bluuebunny/crossref_metadata_2025 huggingface dataset:
A-09 The Relationship Between Subjective Cognitive Complaints, Depression, and Executive Functioning in mTBI Veterans
Authors: Scott T , Spellman J , Walker N , Rivera J , Waltzman D , Mcnerney M , Madore M
Published: August 2020

Objective

Among individuals with mild traumatic brain injury (mTBI), those with depression report greater subjective cognitive complaints than those without depression. In mTBI patients with general cognitive complaints, depression may account for poor performance on objective neuropsychological measures. This study seeks to expand this research by examining depression, subjective executive functioning (EF) complaints, and objective EF performance in Veterans with mTBI.

Method

Fifty-seven Veterans with deployment-related mTBI (12% female; age M = 42.0, SD = 13.6; years education M = 15.0, SD = 1.8) with (n = 29) or without (n = 28) a chart diagnosis of depression. Participants were administered the Behavioral Rating Inventory of Executive Functioning (BRIEF) and objective neuropsychological measures of working memory (i.e., Weschler Adult Intelligence Scale-IV Working Memory Index) and aspects of EF (i.e., Trail Making Test B and Delis-Kaplan Executive Functioning System (D-KEFS) subtests).

Results

Principal component analysis identified similar domains of EF to the BRIEF, including: task monitoring (Trail Making Test B, D-KEFS Letter Fluency, and D-KEFS Tower Test, eigenvalue = 1.93) and shifting (D-KEFS: Color-Word Interference Conditions 3 and 4, and Category Switching, eigenvalue = 1.24). Individuals with depression had greater subjective EF complaints in each BRIEF domain than non-depressed individuals (p’s ≤ .01). However, subjective complaints in these domains were not related to objective performance (r’s = −0.17,-0.19, p’s > .05). Moreover, depressed and non-depressed individuals performed similarly on all EF measures (p’s > .05).

Conclusions

mTBI Veterans with depression report more subjective EF complaints than those without depression. The lack of association between subjective complaints and objective EF performance suggests it is important to treat depression in mTBI patients to remedy perceived cognitive deficits.
A-011 Stability of Impairment Rating Discrepancies in a Longitudinal Observational Alzheimer’s Study
Authors: J Kaylegian , A Ritter , J Caldwell
Published: August 2020

Objective

The present study investigated frequency and 12-month persistence of discrepant Clinical Dementia Rating (CDR) and comprehensive neuropsychological assessment ratings of impairment.

Methods

We examined CDR and neuropsychological test scores from year 1 and 2 visits of 162 adults enrolled in a longitudinal observational study. Neuropsychological measures included Wide Range Achievement Test, American National Adult Reading Test, Rey Auditory Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Dementia Rating Scale 2nd edition, Boston Naming, Verbal Fluency/Color Word Interference from the Delis-Kaplan Executive Function System, Judgment of Line Orientation, Trail Making Test, Symbol Digit Modalities Test, and Digit Span/Letter Number Sequencing from The Wechsler Adult Intelligence Scale 4th edition. Discrepancies were defined as: CDR = 0 and 2 test impairments, CDR = 0.5 and > 5 or 0 impairments, CDR = 1 and 0 impairments.

Results

Including all test domains, 40.1% of participants in year 1 and 44.3% in year 2 showed discrepancies. 69% maintained this discrepancy at year 2 and 68% of these showed no change in discrepancy type. Considering only memory tests, 37% of participants in year 1 and 28.4% in year 2 showed discrepancies, with 45% maintaining at year 2 (74% showing no change in discrepancy type). A majority of discrepancies observed in both years 1 and 2 revealed the CDR was under reporting impairment compared to the neuropsychological battery year.

Conclusions

The results provide evidence that within our study population, impairment as rated by the CDR frequently does not match the level of measured cognitive impairment and this observation is stable year to year.
A-03 Executive and Memory Components of Prospective Memory in Aging and Dementia
Authors: W Olmos , J Moreno , J Tran , L Alving , E Woo
Published: August 2020

Objective

Prospective memory (PM) involves remembering to perform an intended action in the future. PM is critical for older adults’ daily functioning. This ability is not a unitary construct, so in this study, we determined the roles of executive and memory functioning in different subtypes of PM, including simple PM (ability to execute a single action in the future) and complex PM (ability to execute different actions depending on the context).

Method

Participants included 58 healthy older adults, 64 persons with mild cognitive impairment (MCI), and 17 participants with Alzheimer’s disease. Simple PM was defined as remembering to ask the examiner for a pill after each neuropsychological test performed. Complex PM was defined as asking for the correct number of pills based on whether the test just completed involved memory (1 pill) or not (2 pills). An Executive composite score included Trail Making Test-B and FAS. The Memory composite score included delayed recall from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised.

Results

Whole group analyses showed that simple PM was significantly correlated with memory functions, and complex PM was significantly correlated with both memory and executive functions. Specific to the MCI group, regression analyses showed that executive and memory skills predicted both simple PM and complex PM.

