment. Method: The individual selected for this case study was referred by a community health program for neuropsychological evaluation. He was a Caucasian male, age 73, with 19 years of education. He had practiced as an attorney for 45 years. During the psychosocial interview, he reported neurocognitive complaints of decline in his short-term memory and balance. His estimated IQ using the Wechsler Test of Adult Reading (WTAR) was 125, and his RBANS Total scale was a 96, Immediate Memory was 94, Visuospatial/Constructional was 87, Attention was 100, Language was 99, and Delayed Memory was 110. Based on the results of a neuropsychological battery, he was diagnosed with non-amnestic mild cognitive impairment (na-MCI). Results: The Revised Standardized Difference Test (RSDT) as reported by Crawford, Garthwaite, & Porter (2010) was used to determine whether RBANS index scores were significantly lower than might be expected given his WTAR-based premorbid estimate. This method identified that his Visuospatial/Constructional and Total Scale scores were aberrantly low. Individual standards using differences between scores lacked utility. Conclusion: Utilizing the RSDT resulted in detection of impaired RBANS index scores in a high achieving individual with na-MCI where normative methods would not have detected any impairment.
      PubDate: 2017-09-06
       
  • C-49 Explaining the Relationship Between Education and Total Scale Score
           
    • Authors: Goette W; Schmitt A, Carballo A, et al.
      Abstract: Objective: To confirm a previous finding of a mediation effect of Weschler Test of Adult Reading (WTAR) on the relationship between education and the RBANS Total Scale score, and to identify moderators of this effect. Method: The study used archival data for a sample of 103 individuals (64 women) with a mean age of 77.2 (SD = 6.3) and mean education of 12.4 years (SD = 3.2) who were referred for dementia assessment. A database of their results on a standardized neuropsychological assessment was used for this study. Results: Based on previous findings with a different dataset, we first confirmed an observed mediation of the WTAR on education and RBANS Total Scale score, which was confimed (z = 3.19, p = .001, R2 = .09). Based on previous findings, the relationship between the WTAR and RBANS Total Scale score was tested for moderation by raw score on the University of Pennsylvania Smell Identification Test (UPSIT), and this moderation effect was tested for moderation by a dichotomous diagnosis variable (non-impaired versus impaired). The total model demonstrated good fit for RBANS Total Scale (F(10, 69) = 26.56, p < .001, R = .88, R2 = .78). Bootstrap confidence intervals confirmed an overall moderated moderated mediation model (Index = −0.79, 95% Confidence Interval: −1.64, −0.17). Conclusion: Cognitive impairment and below average performance on the UPSIT both moderate the mediation effect of the WTAR on education and RBANS Total Scale, suggesting that cognitive reserve may be eroded in those cases and no longer related to current global cognitive ability.
      PubDate: 2017-09-06
       
  • C-50 Factorial Relationships of Visual Pattern Recognition to Intelligence
           and Spoken Language
    • Authors: Gukasyan M; Moses J, Lai J.
      Abstract: Objective: We investigated the effect of language and intelligence on visual pattern recognition on the Visual Form Discrimination Test (VFDT) by using factorial components of spoken language from the Multilingual Aphasia Examination (MAE) and the fourteen subtests of the Wechsler Adult Intelligence Scale - III (WAIS-3). Method: A sample of 104 ambulatory American Veteran patients (98 men, mostly Caucasian) with a wide variety of mixed neuropsychiatric diagnoses (e.g.: mood, posttraumatic, psychotic, substance abuse) and with or without general medical problems who had completed the WAIS-3, MAE, and the VFDT were examined. There were no demographic or diagnostic exclusion criteria. Mean age of the sample was 49.02 years (SD = 13.70), and mean educational level was 13.20 years (SD = 2.54). Results: The 16 items of the VFDT were factored using principal component analysis, which produced a five-factor solution. A principal component analysis of the four components of the WAIS-3 with the four spoken language variables from the MAE (naming, repetition, verbal fluency, auditory comprehension) showed a one-to-one factorial correspondence of the intellectual measures to linguistic variables (variance explained = 70.26%). These four components along with the five VFDT factors were submitted to a separate principal component analysis. Results showed that each of the first four VFDT factors correlated with one of the intellectual/linguistic factors, while the last VFDT factor was independent (variance explained = 68.63%). Conclusion: Our study suggests that, despite being a perceptual measure, performance on the VFDT is systematically related to specific verbal mediation factors and to specific intellectual skills.
      PubDate: 2017-09-06
       
  • C-51 Neuropsychological Capacity Measures in Cognitive Impairment: A
           Meta-analytic Review
    • Authors: Miller K; Hewitt K, Mullen C, et al.
      Abstract: Objective: Measurement of decisional capacity is essential to identification of effective treatment in cognitively impaired populations. The purpose of the following meta-analysis was to explore the effectiveness of measures in use at determining decisional capacity. Data Selection: A search of PsycINFO, PubMed, and Google Scholar databases was conducted to identify articles evaluating decisional capacity in cognitively impaired populations. Studies involving children, adolescents, and individuals diagnosed with severe mental illness were excluded. Sample search terms included “decisional capacity,” “MacArthur Competence Assessment Tool for Clinical Research,” “Hopemont Capacity Assessment Interview,” and “Capacity to Consent to Treatment Instrument” for the “adult,” “Traumatic Brain Injury” and cognitively impaired populations. Studies were included in the analysis if they provided enough information to calculate effect sizes comparing decisional outcomes between treatment and control groups. Weighted effect sizes were calculated using random effects models per recommendations and syntax provided by Field and Gillett (2010). Data Synthesis: The search resulted in 46 studies of capacity measures, including the MacCat-CR, CCTI, and HCAI, with 17 comparisons between distinct outcomes (n = 1,519). Preliminary analyses had a mean controlled Cohen's d of 0.47 (z = 1.85, p < .001). Rosenthal's fail-safe N, a measure of the effects of publication bias, indicated that 466 unpublished studies with null results would be needed to make the effects of the interventions non-significant. Conclusion: Results suggest that measures currently in use are an effective means of determining decisional capacity.
      PubDate: 2017-09-06
       
  • C-52 The Role of Inflammation in the Relationship Between Early Life
           Adversity and Adult Neurocognitive Functioning
    • Authors: Moltisanti A; Scheffler J, Sachs-Ericsson N.
      Abstract: Objective: Early life adversity (ELA) has been associated with deleterious effects on adult cognitive functioning. Chronic stress during childhood can alter the development of normal immune system functioning, causing heightened immune responsiveness to stressors later in life. This may affect health and cognitive outcomes by increasing the propensity for harmful neuroinflammation. ELA has been linked to both adult inflammation and deficits in cognitive function, but no research to date has examined whether ELA relates to adult cognitive functions via inflammation. The present study examined whether the association between ELA and cognitive function is mediated by inflammation. Method: Participants consisted of 877 adults, ages 25–74 (M = 46.03, SD = 11.63), who were recruited by national random digit dialing as part of the Midlife Development in the United States study. Using data from waves 1 and 2, we examined the cumulative impact of multiple forms of ELA on adult levels of inflammation (i.e., fibrinogen, C-reactive protein, serum measures of interleukin-6, and the soluble adhesion molecules e-Selectin and intracellular adhesion molecule-1), executive functioning, and episodic memory. We used bootstrapped mediation analyses to assess inflammation as a mediator to the relationship between ELA and adult cognitive functioning domains. Results: Results showed a significant indirect effect of ELA on executive functions and episodic memory through inflammation, suggesting that ELA negatively impacts adult cognitive functioning in multiple domains through increased neuroinflammation. Conclusion: These findings highlight the long-lasting effects of childhood adversity on neurobiology and emphasize the need for early interventions to alleviate chronic stress and improve long-term cognitive outcomes.
      PubDate: 2017-09-06
       
