bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-152 Long-term Outcome Profiles of Survivors of Traumatic Brain Injury and Stroke After Holistic Milieu-Oriented Neurorehabilitation
Authors: S Johnson , R Perumparaichallai , P Klonoff 
Published: August 2020

Abstract

Objective
The present study examined the outcome profiles of survivors of traumatic brain injury (TBI) and stroke up to 30 years after completing holistic milieu-oriented neurorehabilitation.

Method
Participants included 99 individuals with acquired brain injury (TBI n = 70; stroke n = 29) who attended holistic milieu-oriented outpatient neurorehabilitation between 1986 and 2016. On average, time of discharge to follow-up was 9.3 years with a range of 0 to 29.3 years. Data are a part of a larger ongoing follow-up survey using the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and a psychosocial outcome questionnaire developed for this study.

Results
Independent-samples t-tests revealed that the TBI group was significantly younger than the stroke group on factors of age at the time of injury and age at the time of follow-up. However, the groups did not differ on factors of duration between discharge and follow-up as well as between injury and treatment. Regarding functional outcomes, analysis of covariance (ANCOVA) revealed no significant differences between the two groups on the MPAI-4 (Total Score and Subscales) while controlling for age at injury and age at the time of the study. Furthermore, 90% of TBI and 88% of stroke participants were productive (i.e., working/school full-time, part-time, or volunteering); whereas, 10% of TBI and 12% of stroke survivors were unemployed.

Conclusion
Overall, the findings suggest that both groups’ long-term functional outcomes are similar and very positive. Specifically, both stroke and TBI participants were able to successfully maintain functional and productive activities even close to 30 years after discharge from holistic milieu-oriented neurorehabilitation.
A-156 SPECT Imaging Differences During Connors’ CPT Task in Adult Males Versus Females with ADHD Combined Type
Authors: L Stebbins , D Taylor , K Willeumier , B Trinidad , C Golden , D Amen 
Published: August 2020

Abstract

Objective
To examine whether ADHD-Combined-Type in males and females alters brain activity at concentration.

Method
Participants were selected by DSM-IV diagnoses from a de-identified, archival database. Sample(n = 154) included a male(n = 97, Mage = 33.29, 67% Cau.) and female group(n = 57, Mage = 34.54, 71.9% Cau.). Exclusion criteria were most comorbid mood and neurological disorders. Cerebral blood flow(CBF) was assessed using SPECT during a concentration task(Conners’CPT) in 17-brain areas. Independent samples t-tests were performed to determine significant differences between groups (p &lt; .001).

Results
Analysis determined statistically significant CBF differences between the female and male groups at concentration. Chi-square showed no significant associations with age(0.349).The analysis yielded an increase CBF in female group compared to male group in the Bilateral Limbic-System(left area:t(152) = 4.418, p &lt; .0001; right:t(152) = 4.113, p &lt; .001), Bilateral Basal Ganglia(left:t(152) = 5.948, p &lt; .0001; right:t(152) = 5.653, p &lt; .001), Left Motor-Sensory area(t(152) = 4.838, p &lt; .0001), and Vermis(t(152) = 4.414, p &lt; .0001). Male group had increased CBF in the Bilateral Cerebellum (left:t(152) = 6.592, p &lt; .0001; right:t(152) = 7.172, p &lt; .001) and Right Occipital(t(152) = 4.895, p &lt; .0001) and Temporal lobes(t(152) = 3.904, p &lt; .0001).

Conclusions
The female group, showed increases in CBF in the limbic system suggesting cognitive deficits related to emotional disturbances. While in the male group, the emotional control and auditory processing of information deficits can be related to the increased CBF in temporal area. Increased CBF in basal ganglia, vermis, and motor-sensory areas in the female group suggests increased activity related to integration of motor movements. Likewise, the male group showed deficits in motor movements, but also included deficits in balance and analyzation of objects/movement (increased CBF in cerebellum and occipital). Treatment of ADHD-Combined-Type can target discrete brain systems related to these differences in cognitive activity.
A-162 Neurocognitive Functioning in Youth with Neurofibromatosis Type 1: Examining Relations between Executive Functions and Academic Achievement
Authors: C Friedhoff , A Oh , L Ventura 
Published: August 2020

Abstract

Objective
Neurofibromatosis Type 1 (NF1) is an autosomal dominant genetic disorder affecting approximately 100,000 people in the U.S. It is commonly associated with neurofibromas, café-au-lait spots, and optic gliomas. It has also been linked to neurocognitive deficits, including learning disabilities and ADHD. This study examined relationships among executive functions (EF) and academic achievement in children diagnosed with NF1.