Conclusions

These findings suggest that complex PM requires more executive demands than simple PM. For those with MCI, better executive and memory functions predicted PM generally. These findings indicate that both types of PM may be important for assessing the risk state for dementia.
A-033 Subjective Cognitive Decline Symptom Burden Predicts Acceptance of Cognitive Assessment
Authors: M Splonskowski , C Jacova
Published: August 2020

Objective

Individuals endorsing subjective cognitive decline (SCD) are at risk for dementia, likely to endorse depression and anxiety but often don’t seek cognitive assessment. Here we examined the relationship between SCD and acceptance of cognitive assessment.

Method

A nation-wide sample of 483 adults age 50 and older completed an online survey via the crowdsourcing website, Amazon Mechanical Turk. The SCD-MyCog Questionnaire was used to calculate total SCD score and determine SCD and non-SCD groups (>7/24 = SCD). Items from The Perceptions Regarding Investigational Screening for Memory in Primary Care were summed to create total Assessment Acceptance. Anxiety and depressive symptoms were measured using Patient-Reported Outcome Measurement Information System scales.

Results

A hierarchical regression showed SCD total score adding to the prediction of assessment acceptance (R2 change = 8.5%). Once age (R2 change = 0.2%), and depression and anxiety (R2 change = 0.5%) were entered in steps 1 and 2. Step 3 coefficients were − .016, −.047, .019, and .18. The SCD group had an overall acceptance score > 1 SD higher than non-SCD (17.4 ± 2.32 and 15.46 ± 3.46).

Conclusion

SCD endorsed more acceptance even when anxiety and depression symptoms were accounted for. This finding is at odds with reduced help-seeking behavior among SCD. Further research is warranted to understand the specific barriers to seeking assessment among SCD.
A-060 A Developmental Analysis of Auditory Processing and Symptom Severity in Children with Autism Spectrum Disorder
Authors: M Cotter , S Tikir , S Molholm
Published: August 2020

Objective

Children with Autism Spectrum Disorder (ASD) exhibit abnormal responses to sensory events that interfere with the development of social communication. Previous studies have demonstrated that abnormal auditory processing contributes to this response; however, it remains unclear how this deficit is related to ASD severity throughout development. This cross-sectional study examines the relationship between auditory processing and symptom severity in a developmental sample of children, hypothesizing that auditory sensory event related potentials (ERP) will be associated with ASD severity as measured by the Autism Diagnostic Observation Schedule (ADOS), and that there will be interaction between age and severity.

Method

This study included children (ages 6-18) with ASD (n = 116, female = 21) as diagnosed by the ADOS and typically developing children (n = 142, female =76). Exclusion criteria includes Performance IQ below 85, abnormal hearing or vision, and presence of a neurological disorder. Participants performed an audiovisual reaction task in which they pressed a button on a response pad when seeing or hearing the instructed stimuli while recording electroencephalography (EEG).

Results

Electrophysiological indices of auditory processing were identified based on peak amplitudes of averaged N1 responses, an early auditory ERP. A positive correlation was found between severity scores and N1 peak amplitudes (N1a (r(85) = .56, p < .001) and N1b (r(85) = .44, p < .001)). Approximately 72% (R2 = .716) of symptom severity variance can be accounted for by linear combination of ERPs. A linear model demonstrated a significant age by severity interaction with N1b, B = -2.7, F(2,84) = 20.6, p < .001.

Conclusions

Abnormal early auditory processing is associated with symptom severity, and this effect is more pronounced throughout earlier ages.
A-062 Cognitive Profiles in Athletes with Neurodevelopmental Disorders on Baseline Testing
Authors: J Maietta , S Flood , L Johnson , N Hopkins , L Maietta , H Kuwabara , T Kinsora , S Ross , D Allen
Published: August 2020

Objective

The Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) is a commonly utilized sport concussion assessment. Previous literature examined differences in concussion rates, symptom scores, and invalid baselines between healthy athletes and athletes with neurodevelopmental disorders. There are no current studies that investigate cognitive profiles of athletes with autism. The present study explores possible differences in ImPACT performance for these athletes.

Method

Participants included 31,368 high school athletes (mean age = 15.0, SD = 1.2; mean education = 9.0; SD = 1.4; 43.9% female) selected from a larger database who completed baseline ImPACT testing from 2008–2016. Self-reported neurodevelopmental history consisted of these distinct groups: attention-deficit/hyperactivity disorder (ADHD; 3.6%), learning disorders (LD; 1.3%), Autism (0.3%), ADHD/LD (0.6%). ImPACT Composite Scores were analyzed using Mixed-model ANCOVA (age and gender covariates)-Verbal Memory (VerbM), Visual Memory (VisM), Visual Motor Speed (VisMot), Reaction Time (RT), and Impulse Control (IC). Composites were standardized and RT was reverse coded. For comparison purposes, individuals from all neurodevelopmental groups were utilized.

Results

There was a main effect for Composites and neurodevelopmental history (p < .01). An interaction effect between Composites and neurodevelopmental history was found (p < .01). The Autism group scored significantly lower than healthy athletes on VerbM, VisM, VisMot, and RT. No difference was found for IC. Pattern differences between neurodevelopmental groups will also be reported.