  • C-53 Identifying Patient Groups with Latent Class Analysis Using Validity,
           Cognition, and Emotion
    • Authors: Morin R; Axelrod B.
      Abstract: Objective: Latent Class Analysis was used to classify a heterogeneous sample of neuropsychology data. In particular, we used measures of performance validity, symptom validity, cognition, and emotional functioning for classification purposes. Method: A dataset of 680 neuropsychological evaluation protocols was analyzed using a latent variable modeling software. Data were collected from evaluations performed for clinical purposes at an urban medical center. Results: A four-class model emerged as the best fitting model of latent classes. The resulting classes were distinct based on measures of performance validity and symptom validity. Class A performed poorly on both performance and symptom validity measures. Class B had intact performance validity and heightened symptom reporting. The remaining two Classes performed adequately on both performance and symptom validity measures. In general, performance invalidity was associated with worse cognitive performance, while symptom invalidity was associated with elevated emotional distress. Conclusion: Latent Class Analysis appears useful in identifying subgroups in a heterogeneous sample with distinct performance patterns. Further, the orthogonal nature of performance and symptom validities is supported.
      PubDate: 2017-09-06
       
  • C-54 Physiological and Cognitive Intra-individual Variability are
           Negatively Associated
    • Authors: Myers M; Hill B, Joanning H, et al.
      Abstract: Objective: We examined the association between physiological and cognitive measures of intra-individual variability (IIV) and any possible influence of trait anxiety on IIV as part of a pilot study. Method: 15 participants were given RBANS, Trail Making Test (TMT) parts A and B, State-Trait Anxiety Inventory, and had heart rate (HR) recorded for 10 minutes while watching a mildly stressful video [mean age 23.90 years (SD 12.54), range 18–61 years old, mean 13.35 years of education (SD 2.13), 55% male, 100% Caucasian]. Cognitive IIV was computed as the individual's standard deviation around their mean performance on RBANS and TMT (converted to standard scores). HR variability was the physiological IIV measure. Overall test battery mean was 93.53 (SD 9.67), mean cognitive IIV was 13.05 (SD 4.38), and mean HR IIV was .11 (SD .10). Results: Pearson correlations demonstrated strong associations between cognitive IIV and HR IIV (r = −.46), while trait anxiety was related to cognitive IIV (r = .23) but not HR IIV (r = .02). None of these were statistically significant at p = .05, but we consider this to be a power issue. Mann-Whitney U comparisons failed to find significant differences between gender for any of these variables, and none of these approached significance at p = .05. Conclusion: Our results suggest a counterintuitive negative association between individual HR variability and cognitive IIV. If IIV was a global index of pathology, a positive association between physiological IIV and cognitive IIV would be expected but was not found in this study. Further research is needed to determine why a substantial negative association may exist.
      PubDate: 2017-09-06
       
  • C-55 Predicting Parental Distress Among Children Newly Diagnosed with
           Craniopharyngioma
    • Authors: Peterson R; Ashford J, Merchant T, et al.
      Abstract: Objective: A childhood cancer diagnosis is stressful for the entire family. Children diagnosed with craniopharyngioma (Cp) may present with particularly challenging medical and cognitive problems due to tumor location and associated biophysiologic comorbidities. The current study examined parental distress in a sample of Cp patient families treated with proton beam therapy to identify factors for targeted intervention. Method: Prior to (n = 96) and one year after (n = 73) proton therapy, parents of children diagnosed with Cp (9.814.42 [age] years at baseline; 49% male) completed a self-report measure of distress, the Brief Symptom Inventory (BSI). Children completed a cognitive assessment battery at baseline; medical variables were extracted from the study database. Results: At baseline, t-tests revealed parents reported higher levels of distress than normative expectations on Anxiety, Depression, Global Severity, and Positive Symptom Distress scales. Linear mixed effects models revealed that only parent report measures of child executive dysfunction and behavioral issues, not patient's cognitive performance or medical status, were predictive of parental distress (p < .001). Linear mixed effect models revealed a significant reduction only in Anxiety over time (t = −2.19, p < .05). Extensive hypothalamic involvement at baseline predicted reduction in Anxiety (p < .05). Conclusion: Parents are experiencing significant distress before their child begins therapy for Cp, though parental distress appears unrelated to medical complications and only related to parent perceptions of child cognitive difficulties (versus child performance). This may best be explained by a negative parent reporting style among the most distressed parents. Knowledge of socio-emotional functioning in parents related to patient outcomes is important for optimization of intervention.
      PubDate: 2017-09-06
       
  • C-56 Gaming Experience: Hemodynamics and Executive Function
    • Authors: Riccio C; Mehta R, Vidrine S, et al.
      Abstract: Objective: With computer-based/online gaming increasingly more common and evident not only in entertainment, but also education and rehabilitation, there are concerns for associated effects on cognition and neural functioning. Method: In the current study, 50 college-aged participants engaged in a variety of executive function tasks and two gaming tasks, Tetris® and Portal®, with frontal hemodynamics measured using functional near infrared spectroscopy. Based on their self-reported gaming history, 17 were categorized as Gamers (i.e., they reported engaging in game playing online 7 or more hours or every day). Results: As expected Gamers attained higher levels of play on both Tetris® and Portal®; however, no between group differences on performance measures were noted on computerized executive function tasks. In general, both groups showed a dorso-lateral dominance, particularly in the right frontal hemisphere, during the executive functioning tests. No differences in frontal activation levels were seen between Gamers and Non-Gamers during the executive function tasks. Non-Gamers exhibited greater frontal lobe activation than Gamers while playing Portal® but not during Tetris®. Conclusion: The study findings indicate gaming experience affected automatization of resource allocation in frontal hemodynamic responses during certain game play but not during computerized executive function testing.
      PubDate: 2017-09-06
       
  • C-57 Factorial Construct Validation of an Interactive Model of Visual
           Perception and Visual Memory with Verbal and Nonverbal Intelligence
    • Authors: Sakhai S; Moses J, Smith J, et al.
      Abstract: Objective: We investigated factorial component relationships of age, education, visual memory, visual pattern and visual-spatial recognition abilities to verbal and nonverbal intelligence to develop an interactive model of these memorial, perceptual and cognitive domains. Method: Factor scales for components of the Benton Visual Retention Test (BVRT), Visual Form Discrimination Test (VFDT), Judgment of Line Orientation (JLO) and the 14 WAIS-III subtests were available from our previous research. The two BVRT components (BVRT-1: items 1–4, BVRT-2: items 5–10) were factored with the VFDT-1 (items 1–4) and VFDT-2 (items 5–16) components to create two secondary memorial/perceptual factor components. Those new factorial variables were refactored with the two JLO factorial components (JLO-1: items 1–12, JLO-2: items 13–30). Factor scales were computed for the two tertiary memorial/perceptual/spatial components that emerged. Age and educational level were factored with the tertiary components to create quartenary components. Those quartenary components were refactored with the four raw score factorial dimensions of the WAIS-III. Results: WAIS-III Perceptual Organization (PO) was grouped with BVRT-2, VFDT-1, JLO-2 and age. WAIS-III Verbal Comprehension (VC) was grouped with BVRT-1, VFDT-2 and JLO-1. WAIS-III Processing Speed (PS) was grouped with BVRT-2, VFDT-1, JLO-2 and age. WAIS-III Working Memory (WM) was grouped with BVRT-1, VFDT-2 and JLO-1. Conclusion: Nonverbal WAIS-III components were associated with BVRT-1, VFDT-2, JLO-2 and age. Verbal WAIS-III components grouped with BVRT-2, VFDT-1, JLO-2 and educational level. These results support a model of cognition that relates aspects of nonverbal perception, nonverbal memory and demographic features to verbal and nonverbal cognitive processes in a selective and specific manner.
      PubDate: 2017-09-06
       