Methods
Participants included 29 children (ages 2–21; M = 9.28, SD = 5.50) diagnosed with NF1 referred for neuropsychological evaluation as part of standard clinical care. A battery of tests was administered, including measures of intelligence (Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition; Wechsler Intelligence Scale for Children, Fifth Edition; Wechsler Adult Intelligence Scale, Fourth Edition), attention (Conners’ Continuous Performance Test II), EF (Delis-Kaplan Executive Function System), academic achievement in reading and math (Wechsler Individual Achievement Test, Third Edition), and parent rating scales examining EF in the home environment (Behavior Rating Inventory of Executive Function, Second Edition).

Results
Relations between attention, EF, and academic achievement were examined using bivariate Pearson correlations. Lower scores on measures of EF (e.g., inhibition of prepotent responses) were linked to lower math achievement scores (r = .73, p &lt; .05). Difficulties with sustained attention were associated with lower performance on measures of reading (r = −.60, p &lt; .05) and math achievement (r = −.59, p &lt; .05). Parent report of EF difficulties was correlated with lower reading scores (r = −.68, p &lt; .05).

Conclusions
Results suggest that children with NF1 are at risk for deficits in EF and academic achievement. Problems in these two domains are likely to co-exist. Thus, interventions targeting these skills should be well integrated.
A-169 Sleep in Children with Fetal Alcohol Spectrum Disorders (FASD)
Authors: K Shada , R Tangen 
Published: August 2020

Abstract

Objective
Sleep problems in children with FASD have not been well characterized. This study predicts that children with FASD and sleep problems will have more attention [Conner’s Continuous Performance Test (CPT)] and executive functioning [Brief Rating Inventory of Executive Functioning (BRIEF)] difficulties.

Methods
Data from 46 children (ages 3–14) diagnosed with an Alcohol Related Neurobehavioral Disorder whose parents completed the Sleep Disturbance Scale for Children (SDSQ) were reviewed. The sample was divided into two groups: low-sleep (T-score &lt; 64) and high-sleep (T-score &gt; 65) using the SDSQ Disorders of Initiating and Maintaining Sleep subscale.

Results
The FASD clinical population showed more sleep problems than average, t(45) = 6.64, p &lt; 001. Children with high levels of sleep problems showed significantly higher ratings of inhibition than children with low sleep problems on the BRIEF Inhibit Scale, t(35) = −2.095, p = .043). They also showed a higher Global Executive Composite t(35) = −2.033, p = .05, although this finding may be influenced by elevations on the Inhibit Scale.

Conclusion
In conclusion, although parents are reporting more inhibition in daily life, there are no differences on neuropsychological measures suggesting that sleep difficulties do not lead to additional impairment in attention and executive functioning. Findings suggest that children with FASD have difficulties with attention and executive functioning regardless of sleep problems.
A-173 Clinical Comparisons of Performance on the Wisconsin Card Sorting Task: Preliminary Findings for an Updated Adult Normative Data
Authors: K Eversole , C K Block , K C Hewitt , G Lee , E Dawson , C Nguyen 
Published: August 2020

Abstract

Objective
The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological measure of executive functioning. The purpose of this study is to present clinical comparisons of performance on the WCST among a group of adult patients referred for outpatient neuropsychological evaluation.

Method
Over two thousand and four hundred patients completed the WCST as part of a comprehensive test battery at an outpatient neuropsychology clinic (Mean age: 55.21 ± 15.39 years; Mean Education: 14.93 ± 2.76 years; 50.9% Female; and 90.2% White). Patients in the sample were referred for evaluations based on the following group classification: General Cognitive Concerns (n = 931); Dementia and Mild Cognitive Disorders (n = 182); Parkinson’s disease and other Movement Disorders (n = 608); Traumatic Brain Injuries/Concussion (n = 161); Primary Brain Tumors (n = 162); among others.