Discussion

Results reveal cognitive profile differences for athletes with Autism and other neurodevelopmental disorders. The ImPACT provides normative data for LD and ADHD athletes; however, our results indicate similar pattern differences for Autism and ADHD/LD. Future research should investigate whether separate norms may be beneficial for these groups.
A-063 Viewer Engagement Modulates Activation of Social Brain Systems: Evidence from a Natural Viewing fMRI Paradigm
Authors: J Pincus , S Koirala , L Li , A Klin , W Jones , S Shultz
Published: August 2020

Objective

Engagement is critical for social learning—information that does not engage cognition, even when looked at, will go unprocessed and unlearned. Consequently, atypical engagement can contribute to social disability. Despite its importance, the neural mechanisms underlying engagement remain unknown, largely because no studies have successfully quantified the individualized ways that viewers engage with the world. This study uses patterns of eye-blinking—a novel measure of engagement (Shultz, Klin, Jones, 2011)—to examine how a viewer’s own engagement with social stimuli (e.g. faces) modulates activation of social brain systems.

Method

Simultaneous functional MRI and eye-tracking data were collected while children (n = 12, ages 8–12) watched naturalistic social videos of children interacting. Eye-fixation and blink patterns were used to identify moments when viewers looked at a face and were ‘highly engaged’ or ‘less engaged’ with those faces. Whole-brain analyses compared brain activation in response to each condition of interest (‘highly engaging faces’, ‘less engaging faces’).

Results

Whole-brain analyses (z = 2.3, cluster corrected at p < .05) reveal increased activation in bilateral occipital cortex, left middle temporal gyrus, bilateral posterior cingulate, left orbitofrontal cortex and inferior frontal gyrus, right angular gyrus, and right fusiform gyrus, when viewing faces perceived as ‘highly engaging’ versus ‘less engaging’.

Conclusion

Findings suggest that even when viewing the same stimulus category (e.g. faces), one’s own engagement with the stimulus modulates brain activation, even in canonical face processing areas like the fusiform gyrus. Insights into the neural mechanisms of engagement can inform future understanding of social disability and interventions for social learning.
A-072 Neuropsychological Case Study of Behavioral Variant Frontotemporal Neurocognitive Disorder​ in a Vietnamese Woman in a Community Health Setting
Authors: J Naylor , N O'Donnell , N Hans , S Berry , T Uzuncan
Published: August 2020

Objective

Behavioral variant frontal temporal dementia (bvFTD) is characterized by progressive changes in behavior, personality, and cognition. Little is published on the presentation in non-English-speaking populations. Here is the case of a neuropsychological evaluation in a community health setting where language and cultural considerations were salient.

Method

A 73-year-old, right-handed, monolingual Vietnamese widowed female homemaker with five years of education and low literacy, was referred after gradual personality changes over five years caused family tension and a need for increased monitoring. History includes cardiovascular disease, hypertension, hypercholesterolemia, cholestatic hepatitis, and depression with remitting psychotic features and suicidal ideation. Neuroimaging shows right temporal encephalomalacia and mild diffuse atrophy commensurate with age.

Results

A bilingual phone interpreter was used. Test findings revealed low scores across all but two tasks (visuospatial processing speed, recognition memory). Several confrontation naming items were unknown to the patient or culturally irrelevant, per interpreter. Interview with an English-speaking daughter revealed declines in behavior and social comportment (e.g., unsympathetic, demanding, rigid, repetitive, disorganized, compulsive shopping and gaming, confabulatory) and modest declines in activities of daily living. Presentation was notably childlike, overly affectionate, “grabby”, insistent, restless, with poor conversational turn-taking (with interpreter), but generally intact expressive and receptive language. BvFTD was diagnosed.

Conclusions

Addressing needs of a diverse, multi-cultural population in a community health setting can present significant challenges. This case study highlights the importance of non-psychometric sources of data, including history, observation, and collateral interviews, along with consideration of education, language, and culture on the evaluation process and case conceptualization.
A-078 Examining the Neuropsychological Effects of Opioid Use in the Aging Population of People Living with HIV
Authors: A Slaughter , M Savin , A Summers , C Crook , E Breen , K Fidaleo , D Byrd , M Rivera Mindt
Published: August 2020

Objective

People living with HIV (PLWH) exhibit accelerated and premature cognitive aging in comparison to age-matched, seronegative controls. Although opioid use is elevated among PLWH, literature regarding the neurocognitive effects of opioid use across the lifespan of PLWH is limited. This cross-sectional study examines the neurocognitive effects of opioid use across the mid-older adult lifespan of PLWH.

Methods

One-hundred fifty-two PLWH (72% Latinx; 71% Male; Mdn(IQR) Age = 47(43, 51) years; M Education = 133 years) completed comprehensive neurocognitive, neuromedical, quality of education (Wide Range Achievement Test- 4 [WRAT-4]), psychiatric/substance-use (Composite International Diagnostic Interview [CIDI]), and urine toxicology assessments. Opioid users were defined by DSM diagnostics for lifetime opioid use disorder. A series of LSR tested the interactive effects of age and opioid use across seven neurocognitive domains.

Results

After controlling for covariates (e.g., CD4 cell count; WRAT-4; comorbid substance use), a least-squares regression demonstrated significant interactive effects between age and opioid use upon verbal fluency, such that older opioid users exhibited greater verbal fluency scores (F [11] = 4.28, p < .0001, R2 = .33). No significant interactions were detected in other domains.

