bluuebunny/crossref_metadata_2025 huggingface dataset:
A-134 Agile Development of Virtual Reality Treatment for Spatial Neglect: Preliminary Usability and Feasibility
Authors: Chen Peii , Krch Denise , Shekhtman Grigoriy
Published: August 2021

Objective

Examine the usability and feasibility of a virtual reality (VR) treatment for persons with spatial neglect using head mounted display (HMD) and hand tracking technologies.

Method

Recruited from a rehabilitation hospital, 9 stroke survivors with spatial neglect (3 females; mean age = 64.2 years, SD = 9.1; 8 left neglect) participated in user testing for ongoing software development. Participants tested one of four customized treatment modules and completed the System Usability Scale, the Presence Questionnaire, and the Simulator Sickness Questionnaire. Feedback from participants were integrated into iterative prototype revisions. Module 1 (n = 7) required arm movements gradually reaching toward the neglected side of space, while the virtual hand appeared reaching straight ahead. Module 2 (n = 4) required head movements from the non-neglected to the neglected side. Module 3 (n = 6) involved head and arm movements towards both sides of space to collect objects. Module 4 (n = 2) was to stop approaching objects from a distance ahead.

Results

Despite reporting a lack of realism, participants preferred VR over conventional therapy. Participants felt comfortable and confident engaging in the virtual environment. Module 4 was more difficult than the other modules as participants required more practice to perform the task. Two participants reported Module 3 being tiresome, with one reporting mild shoulder pain and eye strain, and moderate sweating. However, all reported symptoms were temporary and resolved following a short break.

Conclusion

VR-based rehabilitation for spatial neglect using HMD and hand tracking technologies may be a viable treatment option for stroke survivors with spatial neglect. The modules benefited substantively from modifications based on participants’ feedback.
A-135 Telehealth Motivationally Enhanced Compensatory Cognitive Training for Older Veterans with Cognitive Complaints: A Pilot Study
Authors: Zilberfayn Irina , Marceaux Janice C , McPherron Jesse A
Published: August 2021

Objective

This study evaluated the effectiveness of Motivationally Enhanced Compensatory Cognitive Training (ME-CCT), conducted via telehealth. Cognitive performance, self-reported functioning, and activity engagement were expected to improve following participation. Compensatory strategy use was projected to predict posttest memory performance.

Method

Data from VA electronic medical records was obtained for five veterans (80% male; ages 68–84) who completed an 8-week ME-CCT protocol via telehealth. All completed pre/post neuropsychological screening (RBANS subtests, Oral TMT-B [O-TMT-B]) and self-report measures (PHQ-9, GAD-7, WHODAS, Multifactorial Memory Questionnaire [MMQ]). All had cognitive complaints but no cognitive disorder. Wilcoxon signed-rank test compared pretest-posttest scores. Hierarchical linear regression examined whether strategy use was predictive of posttest memory scores, controlling for age and pretest scores.

Results

O-TMT-B time (Z = -1.75, p = 0.040, r = −0.78) and errors (Z = -1.73; p = 0.042, r = −0.77) improved significantly, but not semantic fluency (p = 0.358). Immediate (p = 0.055) and Delayed Memory (p = 0.447) did not change. MMQ-Strategy increased (Z = -1.826; p = 0.034, r = −0.82). MMQ-Abilities (p = 0.055, r = −0.82) and MMQ-Satisfaction (p = 0.143 r = −0.48,) did not differ but showed a moderate to large effect. PHQ-9 was lower (Z = -1.841, p = 0.033, r = −0.82); there was a non-significant but large effect on GAD-7 (Z = -1.414, p = 0.079, r = −0.63). WHODAS-Total did not differ (p = 0.231). Use of strategies did not predict Immediate (p = 0.669) or Delayed (p = 0.631) Memory scores.

Conclusions

Preliminary findings support the use of the ME-CCT protocol with older adults via telehealth, as results suggest possible improvement in aspects of cognition, greater use of strategies, and reductions in mood-related symptoms. Further research with a larger sample is needed to replicate the results and further explore possible outcomes following ME-CCT.
A-138 The Correlation between Inattentiveness and Depression in an Adult Population Sample
Authors: Kajani Nisha , Rifai Lara , Kotalik Kayla , Ailes Erica , Lashley Lisa , Golden Charles J
Published: August 2021

Objective

To test if there is a correlation between the inattentive domain of the Conners Continuous Performance Task 3rd Edition (CPT-3) and depression scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2).

Method

Adult mixed psychiatric clinical sample was derived from a large de-identified database through a SPSS descriptive statistics analysis. Participants (n = 256) were a diverse distribution of race (62.1%Caucasian,16%Latinx,12.9%African American, and 9%Other), gender (60.5%female, 39.5%male), age (27.25-years average), and education (16-years average). Each participant was administered the Conners CPT-3 to evaluate the inattentive domain which consisted of Detectability, Omissions, Commission, Hit-Reaction-Time (HRT), HRT-Standard-Deviation, and Variability; and the MMPI-2. A bivariate correlation was run to determine significance.

Results

The CPT-3 and MMPI-2 were correlated at p < 0.01 significantly on Variability with the K-Scale (r = −1.69) and VRIN-Scale (r = 0.177). They were correlated at p < 0.05 significantly on Variability with the TRIN-Scale (r = 0.126) and 2-Scale (r = 0.152); on HRT-Std-Dev with the TRIN-Scale (r = 0.127) and 1-Scale (r = 0.128); on Omissions with the VRIN-Scale (r = 0.151) and 9-Scale (r==0.126); and on Commissions with the 7-Scale (r = −0.124) and 8-Scale (r = −0.124).