  • C-58 The Relationship Between Executive Function and Intelligence to
           Driving Simulator Performance
    • Authors: Sattaur Z; Grodner K, Keith M, et al.
      Abstract: Objective: This study examines the relationship between executive functioning tasks (Stroop, Trails B, WCST) and IQ (WAIS-IV) on driving simulator performance in a normal adult population. Method: Participants included 141 male and 177 female participants who completed a driving simulator task with an average age of 28.22 (SD = 11.77). The data was derived from an ongoing de-identified database of normal adults. Subjects with psychiatric or neurological issues were excluded. They were given the WAIS-IV, WCST, Stroop, Trails B, and a driving simulation in which their total driving collisions consisting of collisions, off-road accidents, and pedestrians hit were categorized and recorded. Results: Results of an ANOVA test indicated significance when using the executive functioning measures as a model for predicting total collisions, F(316) = 6.623, p < .05. A regression analysis indicated only one test was significant individually. The Stroop Color Word T-test score was significant as an individual predictor of total collisions, t(316) = −2.774, p = .011. Conclusion: The results show a significant relationship between the tests of executive functioning over a test of intelligence in predicting total collisions. The Stroop Test was the most significant individual predictor of total collisions. The strength of the Stroop Test in measuring cognitive flexibility and attentional abilities could have contributed to its individual significance. This demonstrates the clinical utility of using executive functioning tasks, particularly the Stroop test, along with other information in determining driving ability. Future studies should further examine the relationship between executive functioning tests and driving ability in clinical and older-adult populations.
      PubDate: 2017-09-06
       
  • C-59 How Do We Measure Cognitive Outcomes in Children Treated for
           Cancer'
    • Authors: Silva T; Riccio C.
      Abstract: Objective: Assessment of cognitive declines among children with cancer as well as survivors of childhood cancer is essential for the identification and management of these declines. This review focus on the neuropsychological assessment used in studies investigating cognitive changes in children with central nervous system (CNS) tumors. There are multiple pediatric standardized cognitive tests available, however there is low agreeability on an efficient way to measure the most common areas of decline including processing speed, memory, and attention. Data Selection: A total of 15 studies conducted between 1996 and 2017 were identified using the PubMed and PsycInfo databases. Search terms included neuropsychological assessment and pediatric cancer, cognitive assessment and cancer and pediatrics, and central nervous system tumors and cognitive assessments. The only exclusion criteria was the absence of neuropsychological assessment in the areas of attention, memory, and/or processing speed. Data Synthesis: Most studies measured memory and processing speed using the Wechsler intelligence scales, with small variability between subtests administered. The attention and executive functioning domains were mainly measured with the Forms A and B of the Trailmaking Test. Motor integration was also an area found to be commonly measured. Conclusion: While there is a discrepancy between measures used to investigatet he cognitive functioning of children with cancer, frequency distribution shows a consistent pattern of areas of investigation as well the methods employed to identify and manage the most common cognitive deficits observed in this population.
      PubDate: 2017-09-06
       
  • C-60 Circus Tricks: Guessing FSIQ using Clinical and Actuarial Prediction
           Models
    • Authors: Axelrod B.
      Abstract: Objective: After years of playing “guess the IQ within 5 points” a standardized procedure was used to estimate FSIQ based solely on information obtained during the clinical interview. Method: The sample was composed of 118 consecutively referred patients for neuropsychological evaluation at an urban VA medical center. The sample averaged 56 years of age and 13 years of education; the sample was 58% White and 42% African American. Examinees underwent a standard clinical interview. In thinking that age, education, and ethnicity might play a subtle role in formulating predictive FSIQ, that information was recorded. Results: Obtained FSIQ was 87.0 (13.1) for the entire sample, with average Interview IQ (I-IQ) of 89.4 (10.5) falling statistically higher. I-IQ was correlated with FSIQ at .69, sharing 48% of the variance. I-IQ was within 5 points of FSIQ for 43% of the cases and within 10 points for 70% of the cases. Multiple regression (MR) predicted FSIQ scores with age, education, and ethnicity. Mean MR FSIQ of 89.4 (6.3) was statistically higher than actual FSIQ, correlating at .59, sharing 35% of the variance. MR FSIQ was within 5 points of FSIQ for 36% of the cases and within 10 points for 62% of the cases. Conclusion: Clinical and actuarial prediction (age, education, and ethnicity) provide comparable estimations of FSIQ within a reasonable range. Internalization of actuarial prediction might be responsible for the consistency of these methods. Measure Mean (SD) r w/ I-IQ Interview IQ (I-IQ) 89.4 (10.5) FSIQ 87.0 (13.1)* .69 GAI 90.0 (12.9) .66 VCI 91.5 (13.4) .64 PRI 90.4 (13.0) .52** WMI 88.8 (14.1) .55 PSI 84.9 (15.1)* .49** ToPF 92.1 (12.1)* .54 *significantly different from I-IQ; **correlations significantly lower than .69.
      PubDate: 2017-09-06
       
  • C-61 Impact of an Embedded Measure of Performance on Neuropsychological
           Test Performance
    • Authors: Axelrod B; Crockett D, Sugarman M.
      Abstract: Objective: This study investigated whether poor performance on the Word Fluency Task (WFT-FAS) reflected cognitive impairment or suboptimal engagement. Method: The performance of 1,427 patients (AGE = 40.8, SD = 15.8, ED = 12.4, SD = 3.1) on the WFT-FAS was examined. Patient who failed to produce 18 or more units of expressions (n = 218) were assigned to the poor validity group (PV) and had their performance compared to patients with purported good validity (n = 1209). We adopted p < .01 as the criteria for statistical significance for this study. Results: Patients in the PV group were significantly older, had less education, and scored lower on a measure of intelligence (ps < .01). They had similar performance with regard to errors on the WFT-FAS and overall word knowledge, but named fewer pictures of objects and meaningful gestures correctly (ps < .01). They were slower on single- and dual-processing psychomotor tasks (ps < .01). They had slower processing speed, made more perseverative errors on a sorting task, and difficulties solving problems (ps < .01). They reproduced a complex figure less accurately during the copy, immediate- and delayed-conditions (ps < .01). On a verbal memory test, they recalled fewer words during the learning, distraction, and delayed recall trials (ps < .01). In contrast to the generalized deficits demonstrated by the PV group on cognitive tasks, the groups did not significantly differ in terms of self-reported levels of depression or anxiety. Conclusion: The data are consistent with embedded measures of effort tapping into true neuropathology as well as incidences of suboptimal performance. The inclusion of freestanding measures of suboptimal performance may assist in distinguishing between invalid results and genuinely poor ability.
      PubDate: 2017-09-06
       