Discussion

The moderate observed effect sizes indicate a positive relationship between older age and lifetime opioid use upon verbal fluency among PLWH. These findings may be representative of a selective survival bias among opioid users within this population. Nonetheless, verbal fluency could serve as a marker of greater survivability among PLWH with opioid use histories. Future directions should examine this interaction longitudinally and evaluate differences in the severity/duration of opioid use.
A-080 Prediction Model for Verbal Memory Decline in Different Epilepsy Surgery Procedures: Temporal Lobectomy vs. Amygdalohippocampectomy
Authors: K Hageboutros , A Bono , B Johnson-Markve , K Smith , G Lee
Published: August 2020

Objective

Mathematical models predicting risk of verbal memory decline after resective epilepsy surgery have been developed for patients undergoing temporal lobectomies. This study was undertaken to determine if application of the Stroup memory loss prediction model was as accurate in foreseeing verbal memory decline after temporal lobectomy as in the less invasive selective amygdalohippocampectomy procedure.

Method

This retrospective study examined the verbal memory performances of 40 left temporal lobectomy (ATL), and 16 left subtemporal approach selective amygdalohippocampectomy (SA-H), patients before and after epilepsy surgery using word list learning (Rey Auditory-Verbal Learning Test, Buschke Selective Reminding Test) and story memory (WMS Logical Memory) tests. Patients were assigned to one of four groups using the Stroup multiple regression equation: Minimal Risk (61% risk). To classify memory decline in individual patients, a pre-to-post surgery decrease of > 1 SD on at least one memory test constituted memory decline.

Results

The prediction model accurately classified 82% (9/11) of ATL, and 75% (3/4) of SA-H, High Risk patients. Verbal memory loss was higher among ATLs than SA-Hs in the Moderate Risk (87% vs. 18%) and Low Risk (71% vs. 0%) groups.

Conclusion

The Stroup verbal memory loss risk model under-predicted memory loss among temporal lobectomy patients (71% of Low Risk patients showed memory decline) and over-predicted memory loss among selective amygdalohippocampectomy patients (only 18% of Moderate Risk patients showed memory decline). Results should be considered preliminary due to methodological limitation including small Ns and unequal sample sizes.
A-083 A Lesser Form of ADHD? Exploring the Neuropsychological Profiles of Adult ADHD Diagnostic Subgroups
Authors: N Baggett , C Jacova
Published: August 2020

Objective

Many individuals experience clinically-elevated symptoms of attention-deficit/hyperactivity disorder in adulthood that were absent, sub-threshold, or unapparent prior to age 12 (late-onset ADHD). These individuals might be experiencing a less-severe form of ADHD. We explored whether the neuropsychological performance profiles of different diagnostic ADHD subgroups of community-dwelling individuals in the Pacific Northwest, USA, supported this form of ADHD. We compared individuals who endorsed clinically-elevated ADHD symptoms in adulthood only (ADHD-A), in both childhood and adulthood (ADHD-CA), and individuals who did not endorse symptoms (None).

Method

Subgroup placement was determined based on symptom endorsement on the Adult ADHD Clinical Diagnostic Scale in accordance with DSM-V criteria. Our sample included n = 41 placed in the ADHD-CA group (mean age = 39.12, range 18–71), n = 12 in the ADHD-A group (mean age = 51.83, range 20–73), and n = 50 in the None group (mean age = 50.52, range 18–86). ANCOVAs with pairwise comparisons were conducted to compare group performance on the CVLT-II, WMS-V Spatial Addition and Visual Reproduction, and D-KEFS Verbal Fluency Letter and Color-Word Inhibition tasks after controlling for age.

Result

Group differences were found on the D-KEFS Color-Word Inhibition task where the ADHD-A group’s score was higher than that of the ADHD-CA group (d = 1.37, p = .340) but lower than that of the None group (d = −1.03, p = .462). No other group differences were found.

Conclusions

Adults with late-onset ADHD may display a less-severe impairment on neuropsychological measures closely related to ADHD symptomology (e.g. inhibitory control) than those meeting full ADHD diagnostic criteria. There is no evidence that this pattern extends to other neuropsychological domains.
A-137 Increased Symptom Burden during Baseline Concussion Testing: What Does it Mean?
Authors: K Riegler , E Guty , G Thomas , G Bruce , P Arnett
Published: August 2020

Objective

Explore factors that are predictive of an increase in symptoms over the course of a baseline neuropsychological evaluation and examine the impact of symptom increase on objective test performance.

Method

266 athletes (M = 198, F = 68) were assessed at baseline. A 21-item post-concussion symptom checklist (PCSS) was administered at the beginning (Pre-PCSS) and end (Post-PCSS) of a two-and-half hour baseline assessment. Symptoms were rated on a 7-point Likert scale (0 = none, 6 = severe). A difference score was calculated for each athlete by subtracting Post-PCSS from Pre-PCSS. Athletes were categorized into three groups based on the criterion of a half standard deviation cutoff from the mean difference score: decrease (N = 47), increase (N = 57), and no change (N = 162). The decrease and no change groups were combined into the “stable symptom” group (N = 219) which was compared to the “increased symptom” group (N = 47). Clinically significant depression was operationalized as a Beck Depression Inventory-Fast Screen score ≥ 4. Two neurocognitive composites were created (memory and attention/processing-speed).