Conclusion

Mitchell et al. (2013) conducted a study to assess the relationship between ADHD and negative automatic thoughts associated with depression in adults which found that inattentive ADHD significantly associated with negative automatic thoughts. Although the current analysis found some correlation between the measures, there was a lack of significant correlation between inattentiveness and depression. These findings are important as they contradict a criteria for depression. Further research is needed to understand the dynamic between the two measures.
A-144 Impairment of Attention in Persons with Post Traumatic Stress Disorder by Neuropsychology Assessments and Rehabilitation Training Course
Authors: Almoula Oroub , Almutairi Ahmad , Alozairi Abdullah , Coetzer Rudi , Bracewell Martyn
Published: August 2021

Objective

Scholars consider Mindfulness to develop a person’s capacity for awareness of self and others. This approach can also be used in Neuropsychological counselling. Recent research studies have shown that mindfulness has a positive impact on cognitive performance, attention and emotion regulation. This study aimed to examining a possible difference in attention trained between twenty PTSD Syrian’s refugees who were using the mindfulness programme for two weeks and those who trained Cognitive behavioural therapy course. This study was also intended to translate some widely used tests in neuropsychological assessments, and determining the potential efficiency of Mindfulness-based cognitive therapy as a rehabilitation course for these clinical populations. Two separate three-way mixed ANOVA models (Within-Within-Between) were performed to assess if the Stroop effect and Stroop R effect differ between the three Stroop scenarios (within-Subjects effect: Control – Practice – Main test) and Conditions (within-Subjects effect: Congruent – Incongruent) when two different separate treatments were applied to twenty Syrian’s refugees participants (Between-Subjects main effect: Mindfulness vs Cognitive behavioural therapy, there were also applied other attention measures such as; Trail Making test, Coding and Symbol search from WIAS-IV. For Stroop R model 2 we identified a significant within-subjects main effect of Stroop (F (2, 36) = 8.248, p = 0.002, partial-eta = 0.295). There was a significant within-subjects main effect of Conditions indicating a significant difference between congruent and incongruent treatment. Also, there was a significant two-way interaction effect of Stroop and Condition. Refugees participants reveal significantly differences for Coding, Trail numbers and Trail Numbers and Letters.
A-149 Demographic Correlates of a Short-Form Test of Executive Functioning
Authors: Horton Arthur M , Reynolds Cecil
Published: August 2021

Objective

This poster explores demographic correlates of a recently developed Short-Form Test of Executive Functioning.

Method

Subjects were 23 adults referred by neurologists and psychiatrist for neuropsychological testing to a private practice. All subjects signed informed consent documents. Subjects included 12 males and 11 females, 20 subjects were Caucasians and 3 were African-Americans, 22 were right handed. The subjects’ ages ranged from 20 to 74 (M-52.04, SD-14.87) and the subjects education levels ranged from 10–20 (M-15.87, SD-3.45). Diagnoses included Stroke-12, Traumatic Brain Injury-6, Alzheimer’s disease-2, Multiple Sclerosis-1, Parkinson’s disease-1 and Epilepsy-1. All subjects were administered neuropsychological testing including the Short-Form Test of Executive Functioning (SF-TEF) The Sf-TEF is composed of 3 card sorting subtests of the Test of Verbal and Conceptual Fluency (TVCF) but rather than administering 116 cards only 58 are administered and full scales scores prorated to save time. The scales are Number Correct, Perseveration Errors and Number of Categories. The 3 short form subjects were each correlated with the subjects age and education variables.

Results

The correlations between the Number Correct, Perseveration Errors and Number of Categories scores and age scores were 0.247, 0.01, and 0.08 and correlations between the Number Correct, Perseveration Errors and Number of Categories scores and education levels were 0.21, 0.273 and 0.12 which were all non-significant at the P < 0.05 level of statistical significance.

Conclusions

These results suggest that the scores of the Number Correct, Perseveration Errors and Number of Categories subtests were not unduly influenced by the subjects’ age and education.
A-155 The Relationship between Parent-Reported Inattention Symptoms and Intra-Individual Variability in Neuropsychological Performance in Male Children and Adolescents
Authors: Rosenberg Raquel , Nash Allison , Friedhoff Claire , Paxton Jessica
Published: August 2021

Objective

While previous research has demonstrated that males show greater intra-individual variability (IIV) in neuropsychological performance than females (Roalf et al., 2014), previous studies have not investigated how IIV relates to psychological factors in each gender. This study examined the relationship between psychological symptoms (i.e., depression, anxiety and inattention) and IIV in male and female pediatric samples.

Method

Participants included 135 male and 210 female individuals between the ages of 6 and 17 from Nathan Kline Institute’s Rockland Project. Participants endorsing a medical diagnosis associated with cognitive impairment (e.g., brain injury; n = 19) were excluded. The four psychological variables included T-scores from the Children’s Depression Inventory (CDI) total to measure depression, the Multidimensional Anxiety Scale for Children (MASC) to measure anxiety, Conners ADHD Rating Scale - Parent to measure parent-ratings of inattention, and the Conners ADHD Rating Scale – Youth to measure self-rated inattention. IIV scores for accuracy were calculated from 10 subtests from the Penn Computerized Neurocognitive Battery.