  • C-62 Alternative Reliable Digit Span and WAIS-IV Digit Span Scaled Scores
           as Measures of Malingering
    • Authors: Burley C; Abu-Suwa H, Lupton A, et al.
      Abstract: Objective: To examine the diagnostic accuracies of an alternative Reliable Digit Span (RDS) measure including the digits forward and sequencing tasks from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and the WAIS-IV Digit Span Scaled Score (DS-SS) relative to performance validity as determined by trials 2 and 3 of the Test of Memory Malingering (TOMM) in a diagnostically diverse sample. Method: Individuals (n = 342) with complete data were selected from a de-identified, archival psychiatric database. The sample included psychiatric (n = 150), neurologic (n = 146), and normal (n = 46) diagnoses. Average age was 33.46 (SD = 13.72). Failing scores on the TOMM were defined as =45 on Trials 2 or 3. Failing scores for the alternative RDS were defined as =8. Failing scores for the WAIS-IV DS-SS were defined as =6. Results: Initial analyses determined that 3.8% of individuals failed Trial 2 and 4.6% failed Trial 3 of the TOMM. Cross-tabulation analyses determined respective sensitivities of 38.5% and 25.0% and respective specificities of 95.7% and 95.4% relative to Trials 2 and 3 of the TOMM for the alternative RDS. DS-SS had respective sensitivities of 68.8% and 69.2% and respective specificities of 81.3% and 80.9% relative to Trials 2 and 3 of the TOMM. Conclusion: Alternative RDS showed weak sensitivity but good specificity relative to the TOMM. DS-SS showed modest sensitivity and fairly good specificity relative to the TOMM. The weak sensitivities of alternative RDS and the modest sensitivities of DS-SS indicate that these embedded measures yielded different outcomes than did the TOMM across individuals suspected of psychiatric, neurologic, and normal diagnoses.
      PubDate: 2017-09-06
       
  • C-63 Assessing Performance Validity with the Medical Symptom Validity Test
           (MSVT) During Neuropsychological Evaluation of Children and Adolescents
           with Epilepsy
    • Authors: Dalrymple J; Salinas L, MacAllister W.
      Abstract: Objective: Evaluation of performance validity in youth with epilepsy is imperative for drawing accurate diagnostic conclusions and, occasionally, informing surgical decision-making. Identification of effective stand-alone performance validity tests (PVTs) is therefore of great importance. This study examined the relations between scores on the Medical Symptom Validity Test (MSVT) and epilepsy severity and other cognitive variables. Method: Twenty-seven youth with confirmed epilepsy were administered the MSVT as part of their comprehensive neuropsychological evaluations at a tertiary care epilepsy center. Epilepsy severity information (age of onset, seizure frequency, number of antiepileptic drugs) was collected. Pearson and Spearman's coefficients assessed relations between MSVT subtests and epilepsy severity variables, Full Scale IQ (FSIQ), reading level, and verbal learning and memory. Results: The majority of children passed the MSVT (92.6%), including those with reading level below 3rd-grade, intellectual impairment, MRI abnormalities, and/or prior neurosurgery. The two children who failed the MSVT were clinically judged to be true failures (one admitted to underperformance, the other was randomly responding). MSVT scores were unrelated to epilepsy severity variables. MSVT performance validity scores (Immediate Recall [MSVT-IR], Delayed Recall, Consistency) were unrelated to FSIQ. Only MSVT-IR correlated with reading and list-learning, r = .51 to .56, p < .01. MSVT subtests intended to quantify true memory performance (Paired Associates [MSVT-PA] and Free Recall) were correlated with reading, learning, and memory, r = .44 to .66, p < .05, while FSIQ only correlated with MSVT-PA, r = .57, p < .01. Conclusion: These findings provide initial support for the utility of the MSVT in an epilepsy population, including those with severe cognitive impairment.
      PubDate: 2017-09-06
       
  • C-64 Examining Differences in Performance on a Test of Malingering in
           Those With and Without Acquired Brain Injuries
    • Authors: Ethridge K; Diah K, Golden C.
      Abstract: Objective: To determine if presence of an acquired brain injury was associated with differences in performance on a test of malingering. Method: Data came from a de-identified adult clinical database. Variables included whether or not the individual had an acquired brain injury as well as scores on the Test of Memory Malingering (TOMM), a test that measures performance malingering. MANOVA was used to determine differences between those with and without acquired brain injuries on three scores on the TOMM:Trial 1, 2, and 3. Brain injury was determined based on the participants’ responses of “yes” (n = 37) and “no” (n = 362) to an intake questionnaire. Results: At the .05 level significant differences were found between groups on trials 2 (F = 5.957, p = .015) and 3 (F = 6.457, p = .011). Trials 2 and 3 were significantly lower in those with acquired brain injuries as compared to those without such injuries. No significant differences were found on trial 1. Conclusion: Brain injury can result in deficits in attention, memory loss, perceptual difficulties, and mood symptoms such as anxiety, to name some challenges. These types of deficits may explain differences in performance on tests of malingering. However, more research is needed to tease apart neuropsychological compromises from ulterior motives and true malingering on evaluations. This suggests a need for more sensitive malingering measures or training in integrating data on malingering tests with performance on a comprehensive battery. It also calls into question the mechanism behind poor performance on malingering measures and if similar brain regions are being implicated in poorer performance, regardless of the reason.
      PubDate: 2017-09-06
       
  • C-65 Automated Sequences as a Performance Validity Test' Difficult if
           you Never Learned Your ABCs
    • Authors: Harrison A; Armstrong I.
      Abstract: Objective: Recently, Kirkwood, Connery, Kirk and Baker (2013) developed the Automated Sequences Test (AST) for use in pediatric populations. This test evaluates fluidity of recall of sequences such as the alphabet or days of the week. They assert that slow performance can help identify invalid response patterns. This study investigated whether the AST might misidentify students with known specific reading disorders (SLD) as noncredible performers. Method: The AST was administered to 68 adolescents with an existing identification as “reading disabled” (69.1% male) aged 12.2 y (SD. = .45 y). All participants were administered two PVTs as well as the AST. Results: Participants who failed a PVT were more likely to have slow alphabet time (p = .023) and slow count-to-20 time (p = .058, Fisher's exact = .03), and all six of these participants were in the low IQ group. After removing these six, intelligence scores were still positively related to slow counting time (p = .008). Word decoding skill and reading fluency were related to time taken to recite the days of the week (all p's < .02). Further, SLD adolescents made errors when reciting months of the year and the alphabet. Conclusion: Automated sequences appear difficult for adolescents with SLD. Anywhere from 18% to 36% of SLD adolescents investing good effort failed one or more of these tasks. Clinicians should be cautious if using this PVT with individuals who have a documented history of reading or learning problems.
      PubDate: 2017-09-06
       
  • C-66 Recognition Discriminability (‘d): An Efficient Replacment for
           Forced-Choice Recogntion on the California Verbal Learning Test II
           (CVLT-II)
    • Authors: Isaac L; Stoler K, Wilcox T, et al.
      Abstract: Objective: Performance validity tests (PVTs) are commonly used in neuropsychological evaluations (Meyers & Volbrecht, 2002). However, administration is subject to several constraints, including time and interference. The California Verbal Learning Test, Second Edition (CVLT-II), features a delayed Forced Choice Recognition (FC) as an embedded PVT. The FC is preceded by a Cued Recognition trial, which includes a Total Recognition Discriminability (d’) statistic. It is hypothesized that d’ would have acceptable classification accuracy and serve as an efficient PVT independent of the FC. Method: The sample consisted of 895 individuals who completed neuropsychological evaluation in a private practice setting. The sample was equally distributed among sex (Male = 50.17%) and was reasonably ethnically diverse (Caucasian = 62%). Each participant was administered the CVLT-II as a part of a larger neuropsychological battery. Results: Total Recognition Discriminability (d’) had excellent classification accuracy, [AUC] = .84, SE = .02, p < .001,. The suggested/cut score threshold of d’ = 2.6 resulted in strong specificity (.91) and moderate sensitivity (.61). Conclusion: These findings indicate preliminary evidence that Total Recognition Discriminability can serve as an effective replacement for Forced Choice Recognition. Further research on the correspondence of d’ to other performance validity tests is warranted.
      PubDate: 2017-09-06
       