Results

Independent samples t-tests were conducted to compare the stable symptom and increased symptom groups on the two neurocognitive composites. Compared with the stable symptom group, the increased symptom group demonstrated significantly worse memory composite performance, t(264) = 2.21, p = .03, d = .33, but no differences on attention/processing-speed composite performance, p > .05. Also, a significantly greater proportion of athletes in the increased symptom group reported depression (17%) compared to the stable symptom group (3%), χ2(1,N = 266) = 13.81, p < .001, φ = .23.

Conclusions

Depression and poor memory performance are associated with an increase in self-reported symptoms during the cognitive exertion associated with a typical baseline concussion assessment.
A-140 Single-Item Screening for Anxiety and Depression using the Neurobehavioral Symptom Inventory
Authors: S Rolin , K Kitchen Andren , C Mullen , N Kurniadi , J Davis
Published: August 2020

Objective

Previous research in a Veterans Affairs sample proposed using single items on the Neurobehavioral Symptom Inventory (NSI) to screen for anxiety (item 19) and depression (item 20). This study examined the approach in an outpatient physical medicine and rehabilitation sample.

Method

Participants (N = 84) underwent outpatient neuropsychological evaluation using the NSI, BDI-II, GAD-7, MMPI-2-RF, and Memory Complaints Inventory (MCI) among other measures. Anxiety and depression were psychometrically determined via cutoffs on the GAD-7 (>4) and MMPI-2-RF ANX (>64 T), and BDI-II (>13) and MMPI-2-RF RC2 (>64 T), respectively. Analyses included receiver operating characteristic analysis (ROC) and logistic regression. Logistic regression models used dichotomous anxiety and depression as outcomes and relevant NSI items and MCI average score as predictors.

Results

ROC analysis using NSI items to classify cases showed area under the curve (AUC) values of .77 for anxiety and .85 for depression. The logistic regression model predicting anxiety correctly classified 80% of cases with AUC of .86. The logistic regression model predicting depression correctly classified 79% of cases with AUC of .88.

Conclusion

Findings support the utility of NSI anxiety and depression items as screening measures in a rehabilitation population. Consideration of symptom validity via the MCI improved classification accuracy of the regression models. The approach may be useful in other clinical settings for quick assessment of psychological issues warranting further evaluation.
A-171 A Factor Analytic Investigation of the Behavior Rating Inventory of Executive Function, Second Edition in a Pediatric Clinical Sample
Authors: J Lace , D Seitz , E Kennedy , T Austin , B Ferguson , M Mohrland
Published: August 2020

Objective

The parent-report Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) is a widely used measure in pediatric clinical neuropsychology. Unfortunately, despite notable changes from its predecessor, few studies to date have examined its internal factor structure (comprised of Behavioral Regulation [BRI], Emotion Regulation [ERI], and Cognitive Regulation [CRI]). Thus, this study sought to investigate the dimensionality of the parent-report BRIEF-2 in a mixed clinical sample.

Method

Two hundred two (202) outpatient pediatric neuropsychology examinees (M age = 9.90; 68% males; 53.5% with diagnosis of autism spectrum disorder) with complete data for the parent-report BRIEF-2 were extracted from an archival dataset. The sample was randomly split for confirmatory and exploratory factor analyses (CFA and EFA; ns = 101).

Results

Descriptive results revealed elevated scores across BRIEF-2 scales (Global Executive Composite M T = 70.16). CFA revealed that the theoretical three-factor model described by the BRIEF-2’s authors provided generally poor fit (root mean square error of approximation [RMSEA] = .12). Also, the three-factor model did not provide statistically significantly nor relatively better fit than a simpler two-factor model (RMSEA = .12), which merged BRI and ERI (consistent with the original BRIEF), identified via EFA.

Conclusion(s)

A two-factor structure (CRI and BRI/ERI) for the BRIEF-2 may be a more parsimonious and preferred model compared to the theoretical three-factor model in heavily neurodevelopmental clinical samples with high levels of reported executive dysfunction. Implications of these findings in context of previous literature, limitations of the present study, and appropriate directions for future inquiry are noted.
A-188 Psychometric Characteristics of the Cognitive Difficulties Scale in a Clinical Referral Sample
Authors: C Gass , B Patten , A Penate , A Rhodes
Published: August 2020

Objective

Evaluate the psychometric characteristics of the Cognitive Difficulties Scale (CDS; McNair & Kahn, 1983), a 39-item Likert-type self-report instrument that requires a fifth-grade reading level. The CDS is a popular instrument that has been shown to predict cognitive decline. Evaluation included an exploratory factor analysis, measures of internal consistency, relation to demographics, criterion validity, and normative table for raw to T score/percentile transformation.

Method

Participants were 643 consecutive referrals (71% women, mean age 60.6 and education 14.6 years) for a neuropsychological examination in a memory disorders clinic as part of a broader neurodiagnostic workup for cognitive decline. A principal components analysis was conducted followed by varimax rotation (Kaiser). Factor scores were investigated in relation to multiple internal and external criteria.