Results

In male participants, a regression analysis predicting IIV accuracy scores revealed that the four psychological variables together accounted for 7% of the variance in IIV accuracy scores. Conners Parent Inattention T-scores significantly predicted IIV accuracy scores in males (β = 0.19, p 0.16). In an analogous regression analysis with female participants, psychological symptoms did not significantly predict IIV accuracy scores.

Conclusions

Results indicated that inattention reported by parents predicted IIV accuracy for male children and adolescents in a community sample.
A-161 Swiping Left on External Reminders, Internal Monitoring, and Recollections: Level of Importance Predicts Greater Likelihood of Prospective Memory Success during Smartphone Use
Authors: Cooke Holly E , Jacova Claudia
Published: August 2021

Objective

This study aimed to understand the implications that smartphones have for prospective memory (PM) performance. We examined normal adults’ performance on an event-based PM task embedded in an online survey, and its relationship with the PM strategies used prior to the PM cue.

Method

Participants included 349 individuals aged >18— (M = 38.31; SD = 11.15); 62% male; non-Hispanic (83.38%); with education = HS diploma or less (8.31%), some college (12.61%), and college degree (79.08%)—recruited through Amazon Mechanical Turk. Participants completed the survey on their smartphones. The PM task required participants to respond “N/A” to a question presented later in the survey. Follow-up questions were asked about the use of external reminders, internal monitoring, recollections, and level of importance participants attributed to the PM task.

Results

One third of participants were successful on the PM task. Of those who had PM success, 11.50% used external reminders, 53.10% used internal monitoring strategies, 62.83% had recollections, and 95.56% considered the task at least somewhat important to remember. Logistic regression revealed that non-Hispanic ethnicity, ≤ high school education, and high perceived importance predicted PM success (Table 1). Interestingly, 40% of individuals with PM failure used external reminders, showing a significant negative relationship with PM success.

Conclusions

We found that external reminders, internal monitoring, and recollections may make PM success less likely during smartphone use—strategies which were associated with PM success in previous research. Only perceived importance predicted PM success, akin to previous findings. Implications reveal that smartphones may change the demands of PM tasks.
A-162 Neuropsychiatric Elevations in Epilepsy Patients with and without Severe Memory Impairment
Authors: Strebler Pelin , Funk Brent
Published: August 2021

Objective

Severe memory impairment in epilepsy is associated with increased difficulties in daily living that extend beyond the limitations of having seizure disorder and create greater emotional burden. Accordingly, the current study explored psychopathological differences between epilepsy patients with and without severe memory impairment.

Method

This retrospective chart review study included 78 adults with epilepsy who underwentneuropsychological testing in a hospital setting. Most participants (78%) had temporallobe epilepsy. Study measures included Word Memory Test (WMT), cognitive measures, and self-report Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Genuine Memory Impairment Profile (GMIP) on the WMT was used as an indicator of severe memorydeficit.

Results

GMIP group had 30 participants and significantly higher number of males (Χ 2 (1) = 4.929, p = 0.03). Significantly lower performances in overall cognitive functioning and memory functioning were seenin the GMIP group. As expected, the GMIP group had increased mean scores across on all MMPI-2-RF higher order scales and majority of Specific Problem Scales, however only Substance Abuse Scale showed a statistically significant difference (t(76) = −1.96, p = 0.05).

Conclusions

Those with severe memory impairment showed a non-significant tendency to obtain higher scoreson most indices of psychopathology and a significantly higher elevation concerning substance abuseproblems. Those with severe memory decline may have increased risk for substance abuse problemsthat can be associated with reduced treatment effectiveness and provoke seizures due to either acuteneurotoxicity or withdrawal. Additional studies with larger samples are needed to characterizesubstance abuse problems in epilepsy patients with severe memory decline.
A-164 The Role of Working Memory in Reading Abilities
Authors: Arias Brittny , Goulart William , Gestido Samantha , Peart Zachary , Sydow D'anna , Golden Charles
Published: August 2021

Objective

To determine the extent to which memory can predict reading abilities after controlling for gender, age, and education.

Method

The participants were drawn from a de-identified adult clinical database. Two hierarchical multiple regressions (n = 246, Mage = 33.5, Medu = 13.8, 56% Caucasian, 58% Female) tested the ability of the Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Working Memory Index (WMI) Score, and the Weschler Memory Scale Fourth Edition (WMS-IV) Visual Working Memory Index (VWMI) Score to predict reading abilities on the Nelson Denny Reading Test (NDRT) Vocabulary and Comprehension Standard Scores after controlling for the effects of gender, age, and education.

Results

In both regressions, gender, age, and education were entered in step 1 and WMI and VWMI were entered in step 2. In analysis of Vocabulary, step 1 explained 8% of variance; after step 2 the model explained 21% of variance F (5, 240) =12.98, p < 0.001. WMI and VWMI scores explained 12% of variance after control variables, In analysis of Comprehension, step 1 accounted for 0.3% of variance; after step 2, the model explained 12% of the variance F (5, 240) = 6.54, p < 0.001.