Results
Descriptive characteristics of raw scores for Total Errors, Perseverative Responses, Perseverative Errors, Nonperseverative Errors, Conceptual Level Responses, and Number of Categories Completed are presented based on clinical population. Group means and standard deviations for scores are presented. The sample are stratified into groups based on age, gender, and education. Base rate comparisons are presented.

Conclusions
Preliminary findings will contribute to efforts for an updated and demographically corrected normative data for the WCST. Implications are discussed.
A-179 The Relationship Between Self-Rated Everyday Memory and Cognitive Status Among Older Adults
Authors: M Vasquez , J Helphrey , A Sandlin , L Bennett-Leleux , R Donnell , T Glover , C Markey , J Moore , M Barnett 
Published: August 2020

Abstract

Objective
Neuropsychologists often supplement performance-based measures of cognition with self-report questionnaires. One questionnaire—the Measurement of Everyday Cognition (ECog)—has shown promise in differentiating between impaired and non-impaired populations; however, little research has been done specifically on the memory items from the shortened version: the ECog-12. The purpose of this study was to examine the extent to which the Ecog-12 Memory subscale can predict actual cognitive function as measured by a performance-based screening test.

Method
Older adults (ages 55–90; n = 74) completed the ECog-12 and were administered the Mini-Mental Status Exam—2nd Edition (MMSE-2), with scores dichotomized into normal function and impaired function.

Results
Binary logistic regression found that the ECog-12 Memory subscale items explained between 57% and 87% of variance in normal/impaired MMSE-2 scores and accurately classified 79.7% of cases.

Conclusion
Brief self-report measures of everyday memory functioning are sensitive to cognitive decline among older adults.
A-206 “Mittenberg-Type formula for Identifying Feigned ADHD Using WAIS-IV”
Authors: M Harrell , M Myers , S Aita , S Taylor , J Beach , M Calamia , B Hill 
Published: August 2020

Abstract

Objective
This study utilized logistic regression to determine whether performance patterns on the WAIS-IV subtests could differentiate between genuine-effort and simulated ADHD groups.

Method
Participants were 355 college students (55.3%% female; 65.7% Caucasian, 23.9% African American, 4.2% Asian; age range 17–51 years, Mage = 20.93 years, SD = 4.63; 76.4% no psychological diagnosis) who completed the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). Mean FSIQ for control group was 102.35 and 87.48 for the simulator group. Eighty participants (22.5%) simulated ADHD symptoms, while 276 participants (77.5%) provided genuine effort.

Results
A logistic regression analysis was performed with known group as the dependent variable and WAIS-IV subtest scaled scores as predictor variables. The final model of five predictor variables (Similarities, Information, Digit Span, Symbol Search, and Coding) significantly predicted group status (χ2 = 140.91, df = 5, N = 355, p &lt; .001). The model accounted for 33% to 50% of the variance (Cox and Snell R2 = .33; Nagelkerke R2 = .50) in performance classification with overall 86% of individuals correctly predicted to their known group. At a cut value of .65 the sensitivity was 69.6% and the specificity was 90.6%. A cut value of.55 the sensitivity was 53.2% and the specificity was at 94.6%.

Conclusions
These findings are consistent with prior research suggesting discriminant function analysis derived from clinical measures (e.g., WAIS-IV) can be useful as embedded validity measures in distinguishing suspicious and genuine performance. Sensitivity, specificity, and predictive power of the WAIS-IV subtests were acceptable at 5% and 10% false positive rates.
A-212 The Relationships between PAI over-reporting SVTs and PVTs in a Military Sample
Authors: P Armistead-Jehle , P Ingram , N Morris 
Published: August 2020

Abstract

Objective
Recent research has worked to explore the relationships between symptom and performance validity testing. The current study sought to examine the association between PAI over-reporting SVTs and well validated stand-alone and embedded PVTs.

Methods
Retrospective review of 468 active duty Army cases referred for outpatient neuropsychological testing at a Military Health Center. Each subject was administered the PAI, MSVT, NV-MSVT, and RBANS Effort Index. Groups were defined in two ways, as valid (0 PVT failures) or invalid (1 or more PVT failures) and based on the number of failed PVTs (0, 1, 2, and 3).