Results

Six dimensions of cognitive complaint emerged accounting for 64% of the variance: Attention/Concentration, Fine Motor Skill, Prospective Memory, Speech Problems, Memory for Names, and Temporal Orientation. Factors showed good internal consistencies (alphas > .850). Correlations with Logical Memory, Visual Reproduction, and Digit Span were all nonsignificant. CDS factor scores were highly predictive of MMPI-2 measures of anxiety, depression, and somatic preoccupation. Percentiles and T-scores were derived for the CDS total score and its six component scales.

Conclusion

The CDS is a multidimensional measure of subjective cognitive complaints that provides clinicians with a psychometrically sound basis for deriving a profile with six subscale scores. The test has substantial clinical utility, and is a potentially useful tool in exploring subjective cognitive decline as a prodrome to dementia.
A-192 The General Ability Measure for Adults Underrepresents True IQ in a High-Functioning Aviation Population
Authors: A Dacosta , A Crane , A Roccaforte , M Davies , D Prewett , F Webbe , A Logalbo
Published: August 2020

Objective

The General Ability Measure for Adults (GAMA) is a brief nonverbal assessment of general intellectual ability (Naglieri & Bardos, 1997). Previous research supports use of the GAMA as a screening measure of cognitive ability in neurological populations (Davis, Bados & Woodward, 2005). However, there is a lack of research involving the use of the GAMA in high functioning populations commonly referred for neuropsychological evaluation (i.e. aviation pilots).

Method

Aviation pilots (n = 59; mean age = 44.90, SD = 9.78) were referred for a neuropsychological evaluation and were concluded to be cognitively intact. They were administered a battery that included the GAMA and Wechsler Adult Intelligence Scale—4th edition (WAIS-IV) among other measures.

Results

A paired samples t-test revealed that IQ scores on the GAMA (M = 118.19, SD = 11.51) were significantly lower than IQ scores on the WAIS-IV (M = 125.73, SD = 10.12; p < .001), with WAIS-IV IQ being 7.54 points higher on average. A Chi-square test of independence determined there was disagreement in score classification between the two tests (χ2(9) = 15.463, p = .079).

Conclusions

The GAMA appears to significantly underrepresent true IQ in both score and classification when compared to a more robust measure of intellectual assessment. Clinically, this suggests that IQ screeners, such as the GAMA, may not be appropriate for assessing patients who are suspected to be of higher premorbid functioning. Future research should expand on these results to assess the validity of verbal-based IQ screening measures in high-functioning populations.
A-207 Applying the Hartford Consistency Index to the Brief Visuospatial Memory Test—Revised for Assessing Performance Validity in an Outpatient Sample: A Pilot Study
Authors: K Sheikh , C Peck
Published: August 2020

Objective

Prior studies have examined indices within the Brief Visuospatial Memory Test—Revised (BVMT-R) as potential embedded performance validity tests (PVT). Findings from these studies, however, are limited and with mixed results. Therefore, the purpose of the current study was to compare the classification accuracy of the Hartford Consistency Index (HCI) with published BVMT-R performance validity measures in an outpatient sample.

Method

A total of 115 archival files met study inclusion criteria: a) ≥ 18 years-old; b) administered > 2 PVTs (Reliable Digit Span, Dot Counting Test, and Test of Memory Malingering); and c) no diagnoses of intellectual disability or dementia. Utilizing standard cutoffs, participants were classified as ‘Valid’ (n = 94) or ‘Invalid’ (n = 21). ‘Valid’ profiles passed all PVTs and were free of known external incentives while ‘Invalid’ profiles failed ≥2 PVTs.

Results

An HCI cutoff of < 1 yielded 90% specificity, 48% sensitivity, and the area under the curve (AUC = .70) was adequate. Applying published cutoffs for Recognition Hits (≤4) and Percent Retention (≤58%) to our sample produced > 90% specificity, but sensitivity rates were < 40% and AUCs were consistently < .70. Similarly, the Recognition Discrimination (≤4) cutoff revealed inadequate specificity (84%), but acceptable sensitivity (63%), and AUC (.73).

Conclussions

Results from our study support the use of the HCI as an embedded PVT within the BVMT-R for non-demented outpatient samples. Furthermore, the HCI outperformed other embedded PVTs examined. Limitations of our study and future directions are discussed.
A-222 Efficacy of D–KEFS Trail Making Test Conditions 1–5 Using Age-Corrected Scaled Score Cutoffs as Embedded Validity Indicators in a Sample of Youth Athletes
Authors: R Thompson , S Arastu , S Markuson , A Deneen , R Hirst
Published: August 2020

Objective

Embedded validity indicators (EVI) assist in the evaluation of performance validity across a neuropsychological battery without increasing the time or cognitive demand on patients during testing. Erdodi et al. (2018) evaluated Delis–Kaplan Executive Function System (D–KEFS) Trail Making Test Conditions 1–5 (TMT1–5) as EVIs in adults using age-corrected scaled score (ACSS) cutoffs, demonstrating adequate specificity but inadequate sensitivity. This study assessed the TMT1–5 as EVIs in children using a specificity threshold of > .89 (Boone, 2013).