Conclusion

WMI and VWMI contributed unique variance to Vocabulary (12%) and Comprehension (12%). This suggests that memory is an important predictor of reading abilities. Additionally, education becomes a significant factor when predicting Comprehension. This may suggest that education may mediate the relationship between memory and reading abilities. The results indicate the vital role memory plays to carry out processing and storage functions while reading.
A-177 Classification Statistics of the Clinical Assessment of Attention Deficit – Adult (CAT-A) Negative Impression Scale for ADHD Evaluations in an Active Duty Sample
Authors: Grills Chad , Cooper Douglas B , Yamashita Jennifer M , Armistead-Jehle Patrick
Published: August 2021

Objective

To evaluate the classification statistics of the Clinical Assessment of Attention Deficit – Adult (CAT-A) Negative Impression (NI) scale, relative to the MMPI-2-RF in an active duty military sample. We hypothesized that MMPI-2-RF RBS would have the largest AUC.

Method

Retrospective review of 108 active duty service members consecutively referred to neuropsychology for clinical ADHD evaluations in a Midwest Army Health Center. Cases with missing data (10) and failures of MMPI-2-RF response consistency scales (3) were removed from analysis, resulting in final sample of 95. Average age was 32.62 (SD = 8.87) and average education was 14.66 (SD = 2.66). MMPI-2-RF symptom validity scales (F-r, Fp-r, Fs, FBS-r, and RBS) were employed as criterion measures at all standard cut-offs to evaluate the CAT-A NI scale.

Results

ROC analyses for the MMPI-2-RF over-reporting symptom validity scales ranged from 0.599 to 0.808, with the MMPI-2-RF RBS scale >79 demonstrating the lowest AUC (0.599; p 52. With specificity held at or above 0.90, sensitivities ranged from 22.86 to 60.00, with positive and negative predictive values ranging from 11.1 to 58.8 and 66.7 to 98.8, respectively.

Conclusions

The CAT-A NI scale demonstrated reasonable AUC values for nearly all MMPI-2-RF over-reporting scales. Psychologically-based over-reporting scales were superior to cognitively-based over-reporting scales in terms of classification statistics. The optimal cut in the current data (>52) is slightly higher (though roughly commensurate) to the cut score for atypical responses in the CAT-A manual (>45).
A-2 Mean Arterial Pressure Effects on Hippocampal Volume by Alzheimer’s Disease Risk
Authors: Sarles-Whittlesey Heidi , Sweet Lawrence
Published: August 2021

Objective

Extant literature demonstrates increased risk of Alzheimer’s Disease (ad) and hippocampal degeneration with hypertension. Less is known about blood pressure (BP) and APOE4 effects, and their interaction on hippocampal volume. We hypothesized that the effects of elevated mean arterial pressure (MAP) on hippocampal volume would be stronger among those with at least one APOE4 allele. We further hypothesized that MAP effects would be stronger in an ad group than either mild cognitive impairment (MCI) or control groups, and stronger in MCI than controls.

Methods

Participants (N = 965; 46.4% female; 92.9% White; 56.7% MCI, 18.3% ad) were selected from the ad Neuroimaging Initiative database. Inclusion criteria: complete demographics, diagnostic evaluation, APOE genotyping (46.6.% APOE4 positive), BP measurements (mean MAP = 94.55mmg3 (SD = 10.41)), and MRI. Hippocampal volume was quantified using FreeSurfer 5.3 (bilateral mean = 6844.51 mm3 (SD = 1191.68)). The sample age was 72.84 (SD = 7.55) with 16.02 (SD = 2.77) years of education on average.

Results

Although MAP and APOE4 each significantly accounted for variance in bilateral and each hippocampal volume using a hierarchical multiple quadratic regression, the interaction of MAP and APOE4 did not (see Table). Similarly, while MAP and diagnostic group were each found to significantly account for variance in hippocampal volumes, their interactions did not.

Conclusions

Results are consistent with previous findings that higher BP negatively impacts hippocampal volume. However, interaction hypotheses were not supported. Therefore, APOE4 and MAP may represent independent mechanisms in ad pathology. However, antihypertensive medication effects, which may mitigate hippocampal atrophy, were not assessed. Future investigations might control medication effects and investigate homogenous versus heterogeneous APOE variants.
A-182 Development of a PTSD-Specific Embedded Validity Measure in the Personality Assessment Inventory
Authors: Myers Melissa A , Basu Natasha , Harrell Murphy N , Pizer Jasmin H , Hawley Nanako A , Aita Stephen L , Calamia Matthew , Hill Benjamin D
Published: August 2021

Objective/Background

The present study investigated the feasibility of developing a PTSD-specific malingering scale embedded within the Personality Assessment Inventory (PAI).

Methods

Participants consisted of 489 individuals [mean age = 20.0 (SD = 3.29); 71% female; 73.0% Caucasian, 17.6% African American, 3.5%, 9.4% Other] who completed PAI. 274 individuals were in the control group and instructed to answer normally while 215 were instructed to simulate PTSD with intent to successfully feign PTSD in the context of a legal case. The following were identified as candidate PAI subscales for logistic regression to identify feigned PTSD: ARD-T, BOR-A, SCZ-T, ANX-P, and DEP-P.

Results

Logistic regression analysis was performed with known group as the dependent variable and PAI subtest normed T-scores as predictor variables. The final full model of five predictor variables significantly predicted group status (χ2 = 384.9, df = 5, N = 489, p < 0.001). The model accounted for 54.5% to 73.0% of the variance (Cox and Snell R2 = 0.545; Nagelkerke R2 = 0.730) in performance classification with overall 89.4% of individuals correctly predicted to their known group. At a cut value of 0.65 the specificity was 94.9%, and the sensitivity was 82.3%. Within the model, the following variables were incrementally predictive of group membership: ARD-T (B = 0.05, p < 0.001), BOR-A (B = 0.04, p < 0.05), and ANX-P (B = 0.04, p < 0.05).