  • C-67 Victoria Symptom Validity Test in Child through Geriatric
           Populations: Systematic Literature Review
    • Authors: Mazur-Mosiewicz A; Keener A, Ito F, et al.
      Abstract: Objective: The Victoria Symptom Validity Test (VSVT) is one of the most popular adult validity tests. Although the test is standardized on age range 18–72, the VSVT is commonly used beyond these age brackets. With little information about the utility of VSVT in children and older adults, the current study systematically reviewed peer-reviewed publications to examine the VSVT pass/fail rates in children, adult, and geriatric groups. The investigation aimed to (1) compare pass/fail rates among different age groups, and (2) report most common correlates of failing performance in specific age groups. Method: MEDLINE, Web of Science, Embase and PsychINFO databases were searched using a combination of controlled vocabulary and relevant keywords. Results were limited to peer-reviewed, English-language articles published between January 1, 1996 and October 6, 2016. Results: The search identified 287 initial records. Two blinded reviewers screened the records’ titles and abstracts, and identified 47 papers. Of those, 32 records met the inclusion criteria. Data extraction and quality analysis was performed. The results suggested that the VSVT is used in all age ranges. Although the test shows some usefulness with older children, it may not be appropriate for older adults, young children, or children with cognitive difficulties. In both populations, hard items were often lower than the easy items scores. Conclusion: Children and older adults demonstrate lower scores than adults on the VSVT, but in-group variation should be taken into consideration when using the VSVT. Clinical implications and guidelines are discussed.
      PubDate: 2017-09-06
       
  • C-68 Cross-validation of Embedded Language-based Performance Validity
           Tests in a Mixed Rehabilitation Sample
    • Authors: Rolin S; Davis J.
      Abstract: Objective: Whiteside and colleagues (2015) examined performance validity tests (PVTs) on the Boston Naming Test (BNT), phonemic (PWG) and semantic word generation (SWG), and a regression-derived composite score (L-PVT) combining the three tests. This study cross-validated these PVTs in a rehabilitation sample. Method: The sample (N = 202) was 37% female with average age and education of 43.9 and 13.6 years, respectively. Participants completed BNT, PWG, SWG, and 3–9 separate PVTs. Participants were grouped by diagnosis: cerebrovascular (CVA; n = 51), mild TBI (MILD; n = 62), moderate-severe TBI (M-SEV; n = 54), and mixed rehabilitation (MIX; n = 24). Results: Seventeen percent of participants failed two or more separate PVTs with the following group rates: CVA (18%), MILD (23%), M-SEV (9%), and MIX (25%). Receiver operating characteristic curve analyses revealed the following area under the curve (AUC) values in the whole sample: BNT (AUC = .65), PWG (.71), SWG (.66) and L-PVT (.58). In a similar MILD versus M-SEV comparison as in the derivation study, the following AUC values were observed: BNT (.63), PWG (.73), SWG (.69) and L-PVT (.58). Within diagnostic groups, L-PVT showed the following classification accuracy values (sensitivity/specificity): CVA (11%/81%); MILD (7%/92%); M-SEV (50%/92%); MIX (17%/94%). Conclusion: A recently proposed composite PVT based on language scores showed adequate specificity in TBI and mixed rehabilitation participants, but elevated false positives in participants with stroke history. Compared to its components, the composite score showed relatively weaker classification accuracy in this sample. Further research appears needed to refine the composite score and cutoffs.
      PubDate: 2017-09-06
       
  • C-69 The Role of Cognition in Self-Advocacy in Adult Protective Services
           Cases
    • Authors: Lande E; Gauthier J, Stanley-Olson A, et al.
      Abstract: Objective: Adult Protective Services (APS) is a voluntary program that assists abused and neglected seniors and dependent adults. A major challenge for APS is determining the level of support clients need to improve health and safety, while still maintaining independence. Measures of cognitive skills and mood were examined to differentiate between APS clients who demonstrate self-advocacy and those who do not. Method: Participants wereAPS referrals (N = 142) evaluated regarding independent living capacity. Participants (82 women and 60 men) age 26 to 95 (M = 77.88 years) ranged in education from 0 to 20 years (M = 12.02 years). Measures of information processing, executive functioning, memory, language skills, functional skills, and mood were evaluated. Confirmation of self-advocacy was determined by a social worker using the Tool for Risk, Interventions, and Outcomes (TRIO), an observer checklist. Results: T-tests indicated no significant group differences in age or education. Statistically significant differences were found for: RIST Index (t(90) = 2.904, p = .005), TMT B (t(91) = 2.730, p = 0.008), NAB Comprehension (t(109) = 2.649, p = .009), NAB List Learning Immediate Recall (t(117) = 3.016, p = .003), NAB Story Learning Immediate Recall (t(107) = 2.630, p = .010), NAB Figure Delayed Recall (t(106) = 3.850, p = .000), ILS Health and Safety (t(109) = 3.452, p = .001), ILS Money Management (t(25.682) = 5.370, p = .000), (M = 31.49, SD = 13.814), and HADS Depression (t(32.498) = −3.780, p = .001). Conclusion: Performance on measures of functional skills, set-shifting, verbal comprehension, memory encoding, and depression differentiated between those who are and are not effective self advocates. Implications for clinical practice are discussed.
      PubDate: 2017-09-06
       
  • C-70 The Role of Neuropsychological Testing in Identifying Differing
           Levels of Impairment Between Self-neglect Versus Other-neglect or Abuse in
           Adult Protective Services Referrals
    • Authors: Stanley-Olson A; Gauthier J, Henderson L, et al.
      Abstract: Objective: To determine if measures of neuropsychological functioning differ between persons with self-neglect from other-neglect or abuse referrals. It was hypothesized that established measures of independent living ability and executive function would differentiate between individuals referred for self-neglect versus other-neglect or abuse. Method: Participants wereolder adults(60+ years) withoutprior cognitivediagnosis (N = 46) referred toAdult Protective Servicesforevaluationof cognitiveconcernsinthe contextofindependent living abilityordependent adultabuse. Participants (31 women and 15 men) age 64 to 95 (M = 82.52 years) ranged in education from 9 to 20 years (M = 13.15 years), and were selected based on receiving a final diagnosis of Major Neurocognitive Disorder. The Neuropsychological Assessment Battery (NAB) Figure Drawing and Trail Making Test are measures of executive function, requiring skills such as planning and organization, simple and complex processing speed, and set-switching. Confirmation of self-neglect versus other-neglect was determined by a social worker using the Tool for Risk, Interventions, and Outcomes (TRIO), an observer checklist. Results: T-tests indicated significant group difference (t(40) = 2.176, p = 0.036) on Trail Making Test B scores, with the self-neglect group (M = 24.41, SD = 9.16) showing greater impairment than other-neglect group (M = 31.53, SD = 11.82). No significant group differences on NAB Figure Drawing or independent living ability measures were found. The hypothesis was partially supported. Conclusion: Performance on Trail Making Test B is one indicator of self-neglect versus other-neglect or abuse among individuals diagnosed with dementia. Implications for clinical practice are discussed.
      PubDate: 2017-09-06
       
  • C-71 Sensitivity and Specificity of The Trail Making Test in a
           Spanish-speaking Population with Mild Cognitive Impairment
    • Authors: Beckman L; Zink D, San M, et al.
      Abstract: Objective: Information is lacking regarding the sensitivity and specificity of neuropsychological tests developed for English speaking populations in detecting brain damage when these tests are administered to Spanish speaking populations, English-based norms are used to interpret scores. The Trail Making Test (TMT) is a commonly used neuropsychological test in both English and Spanish speaking populations. The current study examined sensitivity and specificity of TMT performance administered in Spanish to Spanish-speakers with mild cognitive impairment (MCI). Method: The TMT was administered to individuals whose primary language was Spanish by a Spanish-speaking neuropsychologist with test instructions translated to Spanish. Participants included 53 individuals with MCI and 36 controls. The TMT was administered as part of a larger test battery for individuals referred for neuropsychological evaluation due to confirmed or suspected brain disorder. Results: Raw scores were converted to standard scores using Heaton and Tombaugh norms. Receiver operator characteristic analysis were then used to examine sensitivity, specificity, positive and negative predictive value of the TMT Part A and Part B to MCI. Results indicated that for the Heaton norms, area under the curve (AUC) was .65 for TMT part A and .60 for TMT Part B. Comparable AUC's for the Tombaugh norms were .69 and .62, respectively. Conclusion: Results indicate the Tombaugh norms tended to produce a standard score that had higher classification accuracy, although results are preliminary based on the limited sample size. Based on these findings, careful consideration should be given to the selection of norms when interpreting neuropsychological test scores of Spanish speaking individuals.
      PubDate: 2017-09-06
       