Method

Youth athletes (n = 134, M age = 12.2) completed a two-hour neuropsychological battery that included TMT1–5 and TOMM during a larger sport-related concussion clinical research evaluation. Specificity, sensitivity, and area under the curve (AUC) were calculated for TMT1–5 using ACSS cutoffs to predict TOMM Trial 2 (TOMM2) pass/fail performance.

Results

When predicting TOMM2 (cutoff.89) and inadequate sensitivity (.00), with TMT3 and TMT4 having the highest AUC (.81 and .74, respectively). The following ACSS cutoffs met the specificity threshold (>.89): TMT1 ACSS < 7, TMT2 < 9, TMT3 < 6, TMT4 < 7, and TMT5.79, we increased sensitivity for TMT1–3 (.33).

Conclusion

D–KEFS TMT1–5 achieved excellent specificity (>.89) when predicting TOMM2 performance but demonstrated inadequate sensitivity. Lowering the specificity threshold slightly still yielded low sensitivity. These data suggest that D–KEFS TMT3 and TMT4 were most effective at detecting adequate effort, but should be supported with other validity measures when assessing performance validity across a neuropsychological battery.
A-226 Identifying Performance Validity Indices within the NIH Toolbox
Authors: S Monaghan , C Laduke
Published: August 2020

Objective

The National Institute of Health Toolbox–Cognitive Battery (NIHTB-CB) is a rigorously developed, state-of-the-art neuropsychological screening battery. However, one of its current limitations is the lack of any embedded measures of performance validity. To address this critical gap, the current project explored the relevant literature to determine which NIHTB-CB indices might be most suitable for further investigation.

Data Selection

A targeted literature review was conducted to explore the development of embedded indicators of performance validity within contemporary neuropsychological batteries. The most foundational and scientifically rigorous literature was gathered using targeted search terms in PsycInfo and Google Scholar.

Data Synthesis

This selected literature base was reviewed and compared to relevant NIHTB-CB indices. The most suitable indices within the NIHTB-CB appear to include: (1) a pattern of responding on the recognition trial for the Picture Sequence Memory Test that is inconsistent with that of individuals with known brain damage; (2) a severely impaired score on the Picture Vocabulary Test and the Oral Reading Recognition Test; (3) the frequency and length of unusual reaction time differences on the Pattern Comparison Processing Speed Test; and (4) overall performance comparisons with groups with known brain injury or illness.

Conclusions

Several indices within the NIHTB-CB hold great promise as performance validity indicators. Future research is needed to establish the validity of these indices using simulation and known-group designs. Establishing indicators of performance validity within the NIHTB-CB will result in more rigorous clinical research and improved clinical practice.
A-250 Evidence for Language and Memory Improvements Following Right Anterior Temporal Lobectomy in a Patient with Mixed Language Dominance
Authors: S Leonard , E Olsen , K Bradbury
Published: August 2020

Objective

Anterior temporal lobectomy (ATL) surgery for epilepsy is commonly associated with post-surgical impairments in memory and language abilities, specifically episodic memory and confrontational naming. Less is known regarding outcomes of patients with atypical language dominance.

Method

Casey is a 19 year-old, ambidextrous, male with a history of remote symptomatic medically intractable focal epilepsy secondary to right inferior temporal encephalomalacia. Casey underwent right anterior temporal lobectomy and resection of mesial structures including part of the hippocampus.

Results

Casey’s pre-surgical neuropsychological evaluation revealed overall intellectual functioning in the average range with relative strengths in perceptual reasoning skills and weaknesses in attention, executive control, confrontational naming, and verbal fluency. Casey’s pre-surgical cognitive profile and functional MRI were suggestive of bilateral language organization. At post-surgical evaluation, Casey demonstrated strong overall cognitive abilities, basic reading, visual–spatial skills, and visual memory, as well as notable improvements in his processing speed and visual-motor integration. He demonstrated significant improvement in verbal working memory, verbal fluency, and contextual verbal memory. Casey continued to show significant weaknesses in word finding, phonetic verbal fluency, and rote verbal learning and memory, and milder weaknesses in aspects of executive functioning. Casey continued to demonstrate mood difficulties.

Conclusions

The current case provides evidence of continued mild deficits in traditional dominant hemisphere skills including rote verbal memory and focal language abilities, in a patient with a history of mixed language dominance, following right hemisphere ATL surgery. This case further highlights the importance of pre-surgical neuropsychological evaluation and fMRI in patients undergoing right ATL surgery.
Higher-order income dynamics with linked regression trees
Authors: Druedahl Jeppe , Munk-Nielsen Anders
Published: August 2020

We propose a novel method for modelling income processes using machine learning. Our method links age-specific regression trees, and returns a discrete state process, which can easily be included in consumption-saving models without further discretizations. A central advantage of our approach is that it does not rely on any parametric assumptions, and because we build on existing machine learning tools it is furthermore easy to apply in practice. Using a 30-year panel of Danish males, we document rich higher-order income dynamics, including substantial skewness and high kurtosis of income levels and growth rates. We also find important changes in income risk over the life-cycle and the income distribution. Our estimated process matches these dynamics closely. Using a consumption-saving model, the implied welfare cost of income risk is more than 10% of income.
May Measurement Month 2018: an analysis of blood pressure screening results from Mauritius
Authors: Ori Bhooshun , Kowlessur Sudhirsen , Heecharan Jaysing , Poulter Neil R , Ster Anca Chis , Xia Xin , Beaney Thomas
Published: August 2020