Conclusions

Preliminary evidence for use of an embedded PAI malingering scale within the PAI was found. Further replication is needed in clinical populations prior to use in practice.
A-188 Starting Well: Creating Training Opportunities for Graduate Students Interested in Neuropsychological Assessment
Authors: Safi Diomaris , Miranda Albert , Sylva David M
Published: August 2021

Objective

Practicum experiences are critical to internship readiness. While established guidelines for practicum training in clinical neuropsychology exist, the application of such guidelines across training sites has received little attention. The objective of this study is to compare practicum training models across different sites.

Methods

We surveyed training supervisors regarding the cost and benefit of training practicum students in their setting.

Results

Despite wide variability across settings, results indicated that on average, practicum sites spent around 6 hours per week in direct active training and onboarding during the first 1–3 months of the training year. After 3–4 months, the hours spent on supervision decreased to about 1–2 hours of individual supervision and 1–2 hours of group supervision per week. By the 8th month, each practicum student provided the clinic with approximately 36 hours of direct service (considered an administrative benefit to the clinic).

Conclusion

Training practicum students is a labor of love, with overall net administrative benefits to the clinic. An advantage was seen in settings with multiple trainees, trainees at multiple levels, and tiered supervision models with access to diverse didactic experiences.
A-190 An Examination of the Equivalence of the in-Person and Remote Administration of the Feifer Assessment of Reading Screening Form
Authors: Morera Carrie Champ , Carrillo Alicia , Feifer Steven G
Published: August 2021

Objective

As psychologists rely more on technology while navigating the digital world, we must adapt existing assessment tools. In response to this need, a process was designed for conducting remote administration of the Feifer Assessment of Reading Screening Form (FAR Screening Form; Feifer, 2015), which was designed to identify children “at risk” for developmental dyslexia. Our current study evaluates the equivalence between remote, online administration and in-person administration of the FAR Screening Form.

Method

This is a paired case control study in which 70 participants were administered the FAR Screening Form in an online, remote format, following a specific procedure to retain the validity of scores. These individuals were matched based on age, sex, education, and race with participants from the standardization sample of the FAR Screening Form.

Results

Independent-samples t-tests were conducted, and determined no significant effect of administration format for scores on the Phonemic Awareness (PA) and Semantic Concepts (SC) subtests, as well as the overall FAR Screening Index. Rapid Automatic Naming (RAN), a speeded subtest, showed a significant effect for administration format. Due to this effect, a new FAR Remote Screening Index (SRI) was created that includes only the PA and SC subtests. The SRI has demonstrated reliability and validity consistent with the FAR Screening Index.

Conclusions

The present study suggests that remote and in-person administrations of the PA and SC subtests of the FAR Screening Form are generally equivalent. During remote administration, it’s not recommended to use the RAN subtest; the SRI should be used to derive the screening index score.
A-196 The Texas Postconcussion Symptom Inventory (TPSI): An Exploratory Factor Analysis and Reliability Analysis
Authors: Longoria Anthony J , Mokhtari Ben K , Meredith-Duliba Tawny , Hershberger Mary A , Champagne Patricia , Hart John , Cullum Munro , LoBue Christian
Published: August 2021

Objective

Self-report scales are commonly used to evaluate non-specific symptoms following concussion. While several scales have been developed, few were created using a systematic process and most contain several ambiguous items that may be misinterpreted. To address this, a new theoretically-based, multidimensional measure was designed to assess Cognitive, Neuropsychiatric, and Somatic symptoms associated with concussion. This study used sophisticated psychometric techniques to develop the Texas Postconcussion Symptom Inventory (TPSI) and establish initial reliability and validity.

Method

Because concussion symptoms are non-specific, a pool of 76 potential items was developed and administered to a diverse clinical sample (N = 350) that included patients with concussion, epilepsy, and dementia. Polychoric correlations were utilized to remove items based on poor fit/multicollinearity and an exploratory factor analysis (EFA) with an Oblimin rotation was used to determine factor structure.

Results

A three-factor model best fit the data, and represented Cognitive, Neuropsychiatric, and Somatic domains as designed. Ten items were discarded, resulting in a total of 66 items. The model explained 48.5% of the total variance and contained adequate sampling (Kaiser-Meyer-Olkin measure =0.92) and sufficient item correlations (Bartlett’s Test of Sphericity, p < 0.05) for EFA. All three factor structures displayed high internal consistency (Cronbach’s α > 0.88).

Conclusions

The TPSI is a brief, multidimensional measure with evidence of strong internal consistency and reliability as well as distinct Cognitive, Neuropsychiatric, and Somatic symptoms associated with concussion. Future research will investigate its convergent and divergent validity in concussion as compared to existing popular symptom measures.
A-7 Discriminating between Mild Cognitive Impairment and Alzheimer’s Disease on the MoCA
Authors: McDonald Taylor , Marker Craig D , Ratcliffe Lauren
Published: August 2021

Objective

The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between MCI and Alzheimer’s disease (ad) on MoCA subtest scores. Specifically, impaired performance on the clock drawing (i.e., number and hand placement), rhino naming, serial 7’s, word recall, and orientation were suggestive of ad. The aim of the present study is to assess for discrimination patterns in MoCA performance between MCI and ad.Method: Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) and ad groups (n = 1339; 56% female, 89% White, 9% Black, 2% Asian/Pacific Islander) were examined.