  • C-72 Wisconsin Card Sorting Test: Normative Data for a Pediatric
           Population in Spain
    • Authors: Benito S; Vergara-Moragues E, Ferrer-Cascales R, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Wisconsin Card Sorting Test (WCST) in a pediatric population from Spain. Method: 964 healthy children from Spain were evaluated. Inclusion criteria were an IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), a score of < 19 on the Children Depression Inventory, and T-score < 65 on the Revised Child Anxiety and Depression Scale. 50.8% were girls with an average age of 11.2 ± 3.36 years. The WCST Correct Categories, Perseveration errors and Total errors were normed using multiple linear regressions (MLR) and standard deviation of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: The final MLR models showed a main effect for age on all outcomes, such that score increased linearly as a function of age for correct categories (B = 0.224; p < 0.001) and decreased for perseveration errors and total errors (B = −1.333; p < 0.001). Age2 also had a significant effect on categories (B = −0.025; p < 0.001), perseveration errors and total errors (B = 0,142; p < 0.001). Children with MLPE > 12 years had higher correct categories (B = 0.344; p < 0.001) and lower Total errors (B = −1.707; p < 0.01). Sex had a significant effect on Total errors (B = 1.312;p < 0.01). The amount of variance explained ranged from 12.4%-21.9%. Conclusion: Older age, being a boy, and higher parents’ education levels were found to influence children's WCST scores and should be accounted for during interpretation of assessments with this test.
      PubDate: 2017-09-06
       
  • C-73 Symbol Digit Modalities Test: Normative Data for a Pediatric
           Population in Spain
    • Authors: Benito S; Sanchez-SanSegundo M, Ruiz-Gómez A, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Symbol Digit Modalities Test (SDMT) in a pediatric population from Spain. Method: The sample consisted of 964 healthy children from Spain were evaluated. Inclusion criteria were an IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), a score of <19 on the Children Depression Inventory, and T-score < 65 on the Revised Child Anxiety and Depression Scale. 50.8% were girls with an average age of 11.2±3.36 years. The SDMT scores were normed using multiple linear regressions (MLR) and standard deviation of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. The non-significant variables (p > 0.05) were removed and the model was run again. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: The final MLR model showed a main effect for age on SDMT, such that scores increased linearly as a function of age (B = 3.737; p < 0.001) and decreased with age2 (B = −0.236; p < 0.001). SDMT scores increased for children with MLPE >12 years (B = 1.900; p < 0.01). Sex was not a significant predictor. The amount of variance explained was 64.8%. Conclusion: Older age and higher parents’ education levels influence SDMT scores and ought to be taken into account when interpreting children's results on this test.
      PubDate: 2017-09-06
       
  • C-74 D2 Attention Test: Normative Data for a Pediatric Population in Spain
    • Authors: Benito S; Vergara-Moragues E, Albaladejo-Blazquez N, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the D2 Attention test in a pediatric population from Spain. Method: 964 healthy children from Spain were evaluated. Inclusion criteria were an IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), a score of <19 on the Children Depression Inventory, and T-score < 65 on the Revised Child Anxiety and Depression Scale. 50.8% were girls with an average age of 11.2 ± 3.36 years. The D2 scores for Total number of correct responses (CR), Omission errors (OE), Total performance (TP), Concentration performance (CP) and Fluctuation rate (FR) were normed using multiple linear regressions (MLR) and standard deviation of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: The final MLR models showed main effects for age on all D2 scores, such that scores increased linearly as a function of age (p's < 0.01). Age2 had significant effects on OE (B = 0.105;p < 0.01), TP and FR (p's < 0.05). Children with MLPE > 12 years had higher CR, TP, and CP scores (B = 9.400;p < 0.001) and lower OE scores (B = −2.028;p < 0.05). Sex had a significant effect on FR (B = −0.768;p < 0.05). The amount of variance explained ranged from 1.5%-60.5%. Conclusion: Higher parents’ education levels influenced four D2 Test outcomes, and older age impacted three. Sex also determines appropriate score on at least one outcome. Clinicians should be aware of the importance of these factors in assessment with this test.
      PubDate: 2017-09-06
       
  • C-75 Predictive Value of the Clock-in-the-Box in a Clinical Sample of
           Older Veterans
    • Authors: D'Orio V; Sabbah L, Grande L.
      Abstract: Objective: The Clock-in-the-Box (CIB) is a modified clock drawing task that has been shown to be a valid and reliable cognitive measure in community samples, yet the predictive utility of the CIB in the clinical VA setting is unknown. The current study evaluated the CIB in an outpatient VA sample. Method: Through retrospective chart review, data from 80 older veterans (age 60 + , M = 72.62, SD = 8.72; 98.8% male; 91.4% white; 23.5% with Major Neurocognitive Disorders, 34.6% Mild Neurocognitive Disorders, 14.8% rule-out diagnoses, and 25.9% no cognitive diagnosis) who underwent neuropsychological evaluation was analyzed using Pearson correlations, linear regressions, and t-tests. The CIB was compared to commonly administered clinical measures of learning/memory, attention/processing speed, visuospatial ability, and language. Results: CIB Total scores were significantly correlated with, and were significant predictors of, learning (r = .277,p < .05; β = .277, t(70) = 2.39,p < .05), list memory (r = .274,p < .05; β = .274,t(69) = 2.35,p < .05), immediate story memory (r = .399, p < .01; β = .399,t(51) = 3.07,p < .01), delayed story recall (r = .405,p < .01; β = .405,t(50) = 3.09,p < .01), figure copy (r = .459,p < .05; β = .459,t(23) = 2.43,p < .05), and visual attention/processing speed (r = −.355, < .01; β = .274,t(72) = 2.40,p < .05). Comparison of group means demonstrated significant differences in CIB overall scores for learning/memory difficulties (list: t(20) = 2.56,p < .05,t(68) = 2.19,p < .05, story: t(50) = 3.73,p < .01), significant difference in CIB-Planning/Organization subscale score for those with poor figure copy (t(19) = 5.48,p < .01) and list learning (t(65) = 2.62,p < .05), and significant difference in CIB-Working Memory subscale scores for those with lower visual attention/speeded processing (t(27) = 3.91,p < .01) and verbal memory (t(64) = 2.24,p < .05). Conclusion: Results suggest that the CIB may be useful in clinical neuropsychological evaluation of older veterans, and may be an easily administered screening measure for non-neuropsychological providers due to ease of use and predictions of performance in multiple cognitive domains.
      PubDate: 2017-09-06
       