Results
Partial results are summarized here for the valid/invalid analysis. The PAI Negative Impression Management (NIM), Multi-Feigning Index (MFI), and Malingering Index (MAL) differed significantly as a function of PVT performance (p &lt; .05). Differences on Rogers Discriminant Function were not significant. AUC for NIM, MAL, and MFI were .69, .66, and .54 (respectively). AUC for RDF was unacceptable at .49. At a T-score of 64 the NIM scale had specificity of .91, sensitivity of .32 and at a T-score of 59 the MAL had specificity of .91 and sensitivity of .14.

Conclusions
There appears an association between PVTs and PAI over-reporting scales, such that elevations on the NIM, MAL, and MFI scales are related to PVT failure. However, the sensitives of these scales are limited in predicting PVT failure. To this end, the current data are in line with previous studies that indicate the need to administer both performance and symptom validity scales.
A-214 Multiple Assessments of Effort in Retired NFL Players Seeking Compensation
Authors: D Hadorn-Papke , D Gibson , C Golden 
Published: August 2020

Abstract

Objective
Determining the effort level allocated during a neuropsychological evaluation is essential, as effort has been shown to predict performance.

Method
One hundred and thirty-seven former NFL players were given the Test of Memory Malingering (TOMM) and Green’s Medical Symptoms Validity Test (MSVT) as part of a comprehensive neuropsychological evaluation.

Results
Based on established “cutoff” scores, 42 of the 137 individuals failed the TOMM (Trial 2, raw score &lt; 45). Using the recommended “cutoff” scores, (Immediate recall, Delayed recall, Consistency &lt;=85%, Paired Associated &lt;=70%, Free recall&lt;=50%), 74 individuals failed the MSVT. Together, the TOMM and the MSVT identified 81 individuals with sub-optimal effort and likely invalid neuropsychological test data, as both the TOMM and MSVT are passed by groups with known traumatic brain injury and other impairments.

Conclusions
We conclude that 59.1% of the Former NFL players put forth inadequate effort during testing. While the reasons for PVT failure are known only by the test-takers themselves, the validity of the results is highly questionable regardless and must be interpreted in this context.
A-216 The Relationship Between Cognitive Performance on a Sports-Concussion Assessment Battery and the Motivation Behaviors Checklist (MBC)
Authors: E Guty , K Riegler , G Thomas , P Arnett 
Published: August 2020

Abstract

Objective
The Motivation Behaviors Checklist (MBC) was designed as an observational rating scale to assess effort during baseline evaluations (Rabinowitz, Merritt, and Arnett, 2016). This study aims to explore the MBC in relation to a comprehensive battery of neuropsychological tests, including paper-and-pencil tests.

Method
Participants included 291 (M = 213, F = 78) student-athletes from a Division I University sports concussion program. Seventeen neuropsychological test indices were used to create a neurocognitive composite. The 18-item MBC was scored such that higher values indicate greater motivation/effort. Across test indices, the number of impaired scores (below the 80th percentile) was also calculated. Individuals were placed into impairment groups (Impaired ≥3 impaired scores) and motivation groups based on their MBC scores (High Motivation = score greater than the median of 49).

Results
Bivariate correlations demonstrated a significant relationship (ρ = .39, p &lt; .001) between cognitive performance and the MBC total score. Chi-square analysis demonstrated that significantly more of the 81 individuals in the Impaired group were also in the Low Motivation group (n = 56, 69%), χ2 (1, N = 291) = 18.53, p &lt; .001, Φ = −.25.

Conclusions
Higher motivation scores on the MBC are related to better cognitive performance. Compared with cognitively intact individuals, those who were cognitively impaired were significantly more likely to score below the cut off score of 49 on the MBC. Future work will explore different cutoff values that maximize sensitivity and specificity for test performance in order to provide guidelines for clinicians wishing to utilize the MBC.
A-217 Associations among Symptom Validity Tests in Combat Veterans
Authors: R Shura , P Armistead-Jehle , J Rowland , K Taber , D Cooper 
Published: August 2020

Abstract

Objective
The Neurobehavioral Symptom Inventory (NSI) is a 22-item self-report measure of non-specific cognitive and somatic symptoms, which contains an embedded measure of symptom validity (Validity 10 scale [V-10]). The mild brain injury atypical symptom (mBIAS) is a separate 5-item measure of symptom validity designed for use in mild traumatic brain injury evaluation. The current study evaluated the NSI V-10 and mBIAS in relation to the Structured Inventory of Malingered Symptomatology (SIMS) Total score and subtest scores.