Results

An initial independent t-test revealed a statistically significant difference in MoCA scores for MCI (M = 22.01, SD = 3.49) and ad (M = 14.46, SD = 6.05; t(2480) = 38.72, p = 0.000, Cohen’s d = 1.53). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for MCI and ad groups across all MoCA subtests and domains. Despite no discrimination in profiles noted on t-tests, further examination using normal distribution revealed worse performance on trails, clock hands, serial 7’s, repetition, fluency, date, and place in ad groups.

Conclusions

Consistent with previous findings, clock hands, serial 7’s, and orientation were able to discriminate between ad and MCI. This study found further discrimination in trails, repetition, and fluency. These findings may allow for clinicians to use these patterns of performance as early cognitive markers of impairment.
A-9 Examining Neural Variability during Dual-Task Walking and Cortical Thickness in Older Adults
Authors: Ross Daliah , Wagshul Mark E , Izzetoglu Meltem , Holtzer Roee
Published: August 2021

Objective

Greater intraindividual variability (IIV) in behavioral and cognitive performance is a risk factor for adverse outcomes but research concerning IIV in neural signal is scarce. Using functional near-infrared spectroscopy (fNIRS), we showed that IIV in oxygenated hemoglobin (HbO2) levels in the prefrontal cortex increased from single task (Single-Task-Walk–STW; Single-Task-Alpha–STA) to Dual-Task-Walk (DTW) conditions in older adults. Herein, we predicted that, consistent with the neural inefficiency hypothesis, reduced cortical thickness would be associated with greater increases in IIV in fNIRS-derived HbO2 from single tasks to DTW when adjusting for behavioral performance.

Method

Participants were right-handed older adults without dementia recruited from the community (N = 55; M(SD) age = 74.84(4.97); %female = 49.1). Neuroimaging included fNIRS for HbO2 levels in the prefrontal cortex during tasks and MRI for cortical thickness. IIV was operationalized using the SD of fNIRS-derived HbO2 observations assessed during a 30-s interval in each experimental condition.

Results

Moderation analyses, assessed through linear mixed effects models, revealed that in several frontal (p < 0.02), parietal (p < 0.02), temporal (p < 0.01), and occipital (p < 0.01) regions, thinner cortex was associated with greater increases in HbO2 IIV from the single tasks to DTW.

Conclusion

Reduced cortical thickness was associated with inefficient increases in IIV in fNIRS-derived HbO2 from single tasks to dual-task walking. Worse IIV in gait performance under DTW predicts adverse mobility outcomes. Reduced cortical thickness and worse IIV of fNIRS-derived HbO2 during DTW are possible brain mechanisms that explain the risk of developing mobility impairments in aging and disease populations.
A-11 Investigating Gene–Gene Interactions by Cognitive Domain in Healthy Older Adults
Authors: Pizzonia Kendra L , Bryant Andrew M , Clark Leatha A , Clark Brian C , Suhr Julie A
Published: August 2021

Objective

ApoE is a well-known gene carrying risk for Alzheimer’s disease and is associated with memory performance while the COMT gene is associated with executive functioning but is understudied. The present study investigated these gene interactions across cognitive domains.

Method

A larger study on gait and aging recruited 89 healthy community-dwelling adults over the age of 60. The primary analyses included 82 participants (67% female, mean age = 74.61, SD = 6.71). The analyses on executive functioning included 72 participants (65% female, mean age = 73.02, SD = 4.99) who completed all measures of interest. ApoE status was defined as presence/absence of Ɛ4. The rs4680 gene on the COMT allele was classified into Val/Met, Val/Val, and Met/Met genotypes. Biological sex was included as a binary term (i.e., male/female). Index variables and age corrected standard scores on the Repeatable Battery for the Assessment of Neuropsychological Status, verbal fluency, and Trail Making Test were included.

Results

Gene–gene interactions were found for overall cognitive functioning, immediate memory, and semantic fluency. There were main effects of sex for overall cognitive functioning, immediate memory, delayed memory, and semantic fluency. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for visuospatial functioning, coding, and verbal fluency (all p’s < 0.05). There were no ApoE x COMT x Sex interactions and Trail Making Test B was not related to either gene or sex.

Conclusion(s)

Our findings suggest that both COMT and ApoE (and their interaction) influence cognition. Future research should investigate gene–gene interactions in larger samples with more comprehensive cognitive batteries.
A-12 Relationships between Performance on the Virtual Environment Grocery Store and Adaptive Functioning among Older Adults
Authors: Hardesty Danielle R , Chek Carmen , Persin Michael , Barr Emma , Sasser Hannah , Glover Trisha , Coldiron Allyson , Parsons Thomas D , Barnett Michael D
Published: August 2021

Background/Problem

Neuropsychologists are often asked to evaluate patients’ functional capacities, yet traditional neuropsychological tests have limited correspondence with real-world outcomes. The Virtual Environment Grocery store (VEGS) is a virtual environment that stimulates shopping tasks. Previous research has found support for the construct validity of the VEGS among older adults (Parsons & Barnett, 2017); however, no extant research has examined relationships between the VEGS and adaptive functioning among older adults.