  • C-76 Psychometric Evaluation of a New Brief Test of Social Cognitive
           Abilities (BTSCA)
    • Authors: Paul N; Zenisek R, Becker M, et al.
      Abstract: Objective: Despite extensive research on social cognition (SC) in many clinical populations, there is no currently available brief measure of SC that can be easily administered to such groups. The current study reports initial psychometric information on the Brief Test of Social Cognitive Abilities (BTSCA) which was designed to provide clinicians and researchers with a screening measure for SC deficits. Method: Participants included 65 normal participants (mean age = 25.4, SD = 10.3; female = 50.8%). The BTSCA was developed from tests used to assess SC, most of which are typically employed for research purposes. Based on our prior research, we selected items that are sensitive to SC deficits in schizophrenia, a disorder with well-characterized SC deficits. The BTSCA includes three SC domains: affect recognition, social perception and processing, and theory of mind. Results: Examination of skewness and kurtosis indicated that the BTCSA subtests scores were normally distributed. Correlations (Pearson) among subtests ranged from .01–.34, suggesting that the subtests assess distinct constructs. Subtest correlations with the total score ranged from .39–.65. Examination of means and standard deviations suggested items from the Reading the Mind in the Eyes were the most difficult, followed by Hinting, WAIS III Picture Arrangement, Facial Identification of Affect, and Situational Features Recognition. Conclusion: Initial results reveal promising psychometric properties for the BTSCA. Future research with larger samples and clinical populations are needed to address other psychometric aspects. Further investigations should also determine the BTSCA's clinical utility in identifying SC deficits and predicting functional outcomes.
      PubDate: 2017-09-06
       
  • C-77 Stroop Color-Word Interference Test: Normative Data for Colombian
           Children
    • Authors: Restrepo B; Díaz C, Quijano M, et al.
      Abstract: Objective: To generate normative data for the Stroop Color-Word Interference Test in a pediatric population from Colombia. Method: 1657 healthy children from nine cities in Colombia. Inclusion criteria were an IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), a score of <19 on the Children's Depression Inventory, and T-score < 65 on the Revised Child Anxiety and Depression Scale. 52.1% were girls with an average age of 11.4 ± 3.3 years (range 6–17). Stroop-Word, Color, and Word-Color scores were normed using multiple linear regressions (MLR) and standard deviation of residual values. Age, age2, sex, and mean level of parental education (MLPE) were included as predictors in the analyses. A four step analyses were used to generate norms 1) the predictive value was obtained using b-values of each model, 2) the residual value was obtained, 3) the residual value was standardized, and 4) tables of percentiles were calculated. Results: Three final MLR models showed main effects for age on all scores, such that scores increased linearly as a function of age (B's > 2.333; p's < 0.001). Age2 had a significant effect on Stroop-Word (B = −0.277; p < 0.001) and Stroop-Color (B = −0.107; p < 0.001) scores. Models for all scores showed that children with parents with a MLPE > 12 years of education obtained higher scores compared to children whose parents had MLPE = 12 years (B's>1.866; p's < 0.001). Models from Stroop-Color (B = 1.339; p < 0.05) and Stroop-Word-Color (B = 0.967; p < 0.05) scores showed main effect for sex. Conclusion: These norms provide neuropsychologists in Colombia a more accurate way to interpret Stroop Test scores when used in assessment of pediatric populations.
      PubDate: 2017-09-06
       
  • C-78 Rey-Osterrieth Complex Figure: Normative Data for Colombian Children
    • Authors: Restrepo B; Rivera D, Trujillo T, et al.
      Abstract: Objective: To generate demographic-adjusted norms for the Rey-Osterrieth Complex Figure (ROCF) in a pediatric population from Colombia. Method: The sample consisted of 1657 healthy children from nine cities in Colombia. Inclusion criteria were an IQ ≥ 80 on the Test of Non-Verbal Intelligence (TONI-2), a score of <19 on the Children's Depression Inventory, and T-score < 65 on the Revised Child Anxiety and Depression Scale. 52.1% were girls with an average age of 11.4 ± 3.3 years. Copy and immediate-recall scores were normed using multiple linear regressions (MLR) and standard deviation of residual values. Age, age2, sex, and the mean level of parental education (MLPE) were included as predictors in the analyses. To generate norms 1)-the predictive value was obtained using b-values of each model, 2)-the residual value was obtained, 3)-the residual value was standardized, and 4)-tables of percentiles were calculated. Results: Two final MLR models showed yielded main effects for age on copy and immediate-recall scores, so that scores increased linearly as a function of age (B's > 1.363; p's < 0.001). In addition, quadratic-age showed a significant effect in both scores (B's>−0.174; p's < 0.001). The immediate-recall model showed that children whose parents had a MLPE>12 years of education obtained higher scores compared to children whose parents have a MLPE = 12 years (B = 0.960; p < 0.01). Sex did not affect any of the outcome measures. The amount of variance explained in ROCF scores ranged from 30.4% to 41.1%. Conclusion: These norms will help neuropsychologist in Colombia to have a valid assessment tool that can be used in their everyday practice with pediatric populations.
      PubDate: 2017-09-06
       
  • C-79 Reliable Change on the RBANS: A Meta-Analysis
    • Authors: Saurman J; Gavett B, Duff K, et al.
      Abstract: Objective: Despite the frequent use of serial assessments in neuropsychology, adequate information to appropriately assess change on measures is often not available. This meta-analysis aimed to aggregate test-retest reliability data available from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Data Selection: A literature search of articles available between 1999 and October 2016 was performed using PubMed, PsycInfo, and Scopus databases to identify those that used a test-retest design and reported the correlation coefficient between RBANS scores at two time points. Studies included in this meta-analysis were not excluded on the basis of the participant sample characteristics. Data Synthesis: Ten studies met inclusion criteria. A multi-level linear random effects meta-analysis was conducted on RBANS Indexes. Pearson's r or the intra-class correlation (ICC) were quantitatively aggregated. The results revealed an aggregate test-retest reliability of 0.85 (SE = 0.02, 95% CI [0.80, 0.89]) for the RBANS Total Scale score, with individuals Indexes ranging from 0.67 (Language) to 0.82 (Attention). The length of the retest interval weakly moderated the aggregate test-retest reliability estimate (ranging from b = 0.0000 for the Immediate Memory Index to b = −0.0005 for the Attention Index). Conclusion: Of the studies examined, only the Total Scale and Attention Index possessed adequate test-retest reliability (i.e., > .80). The retest interval weakly affected these RBANS test-retest reliabilities. Despite its widespread use in serial assessments of cognition, clinicians should be aware of the relatively low reliability of the RBANS, which limits its ability to detect reliable change in an individual patient.
      PubDate: 2017-09-06
       
  • C-80 Construct Validity of Allen Cognitive Level Screen-5: Role of
           Executive Function
    • Authors: Schubmehl S; Barkin S, Cort D.
      Abstract: Objective: This study examined the convergent validity between the ACLS-5 (Allen Cognitive Lacing Screen-5) and measures of executive functioning, as well as the relationship between Allen Cognitive Level (ACL), level of nursing support required to complete activities of daily living (ADLs), and post-hospitalization discharge disposition, within samples of acute psychiatric inpatients. Method: Adult participants (n = 193) in the acute phase of psychiatric illness who demonstrated the capacity to provide informed consent were recruited from an inpatient psychiatric hospital in California. Exclusion criteria included inability to complete the assessment battery due to language, motor, vision, or hearing deficits. A subsample of 31 consecutive participants with acute psychotic disorders were administered three measures of executive function: Block Design subtest of the Wechsler Adult Intelligence Scale-Fourth Edition, a measure of visuospatial construction; Trail Making Test A and B, measures of motor processing speed and set shifting; and the Controlled Word Association Test, a measure of phonemic fluency. Results: Findings indicated significant moderate positive correlations between ACL and motor processing speed r(29) = .46, p < .01, set shifting r(29) = .45, p < .05, and phonemic fluency r(29) = .47, p < .01, and a nonsignificant relationship with visuospatial construction. There was no significant correlation between ACL and either ADL performance or post-hospitalization discharge disposition. Conclusion: In contrast with prior research, there was no significant correlation between ACL and level of nursing assistance required to complete ADLs, and ACL was not a contributing factor to post-hospitalization discharge disposition. These findings call into question the clinical utility of the ACLS-5 as an assessment of functional cognition for those experiencing acute psychosis.
      PubDate: 2017-09-06
       