Method
Participants were 338 veterans who completed a parent study at a VA Medical Center. All participants deployed to Iraq and/or Afghanistan, did not have a history of moderate or severe traumatic brain injury, and did not have significant neurological or psychiatric conditions. Participants completed the SIMS and the NSI with mBIAS as part of a larger battery. The sample was 86% male and 57% White, with a mean age of 42 years and education of 15 years.

Results
AUC values using a higher SIMS Total cutoff score were .887 for the V-10 and .735 for the mBIAS; diagnostic accuracy data at various cutoff scores are presented. For SIMS subscales, the mBIAS had higher correlations to the Psychosis (r = .48) and Low Intelligence (r = .31) scales, whereas the V-10 had higher correlations to the Neurologic Impairment (r = .73), Amnestic Disorders (r = .66), and Affective Disorders (r = .59) scales.

Conclusion
Current data suggest that the V-10 and mBIAS measure different symptom validity constructs and could therefore be employed in a complimentary manner.
A-225 The Rey Dot Counting Test as a Tool for Detecting Suboptimal Performance in Athlete Baseline Testing
Authors: A Dacosta , A Roccaforte , R Sohoni , A Crane , F Webbe , A Logalbo 
Published: August 2020

Abstract

Objective
The limitations of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)‘s embedded validity measures (EVMs) are well-documented, as estimates suggest up to 35% of invalid baseline performances go undetected (Gaudet & Weyandt, 2017). Few studies have examined standalone performance validity tests (PVT) as a supplement to ImPACT’s EVMs (Gaudet & Weyandt, 2017).

Method
College athletes (n = 1,213) were administered a preseason baseline assessment that included ImPACT and the Rey Dot Counting Test (DCT), a standalone PVT, among other measures.

Results
Sixty-nine athletes (5.69&#37;) met criteria for suboptimal effort on either ImPACT or the DCT. The DCT detected more cases of suboptimal effort (n = 50) than ImPACT (n = 21). A χ2 test of independence detected significant disagreement between the two measures, as only 2 individuals produced suboptimal effort on both (χ2(2) = 1.568, p = .210). Despite this disagreement, there were significant differences between the suboptimal effort DCT group and the adequate effort DCT group across all four ImPACT neurocognitive domains (U = 19225.000, p &lt; .001; U = 17859.000, p &lt; .001; U = 13854.000, p &lt; .001; U = 17850.500, p &lt; .001).

Conclusions
The DCT appears to detect suboptimal effort otherwise undetected by ImPACT’s EVMs.
A-229 Is the Multitude Proficiently Able to Elucidate the Imperative Substance and Subsequently Able to Identify the Applicable Inferential Material to Adequately Utilize Assessments: Can People Read and Understand our Reports?
Authors: G Newsham , Z Imre , M Kibby , H Cormier 
Published: August 2020

Abstract

Objective
Many U.S. adults read at an eighth-grade level (Safeer, R., 2005). Thus, neuropsychological reports’ technical language might present a challenge for average readers. However, there are no professional guidelines on report readability and little formal research on the topic. Hence, the study’s objective was to investigate the average readability of psychological and neuropsychological reports from a local university clinic and to provide suggestions for improving the readability of reports.

Method
73 psychological reports and 34 neuropsychological reports were analyzed using the readability feature in Microsoft Word. This feature provides two outcomes of interest: the Flesch Reading Ease score (a 100-point scale with higher numbers indicating easier readability) and the Flesch–Kincaid Grade Level Score (which provides a U.S. grade-level equivalence). Documents are considered readable with a reading ease score of 60 and a grade level score of 8.0. The average and range of scores for each report type were calculated.

Results
In general, psychological reports were written at a 13.2 (12–14.8) grade level, with a readability score of 34.3 (24.2–41.4). Neuropsychological reports were written at a 12.6 (11.2–14.5) grade level, with a readability score of 36.3 (25.5–42.7).

Conclusion(s)
The reports reviewed are functionally unreadable to many in the general public, which has important implications for clinical practice. This could be addressed by altering the reading level at which reports are written, including “plain-language” inserts, or altering specific parts of reports that have the most relevance to clients (e.g. summary and recommendations) to increase comprehension. Feedback on these ideas will be garnered at the poster.