Method

Older adults (n = 30; age 43–90 M = 77.09, SD = 12.94) were administered the Virtual Reality Grocery Store (VEGS) and the Texas Functional Living Scale (TFLS) and completed the Instruments of Daily Activities (IADLS) Questionnaire.

Results

VEGS variables explained 39.6% of the variance in self-reported adaptive functioning (I, e., the IADLS) and 60.0% of the variance in performance-based adaptive functioning (i.e., the TFLS).

Conclusion

These results suggest that the VEGS is a predictor of adaptive functioning – particularly when measured with a performance-based measure – among older adults.
A-15 Validity of the NIH Toolbox Cognitive Battery in a Healthy Oldest-Old 85+ Sample
Authors: Sims Sara A , Levin Bonnie , Rundek Tatjana , Cohen Ronald A , Alexander Gene , Visscher Kristina M
Published: August 2021

Objective

The NIH Toolbox (NIHTB) Cognitive assessment battery has not been validated in the oldest-old population (85 years and older). Factor analysis of the NIHTB cognitive measures with “gold-standard” measures of the same cognition domains has revealed convergent and discriminant validity of these measures in a young adult population. Here we investigate if there is convergent and discriminant validity among the NIHTB and validated measures in the oldest old.

Methods

An exploratory factor analysis using the principal-axis factor extraction with Varimax rotation was conducted to determine the factor structure of the NIH Toolbox Cognitive Battery and other validated measures of cognition in the healthy oldest-old population. The sample, collected as part of the McKnight Brain Aging Registry, included 170 independent, healthy, community-dwelling adults aged 85+.

Results

Results indicated four factors with eigenvalues exceeding one with 58.6% variance explained. These four factors were interpreted as Memory, Working Memory, Speed/Attention, and Language. NIHTB Dimensional Change Card Sort test was removed due to low correlations with other measures.

Conclusion

Most tests from the NIH Toolbox converged with other tests of the same domain and were discriminable from tests of different domains, especially for memory, working memory, and language. The first factor, Speed/Attention, included attention and processing speed measures, but also canonical executive functioning measures such as Trails B. This overlap indicates that executive functioning tasks that rely on motor speed task demands (like the NIHTB DCCS) may mask preserved aspects of executive function in the oldest old. Further work is needed to confirm this interpretation.
A-28 Attention-Deficit/Hyperactivity Disorder or Trauma?: A Case Study
Authors: Herby Cecily A
Published: August 2021

Objective

Previous literature has found that it can be difficult differentiating between trauma disorders and Attention-Deficit/Hyperactivity Disorder (ADHD), and that children diagnosed with ADHD have higher exposure to traumatic events compared to children without ADHD. This current case exemplifies the complexity of factors involved in ADHD, including history of trauma.

Method

Patient is an 11 year old, African American, cisgender male. History is significant for childhood neglect, trauma, and housing and caregiver instability. He carries a diagnosis of ADHD for which he receives psychiatric and therapeutic treatment. Neuropsychological evaluation was pursued due to concerns regarding academic skill development, attention/concentration, potential trauma reactions, and socialization skills. In particular, patient’s guardians sought evaluation to parse out what may be neurodevelopmental concerns (ADHD) versus challenges associated with his history of trauma and neglect.

Results

On objective measures of executive functioning, patient displayed some difficulties with planning and inhibition. Additionally, on parent and teacher forms (BASC-3 and BRIEF-2), significant concerns were noted regarding attention, hyperactivity, and other domains related to executive functioning. Parents and teachers also reported concerns regarding conduct, anxiety, and atypicality. Additionally, on the BASC-3 self-report, patient reported low self-esteem—a symptom common in both ADHD and trauma-related disorders.

Conclusions

This case demonstrates the difficulty of parsing out ADHD symptoms from trauma reactions. The purpose of examining this case is to further explore the relationship between trauma and ADHD, as well as to add to the conversation regarding the misattribution of symptoms related to trauma as being solely ADHD or behavioral in African American, pediatric males.
A-33 Pediatric Intraindividual Variability: Examining Dispersion across Cognitive Domains
Authors: Friedhoff Claire , Kirsch Alexandra
Published: August 2021

Objective

Intraindividual variability (IIV), defined as variability in performance across different cognitive domains within an individual, has been studied in adults and found to be linked to sex, age, and mean cognitive performance, and associated with developmental disorders (e.g., ADHD), focal disorders, and cognitive decline. In contrast, IIV in children is thought to be related to cognitive development rather than impairment, but has not been well studied with relation to differences across sex, age, diagnoses, or mean cognitive performance.

Method

Participants included 426 children/young adults (ages 3–25; M = 11.75, SD = 4.01; 62.3% male) referred for neuropsychological evaluation at a hospital-based outpatient clinic. A battery of tests was administered measuring several domains, including intelligence, academics, attention, executive functions, language, memory, visual motor integration, and fine motor skills. Intraindividual standard deviation (ISD) and maximum deviation (MD) were used as measures of IIV.

Results

Sex was not related to ISD or MD, ts(423) = −1.15 – -0.09, ps = 0.251–0.930. Age, measured categorically, was not related to ISD, F(3) = 0.07, p = 0.974, but was related to MD, F(3) = 3.45, p = 0.017 with children age 3–5 having lower MD. ADHD diagnosis was not related to ISD or MD, ts(417) = −1.25 – −1.19, ps = 0.211–0.234. An inverse relationship was observed between mean cognitive performance and ISD, F(1) = 36.43, p < 0.001, and MD, F(1) = 25.92, p < 0.001.