  • C-81 Validation of the Poreh Nonverbal Memory Test in a Sample of Epilepsy
           Patients
    • Authors: Tolfo S; Krivenko A, Poreh A.
      Abstract: Objective: The Poreh Nonverbal Memory Test (PNMT), a novel nonverbal memory assessment, has been previously validated with various populations. However, this measure has never been validated against other widely used nonverbal and verbal measures. The present study examined this new measure with the Rey Auditory Verbal Learning Test (RAVLT) and the Rey-Osterrieth Complex Figure (ROCF) on a heterogenous sample of patients with epilepsy. Method/Results: Results from this study shows that the PNMT differentially correlated with existing memory measures. Namely, the PNMT learning scores significantly correlated with delay scores; 3 min delay, r = −0.566, p < 0.05; and 20 min delay, r = −0.637, p < 0.01, while PNMT delay scores significantly correlated with ROCF immediate, r = −0.560, p < 0.05, and delay scores; 3 min Delay, r = −0.771, p < 0.001; and 20 min delay, r = −0.842, p < 0.001. However, the PNMT learning score did not correlate with the Rey Auditory Verbal Learning Test (RAVLT) learning or delay scores. Both the PNMT and RAVLT learning trials produced robust log learning curves (R2 = 0.9676 and R2 = 0.9478). When controlling for gender, education, and ethnicity confounds, results show PNMT delay significantly correlates with location of epilepsy (right, left, and bilateral), r = 0.820, p < 0.05. In addition, RAVLT delay trial correlates with location, r = −0.731, p < 0.05. When examining global versus local features of the ROCF, ROCF Copy Global features significantly correlates with location of epilepsy, r = 0.693, p < 0.05. Unfortunately, sensitivity and specificity analyses were not able to be detected based on the self-report localization of the patient's seizures. Conclusion: Some limitations include age, gender, education, and ethnicity confounds, lack of access to medical charts to determine right, left, or bilateral epilepsy, and the small sample size. Overall, the PNMT provides an alternate method for nonverbal assessment and is able to differentiate between right and left hemispheric damage, similarly to the ROCF.
      PubDate: 2017-09-06
       
  • C-82 Neuropsychological Assessment Validity with Multifaceted Impairment:
           A Systematic Review
    • Authors: Vogler M; Lennon J, Sytsma B.
      Abstract: Objective: Neuropsychological assessments strive to remain objective and rely on a multifaceted approach to completing specific tasks, which impacts the level of measured cognitive impairment. We aimed to examine the degree to which impairments in specific domains are potentiated by multifaceted impairments, which impacts the validity of test measures and subsequent diagnoses. This review offers insight into the validity of neuropsychological assessment with standalone measures with suggestions for future research. Data Selection: Literature search included Medline, psychINFO, and PubMed databases using the following keywords: Mild/Moderate Neurocognitive Disorder (NCD), dementia, visuospatial, memory, attention, validity, neuropsychology, assessment. Inclusion criteria employed from articles within past ten years: 1) participants had formal diagnosis of a NCD, 2) participants had formal and complete neuropsychological assessment prior to diagnosis, 3) assessments included at least one measure in each domain of functioning. Data Synthesis: Preliminary results suggest specific domains, such as visuospatial functioning, are impacted to a significantly greater degree when impairments in other domains exist. It is unclear whether visuospatial deficits are independent or a byproduct of pre-existing impairments. Conclusion: Neuropsychological assessment validity relating to multifaceted impairment poses a clinical detriment to accurate diagnosis and treatment of specialized populations. These findings illuminate concerns regarding validity of neuropsychological results, as well as the understanding of true visuospatial, memory, and attention deficits independent of concomitant impairments, which in some cases are viewed as pathognomonic of specific disorders. Future research should address specificity in standalone neuropsychological measures when other domains are impaired, while still obtaining sufficient functional data with strong batteries for proper diagnoses.
      PubDate: 2017-09-06
       
  • Improving the Quality of Clinical Neuropsychological Research: Mandatory
           Use of Reporting Guidelines
    • Authors: Lee GP; Schoenberg MR.
      PubDate: 2017-09-06
       
  • C-06 Category and Action Verbal Fluency Test: Normative Data for Basque
           People
    • Authors: Olabarrieta-Landa L; Rivera D, Benito S, et al.
      Abstract: Objective: To develop age, education and sex adjusted norms for the Category and Action Verbal Fluency Test (VFT) in a group of Basque people. Method: The sample consisted of 139 adults from Basque country and Navarre, Spain. All participants were fluent in Basque and Spanish, between 18 and 75 years old who completed primary school. Additional inclusion criteria included: a score of ≥27 on the Mini-Mental State Examination and a score of ≤4 on Patient Health Questionnaire-9. Sixty percent were women, the average age was 45.57 ± 18.9 years, and the average education was 13.7 ± 13.6 years. Participants completed the category (animals, fruits, professions) and action VFT in Basque. Results: The regression models included age, age2, education, and sex as predictor variables, and the scores of Category and Action VFT as single dependent variable in each model. Multiple linear regression (MLR) for Animals category showed effects for education (b = 2.291; p = .002), age (b = −.068; p = .001), and age2 (b = −.006; p < .001). MLR for Fruits category showed effects for sex (b = −1.428; p = .005), and age2 (b=−.003; p < .001). MLR for Professions category showed effects for education (b = 2.461; p < .001), and age2 (b = −.004; p=.001). MLR for Action VFT showed effects for education (b=5.192; p < .001), and age2 (b = −.096; p = .002). To generate adjusted norms, the predictive value was obtained using b-values of each regression model, the residual value was obtained and standardized, and tables of percentiles were calculated. Conclusion: This is the first study to develop norms for the category and action VFT in Basque, which may advance the accurate neuropsychological assessment of Basque speakers.
      PubDate: 2017-09-05
       
  • C-07 Performance Differences Between Monolingual Spanish-speakers and
           Bilingual Basques and Catalans on Three Verbal Fluency Tests
    • Authors: Olabarrieta-Landa L; Ramos U, Gailhajanet A, et al.
      Abstract: Objective: To compare the performance of a group of monolinguals (MO) Spanish speakers, Basque bilinguals (BI) and Catalan BI on letter, category, and action verbal fluency tests. Method: 89 MO, 139 Basque BI, and 132 Catalan BI completed a self-reported sociodemographic and language competence questionnaire. Then they were administered the Boston Naming Test and three verbal fluency test (letter, category, and action fluencies) in Spanish. MO group was older than the Basque BI, with lower educational level and scores in different language skills and vocabulary than to the two BI groups. Results: A MANCOVA revealed significant differences between the three groups ((p < .001). Although no significant differences were found for the letters S, B, or professions category tests (p's > .05), MO scored significantly higher than the two BI groups on the letter A (p < .05) and fruit category (p < .01). There were no significant differences between MO and Basque BI in the letters F, M, R, P, E, and animals’ category (p's < .05). Catalan BI generated significantly fewer words than these two groups in letters F, M and R (p's < .05). Moreover, Catalan BI scored significantly lower than Basque BI on the letter E and action verbal fluency tests (p's < .05). Conclusion: Bilingualism should be taken into account in the assessment of VF, since it may influence test performance. The low scores of Catalan BI in comparison to the MO and the Basque BI might be explained by greater interference of the competing language on the task, because Spanish and Catalan languages are more similar or closer than Spanish and Basque languages.
      PubDate: 2017-09-05
       
 
 
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