Hypertension is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high blood pressure (HBP) and to act as a temporary solution to the lack of screening programmes worldwide. We here provide the results of the 2018 MMM (MMM18) edition in Mauritius. This cross-sectional survey of participants aged ≥18 years was carried out in May 2018. Hypertension was defined as systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg or both. Blood pressure (BP) measurement and statistical analysis followed the standard MMM protocol. Screening was conducted by Non-Communicable Diseases and Health Promotion Unit, which is under the aegis of the Ministry of Health and Quality of Life, mainly in workplaces and community centres, in both rural and urban areas across Mauritius. Of 5471 individuals screened, after multiple imputation, 786 (14.4%) had untreated hypertension. MMM18 was the largest BP screening campaign undertaken in Mauritius. These results suggest that MMM18 is very useful to identify significant numbers of patients with raised BP.
May Measurement Month 2018: an analysis of blood pressure screening results from China
Authors: Chen Xin , Li Yan , Hu Zhe , Liu Min , Yu Jing , Wang Hong-Yu , Xu Li-Ying , Zhou Bi-Rong , Yu Wei , Li Li , Tang Guo-Bao , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Wang Ji-Guang
Published: August 2020

To further improve awareness, treatment, and control of hypertension, the May Measurement Month (MMM) campaign continued in 2018 in China. Study subjects were adults aged 18 years or more, ideally those who had not their blood pressure (BP) measured for at least a year. Blood pressure was measured three times consecutively with a 1-min interval in the sitting position, using automated BP monitors in 288 342 participants and transmitted to a central database by a smartphone app. Questionnaire data were collected with the same app. After imputation, the overall proportion of hypertension was 29.8%. Of those with hypertension, the rates of awareness, treatment, and control were 62.3%, 57.3%, and 35.9%, respectively. In analysis based on linear regression models, both systolic and diastolic BP were higher with cigarette smoking, alcohol intake, and overweight and obesity. Our study results suggest that hypertension management is improving in comparison with the data in MMM 2017 and the nationwide survey in 2012–15, and several known lifestyle factors are key to hypertension management.
May Measurement Month 2018: an analysis of blood pressure screening results from Slovenia
Authors: Božič Nina , Knez Judita , Dolenc Primož , Salobir Barbara , Erhartič Andrej , Čegovnik Borut , Brus Ivanka , Petek Šter Marija , Hlastan Ribič Cirila , Beaney Thomas , Ster Anca Chis , Xia Xin , Poulter Neil R , Brguljan Hitij Jana
Published: August 2020

Elevated blood pressure (BP) is a growing burden worldwide, contributing to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed to raise awareness of high BP. In May 2018, we carried out an opportunistic cross-sectional survey of volunteers from different parts of the country aged ≥18 years. Blood pressure measurement followed the standard MMM protocol and statistical analysis mean of the last 2 of 3 readings was used, where these were unavailable additional imputations were performed. In total, 4883 individuals (61.0% female) were screened during the whole month of May in 91 primary and secondary health facilities, pharmacies and through an online survey. After multiple imputation, 2841 (58.2%) had HTN. Of individuals not receiving antihypertensive medication, 850 (29.4%) were hypertensive. Of those receiving antihypertensive medication, 1025 (51.5%) had uncontrolled BP. MMM18 was the largest BP screening campaign undertaken in Slovenia. A substantial number of people with possible HTN were identified and referred to general practitioners for further management. The high number of individuals with HTN, with newly diagnosed HTN and with uncontrolled BP despite medication, confirms a real need for such screening programmes in our country.
Implementation and outcome evaluation of a team nutrition intervention: increasing knowledge, attitudes, and preferences
Authors: Askelson Natoshia M , Brady Patrick , Ryan Grace , Scheidel Carrie , Delger Patti , Nguyen Phuong , Jung Youn Soo
Published: August 2020

Low-income, rural children are at a greater risk for poor dietary intake. Schools offer a venue to deliver appropriate interventions. Our aim was to evaluate the implementation and effectiveness of Healthy Schools, Healthy Students (HSHS). We conducted a mixed-methods evaluation using a cluster-randomized trial design with 20 schools in a rural, Midwestern state. HSHS included education sessions, cafeteria coaching and taste testing. We interviewed implementers (n = 13) and nutrition educators (n = 8), conducted six focus groups with cafeteria coaches, and surveyed fourth graders (n = 1057) about their nutrition knowledge, attitudes toward and preferences for fruits and vegetables (F&V), F&V consumption and MyPlate awareness. We used multi-level linear models to estimate the intervention effect and qualitative data were coded. There were very few challenges to implementation. HSHS participation was positively associated with knowledge, attitudes toward F&V, preferences for vegetables from the taste tests, MyPlate awareness and vegetable consumption. HSHS was viewed as beneficial and easy to deliver, suggesting this type of intervention could be widely implemented. Improving knowledge and attitudes through nutrition education and preferences through taste testing have the potential to improve dietary intake among rural students. Low-cost nutrition interventions can be successfully implemented in rural elementary schools with positive outcomes.