Conclusions

The current study did not replicate differences in IIV based on sex or diagnosis of ADHD in children. However, differences based on age and mean cognitive performance are consistent with previous literature, suggesting that IIV may reflect differences in cognitive development, secondary to both skill and age, in children.
A-35 Relationship between Suicidality and Discrepancies in Verbal and Nonverbal Intelligence in Adolescents
Authors: Gold Dov , Ravid Danya , Crain Emily , Holler Karen
Published: August 2021

Objective

Many have examined the relationship between intellectual functioning (IQ) and suicidality in children and adolescents. However, no study to date has investigated how discrepancies between verbal and nonverbal IQ may influence suicide risk in adolescents. This study used a sample of patients hospitalized on an adolescent psychiatric unit to compare number of lifetime suicide attempts (SA) among those with a ≥ 22-point difference between verbal and nonverbal abilities.

Method

Data were retroactively collected from a convenience sample. Patients were grouped based on discrepancies between Perceptual Reasoning Index (PRI) and Verbal Comprehension Index (VCI) scores (VCI > PRI & VCI).

Results

The number of lifetime ACEs or size of IQ discrepancy did not significantly differ between groups; however, those in the VCI < PRI (μ = 1.13 ± 0.98) group had a significant higher number of SAs than those in the VCI > PRI group (μ = 0.50 ± 0.86) (t(32) = 2.01, p = 0.05). Hedges’ g revealed large effect for IQ discrepancy type and number of SAs. Linear regression modeling revealed a positive association between number of ACEs and number of SAs (ß = 0.10, t(33) = 2.71, p = 0.01). Size of IQ discrepancy was not significantly contributory to total SAs.

Conclusion

VCI being considerably lower than PRI may increase risk of SA in adolescents. This risk may be further exacerbated by lifetime number of ACEs.
A-37 Interactions between in-Utero Stress Exposure, Externalizing Behavior, and Psychophysiology in Young Children
Authors: Bedoya Ana Cristina , Ginalis Christine , Zaki Jeenia , Nomura Yoko
Published: August 2021

Objective

The current study examines the associations between low resting heart rate (HR), low electrodermal activity (EDA), and externalizing behavior (EB) in children 1–5 years old through the following measures: baseline 1 (B1) HR, startle period HR, and recovery-stage HR HR, EDA amplitude and skin conductance responses (SCR). We also investigate whether in-utero stress (exposure to Hurricane Sandy) moderates these relationships.

Method

A subsample of 206 children was drawn from a NIMH longitudinal study, the Stress in Pregnancy Study, that follows offspring from in-utero to 6 years of age. HR and EDA data was collected during a startle-probe paradigm. Mean age of the participants was 3.89 years. Approximately 52% were female and 50.5% were Hispanic. Participants’ EB was assessed by the Behavioral Assessment Screening for Children Version-2 parent rating scales. Externalizing symptoms were trichotomized (high, medium, and low).

Results

One-way ANOVA showed that three EB groups differed in baseline-HR (p = 0.034), startle-HR (p = 0.006), and recovery-stage HR (p = 0.008) in 4-year olds. EDA was not significantly different between EB groups. Furthermore, Hurricane Sandy exposure significantly and marginally significantly moderates the relationship between EB and amplitude (b = 3.0344, p = 0.044) and EB and SCR (b = 1.5629, p = 0.056), respectively. Hurricane Sandy exposure did not moderate the relationship between EB and HR.

Conclusion

Externalizing problem symptom groups significantly differ in HR, but not EDA. Hurricane Sandy exposure moderates the relationship between EB and EDA, but not EB and HR. Results suggest that HR and EDA are differentially susceptible to environmental influence. Results can guide biologically informed treatments/screeners for EB in children.
A-39 New Cut-Score to Improve Performance of the Memory Validity Profile (MVP) in Heterogenous Clinical Populations
Authors: Tewolde Furtuna G , Svingos Adrian , Norheim Nicole , Turner Elise , Jones Laura , Heaton Shelley G
Published: August 2021

Objective

The Memory Validity Profile (MVP) is a standalone performance validity test developed specifically for use with children. Prior research has demonstrated the MVP’s strength in its ease of administration to children with a wide range of intellectual abilities. However, it has been found to lack sensitivity in detecting noncredible performance in select clinical populations using published cut-offs. The current study examines the MVP’s performance in a diagnostically heterogeneous clinical sample and proposes a new cut-off for optimization of sensitivity and specificity.

Method

Archival clinical data was examined from 96 participants referred for a comprehensive neuropsychological evaluation (ages 6–18). Receiver operating characteristic analysis was used to assess the discriminative ability of MVP in detecting cases of noncredible performance defined as failures on both the Test of Memory Malingering and Reliable Digit Span.

Results

Using published cut-offs, the MVP demonstrated perfect specificity (100%) but suboptimal sensitivity (33.3%). Receiver operating characteristic analysis revealed strong discrimination using MVP Total score (AUC = 0.891 (p < 0.001) and a MVP Total cut-score of ≤30 resulted in optimal sensitivity (89%) and specificity (63%).

Conclusions

Our findings provide additional evidence that published MVP cut-offs may be too lenient to adequately capture instances of noncredible performance and indicate an MVP Total score cut-off of ≤30 may be more appropriate for use with heterogeneous clinical populations.